Angie (00:00)
Welcome back to Tails of Truth, where we tell the truth about veterinary medicine. I'm Dr. Angie, and this is my co-host and veterinary nurse, Extraordinaire Jojo. And today we are going to talk about steroids in cats. I love this topic.

JoJo (00:15)
this topic too.

it's gonna be a quality episode. That's what I'm gonna say. I think I think we

Angie (00:19)
Yes.

JoJo (00:20)
can knock out a lot of misconceptions and truths. Which

Angie (00:23)
Yes. And it's super

relevant because cats often need steroids. They need steroids

JoJo (00:27)
Yeah.

Angie (00:28)
for asthma, for inflammatory bowel disease, for their allergic disease, for all kinds of things. Steroids are really

JoJo (00:33)
Mm. And

Angie (00:36)
useful.

JoJo (00:37)
people in the holistic space really try to avoid steroids. They hear that word steroids and I feel like it's all out panic.

Angie (00:46)
And it's so understandable.

JoJo (00:47)
Yeah. Like a scramble to find any other alternative.

Angie (00:51)
Yes. And that's probably good, but sometimes we really need So we'll talk about in this episode when you probably could avoid steroids and when you probably shouldn't try.

JoJo (01:02)
And there are different types of steroids too, right? Like I think people think only of prednisone when they hear steroid. But we have inhaled steroids for asthma.

Angie (01:11)
Fluticazone, yes.

JoJo (01:13)
So I think the spacers they use. So cute. Side note.

and then we also have budesonide

Angie (01:19)
Budesonide I, yeah.

JoJo (01:21)
Which people often haven't heard of.

Angie (01:23)
Yes.

I think a lot of veterinarians don't recommend it. I think 'cause they don't

JoJo (01:26)
Mm. And it

Angie (01:28)
like it.

JoJo (01:29)
they don't like it. But you like it in some situations.

Angie (01:31)
I do like it. I mean it works for some cats and so if I can get away with it then I'm I'm gonna get away with it because it doesn't have systemic absorption like prednisone or prednisolone.

JoJo (01:42)
And that's where we should start because that's the one that everybody knows. And there's confusion around that because if you have a dog, your dog has probably been prescribed prednisone. And if you have a cat, your vet is prescribing prednisolone difference.

Angie (01:57)
Prednisolone.

I know. Well, some cats, some, probably very few cats, their livers can't change prednisone into prednisolone. But that's probably really pretty rare. My last cat, Simba. Confession, he was only ever on prednisone.

JoJo (02:13)
Why and how come? Why did why did you do prednisone instead of prednisolone?

Angie (02:17)
Because it worked, it's cheaper and I already had it. So I just started them on prednisone. And

JoJo (02:22)
Yeah.

Angie (02:23)
prednisolone for cats is just not as important as we think

it is. Now, I always prescribe prednisolone to my patients. But for my own cat, I already have the bottle of prednisone. So it's like we're just gonna start this. He responded well. So he obviously he could convert. And I think most cats can. So I think most of the time it's fine. I don't know if we have the data to

know how many cats can't convert prednisone to prednisolone. everyone just plays it safe and uses prednisolone.

JoJo (02:53)
Yeah, explain that more. explain that process. The prednisone to prednisolone.

Angie (02:57)
Yeah, so some cats and maybe maybe I'll look this up. You know what? I'm gonna look this up on Vin and I want

JoJo (03:02)
Yeah. Yeah.

Angie (03:05)
you to look it up on Claude. Yeah.

JoJo (03:07)
okay. The

difference between or how the body breaks down prednisone?

Angie (03:12)
Well, what I'm interested in is if we have data to know or have any kind of study to to investigate how many cats and this is a tangent, this is just my ADHD

JoJo (03:24)
Yeah.

Angie (03:25)
tangent, how many cats can't convert prednisone to prednisolone? So I'm gonna

JoJo (03:31)
Yeah, 'cause I

wonder when the default became prednisolone for cats. Yeah. yeah, I have my

Angie (03:37)
like what year? Like what I don't know.

