Chronic enteropathy in cats: budesonide vs prednisolone for remission with fewer systemic effects — MAYBE (weak evidence)

MAYBE (weak evidence): No eligible record exists for this shelf, and this pack is honestly empty (no cards). PubMed searches run at drafting (Nov 10, 2026) — budesonide combined with prednisolone, cats and chronic enteropathy/inflammatory bowel disease (0 records); budesonide with cats and enteropathy (0 records); budesonide with 'feline' (10 records); budesonide with 'cat' (50 records) — found NO study of budesonide in cats with chronic enteropathy at all: no head-to-head trial against prednisolone, no single-agent budesonide enteropathy series, and therefore no feline evidence on whether budesonide gives equal remission with fewer systemic effects. Near-misses, documented here and deliberately not carded: (1) The budesonide-vs-prednisone randomised trial that exists is in DOGS — Dye 2013 (PMID: 24112400), with its companion pharmacokinetic/therapeutic study Pietra 2013 (PMID: 23270349) — and both records already claim-carry on shelf #158 (budesonide vs prednisone in canine inflammatory bowel disease); per the one-home rule and the species rule they are cross-pointed here, never re-carded, and no canine figure is imported into this feline shelf. (2) The only feline budesonide treatment record found, Galler 2013 (PMID: 24000786), gave INHALED budesonide (400 µg twice daily) to cats with asthma and chronic bronchitis — a different disease, a different route and no enteropathy outcome — though it is the source of the only feline systemic-effect signal in the searched records (hypothalamic-pituitary-adrenal axis suppression detected in 3 of 15 re-tested cats, with no clinical corticosteroid side effects observed); it cannot answer an enteropathy remission question and is not carded. (3) One 'budesonide + cat' search hit (PMID: 15017642) is a HUMAN eosinophilic oesophagitis paper whose 'feline' refers to the 'feline oesophagus' endoscopic appearance in people — not a cat study. (4) Feline enteropathy steroid evidence that does exist addresses different questions: prednisolone combined with chlorambucil for low-grade alimentary lymphoma (reviewed in PMID: 30305106) is a neoplasia protocol, not a budesonide comparison in chronic enteropathy, and the narrative review of chronic enteropathy therapies in dogs and cats (PMID: 30523666) reports no feline budesonide-vs-prednisolone comparison. Design class (c): randomisation is not established, because no eligible record exists at all. Until a feline study — even a single-arm budesonide enteropathy series, and ideally a randomised comparison against prednisolone with systemic-effect monitoring (including glycaemic effects, the usual reason budesonide is proposed in cats) — is published, choosing budesonide over prednisolone in feline chronic enteropathy is extrapolation from the canine trial on shelf #158 and from pharmacological reasoning, not feline evidence. Tier C is not engaged (no mortality/survival claim). Drafted Nov 10, 2026 (VetMed build, topic #731); all figures from the abstracts fetched and verified at drafting.