Prednisone taper question -- going back up when symptoms return

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Sara14
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Date Joined Mar 2007
Total Posts : 4509
   Posted 8/7/2018 10:06 AM (GMT -6)   
Hi. I have never before had an issue tapering off of prednisone, but probably because I am an idiot and have not been able to quit smoking yet, my symptoms returned when I went down to 10 mg this time. I still went down to 5 mg, but i'm getting worse. I went back up to 15 two days ago and today I went up to 20 (yes, I'm doing this all on my own because I don't want my doctor to tell me to go on Remicade...lol; I know, not real smart.). So, do I have to go all the way back up to 50 mg now or just back to 15 for a few days to see relief?

I'm not seeing any blood, just having maybe 4-5 BMs a day that err on the constipated side where not everything is coming out (this is what has been happening since I started smoking), appetite is low, crampy pain that is not too bad yet and some urgency and mucous. I haven't smoked for the past 14 hours, but am really struggling not to go buy some, which is so incredibly stupid. I hate cigarettes!
34 years old; diagnosed UC March 2007.
Latest scope: 9-29-16: "mild-to-moderate" chronic and active proctosigmoiditis (infectious cause). Battled reoccuring campylobacter & c diff. Oct-Dec 2016. Healthy since Dec. 25, 2016 until I started smoking May 2018. 5 mg pred. Trying to re-quit smoking. Maintenance meds: Delzicol, 6, 2xday; Rowasa nightly; Singular & Allegra for allergies; Xanax

quincy
Elite Member


Date Joined May 2003
Total Posts : 30836
   Posted 8/7/2018 10:10 AM (GMT -6)   
Alternating taper.....20, 20, 20, 20......15, 20, 15, 20, 15, 20......15, 15, 15, 15, ..... etc
q
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Pulmicort/Oxeze/Airomir (asthma); Effexor XR 75mg (depression); Rosuvastatin 10mg (cholesterol); Telemesartin 80mg (BP)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care + Genuine Health Advanced Gut Health 50 billion @ bedtime)
~Metamucil capsules 6 @ 2x daily with meals; Vitamin D 4500 IU
~URSO 500mg @ 2x daily for Primary Biliary Cholangitis
"TREAT (FROM)BOTH ENDS" worth it !!

Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4509
   Posted 8/7/2018 10:16 AM (GMT -6)   
Thanks, I could try that. I only went down by 5 mg this time every 5-7 days. In the past, I always went down by 10 every week. And I stayed on 10 mg for 10 days because my symptoms were returning.
34 years old; diagnosed UC March 2007.
Latest scope: 9-29-16: "mild-to-moderate" chronic and active proctosigmoiditis (infectious cause). Battled reoccuring campylobacter & c diff. Oct-Dec 2016. Healthy since Dec. 25, 2016 until I started smoking May 2018. 5 mg pred. Trying to re-quit smoking. Maintenance meds: Delzicol, 6, 2xday; Rowasa nightly; Singular & Allegra for allergies; Xanax

quincy
Elite Member


Date Joined May 2003
Total Posts : 30836
   Posted 8/7/2018 10:22 AM (GMT -6)   
Alternating taper is a known withdrawl system of many meds, including pred.
Stop cold turkey re ciggies. Good on you.
Eat something you like...a better addiction.

q
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Pulmicort/Oxeze/Airomir (asthma); Effexor XR 75mg (depression); Rosuvastatin 10mg (cholesterol); Telemesartin 80mg (BP)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care + Genuine Health Advanced Gut Health 50 billion @ bedtime)
~Metamucil capsules 6 @ 2x daily with meals; Vitamin D 4500 IU
~URSO 500mg @ 2x daily for Primary Biliary Cholangitis
"TREAT (FROM)BOTH ENDS" worth it !!

Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4509
   Posted 8/7/2018 10:23 AM (GMT -6)   
So you don't think I'll have to go back up to 40 or 50 mg to get better again? I just saw someone else on here post that her doctor had her do that.

Thanks. Tapering cigs I think prolongs the misery. But I've been saying I'll quit almost every day since April, so not real confident. Thank you.
34 years old; diagnosed UC March 2007.
Latest scope: 9-29-16: "mild-to-moderate" chronic and active proctosigmoiditis (infectious cause). Battled reoccuring campylobacter & c diff. Oct-Dec 2016. Healthy since Dec. 25, 2016 until I started smoking May 2018. 5 mg pred. Trying to re-quit smoking. Maintenance meds: Delzicol, 6, 2xday; Rowasa nightly; Singular & Allegra for allergies; Xanax

quincy
Elite Member


Date Joined May 2003
Total Posts : 30836
   Posted 8/7/2018 10:27 AM (GMT -6)   
Try staying at 20 and see how you do. Cigs are crap, so quit, period.

