Prednisone for dogs can be lifesaving…but also potentially problematic. Integrative veterinarian Dr. Julie Buzby discusses the uses, pros, and cons of this commonly prescribed drug. Learn the benefits and shortcomings of prednisone for your pup.
Prednisone can be a very useful medication when used appropriately—I’ve even taken it myself for bronchitis! However, as a veterinarian, I’m always cautious prescribing it for my patients. Prednisone can work wonders for certain conditions, but it can also be pretty tough on a dog’s body. Side effects can also be dramatic and unpleasant.
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If your dog has been prescribed prednisone, or you plan to ask your vet about it, you may be wondering how this medication works, what it can treat, and whether the side effects are even worth it. Your vet is your best resource for specific questions related to your dog, but together we can take a look at some of the uses and limitations of prednisone in dogs.
What is prednisone for dogs?
Prednisone is classified as a synthetic corticosteroid (a glucocorticoid). Essentially, it is a manufactured version of a naturally occurring steroid hormone called cortisol.
Prednisone and prednisolone (the active form of the drug) are sometimes used interchangeably. Prednisone is converted into prednisolone in the liver. Your vet may prescribe prednisolone rather than prednisone (especially common in cats), but the effects of the two drugs are the same.
We will circle back to prednisone, but first, we need to talk a bit about cortisol. The adrenal glands (a pair of small glands that sit above the kidneys) make cortisol and release it into the body to perform its life-sustaining roles. Yes, you heard that right—life-sustaining. We need cortisol to survive, pure and simple. So it isn’t all bad.
Cortisol plays some important roles in the body:
- Regulates the immune system so that it doesn’t get out of control and cause more harm than good.
- Helps the body maintain a state of “fight or flight” during times of stress.
- Causes the body to break down glycogen to release stored glucose (fuel for the cells).
- Stimulates the body to break down fats and proteins to make glucose for energy.
How does prednisone work?
Because prednisone is designed to be a synthetic version of cortisol, its functions mimic the natural functions of cortisol itself.
Interestingly, the actions of prednisone in the body are dose-dependent. Lower doses of prednisone decrease inflammation, and high doses of prednisone suppress the immune system.
Since cortisol—and therefore prednisone—affects so many body systems, this medication can treat a wide range of conditions in canines.
What is prednisone used for in dogs?
Considering the functions of cortisol, you may be able to figure out some of the reasons a vet might prescribe prednisone for your dog.
1. Prednisone for dogs is used as an anti-inflammatory drug.
Any type of tissue in a dog’s body may become inflamed for one reason or another. Although we have different pharmaceutical options for treating inflammation, sometimes steroids are the most effective at resolving severe inflammation quickly.
Skin inflammation from allergies is one example of this. In veterinary practice, vets see allergic patients who are scratching themselves to the point of bleeding. Your vet may decide to prescribe a short course of steroids to break the itch cycle and deliver relief while waiting for other allergy medications for dogs to kick in.
Vets also use it to reduce inflammation in the central nervous system (i.e. brain and spinal cord). If a dog suffers head trauma and the brain is swelling, prednisone may quickly bring down swelling and inflammation before permanent brain damage occurs.
Prednisone is also commonly used to treat intervertebral disc disease (IVDD) in dogs, but non-steroidal anti-inflammatory drugs (NSAIDs) may be more appropriate in some cases. Though it’s unlikely to cure a severe case of IVDD-induced paralysis, for an IVDD dog with a weak hind end, prednisone can help them recover without surgery.
2. Prednisone is used for dogs with cancer.
In vet school, vet students were somewhat jokingly told, “No animal should die without the benefit of steroids.” Our professors didn’t mean that we should take the use of steroids lightly. Rather they were reminding their students that steroids such as prednisone sometimes improve the quality of life—or even save the life—of patients. Prednisone truly can act as “the magic bullet.”
Cancer is one of those situations. While inferior to other chemotherapy protocols, treatment with prednisone alone induces a short-term partial or complete remission in 50% of dogs with lymphoma. The same is true for approximately 20% of dogs with mast cell tumors. Prednisone has anti-cancer properties because it can stop some cancer cells from growing and dividing.