JoJo (03:41)
answer 'cause Claude is fast. but it didn't

Angie (03:43)
my gosh, okay, I'm still typing.

JoJo (03:45)
give me okay. There's no precise percentage in the literature.

for how many

Angie (03:50)
That's probably right.

JoJo (03:51)
cats fail the conversion entirely. The clinical guidance is population level. So cats as a species are inefficient converters. So prednisolone is a preferred choice for all cats and not just a subset. Hmm, the practical takeaway, assume any cat you're treating needs prednisolone and not prednisone.

Angie (04:10)
Right. And that's what you do. But

JoJo (04:13)
It's just

Angie (04:14)
once again, cats don't get the studies. So we're like, I don't know. Yeah.

JoJo (04:17)
Right, they didn't have the studies. Exactly. It

just says the liver enzyme required for that conversion is present but significantly less efficient in cats over dogs.

Angie (04:27)
I told Ben Nolan,

JoJo (04:28)
Okay.

Angie (04:28)
the internist that helped me with some I like, I just want you to know I'm using prednisone. He's like, Yeah, it's probably fine in most cats but Yeah.

JoJo (04:36)
Yeah. So did you just have

to monitor differently?

Angie (04:38)
No. I mean he just did great on it and like he all

JoJo (04:40)
Yeah.

Angie (04:41)
of his symptoms resolved and so I was like, I'm not gonna change this now. It's cheaper. Yeah. It's cheaper.

JoJo (04:44)
Is it cheaper? Is that one route? Yeah. Prednison is really cheap.

Angie (04:49)
So cheap. And I already had it, already had it in our pharmacy. I wasn't stocking prednisolone. I was just either calling it into pharmacies or special ordering it. And so he did so well that I didn't I didn't change it.

JoJo (05:01)
Yeah.

Angie (05:01)
Someone's gonna come after me in the comments. Yeah.

JoJo (05:04)
How irresponsible you are with your own cat. And then

you smiled while I said that. Okay. Where do we

Angie (05:09)
Mm-hmm.

JoJo (05:11)
start with this? what is a big question that people are afraid of? Side effects?

Angie (05:17)
Well, I can tell you what I'm afraid of. Can we s can we start with me first? Let's let's let's focus on me

JoJo (05:18)
Okay. Yeah, so let's start with you. What are you afraid of?

Angie (05:23)
and then we'll focus on everybody else. the first thing I worry about, and it's it's a small worry, but I when I start a cat on oral prednisolone the first thing I think of is please don't become diabetic. It's happened to me twice in 20 years, but it's it feels bad. Now, if you catch it quickly, you can reverse it.

but that's my worst fear in starting prednisone or prednisolone is that and doesn't happen to dogs very much, it's mostly cats, but that they might become diabetic.

JoJo (05:52)
Hm.

do you think all vets they're having that conversation when they're starting cats on prednisolone? I don't think so either.

Angie (05:58)
No, it's it's

And sometimes I'm starting at such a low dose that I don't always have that conversation.

JoJo (06:05)
Uh-huh.

Angie (06:06)
but yeah, I I I think it's a hard one because it's so rare. And here's what we're weighing as veterinarians is that if we are gonna scare you about the like very rare incident that you might not help your cat. And I think

JoJo (06:23)
Mm, that is a fine

line to walk.

Angie (06:26)
It's a really fine line to walk because a lot of things can happen. but I I tell people, I say, here's what's gonna happen. It's rare, and here's how we're gonna monitor for it. So usually I monitor for changes in weight, changes in behavior. It's you know, it's pretty easy. If you can grab a blood glucose, you can see if your cat's becoming diabetic. But the tricky part is is that prednisolone can cause increased thirst and urination.