Keep us posted.

Are you on probiotics? How are you eating? And have you had blood checks lately?

q
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Pulmicort/Oxeze/Airomir (asthma); Effexor XR 75mg (depression); Rosuvastatin 10mg (cholesterol); Telemesartin 80mg (BP)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care + Genuine Health Advanced Gut Health 50 billion @ bedtime)
~Metamucil capsules 6 @ 2x daily with meals; Vitamin D 4500 IU
~URSO 500mg @ 2x daily for Primary Biliary Cholangitis
"TREAT (FROM)BOTH ENDS" worth it !!

Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4509
   Posted 8/7/2018 10:32 AM (GMT -6)   
Ok, thanks.

No probiotics. They never helped me. I like soy yogurt and sauerkraut though, I should get some of that. I've been eating a lot of junk food. Had blood tests in ER couple months ago when I was really sick. They weren't too bad, but my bloodwork never seems to be too terrible. Calprotectin (sp?) levels were high. Had a colonoscopy July 16 that showed "minimal proctosigmoiditis," but I'm sure it's worse now. I wasn't having any symptoms then. That's also the day I went down to 10 mg and later that week symptoms came back.
34 years old; diagnosed UC March 2007.
Latest scope: 9-29-16: "mild-to-moderate" chronic and active proctosigmoiditis (infectious cause). Battled reoccuring campylobacter & c diff. Oct-Dec 2016. Healthy since Dec. 25, 2016 until I started smoking May 2018. 5 mg pred. Trying to re-quit smoking. Maintenance meds: Delzicol, 6, 2xday; Rowasa nightly; Singular & Allegra for allergies; Xanax

quincy
Elite Member


Date Joined May 2003
Total Posts : 30836
   Posted 8/7/2018 10:34 AM (GMT -6)   
You choose what you want to increase to. Are you on steroid enemas or mesalamine?
q
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Pulmicort/Oxeze/Airomir (asthma); Effexor XR 75mg (depression); Rosuvastatin 10mg (cholesterol); Telemesartin 80mg (BP)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care + Genuine Health Advanced Gut Health 50 billion @ bedtime)
~Metamucil capsules 6 @ 2x daily with meals; Vitamin D 4500 IU
~URSO 500mg @ 2x daily for Primary Biliary Cholangitis
"TREAT (FROM)BOTH ENDS" worth it !!

iPoop
Forum Moderator


Date Joined Aug 2012
Total Posts : 12996
   Posted 8/7/2018 11:15 AM (GMT -6)   
There's no magical pred dosage you need to go to in order to heal. Pred is much like a crutch, you feel great while on it but must maintain when you taper. If your leg isn't fully healed and you try to walk without the crutch then you'll quickly regret it. Same goes with pred, get off it before you're fully healed and supported fully by your maintenance meds then you'll quickly regret it.

I'd just go on the remicade. Likely, you're just delaying the inevitable and kicking the can down the road. It's wishful thinking to go up in pred dosage, change nothing, and expect tapering to work better the second time.
Moderator Ulcerative Colitis
John
, 40, UC Proctosigmoiditis
Rx: Remicade @5mgs/kg/6wks; daily 75mgs 6MP, 4.8g generic-Lialda, and rowasa

You might have UC if a friend/spouse suggests a fun outing, and the very first thing crossing your mind is the people-to-bathroom ratio...

Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4509
   Posted 8/7/2018 11:42 AM (GMT -6)   
The change would be quitting smoking.

quincy -- mesalamine. The steroid ones made me worse last time, don't know why. That was years ago.
34 years old; diagnosed UC March 2007.
Latest scope: 9-29-16: "mild-to-moderate" chronic and active proctosigmoiditis (infectious cause). Battled reoccuring campylobacter & c diff. Oct-Dec 2016. Healthy since Dec. 25, 2016 until I started smoking May 2018. 5 mg pred. Trying to re-quit smoking. Maintenance meds: Delzicol, 6, 2xday; Rowasa nightly; Singular & Allegra for allergies; Xanax

Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4509
   Posted 8/9/2018 3:53 PM (GMT -6)   
Called doctor to see if they can start the pre-approval process to see if I can try Remicade. Although maybe that won't work either because i am a total loser who cannot quit smoking. sad

