Could I ask you a few questions first before I give an opinion.
Thanks for that
I’m sorry to hear of the chronic nature of your cat’s illness. Unfortunately this is sometimes the way with this disease. It’s also unfortunate that your cat requires the predinisolone as well as the doxycycline. Doxycycline is an antibiotic that has been show to be effective against the parasitic organism that causes this disease but sometimes the patient’s immune system is over-reactive and attacks the affected red cells with too much vigour, worsening the anemia. When this happens we need the prednisolone as well.
The recurrences with your cat suggests there may be some immunological weakness as many cats recover after treatment (although often they retain the parasitic organism in a “carrier” state). That is why I asked about the FeLV and FIV. The presence of both of these viruses will make the patient much more susceptible. I’m sure your vet would have impressed upon you her status if she did have FIV but just check up on that. However although it might explain things it wouldn’t give us any different therapy.
The Doxycycline dose is good and certainly shouldn’t be upsetting her in any way.
The prednisolone is being given at a slightly high dose. Generally we will use around 0.5-1.0 mg/lb so at her weight that will be up to 15 mg. Please be reassured though that prednisolone can be used at even higher rates than she is getting. So 20 mg could be causing some lethargy (less play and purring) and can cause a “hangdog” appearance with the ears down. If the dropped ears related to an ear infection it would usually be quite obvious….a lot of flicking the ears, shaking them, a bad smell and often you can see the infective discharge.
I think it is quite probable that the signs you’re seeing relate to the prednisolone. It would be nice to get the dose down but I’m aware that we could see a recurrence of the anemia so we need to be careful.
So to answer your questions more directly. I think the prednisolone is likely to be the cause of the signs. From the history you’ve given me I think it’s probable that she will need long term treatment. However when prednisolone is stopped (or reduced) the side effects will reverse.
You need to contact your vet soon to discuss hopefully lowering the dose. It may be worthwhile trying a different antibiotic and you could discuss that with your vet. Enrofloxacin is effective in some cases and is well tolerated by cats. You need also to watch her thirst. If you feel that is getting greater and particularly if she starts to lose weight she should be reassessed by your vet. This is quite important as it can indicate diabetes!
Sorry about the delay....a lot to type. I hope I’ve been of assistance but I understand that this is quite a complex question so please feel free to contact me back if you need further clarification.
Kindest regards, Peter
ps this is a very good information site on this disease.