Predisone and Other Steroids

Introduction to Steroids in Veterinary Medicine

Steroids, a widely utilized category of medications in veterinary medicine, are employed to treat various diseases. Commonly used steroids include Prednisone, Prednisolone, and Dexamethasone. At lower doses, they effectively reduce inflammation, while higher doses are used to suppress the immune system and treat certain brain cancers. Steroids are also beneficial in alleviating swelling and fluid accumulation in the nervous system, thus offering temporary relief from symptoms in some neurological conditions.

Pets on steroids, particularly those on higher doses, may encounter side effects. Generally, these side effects are more bothersome than dangerous. However, significant complications can arise from long-term or high-dose usage.

Steroids are typically given once or twice daily, with or without food.

chemical structure of prednisone

Skeletal formula of Cytarabine

Managing Missed Doses and Medication Changes for Steroids

If you miss a dose of prednisone and it's not yet time for the next scheduled dose, administer the missed dose as soon as you remember. However, if it's already time for the next dose, skip the missed one entirely. Generally, it's advisable to gradually reduce (taper) steroid doses before discontinuing them. Exceptions to this rule include pets on very short steroid courses and those experiencing serious side effects. As always, it’s crucial to consult with your veterinary team before making any changes to your pet's medication regimen.

Bottle of prescription pills

Drug interactions

Steroids should not be given with any of the Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Preferably, there should be several days between administration of NSAIDS and any steroid, or serious GI side effects may develop. NSAIDs include:

  • Rimadyl/Carprofen/Novox/Quellin

  • Metacam/Meloxicam

  • Deramaxx/Deracoxib

  • Etodolac/Etogesic

  • Aspirin

  • Zubrin/Tepoxalin

  • Previcox/Firocoxib

  • Onsior/Robenacoxib

    There can be drug interactions between steroids and other medications that change the metabolism of these drugs. Your medical team will advise you of any concerning interactions.

Monitoring and Lab Work for Pets on Steroids

Given the significant impact steroids can have on a pet's health, frequent check-ups are recommended. For pets on a stable long-term dose, blood work and urinalysis to monitor for side effects are advised every 3-4 months.

Important Side Effects of Steroid Treatment

It is essential to contact your veterinarian if you observe any of the following side effects in your pet:

  • Inappetence: Lack of appetite is unusual for pets on steroids, as they typically experience increased hunger. If your pet skips a meal, urgent veterinary consultation is advised.

  • Vomiting or Diarrhea: Immediate attention is needed, especially if there is black, tar-like material or blood present.

  • Skin Problems: Alert your veterinarian if you notice redness, crusting, itching, or sores on your pet's skin. Steroids can mask the severity of infections, which may require more aggressive treatment. Rarely, a serious skin condition called calcinosis cutis can develop.

  • Urinary Tract Infection Indicators: Bad odor or discoloration (brown, red) in the urine should prompt a veterinary check, as steroids can conceal most symptoms of a urinary tract infection. Regular urinalysis is performed for pets on long-term steroids.

  • Poor Healing: Inform your veterinarian if your pet requires surgery or a similar procedure while on this medication.

  • Diabetes Mellitus: Long-term use, especially in cats, can cause or worsen diabetes. Regular blood tests are conducted to monitor this.

  • Liver Changes: While mild to moderate liver swelling and bloodwork changes are common, serious liver disease can rarely occur from long-term or high-dose use. This condition typically reverses once steroids are discontinued. Regular blood work helps monitor liver health.

  • Heart Disease in Cats: Prolonged steroid use can lead to congestive heart failure in cats. The effects on dogs with pre-existing heart conditions are not fully understood, so caution is advised.

  • Behavior Changes: While usually mild, such as excitement or depression, severe changes like aggression or mania may occur. Contact your veterinarian if you have concerns.

Annoying (but not dangerous) Side effects

During the early stages of steroid treatment, we encourage you to tolerate these side effects as much as possible. These reactions generally lessen and eventually subside as the dosage of the medication is reduced over time. However, if any of these side effects become excessive and negatively impact your pet’s quality of life, please contact your veterinary team:

  • Increased appetite

  • Excessive thirst

  • Frequent urination

  • Panting or signs of agitation

  • Slowed hair growth with a thin, dull, or dry coat*

  • Weight gain*

  • A pot-bellied appearance*

    Muscle loss, particularly along the head and spine*

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