Additionally, prednisone can sometimes be used in palliative (comfort) care for dogs with cancer, in part because it can reduce inflammation and swelling around tumors. In dogs with brain tumors, this may give them several months of improved clinical signs. It can also help dogs with nasal tumors breathe easier and reduce coughing in dogs with tumors that have spread to the lungs. Additionally, prednisone may boost the appetite and energy of dogs with cancer.
Disclaimer: When prednisone is administered to dogs with suspected cancer, it can make it more difficult to definitively diagnose the cancer. Also, prednisone can make other chemotherapy protocols less effective. For these reasons (and others we will discuss in a bit), please thoroughly discuss the implications of using prednisone as a cancer treatment with your vet. Consider all treatment options before starting prednisone treatment.
To learn more about cancer in dogs, listen to my podcast: The Myths and Misconceptions of Cancer in Dogs with Dr. Sue, Cancer Vet.
3. Prednisone is used as an immunosuppressive drug for dogs.
Vets also use prednisone to manage autoimmune diseases—those where the immune system is attacking a dog’s red blood cells, platelets, joints, skin, or other tissues. These are very serious diseases. When you need to calm down or suppress the immune system, steroids have a powerful ability to save the day.
One of my patients, a 9-year-old Wheaten Terrier, is currently on a course of prednisone for immune-mediated polyarthritis—painful inflammation in multiple joints. His symptoms dramatically improved within a day or two of taking the medication, but we’re now in the process of transitioning him to another drug for long-term management.
Prednisone can also suppress the immune system to treat dogs with inflammatory bowel disease. IBD in dogs can cause severe GI distress, and immunosuppressive doses of prednisone (and other immunosuppressive medications) can alleviate symptoms. That said, IBD is a specific diagnosis, and prednisone is not an appropriate treatment for all causes of diarrhea in dogs.
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Just like it can help reduce inflammation caused by certain allergies, prednisone can be very helpful in “calming down” the immune system of dogs having allergic reactions. Allergic reactions are, after all, an inappropriately heightened immune response to some sort of stimulus—like a bee sting. Immunosuppressive doses of prednisone, often in conjunction with antihistamines (such as Benadryl for dogs), can help dogs having allergic reactions recover quickly.
4. Prednisone is used for dogs with Addison’s disease.
Addison’s disease in dogs is caused by reduced cortisol production by the adrenal glands. Since we know cortisol is essential in managing many bodily functions, dogs with Addison’s disease can be very sick. They may show vague symptoms like lethargy in dogs, vomiting, diarrhea, weight loss, or intermittent shaking.
Alternatively, some dogs suffer an acute Addisonian crisis. They may vomit, have diarrhea, and sometimes collapse. Thus, dogs with Addison’s disease usually take a low dose of prednisone every day for the rest of their lives. It mimics what the body should be doing for itself but can’t. This is lifesaving for them.
With all these potential benefits, prednisone sounds like a cure-all drug, doesn’t it? So you might be wondering why this medication sometimes gets a bad rap. Well, it turns out prednisone has some really significant side effects—both in the short term and the long term.
What are the side effects of prednisone for dogs?
Prednisone can be an amazing, life-saving drug. Even with that knowledge, I tend to be very conservative with it, and am cautious with prescribing it to my canine patients. This is because side effects of prednisone can be severe and sometimes irreversible.
Short-term side effects of prednisone for dogs
People who take prednisone sometimes report feeling weird, so it is understandable that they might worry the same will happen to their dear dogs. While behavior changes in dogs are possible, they are rare. I don’t often hear anecdotal reports from my clients of their dog acting weird on prednisone.
Undeniably, prednisone does come with a litany of other side effects. The most common side effects of prednisone for dogs include:
Increased thirst
Excessive thirst very commonly occurs with prednisone administration and generally stops when the medication is discontinued. This side effect may be dramatic, but restricting water for dogs on prednisone is not generally recommended.
Panting
Dogs taking prednisone often sound as if they’ve just come in from running a 5K in the South Carolina summer heat when they’re at rest. Though this can sound frightening, it also resolves once the medications are done.
Increased appetite
This side effect, an increased appetite, can actually sometimes work to our advantage. Dogs on prednisone for cancer treatment, IBD, or other conditions that affect their appetite often eat better on the medication. However, sometimes ravenous dogs will get into the trash or “counter surf” while on prednisone. This appetite increase can lead to weight gain if unchecked.