Also, my cat, who has never been sick in 7 years, got diarrhea 3 days ago and barely has any appetite (totally unlike her), and I am worried sick. And guess what the vet prescribed? FLAGYL. The most evil antibiotic in the world. I could not get her to take it the first 2 days. Finally got her to swallow one today. I put it in an empty Delzicol capsule (the tablets are inside the capsules and I always throw the capsules away because they are too big for me to swallow and completely pointless). Cut the capsule down so it would be smaller, then I had to put my cat between my legs, kneel over her to keep her in place and pry her mouth open. Her stool samples all came back fine, so not exactly sure what the Flagyl is even supposed to do at this point. But another vet tech I talked to told me they don't test for bacterial infections in cats, only Giardia and parasites, which is totally stupid. I want to know what is causing this. So now I get to inspect both my cat's poop and my own poop every day and worry sick about both of us. Good thing we have 3 bathrooms and 2 litterboxes between the two of us right now...
34 years old; diagnosed UC March 2007.
Latest scope: 9-29-16: "mild-to-moderate" chronic and active proctosigmoiditis (infectious cause). Battled reoccuring campylobacter & c diff. Oct-Dec 2016. Healthy since Dec. 25, 2016 until I started smoking May 2018. 5 mg pred. Trying to re-quit smoking. Maintenance meds: Delzicol, 6, 2xday; Rowasa nightly; Singular & Allegra for allergies; Xanax

countess18
Regular Member


Date Joined May 2016
Total Posts : 261
   Posted 8/9/2018 4:11 PM (GMT -6)   
Sara

When I had C diff my dog had mucous and blood in his stool and I freaked out. He was treated with Flagyl and it went away. It happened again to him about a year after that and the vet said he had colitis-again treated with Flagyl and the symptoms went away. I started thinking it was our well water giving us colitis so I had it tested for everything imaginable. I swear they take on our illnesses. If you have UC wouldn't the smoking help it? I think its a good idea to try the Remicade instead of staying on the prednisone because you have no idea if it will work or how long it will take to get the dose right.

Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4509
   Posted 8/9/2018 4:17 PM (GMT -6)   
That sucks about your dog, but I'm glad it went away. Pumpkin doesn't have any blood or mucous, just liquid stool that was a light-ish brown color today. She had diarrhea about 6 times the Monday night and Tuesday morning. Yesterday, only once, but she wasn't eating much, and this morning, she had D twice. We're on city water, so I doubt it's that. Yeah, smoking is SUPPOSED to help UCers, but unfortunately, it seems to have caused a bad flare for me and I get so extremely grumpy and pissed at the world when I try to quit almost every day, that I haven't quit yet. I got diagnosed with UC as a smoker, so it has never helped me. If I would have known that starting smoking again would take me out of a 1.5-year solid remission, however, I never would have done it. Thank you.
34 years old; diagnosed UC March 2007.
Latest scope: 9-29-16: "mild-to-moderate" chronic and active proctosigmoiditis (infectious cause). Battled reoccuring campylobacter & c diff. Oct-Dec 2016. Healthy since Dec. 25, 2016 until I started smoking May 2018. 5 mg pred. Trying to re-quit smoking. Maintenance meds: Delzicol, 6, 2xday; Rowasa nightly; Singular & Allegra for allergies; Xanax

Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4509
   Posted 8/9/2018 4:19 PM (GMT -6)   
If my cat ends up having IBD, I will be so upset for her. Can dogs get c diff? Do you think it was that the first time?
34 years old; diagnosed UC March 2007.
Latest scope: 9-29-16: "mild-to-moderate" chronic and active proctosigmoiditis (infectious cause). Battled reoccuring campylobacter & c diff. Oct-Dec 2016. Healthy since Dec. 25, 2016 until I started smoking May 2018. 5 mg pred. Trying to re-quit smoking. Maintenance meds: Delzicol, 6, 2xday; Rowasa nightly; Singular & Allegra for allergies; Xanax

Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4509
   Posted 8/9/2018 4:23 PM (GMT -6)   
How'd you get the dog to eat the Flagyl, btw?
34 years old; diagnosed UC March 2007.
Latest scope: 9-29-16: "mild-to-moderate" chronic and active proctosigmoiditis (infectious cause). Battled reoccuring campylobacter & c diff. Oct-Dec 2016. Healthy since Dec. 25, 2016 until I started smoking May 2018. 5 mg pred. Trying to re-quit smoking. Maintenance meds: Delzicol, 6, 2xday; Rowasa nightly; Singular & Allegra for allergies; Xanax

countess18
Regular Member


Date Joined May 2016
Total Posts : 261
   Posted 8/9/2018 4:40 PM (GMT -6)   
We put the pills in little hot dog pieces but dogs eat anything and everything. When my cat had to take thyroid medication we had to do what you did which is strattle him and pry his mouth open. Initially I think we put it in a small amount of wet food and he would eat it but then he got smart and spit it out. Once you close the cats mouth blow on his face --its supposed to make them swallow.
Thanks