And so can diabetes. So people are that are taking that warning seriously are like, Are you kidding me? This is anxiety producing. And for those kitties, we just monitor their blood glucose. Or we can monitor urine. If they're cats that don't want to be touched, we can monitor their urine for glucose.

JoJo (07:08)
When you say catch it quickly, that's kind of vague. So h

Angie (07:11)
Yeah. That is vague Yeah.

JoJo (07:14)
yeah, how soon?

Angie (07:15)
Like I don't know, if we can catch it in the first couple of weeks, four weeks, then a lot of times

JoJo (07:20)
Okay.

Angie (07:21)
we can stop the steroids and then reverse and then the diabetes goes away. Yeah.

JoJo (07:26)
Okay.

well I guarantee you people are nervous about it anyhow because they've Googled it. And that's what's coming up as a side

Angie (07:31)
Yeah. Yeah.

JoJo (07:33)
effect. So I it I I would think it's better to have that conversation ahead of the Google search. Cause I would be kinda mad

Angie (07:41)
Yes. There are two.

JoJo (07:43)
if you didn't tell me that.

Angie (07:45)
Of course you would be. Yeah.

JoJo (07:46)
And I didn't get

to make that decision with that knowledge.

Angie (07:48)
Right. And yeah,

sometimes we

JoJo (07:50)
So I think you've telling people.

Angie (07:52)
Yeah, I know. It's it's tricky. It's tricky.

JoJo (07:54)
Yeah. okay.

Angie (07:57)
Sometimes especially like with the cat that's like that need prednisolone to stay alive that I maybe mention it in passing, but on some level, if they can't have prednisolone, then I don't know how to save them. And so that happens sometimes too.

Where you're like, I hope

JoJo (08:14)
Huh.

Angie (08:14)
you don't become diabetic because you need this to work.

JoJo (08:17)
if they're going to become diabetic, does it typically happen in the beginning for them or if they're on prolonged steroid use, does it increase their risk?

Angie (08:24)
That's a really good question. I have only seen it happen at the very beginning. Yeah. When you've seen cats, yeah. Mm-hmm.

JoJo (08:29)
Okay. That's what my experience has been too. So I feel like if it's a c yeah, so I feel like if it's a

cat that's gonna become diabetic, we're gonna know pretty early.

Angie (08:36)
It's gonna do it right away. And honestly,

it's usually in bigger doses. So the second cat in that I saw that became diabetic, I actually didn't prescribe the steroids, but the steroids were inappropriately large dosing.

Like it just was like, of course this cat became diabetic. And they did it for so long. And so the bigger the steroid dose, the bigger the risk. Yeah.

JoJo (09:01)
That

makes sense. what were they treating with a high dose of steroids? Or was it an over prescribed dose?

Angie (09:07)
they were treating inflammatory bowel disease, but like I would say if your veterinarian, unless it's an internist, is asking you to give over five milligrams of prednisolone per day. And it's not like we're gonna start high for a couple weeks and then come down, or start high for a couple days and come down, if they're just planning on maintaining your cat on more than five milligrams a day, then I would push back on that.

Yeah. I I would wonder what's going on. But you know, sometimes internists will say, I mean, they'll and I I definitely am not gonna undermine an internal medicine specialist, but if they say like, we're gonna do, you know, you have a fifteen pound cat, you're gonna do five milligrams twice a day for a couple of weeks to get things under control, that's different than saying we're gonna give your cat ten milligrams of steroids every day forever.

JoJo (09:57)
Indefinitely.

And well I there's so many ways I want to go with this. So I I heard you say that prednisolone usually you'll see it in the beginning, don't go over ten milligrams. Or if your vet is asking for ten milligrams a day, question that.

Angie (10:11)
Yeah.

JoJo (10:12)
unless there's a very clear protocol of tapering down.

Angie (10:15)
Correct.

JoJo (10:16)
is that and then I wonder does budesonide have the same risk?

