Questions About Budesonide

[Guest jurishound]

Harley has been on enteric budesonide (Entocort EC) for about a week. I picked up some Entocort to tide him over until the generic, non-enteric budesonide could arrive from the compounding pharmacy. It arrived, but now his internist would like him to stay on the enteric form. The generic, non-enteric drug from Wedgewood Pharmacy in NJ is MUCH less expensive than the enteric version, which is around $400 for 30 capsules (he receives two per day). Does anyone have any idea whether (1) enteric is better than non-enteric, (2) generic is okay to give, and (3) where the heck I can get this drug that won't require me to get a second job? Thanks!

Edited April 9, 2012 by jurishound

[tbhounds]

I used the compounded version-- never used the brand name. I found it just as effective.

[Guest jurishound]

I used the compounded version-- never used the brand name. I found it just as effective.

 

Thank you! And I assume it was in a non-enteric capsule? Nervous mom here.

[4My2Greys]

Wow! That is expensive. I thought Nan had misunderstood the pricing from her vet when she said she was quoted $500 a month. Hope you can get the compounded version and it works for Harley.

[tbhounds]

I used the compounded version-- never used the brand name. I found it just as effective.

 

Thank you! And I assume it was in a non-enteric capsule? Nervous mom here.

Correct- non enertic capsule.

[greyhead]

Just seeing this, Joslin. Does your internist realize how much it costs, exactly? Does she plan to keep him on two a day for very long? Is he still taking pred too? This just seems excessive in more ways than one. All I have is our experience, which is one non-enteric 3 mg capsule per day for a very, very sick, very large male greyhound. I hope Harley is continuing to improve.

 

 

[tbhounds]

Chiming in here-- I also only gave 3mgs of non-enteric coated Budesonide once daily to -at the time- a very sick hound. (this was after pred and azathiprine failed to help)

[Guest jurishound]

Just seeing this, Joslin. Does your internist realize how much it costs, exactly? Does she plan to keep him on two a day for very long? Is he still taking pred too? This just seems excessive in more ways than one. All I have is our experience, which is one non-enteric 3 mg capsule per day for a very, very sick, very large male greyhound. I hope Harley is continuing to improve.

 

She does - the trouble is, although he is eating quite a bit (1.5 to 2 lbs of bison plus 1 - 2 sweet potatoes daily), his body condition doesn't seem to have improved. He is skin and bones. We did taper the pred this week to 30 mgs/day (from an initial 80 mgs) but he is still on azathioprine, pepcid and flagyl (we are supposed to switch to tylan/tylosin, but I am waiting to get it in capsule form to avoid the worry of having him go off his food). He also gets a tiny dose of aspirin and sotolol to correct his heart arrythmia. XDH thinks all the meds are causing his condition at this point!

 

I did read this in a publication about treating IBD in dogs with budesonide:

 

Large dogs receive 3 mg twice daily initially, and the dose is later tapered to 3 mg once daily, and then to alternate day administration for longer term use.

 

The compounded, non-enteric budesonide from Wedgewood Pharmacy is much less expensive than Entocort, so I am very relieved to read these comments.

 

I would be much happier giving him less steroids, if at all possible

Edited April 10, 2012 by jurishound

[greyhead]

I did read this in a publication about treating IBD in dogs with budesonide:

 

Large dogs receive 3 mg twice daily initially, and the dose is later tapered to 3 mg once daily, and then to alternate day administration for longer term use.

 

The compounded, non-enteric budesonide from Wedgewood Pharmacy is much less expensive than Entocort, so I am very relieved to read these comments.

 

I would be much happier giving him less steroids, if at all possible

Hey, Joslin, just a quick remark. I don't personally know of anyone who has given their greyhound 3 mg of budesonide twice a day. It may be one of those meds on which greyhounds, as sensitive as they are, do best on half the dose given other dogs their size. That's how thyroid meds are dosed for greyhounds, for example. I'm so sorry I have to run off (to the pharmacy, actually) and can't research this for you right now, but I'm not sure there's anything greyhound-specific about budesonide anywhere but here on Greytalk anyhow. Maybe tbhounds can help us out on this question.

Hugs,

Mary

Edited April 10, 2012 by greyhead

[RobinM]

I agree with greyhead. Only 3 mg for your pup and as I mentioned in my email I never head of using both pred and the budesonide. I think it's too much. When we used bud, Osu was not familiar with it, I don't know if they are now. I'm going to email my vet for you.

[Burpdog]

He needs to get off the pred, or as Marilyn said, it will kill him.

 

 

[Guest jurishound]

I'm going to email my vet for you.

 

Thank you! I asked his internist if we could back off the budesonide, and instead, she suggested reducing the pred dose from 30 mg to 20 mg. He is in terrible shape. I am terrified to make a move in any direction, for fear that I will make the wrong decision. Thankfully, he is still eating, but he just isn't gaining any weight.