Energy changes
Again a side effect that can work to our advantage sometimes. Dogs that don’t feel well often perk up a bit on prednisone. Other dogs may become restless, though.
Increased urination
What goes in must come out. Dogs with increased water intake will have increased urine output. Some otherwise house-trained dogs may have pee accidents in the house because of this.
Vomiting
Dogs on higher doses of prednisone sometimes experience vomiting.
Diarrhea or dark stool
GI upset caused by prednisone can manifest as a dog vomiting, having diarrhea, or both. Dark, tarry stool may be more of a concern, though, as this may be a sign of a GI ulcer.
Long-term side effects of prednisone in dogs
We can all agree that prednisone is a very useful, sometimes life-saving medication. I have certainly used it for many of my patients and have seen tremendous improvement. I am very cautious, though, and try to avoid using prednisone as a long-term treatment whenever possible (the exception being Addisonian dogs).
Prolonged use of prednisone increases the risk of many side effects, especially GI upset. Also, combining exogenous (medication) steroids with endogenous (cortisol produced by the adrenal glands) steroids for a long time may be detrimental to your dog’s health.
Iatrogenic Cushing’s disease
Essentially, by giving prednisone long-term, we can cause a form of Cushing’s disease in dogs, called iatrogenic Cushing’s disease. The term iatrogenic means we caused it ourselves, in this case, by giving too much prednisone. In contrast, when Cushing’s disease occurs naturally, it is because the adrenal glands are producing high levels of cortisol on their own.
Dogs with iatrogenic or naturally occurring Cushing’s Disease tend to have thin skin and a thin coat with areas of hair loss. They may have a potbellied appearance. Additionally, many of the short-term side effects in the list above also apply to dogs with Cushing’s disease.
Other possible side effects of prednisone for dogs
The immunosuppressive andanti-inflammatory effects of prednisone, while helpful in managing some conditions, can also be problematic.
Suppressing a dog’s immune system may leave them susceptible to other maladies, such as:
- Urinary tract infection in dogs—up to 30% of dogs on long-term prednisone have occult (undetected) UTIs
- Decreased wound healing
- Fungal infections
- Viral infections
- Demodectic mange
Long-term use of prednisone in dogs can also affect certain metabolic or endocrine systems. Signs can include:
- Abnormal thyroid function
- Elevated liver enzymes
- Increased kidney enzymes—Prednisone should be used with extreme caution in dogs with kidney disease
- Muscle wasting
- High blood pressure
- Increased blood sugar—Because cortisol (and therefore prednisone) increases glucose production, prednisone can push pre-diabetic dogs into full-blown diabetes
How long can a dog stay on prednisone?
As we have established, long-term use of prednisone carries some pretty weighty risks. Most of the side effects stop when we stop the medication. And although I’ve seen sensationalized social media posts claiming “prednisone killed my dog,” I always keep in mind that those dogs had underlying diseases that prompted their vets to prescribe prednisone in the first place, and prednisone use itself is very rarely fatal.
When I make the call to put a dog on prednisone, my goal is to minimize side effects and to get him or her off of it again ASAP. However, sometimes long-term use can’t be avoided. Without it, the dog would die.
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Treatment courses certainly vary in length, and there is no magical time limit for keeping dogs on prednisone. Generally, anti-inflammatory treatment carries a shorter course than immunosuppressive treatment. Some dogs are on prednisone for weeks, months, or longer to treat autoimmune conditions, heartworm disease in dogs, or other chronic illnesses.
Even when treating chronic conditions, my goal is usually to decrease to the lowest effective prednisone dose or switch off prednisone after we get through acute crises.
Is it okay to use prednisone with other medications?
Any time a vet starts a new medication, they consider how it may interact with other medications the dog is already on, or that the vet may be starting at the same time. Some drug interactions can be very dangerous.
Can prednisone and nonsteroidal anti-inflammatory drugs (NSAIDs) be given together?
If a dog is already taking an NSAID, say for arthritis pain, steroids are a big, emphatic “NO!” Using those two drugs together carries a high likelihood of GI (gastrointestinal) ulceration and GI bleeding. Bloody vomit or dark, tarry diarrhea (also called melena) are urgent concerns for dogs on prednisone, since those may be symptoms of a GI ulcer.