Angie (10:20)
No. No. Budesonide is a steroid that we compound. people will take it for like eosinophilic esophagitis if they have inflammation in their esophagus and it just kind of stays in the GI tract. And so Budesonide doesn't carry the same systemic risks. I guess it's always possible, but it's I've never seen it happen. Yeah.

JoJo (10:43)
So are

you only using Budesonide for IBD kitties? Okay, because it's in the GI tract, so got it. Okay. Okay.

Angie (10:46)
Yeah. Yeah. Yeah. It's not gonna make it anywhere else. Yeah. Yeah.

JoJo (10:53)
that that was one of the big questions that people ask. Will steroids give my cat diabetes? And what are the side effects of giving steroids to my cat?

Angie (11:01)
Usually increased thirst, increased urination, increased hunger, which in a lot of cats we want. we're trying to get cats to eat more. I would say their hair coat can look a little more dull. those would be the biggest things. I don't see cats muscle wasting like dogs do, like they don't tend to lose a lot of muscle. I mean, I suppose they could. All of these side effects are gonna be dose dependent. And so the bigger the dose, the bigger the side effect.

JoJo (11:25)
And if you have an I B D kitty you said you're using it for I B D asthma 'cause

Angie (11:29)
Yeah.

JoJo (11:32)
yeah,

Angie (11:31)
like allergic skin disease.

JoJo (11:32)
are they on it for life?

Angie (11:34)
I mean, they can be if that's what needs to happen, but they don't have to be. I think a lot of people are worried about starting steroids 'cause they think, Well, I can never stop them and that's it's not true. You can you can't stop steroids cold turkey if your cat's been on for a while. But you don't have to commit to a lifelong treatment there.

JoJo (11:54)
Are steroids something that can be given intermittently?

Angie (11:56)
Yes. Especially cats with asthma. Like if they're having an asthmatic flare, like you can give a few doses or some cats are on steroids twice a week. And so there are a lot of ways to dose steroids. you can be creative with it.

JoJo (12:10)
Does it does it give them more energy? Like some cats, do they get spastic? That's a w I

Angie (12:15)
No.

JoJo (12:16)
don't know another word to use. So no, it doesn't like cause

Angie (12:18)
No. I haven't seen that.

JoJo (12:20)
personality changes.

Angie (12:22)
I mean, I guess it could cause personality changes. I guess i it could. It could cause changes like they could become I see this more in dogs where they just kinda get cranky. I haven't seen this in cats. Cats

JoJo (12:35)
Mm. cranky's a good word. Yeah.

Angie (12:38)
Yeah. I mean 'cause if you've ever taken steroids.

JoJo (12:41)
no, I avoid them. I but

Angie (12:42)
Yeah. I mean

JoJo (12:43)
I also haven't had a situation in which I've needed them.

Angie (12:47)
Yeah, it kind of like when I was doing IVF, it I had to take a couple like even short courses of steroids and it kind of just made me want to kill somebody. Like it just

JoJo (12:56)
Yeah.

Angie (12:58)
it made me so cranky. But I just don't see those types of side effects in cats. I see them in dogs, but cats are so graceful like everything else. And sometimes when they need steroids, they just get better on.

JoJo (13:11)
Well,

and I bet we can't see as much like you know, in humans, humans get the moon face when they're on steroids.

Angie (13:15)
Yes.

JoJo (13:16)
Like Puffy.

Angie (13:18)
And dogs get that too. Like if you think about a dog with Cushing's disease, they get

JoJo (13:22)
Mm-hmm.

Angie (13:23)
like the pot belly and their s their skin is thin and they're losing hair. And cats are like, I'm good. I just look better now.

JoJo (13:30)
Yeah, I was gonna say I don't think I yeah, I know, I feel like cats

just do well when they are prescribed correctly. Mm hmm. Yeah.

Angie (13:37)
Yeah, they really do. Most cats are great on steroids

for years.

JoJo (13:42)
And so you talked about briefly, if your cat's been on steroids for a while, you don't just wanna stop them. there's a protocol.