[Guest jurishound]

I am really worried that we are running out of time. I sent a consultation request to OSU this morning.

[4My2Greys]

I am really worried that we are running out of time. I sent a consultation request to OSU this morning.

 

I hate reading stuff like this

[Guest Fasave]

Oh Joslin, so sorry to read this. The fact that he's eating is good. Depending on his diet, it can take a while to put weight on. Sending positive thoughts your way that Harley can turn the corner.

[greyhead]

I am really worried that we are running out of time. I sent a consultation request to OSU this morning.

 

I'm worried about that too, Joslin. I tried to PM you but it says you can't receive them, so perhaps your box is full. While you're waiting to hear from them, you might forget to give Harley that second budesonide pill today. (Spencer's tongue swelled dangerously when we tried more than 3 mg of budesonide in one day. GT thread about it ) I hope you conveyed your sense of urgency to OSU.

[tbhounds]

Can you find another internist in your area?? Sometimes a different set of eyes is all you need to find the right treatment plan for your hound. This is just killing me.

[EllenEveBaz]

I am terrified to make a move in any direction, for fear that I will make the wrong decision.

[RobinM]

My vet is on vacation so I could not ask her. She will be in tomorrow and my kitty is there with a live mass so I will see her. My only concern and I use that word for lack of a better one is the pred AND the budesonide. My understanding was it was one or the other. Although it made Beau, NOT Beau while he was on the pred, it did save his life along with the imuran. As I had mentioned in the email, we only lowered the pred when the weight started being put back on. Your dog is not being stabalized and the meds are getting lowered.

 

For Beau it was 60 mg for 3 weeks after his open abdominal surgery. 3 weeks we added in imuran. Within the month, we started lowering the pred. But we only lowered the pred when the weight started coming on.

 

We fed him 40 pounds of tilapia a week which we baked in tin foil and fed him nothing but tilapia for 3 weeks.Nothing but tilapia. We weighed out enough at every meal so that we made sure he was getting 1500 calories a day. When he was in the peak of gaining he had up to 2800 calories a day We would basically feed what he would eat within reason. We kept a journal in a notebook of every meal, every bite and kept that going for several months. We fed him Every 3 hours round the clock. We had the alarm set for 2:30 AM and my son came home from highschool during his lunch break to help out and feed him. He also had to pee like a race horse every 3 hours because of the pred and the water intake.

 

OSU had no experience with the budesonide so they were of no help at that time. Most vets don't. At this time, I highly suggest you ask on the IBD YAHOO group if it is "normal protocol" to give both pred and Bud at the same time. They are not vets but very knowegable about IBD. You have to fill out their form to join, but it's a good, free and immediate way to get some answers.

 

Thinking about you and your baby.

[Guest jurishound]

Thanks everyone. My poor boy. He is still interested in eating, but he is so weak. I am taking him in to be seen in an hour. I will bring all of this information and ask her to "round" his case, if she hasn't already. No word yet from OSU, though I sent them a follow up message yesterday telling them that it was urgent.

 

There are so many directions to go in, and I still have that lingering fear that it could be lymphoma.

Edited April 13, 2012 by jurishound

[Batmom]

No advice, just hugs for yourself and prayers for your sweet boy.

[greyhndz]

Joslin, how is he doing? Any feedback from his visit yesterday?

 

Prednisone and budesonide is redundant. By this point, he should be off systemic pred and only on budesonide, or there's no purpose to his being on it. I'll also share with you the devastation steroids can have on him. When Dandi was so ill a couple of months ago, he was on pred for about 2 weeks, and within 1 week, the difference was alarming: he'd lost all muscle mass, and actually looked sunken, just protuberant bones. He looked as if he'd lost far more wieght than he actually had, and he was eating 3 meals/day (7-8 cups) at that point. In his case, it made no difference in the diarrhea nor in his albumin level so after the taper was completed, I vowed never to use it again for him. The purpose of using budesonide is to avoid these types of problems, so I hope you and your vet can work this out. Also, if you want a second opinion, do try Marion Haber at MVRH in Woburn.

 

How is his albumin doing? He can develop profound muscle weakness if the albumin is low.

 

Have you gotten the Tylan yet? I have some here if you need it right away. You can get it from KV Vet for a reasonable price. Every dog is different, but Dandi has never had a problem with it being sprinkled on top of his food. It will also take a couple of months before the Tylan will start to make a difference.

 

I hope there will be better news tomorrow

Jordan

[greyhead]

You okay, Joslin? I check your thread a jillion times a day.

[greydogs]

You okay, Joslin? I check your thread a jillion times a day.

 

We received this message from Joslin tonight. This is just the latest of several tough losses for her in the last couple of years, and she has done everything she possibly could for Harley:

 

Harley Earl Murphy

 

August 6, 2001 – April 15, 2012

 

[4My2Greys]

Oh no how very sad

Rest well Harley knowing you were loved.

 

{{{{{{{Joslin}}}}}}}