Prednisone, The Good And The Bad

by Anne Jones RN, BSNE

Outside of antibiotics, there may not be a more useful drug than prednisone, a corticosteroid product. It is used to treat a number of inflammatory conditions so it can be classified as an “anti-inflammatory” like the products we call NSAIDS. The difference is that those products are in the non-steroidal classification whereas prednisone is a steroid. If your dog is prescribed prednisone, you need to have an understanding of how it works and to maintain a close watch on him/her for any of the side effects.

Prednisone, also sometimes referred to as prednisolone, is in a class of drugs called glucocorticords and is a synthetic form of the hormone cortisol. These hormones influence metabolism of carbohydrates, proteins and fats in the blood stream and the liver and they have an anti-inflammatory effect but they also have other effects within the body, including influence on electrolyte balance.

Dogs on glucocorticoids will have increased hunger and thirst, will have increased urination and may show a loss of energy. A dog with a tendency toward diabetes may have a temporary diabetic reaction which can become permanent with prolonged use of prednisone. There may be a tendency to nausea and other signs of upset stomach with the use of “pred” in a dog with an existing sensitive stomach. Stomach bleeding could be a possibility in these sensitive dogs.

These are some of the side effects of steroid use but the drug has many valuable positive effects. It is important to weigh the value against the possible side effects to understand why they are used and when they can become a danger to the pet. This article will help you to have the knowledge needed to oversee your dog’s health while prednisone if being used and to also understand why monitoring is essential to wise use.

The most common usage in Bichons is to manage allergies and allergy is the largest health issue in the breed. With careful observation by the owner and with minimal effective dosage, prednisone can be a Bichon’s best friend. The owner should never rely solely on steroids to control the effects of allergy. Animals treated with prednisone are more prone to infection because the drug suppresses the body’s immune system. Smaller doses suppress immunity less than larger ones, though a larger dose may be needed to treat certain serious disorders discussed below.

Prednisone is used to treat a variety of ailments, including some tumors, blood disorders, orthopedic problems and the above mentioned inflammatory conditions associated with allergy and atopy. It is sometimes injected for faster action, followed by oral tablets. It works on the cellular level to promote healing and in times of stress to build tissue resistance to trauma. Through action in the liver, it has the ability to convert fats and proteins into glucose. In other words, while it is being used for specific anti-inflammatory action, it has additional effects throughout the body.

Anyone whose pet has been treated with prednisone will remember that the dosage is normally given over a 10 day period with the daily dosage stepped downward by half until the final dose on the 10th day. This drug cannot be administered at the higher level for an indefinite time unless it is the only course of treatment for serious disease. Any time the medication is being withdrawn, abrupt stoppage should be avoided and your veterinarian will address any expected effects of doing so. There is a possibility that a lower than normal dosage regimen can be used in the longer term under veterinary supervision and advice.

For the pet owner, a serious discussion with your dog’s vet is critical in understanding proper use of prednisone and its possible side effects. The list is long and one has to weigh the possible results against the possible side effects. In the past, it was the pet owner’s insistence on immediate relief of symptoms that made prednisone the drug of choice for anti-inflammatory action. Today’s pet owners are better educated and wiser about long term issues that can be detrimental. Other drugs and treatment options make it possible to alleviate symptoms in the mildly allergic dog without resorting to steroid treatment and should be tried for a period of weeks, even months, before giving up. These options would include a better understanding of day to day attention to environmental factors, improved diet that will build up immunity and often the simple matter of keeping the dog inside in an air conditioned environment during seasonal allergic reactions. When steroid treatment is absolutely needed, the sooner the drug regimen can be completed the better. While steroids may alleviate symptoms, they are not a cure.

For a better understanding of the immune system and how it works, read the companion article titled The Canine Immune System.

The list below is lengthy and will not be applicable to all dogs on prednisone. However it should serve to alert the owner whose dogs may have any of these side effects.

Side effects that may occur from glucocorticoid drugs:

  • Increased thirst
  • Frequent urination
  • Changes in appetite, usually increased and causing weight gain
  • Increased panting
  • Poor wound healing, thinning of skin
  • Changes in hair coat, with drying and thinning
  • Personality and behavioral changes
  • Lethargy
  • Vomiting
  • Diarrhea
  • Metabolic changes, which can include development of diabetes, Cushing’s syndrome and/or pancreatitis
  • Elevated liver enzymes
  • Muscle wasting
  • Electrolyte imbalance
  • Bone thinning

While some of the information about prednisone is available through drug company data information leaflets, a better resource for confirmation of information provided above is through a discussion with your own veterinarian who should be your advocate in the safe use of this drug to treat your pet. We do not suggest that the drug be avoided, only that it be used safely and wisely.

(This article has been reviewed by a veterinarian for accuracy.)

Also see The Canine Immune System article.