Angie (13:49)
Right. You want to wean down. You want your veterinarian to help you with that because your cat's adrenal glands have become accustomed to the we call it exogenous steroids, like all the steroids that you've added on. And so it stopped making steroids. So then if you take that steroid away, that can put them into crisis, like a really, really medically significant crisis, like time in the ER crisis. So don't do that.

taper down over time. If your cat's been on steroids for a week, that's not gonna happen. But if they've been on steroids for months or years, then you wanna do a respectful tapering so that the adrenals can start making steroids again.

JoJo (14:27)
And I just heard that from a practical standpoint. Make sure your practice has enough time for your refills. I I

Angie (14:32)
Ha ha ha.

JoJo (14:34)
I always hate that when they're like, I have one pill left. I'm like, no. Okay. We I don't have a lot

Angie (14:39)
Yes, yes.

JoJo (14:41)
of time to do this, so give them time. So people are asking why is their cat drinking so much on a steroid?

Angie (14:47)
because it increases steroids increase thirst. It's a thirst thing, yeah. And so

JoJo (14:51)
So it's just a thirst. Yeah.

Angie (14:54)
then they're gonna urinate more

JoJo (14:55)
And this is my favorite question because this is one we get asked holistic practice are there any natural alternatives to steroids? Because I feel like people are really looking for that. And maybe it's dependent on

Angie (15:06)
Yeah.

JoJo (15:06)
disease.

Angie (15:08)
Yeah. Okay. Well, okay. Yeah, let's, let's, let's do this. Okay, let's talk about an asthmatic cat. If your cat has asthma and is struggling to breathe, steroids are the best thing. We can let's go back in later, book a consult with me, and we'll make a plan to see if we can lower that dose, get them off steroids with natural things. But like when they're

In crisis, it's not the time to think about any kind of alternative. Steroids are what your cat needs. And then we can go back. CBD, herbs, probiotics, all the things I like to do for my asthmatic cats. It's not gonna get your cat out of crisis. but if your cat just has a little bit of asthma and you're like, I want to avoid steroids, we can talk about cleaning up their diet, we can talk about adding hemp RX feline, CBD on.

We can talk about doing some San Ren Tang by natural path. We can talk about doing all of those things. So I I do think there are some alternatives

JoJo (15:59)
maintenance versus crisis.

Angie (16:00)
Yes. But if your cat can't breathe, just just do the steroids. They're great. Do them. your

JoJo (16:05)
Yeah. Definitely. Your cat will thank you.

Angie (16:08)
cat's life. Get that inflammation under control.

JoJo (16:11)
Okay, what about with the other common diseases like I B D?

Angie (16:14)
Okay, so if you have a cat with IBD that's not losing weight, that's not, just pooping all the time or is not vomiting like constantly. Let's say you have this is really common, I'll see, that you have like the cat that pukes twice a week, hasn't really lost weight, but you know something's going on. You do the ultrasound, you see the thickened intestines. Maybe you don't do the ultrasound, and we're just gonna guess that your cat has IBD. diet.

using a novel protein diet, switching from kibble to canned. That's a really good step. So I I always try diet first. Some people think the hemp RX feline has really helped their cats with IBD. And I don't want to say they think they've experienced that. I see that happen sometimes, but it doesn't feel enough that I'm like, that's my first line. I usually start with diet.

And not as much supplements with I B

D.

JoJo (17:07)
And are you reaching for steroids when it you suspect it could be I B D versus lymphoma? Is it the same treatment?

Angie (17:14)
Well, it depends. It depends on if it's

JoJo (17:17)
Okay.

Angie (17:17)
large cell lymphoma or small cell lymphoma.

JoJo (17:19)
Mm, fair.

Angie (17:21)
because if it's small cell lymphoma, we're gonna reach for chlorambucil But if your cat is not in the I'm a puker twice a week and I'm stable and let's say they're losing weight or they're in a really bad spot, just just do the steroids. Like we can go back later and add the other things and figure the diet out, but just stabilize them with steroids.

