Steroids for Dogs: Pros & Cons

linda2147

Well-known member
Joined
Mar 13, 2014
Location
New Hampshire
There are a few health conditions for which the long-term use of a steroid may be indicated, such as certain autoimmune conditions and Addison’s disease. When used long-term, the dosage should be maintained at the lowest effective level.

Steroids are perhaps one of the most ubiquitous medications in the veterinary world. They can be used for a host of problems ranging from inflammation and allergies to autoimmune disease. While they are incredibly useful and diverse medications, steroids are not without significant side effects. It is important to know why they are used and how they can best be used. It is also critical to realize the possible negative effects and interactions that can occur. Steroids are not benign.

Corticosteroids, as they are more correctly called, includes a varied group of medications. Some of the most commonly used in veterinary medicine are prednisone, Temaril-P, Neopredef (topical), dexamethasone, dexamethasone sodium phosphate (“Dex-SP”), methylprednisolone (Depo Medrol), and triamcinolone (Vetalog).

They come in many preparations including oral, injectable, ophthalmic (for use in the eye), otic (ear), and topical sprays and powders.

Steroids exert their activity in the body in many different ways. They affect every system, which is why it is important to make sure your veterinarian is aware of any medications that you give your dog, including over-the-counter supplements or pain relievers.

Uses for Steroids on Dogs
Anti-Itch
One of the most general uses of steroids is in fighting “the itch” (pruritus) caused by allergies. Allergies are common in dogs, especially breeds like Boxers, Labradors, Maltese, West Highland White Terriers, Bulldogs, and pit bulls. These allergies can be food- and flea-related, or caused by seasonal allergens – a condition called atopy.

The mechanism by which steroids control itching is complicated, but it includes decreasing the number of allergen-fighting cells (mast cells) in circulation and suppressing release of histamine. Histamine is one of the substances that leads to the formation of itchy hives and wheals.

For allergies, only short-term doses of steroids are recommended. Itching should be controlled while the inciting cause is identified and secondary infections treated, and then the steroids should be tapered off slowly. Newer drugs such as Apoquel (oral) and Cytopoint (injection) are slowly supplanting the regular use of steroids for itching.

The most commonly used oral steroids for allergies are prednisone and Temaril-P. Some veterinarians use longer-acting injections such as Vetalog, as well. Long-acting steroid injections can cause more pronounced side effects than their oral counterparts. Their use is becoming less common as other methods of itch control and more allergy management options become available.

Topical steroids for both the skin and ears have extensive uses and may prove to be a better option than oral medications, as they cause fewer side effects. Topical use can decrease inflammation and itching. This is important within the ear canal, as less inflammation allows ear medications to penetrate deeper. It also damps down itching, so dogs are not continuously self-traumatizing.

Anti-Inflammatory
In conditions such as inflammatory bowel disease (IBD), steroid-responsive meningitis, and intervertebral disc disease, inflammatory cells dominate, causing redness, swelling, and pain. Steroids decrease inflammation by lowering white blood cell release from the bone marrow, among several other pathways. This effect is helpful for addressing IBD and steroid-responsive meningitis. Doctors find steroids useful for treating intervertebral disc disease in humans, and anecdotally, some veterinarians report success with steroids for the same condition in their canine patients, but the scientific literature isn’t really clear either way.

The anti-inflammatory dose of steroids is generally fairly low, but side effects are still noted. Prednisone is used most often for this problem.

Immunosuppression
Autoimmune (AI) disease, a general term describing a variety of ways that the body attacks itself, is common in dogs. The triggers for AI disease are poorly understood. Some antibiotics like cephalosporins have been implicated, as well as vaccines. Cancer also can induce autoimmune processes. In most cases, an underlying cause is never identified.

The list of autoimmune diseases are too numerous for this article, but they can affect all of the organ systems in the body, including the skin, brain, blood cells, joints, and other internal organs. Some of the more commonly seen disorders in veterinary medicine are immune-mediated hemolytic anemia (IMHA), immune-mediated thrombocytopenia (ITP), brain and spinal cord diseases such as meningitis, and skin diseases like pemphigus foliaceous and lupoid onychodystrophy.

ITP is an example of a well-known and frequently seen autoimmune disease, in which the body turns its defenses on its own platelets. Platelets are important in the first step of clotting. As the body attacks and destroys them, the platelet numbers drop rapidly. Bruises become visible on the skin and gums.
Steroids treat this and other immune diseases by suppressing the body’s immune system, its natural defense against infection and illness. In these cases, steroids are started at very high levels (as much as 2 to 4 mg/kg body per day).

As the symptoms improve, the steroids are slowly tapered to the lowest dose possible. This is to keep the autoimmune disease in check while avoiding the worst side effects of steroids. Most dogs with an autoimmune disease will remain on steroids or other immunosuppressive medication for life.

Steroid Insufficiency
Another common condition in dogs is Addison’s disease. The body of a dog with Addison’s does not produce enough steroids and/or mineralocorticoids (responsible for water and electrolyte balance within the body).

Cortisol and mineralocorticoids are essential for life, and when a dog’s body is not producing them, serious illness results. The general symptoms of Addison’s are waxing and waning GI signs: weight loss, vomiting, diarrhea, and picky appetite. Addison’s is often called the “great pretender” because it can look like many other diseases and can be difficult to diagnose.

In these cases, steroids are indicated to replace those that the body is not making, as well as supplementation with a medication called Percorten or Florinef to replace the other corticoids. A few rare dogs with Addison’s can be maintained on Percorten alone; however, in times of stress or illness, they would require prednisone as well.

Some dogs are affected by atypical Addison’s disease, in which only the cortisol levels are low. These patients can be even more difficult to diagnose, as the characteristic electrolyte changes on bloodwork are absent. Once diagnosed, these dogs must remain on a steroid for the rest of their lives. In this case, the steroids are usually administered on a twice daily to daily basis. The most commonly used steroid for this is prednisone, an inexpensive tablet

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CatMom1994

Loving cats forever
Joined
Jul 23, 2017
Location
Florida
For allergies, only short-term doses of steroids are recommended. Itching should be controlled while the inciting cause is identified and secondary infections treated, and then the steroids should be tapered off slowly. Newer drugs such as Apoquel (oral) and Cytopoint (injection) are slowly supplanting the regular use of steroids for itching.
This reads like Apoquel and Cytopoint are both safer than steroids for long-term use. Is the WDJ actually recommending the worst allergy drug ever invented for dogs?
 


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