If a dog on prednisone needs additional pain management, medications like gabapentin for dogs can be safely used with steroids in lieu of NSAIDs.
What is the prednisone dosage for dogs?
The dosing range for prednisone is fairly wide, and very dependent on the condition that is being treated. I’ve had some clients (and non-clients) ask me if it’s safe to give their “people-prednisone” to their dog. Although the actual medication is the same formulation, the dose for people is not the same as for dogs.
The side effects of prednisone can be serious and can be magnified by an inappropriate dose. This is one drug that I never advise people to dose at home, and always to get a prescription from their vet. Potentially saving a bit of money or time is just not worth the risk to your dear dog.
Is it true that you have to taper the prednisone dosage rather than stopping your dog cold turkey?
Sometimes a vet may give a very short course of prednisone—maybe three to five days—in which case we don’t typically need to taper. Otherwise, and more commonly, the prednisone dose starts out high, drops to a mid-range dose, and then finally to a low dose, before stopping completely.
The reason for this lies with the adrenal glands. Since prednisone supplies an outside source of cortisol, the adrenal glands produce less of the natural form. If this goes on long enough, the adrenal glands will actually atrophy, or shrink. We don’t want this to happen.
By tapering the prednisone, the blood levels will begin to fall gradually. This “wakes up” the adrenal glands and signals them to make more cortisol. That is really critical. Otherwise, you can induce an Addisonian crisis where the body’s cortisol levels become dangerously low.
How are dogs on prednisone monitored?
Anytime I have a dog on medication for a length of time, I want to keep a close eye on his or her bloodwork. For dogs on prednisone, this often means bloodwork to evaluate the kidneys, liver, and blood sugar.
I also want to track the status of whatever condition I am treating with prednisone through recheck exams. This lets me taper as quickly as possible to that lowest effective dose. This minimizes side effects and keeps the adrenal glands functional, active, and happy.
Helpful tips for dogs on prednisone
If your dog has been prescribed prednisone, you may be wondering how you can make things easier for your canine companion and for you. My best advice is to be aware of the side effects, and remember they are generally not permanent.
Keep in mind that dogs on prednisone will have increased thirst and urination. Your pup will likely need to go out more frequently for potty breaks, and may even have some accidents in the house. Although you may be tempted to try to minimize this side effect, never, ever restrict water intake.
Prednisone also increases a dog’s appetite, but that doesn’t mean you should give in to those begging eyes. The four weight management tips I share in my article, How to Help a Dog Lose Weight, may help prevent your dog from packing on the prednisone pounds.
Dogs on prednisone may be restless (or even just seem restless with all the panting). Try to minimize outside stressors by keeping their routine the same, making sure they have a comfortable place to rest, and getting plenty of TLC!
What should I discuss with my vet if my dog is going to take prednisone?
As you can see by now, the decision to use prednisone for dogs should never be made lightly, but sometimes it is necessary and even lifesaving. The best advice I can give you is to have an open and honest conversation with your vet if you have concerns.
- Listen carefully to the explanation of why prednisone is being used and ask any questions that arise.
- Find out how long your vet expects your dog to be on prednisone and discuss the plan for tapering.
- Review the side effects and what to monitor.
Watch your pet for any serious or unexpected side effects and report them to your veterinarian immediately. Also, keep him or her apprised of how your dog’s condition is responding to the prednisone so dosage adjustments can be made if needed.
Parting thoughts on prednisone for dogs
As veterinarians, we love helping our patients. We also love helping our clients understand why we’re doing what we’re doing and how they can best help their pets.
Prednisone for dogs can have some really significant side effects. But sometimes it is necessary and even miraculous. When used judiciously, it can really improve the quality of life in dogs with lots of different conditions.
Work with your veterinarian
As with any medication (but maybe especially with prednisone), talk to your vet about its use, dosage, side effects, and course of treatment. You should have clear and open communication with your veterinarian before, during, and after your dog’s treatment with prednisone.
If you have questions about prednisone for your dog, please discuss them with your vet!
If your dog has taken prednisone, what advice would you give to others?
Please comment below. We can all benefit from the experiences of others.
Editor’s note: This post was originally published April 26, 2021. It has been updated to include more information on prednisone for dogs.
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