JoJo (17:41)
And then what was the the last disease again? The skin stuff. Yeah. I was gonna just gonna say, is that a Doctor Dell conversation?

Angie (17:42)
This the skin stuff. my god, we need to have Dr. Dell back on.

I mean, I yeah. But once again I start with food. And so yeah, but the skin cats we can often rescue with steroids. So I would just rescue them with steroids and then we can talk about more maintenance. because we do have other choices with skin disease other than steroids. And so if I ever have another choice, and that's most veterinarians, by the way.

there's no veterinarian that's like, I only like steroids and they're my first line treatment for everything. Like all

JoJo (18:18)
Yeah.

Angie (18:19)
veterinarians want to avoid steroids whenever

possible.

JoJo (18:21)
And and

I guess that's the question, why are we wanting to avoid steroids?

Angie (18:25)
I mean, I feel stronger about avoiding steroids in dogs than I do in cats. just because over time we know there is some breakdown of muscle, of ligaments. it's not as problematic in cats. Cats are just amazing. But in dogs, I'm trying to avoid steroids because I have better ways to suppress the immune system than steroids that have less side effects.

yeah.

JoJo (18:48)
other questions. I I have a list of questions of people of cats with steroids in case people are watching and they're seeing me look at something. Will steroids make my cat's kidney disease worse?

Angie (18:57)
Ooh, that depends. That depends on what you're using the steroids for. I use steroids for cats with kidney disease all the time. So it doesn't stop me from using them. but because cats with kidney disease, like their kidneys aren't concentrating the urine. So they're drinking a lot and urinating a lot. So that's already gonna happen. and so now we're gonna make that a little bit worse with steroids, maybe.

And so it really depends on how bad the kidney disease is. But most of the time the cats that need steroids need them regardless of their kidney function.

JoJo (19:28)
Mm. Because you probably have a senior kitty that has a comorbidity that you're treating, obviously. So

Angie (19:32)
Yes. Yeah.

JoJo (19:35)
and then the other big question, which I feel like comes this question comes with almost any medication you prescribe. Will it cause cancer in my cat?

Angie (19:41)
No. And if anything, it might help reduce the risk of lymphoma for cats with inflammatory bowel disease. So, I wonder, let's do the thing where you ask Claudia.

JoJo (19:52)
We we call

Claude, which is an AI platform, Claudia, 'cause we just feel like he should be she. So Yeah. What

Angie (20:00)
Cause she's so useful. Let's see.

JoJo (20:03)
are we asking her?

Angie (20:05)
Okay. We should say, let's ask her if and I'm gonna consult Vin, which I trust a lot. We're gonna ask if we have any evidence, because I wanna see if Claude hallucinates, if we have any evidence to support that cats with inflammatory bowel disease have a less incidence of lymphoma using steroids. Okay, so it is.

JoJo (20:26)
You guys get to just listen to us type. Which Vin, by the

Angie (20:28)
I know, we're just like typing.

JoJo (20:30)
way, is a veterinary information network. People may not know

Angie (20:33)
Yes.

JoJo (20:33)
what that is. So it's a a reliable resource.

Angie (20:36)
Yeah.

JoJo (20:36)
Mm,

mine says the relationship is murky and evidence is weak.

See.

Angie (20:41)
Yeah, I don't have I didn't get anything on VIN They probably haven't done a study.

JoJo (20:44)
Well, here's what Claudia says the literature does support.

Angie (20:49)
Okay.

JoJo (20:49)
Cats with IBD have a higher risk of progressing to small cell lymphoma. Steroids like prednisolone are standard treatment for both IBD and small cell lymphoma, which creates a diagnostic and treatment overlap plan. And some cats diagnosed with IBD probably already likely have small cell lymphoma that wasn't caught.

Angie (21:09)
I don't think I agree with that.