T
diagnosed proctitis April 2016 s/p a c diff infection age 53
Nov 2017- ?Crohns colitis to mid transverse - mild/moderate
started Humira 11/17/17, -5/17- failed Humira
started Remicade 6/8/17 -on pred wean again
past meds- cortifoam, canasa, rowasa,balsalazide, prednisone

Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4509
   Posted 8/9/2018 4:54 PM (GMT -6)   
Thanks! I did the blowing up face thing today. Not looking forward to putting her through this again for several more days, twice a day, and worried about side effects because Flagyl makes me feel like hell.
34 years old; diagnosed UC March 2007.
Latest scope: 9-29-16: "mild-to-moderate" chronic and active proctosigmoiditis (infectious cause). Battled reoccuring campylobacter & c diff. Oct-Dec 2016. Healthy since Dec. 25, 2016 until I started smoking May 2018. 5 mg pred. Trying to re-quit smoking. Maintenance meds: Delzicol, 6, 2xday; Rowasa nightly; Singular & Allegra for allergies; Xanax

notsosicklygirl
Forum Moderator


Date Joined Dec 2008
Total Posts : 16558
   Posted 8/9/2018 7:47 PM (GMT -6)   
Flagyl is an anti-diarrheal for dogs for sure, probably for cats too. I usually get liquid flagyl for my dogs and i just put it in their mouth while they are eating. Flagyl tends to taste terrible, but they do compound it for dogs on some online pharmacies, and the compounded ones come in flavors. I have given pills and i am good at giving them pills. You just have to put it down far enough that they can't spit it out. My girl can find a pill in anything. I have to give her seizure pills 3x a day so I had to figure out a way to make it happen without giving tons of junk food - especially since she gets D from anything rich. They also do really well with diet. Vet diet food can help calm GI situations in animals. I wonder how common it is to actually diagnose IBD in dogs. I feel like usually they try drugs repeatedly and if it works, you go on your way for long periods. They would have to have symptoms that didn't clear and kept coming back in order to warrant a scope or ultrasound. I hope none of our babies ever go through that.
Moderator: UC
Currently: no meds 6/15 Step 1 J-pouch Surgery Complete 9/15 Step 2 Complete 11/15 Step 3 Complete
From Sickly to UC Free

Give a man a fish and he will eat for a day; teach a man to fish and he will eat for a lifetime; give a man religion and he will die praying for a fish

Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4509
   Posted 8/10/2018 12:03 PM (GMT -6)   
Yes, I would be beyond myself if she ever got IBD. Not to mention, I really don't want to see my cat on prednisone, haha. She's already nuts enough! smile I've gotten 3 pills down now. I put it in an empty gelcap and coat the gelcap with wet food, then force it in her mouth and she swallows. I can't imagine having to give her pills daily for any extended period of time! She still won't eat any of her dry food, but is eating plenty of wet food now at least. Didn't have diarrhea this morning! (Neither of us did, lol).
34 years old; diagnosed UC March 2007.
Latest scope: 9-29-16: "mild-to-moderate" chronic and active proctosigmoiditis (infectious cause). Battled reoccuring campylobacter & c diff. Oct-Dec 2016. Healthy since Dec. 25, 2016 until I started smoking May 2018. 5 mg pred. Trying to re-quit smoking. Maintenance meds: Delzicol, 6, 2xday; Rowasa nightly; Singular & Allegra for allergies; Xanax

quincy
Elite Member


Date Joined May 2003
Total Posts : 30836
   Posted 8/10/2018 12:06 PM (GMT -6)   
That's a plus....what dry food does she eat?
q
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Pulmicort/Oxeze/Airomir (asthma); Effexor XR 75mg (depression); Rosuvastatin 10mg (cholesterol); Telemesartin 80mg (BP)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care + Genuine Health Advanced Gut Health 50 billion @ bedtime)
~Metamucil capsules 6 @ 2x daily with meals; Vitamin D 4500 IU
~URSO 500mg @ 2x daily for Primary Biliary Cholangitis
"TREAT (FROM)BOTH ENDS" worth it !!

Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4509
   Posted 8/10/2018 12:23 PM (GMT -6)   
Blue Buffalo Weight Control. If this continues, I'll try switching to something else, but I don't think it's the dry food, because she won't eat treats either, and the first couple days she wouldn't eat much wet food either. I hope she gets all better and starts eating dry food again soon because I have a 5-day trip planned for September, and I can't leave if I can't leave dry food out (and of course mostly because I want her to feel better).
34 years old; diagnosed UC March 2007.
Latest scope: 9-29-16: "mild-to-moderate" chronic and active proctosigmoiditis (infectious cause). Battled reoccuring campylobacter & c diff. Oct-Dec 2016. Healthy since Dec. 25, 2016 until I started smoking May 2018. 5 mg pred. Trying to re-quit smoking. Maintenance meds: Delzicol, 6, 2xday; Rowasa nightly; Singular & Allegra for allergies; Xanax

quincy
Elite Member


Date Joined May 2003
Total Posts : 30836
   Posted 8/11/2018 12:38 PM (GMT -6)   
My friend's cat has intestinal bleeding and her cat has been changed to a different hard food. I'll text her and find details if you like. If she isn't eating it, there is an instinctual reason she has an aversion....wish they could talk! How are her teeth?

q
*Heather* I give suggestions, do with them what you will.
Status: ...Asacol 3 @ 2x daily; Salofalk enema @ 3rd night (nightly/ flares, tapered/maintenance)
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol 20mg as needed; Zantac 150mg; Pulmicort/Oxeze/Airomir (asthma); Effexor XR 75mg (depression); Rosuvastatin 10mg (cholesterol); Telemesartin 80mg (BP)
~vitamins/minerals/supplements; Probiotics....(RenewLife Ultimate Flora Critical Care + Genuine Health Advanced Gut Health 50 billion @ bedtime)
~Metamucil capsules 6 @ 2x daily with meals; Vitamin D 4500 IU
~URSO 500mg @ 2x daily for Primary Biliary Cholangitis
"TREAT (FROM)BOTH ENDS" worth it !!

Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4509
   Posted 8/11/2018 2:05 PM (GMT -6)   
If you want to, you can ask. Thanks! She just had a solid poop! Never have I been so excited about a cat turd before. Lol. I'm guessing it is some type of infection but who knows. I wish they could talk, too! She is eating wet food, but doesn't seem that excited about that either and normally, this is a cat who begs me for food all day long and gets extremely excited when I open a can of wet food. She is two pounds overweight, so a week of eating a bit less isn't going to hurt her, but I hate seeing her not her normal self. A side effect of Flagyl can be lack of appetite, too.
34 years old; diagnosed UC March 2007.
Latest scope: 9-29-16: "mild-to-moderate" chronic and active proctosigmoiditis (infectious cause). Battled reoccuring campylobacter & c diff. Oct-Dec 2016. Healthy since Dec. 25, 2016 until I started smoking May 2018. 5 mg pred. Trying to re-quit smoking. Maintenance meds: Delzicol, 6, 2xday; Rowasa nightly; Singular & Allegra for allergies; Xanax

Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4509
   Posted 8/11/2018 2:07 PM (GMT -6)   
Teeth look fine.
34 years old; diagnosed UC March 2007.
Latest scope: 9-29-16: "mild-to-moderate" chronic and active proctosigmoiditis (infectious cause). Battled reoccuring campylobacter & c diff. Oct-Dec 2016. Healthy since Dec. 25, 2016 until I started smoking May 2018. 5 mg pred. Trying to re-quit smoking. Maintenance meds: Delzicol, 6, 2xday; Rowasa nightly; Singular & Allegra for allergies; Xanax

Sara14
Veteran Member


Date Joined Mar 2007
Total Posts : 4509
   Posted 8/11/2018 4:24 PM (GMT -6)   
Maybe it is something with her teeth or gums. Odd that she wont eat dry food or treats and she seems to be licking her wet food/eating it strangely. But she usually begs me for a little avocado when I slice into one and she wont eat that either. Sorry this is so off topic from UC.
34 years old; diagnosed UC March 2007.
Latest scope: 9-29-16: "mild-to-moderate" chronic and active proctosigmoiditis (infectious cause). Battled reoccuring campylobacter & c diff. Oct-Dec 2016. Healthy since Dec. 25, 2016 until I started smoking May 2018. 5 mg pred. Trying to re-quit smoking. Maintenance meds: Delzicol, 6, 2xday; Rowasa nightly; Singular & Allegra for allergies; Xanax
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