JoJo (21:10)
Yeah. See. There's no convincing prospective evidence that steroid use reduces lymphoma incidence in IBD cats. If you've seen a paper claiming this, I'd really like to see it. Yeah. Yeah.

Angie (21:20)
Is that what is that what Claude said?

Okay. Well, I guess in theory, if you're reducing longstanding inflammation, you would think that it could lower your cat's risk of lymphoma.

JoJo (21:31)
my gosh, which just made me realize when we get the GLP ones for cats, which they're like in the next stage of the study, it's like it's going well. I

Angie (21:36)
Yes. Yeah.

JoJo (21:39)
wonder if we'll see less lymphomas 'cause it's an inf

Angie (21:42)
my gosh, yes.

JoJo (21:44)
and I B D's 'cause it's an inflammatory disease.

Angie (21:47)
Yeah. That makes sense. That makes sense why we would. Yay.

JoJo (21:50)
I wonder. Yay, for yeah, it's

getting some studies and some progression of medications. is there any else you want to cover? And how do we want to

Angie (21:59)
I think

JoJo (22:00)
close it out?

Angie (22:00)
I want to tell people that I would not worry about using steroids in cats. So we just need to watch for that diabetes initially. And obviously, if your cat doesn't do well on steroids or if it doesn't help, like don't give steroids just for the sake of giving steroids. But as a integrative veterinarian, I'm not worried about steroid use in cats. So do it.

JoJo (22:22)
under the appropriate

circumstances and appropriate doses with appropriate protocol.

Angie (22:25)
Yes.

Yes. Yes.

JoJo (22:29)
Yeah. hey kitty.

Angie (22:31)
I know. She says, I'm gonna come talk about steroids too. I bet one day this kitty's gonna need steroids. I feel like she every once in a while she coughs and then she'll get

some like she's got food allergies and she's got all kinds of inflammatory things, but hopefully not. Hopefully we can avoid it with some diet and some herbs.

JoJo (22:49)
I wanna throw in one more thing too, because

I know it can feel overwhelming to dose your cat a pill every day and just to know

Angie (22:55)
yeah.

JoJo (22:55)
that this can be compounded into a formulation that works for you and your cat. So ask about that too.

Angie (23:01)
Yeah, and cats really like marshmallow flavor. Like that makes no sense. Chicken marshmallow.

JoJo (23:03)
Yeah, it's weird. They do. Mar chicken marshmallow, you can do that too. If your cat doesn't have a chicken allergy.

Angie (23:12)
Well, the flavor is not even real chicken. Yeah, I can understand

JoJo (23:14)
I know, that's what they said, but I think people still get nervous about it. 'Cause I did ask. It's like

it's chicken in quotations. So

Angie (23:22)
Yes. Yes.

And we have two things to offer you if you want to learn more about steroids in cats. we have two courses. We have a feline asthma course and a vomiting in cats, basically, an IBD course. So if you go to boulderholisticvet dot com and if you go to learn with us, learn more. my gosh, I can't get it. And

JoJo (23:41)
Learn more. Learn more.

Angie (23:45)
if you go to the courses.

then you can consume both of those courses for free if you use the code truth tales t-a-l-e-s or t-a-i-l s. And if you want to chat about your kitty and your cat's exact situation, you can go to Boulder Holistic vet and hit book a consult. And as soon as I open more times up, you can grab some time on my calendar. Sorry, summers rough.

I will look over your cat's records. We'll meet on Zoom. It will all be recorded and I'll help you put together an integrative plan for your cat's inflammation.

JoJo (24:23)
I hope this episode

Angie (24:24)
Okay.

JoJo (24:24)
felt helpful.

Angie (24:26)
I hope so too. Let us know. Don't don't forget to hit subscribe wherever you're listening. YouTube, Apple, Spotify, and leave us a comment and tell us what you think.

JoJo (24:38)
Take care.

Angie (24:39)
see you later.