How to Treat Prednisone Side Effects in Dogs on Steroid Therapy

Learn how to manage/treat the side effects of prednisone in dogs, like skin problems, vomiting, muscle wasting, excessive thirst, urination and infection.

LEARN HOW TO TREAT SOME SIDE EFFECTS OF A DOG

Prednisone is a glucocorticoid that's used to treat inflammation, skin conditions, gastrointestinal problems, asthma and autoimmune disorders like lupus. Prednisone may be prescribed on a short term basis, or it may be prescribed on a long term basis.
There are many significant side effects associated with steroid therapy and some can be a bit difficult to manage. In fact, prednisone is one drug that can actually change the pet's body over time. It can permanently affect the dog's adrenal glands after just one week, resulting in Cushing's Disease (associated with overactive adrenal glands) or Addison's Disease (associated with adrenal insufficiency.) This can lead to a dependence upon the drug and it's one reason why the dog's prednisone dosage must be tapered gradually at the end of the treatment period.

Adjusting the Dog's Dose to Reduce Prednisone Side Effects
Many prednisone side effects can be lessened or eliminated by lowering the dog's dose, so consult the dog's veterinarian to determine if a dose adjustment is a viable option for your pet. The prednisone dosage is calculated based on weight and the nature of the condition that's being treated. When it's prescribed for its anti-inflammatory properties, the dosage is 0.1 mg to 0.3 mg per pound of body weight, given twice a day. When prednisone is used as an immunosuppressant, the dosage is 1 mg to 3 mg per pound of body weight, up to three times per day.
The pet should be on the lowest possible dose with a therapeutic effect. Every dog's body is slightly different, so an effective dose for one 50-pound dog may be excessive or insufficient for another 50-pound dog.
Managing Excessive Drinking and Urination as a Side Effect of Prednisone
Most dogs on prednisone experience excessive thirst, called polydipsia, and excessive urination, known as polyuria. These particular side effects cannot be counteracted or eliminated; they must be managed as follows:

• Ensure your dog has constant access to water;
• Arrange for more frequent walks or provide a doggy door so the pet can access the bathroom area when needed; and
• Provide puppy pads if your dog is left home alone for long periods of time and cannot access the bathroom area.

Aside from being inconvenient, the dog's excessive thirst and frequent urination are not harmful. In fact, the increased urination will help to flush toxins from the dog's kidneys. Many dogs on steroid therapy long term will experience slight bloating or "water weight," as the tissues in the dog's body retain a bit more water than what's normal.
Increased Appetite, Weight Gain and Muscle Wasting in Dogs on Steroids
Many dogs on prednisone will gain weight because the drug can increase appetite. An easy solution to this problem involves adding water to the pet's kibble. Add hot water to the pet's food -- the kibble should be completely covered with hot water. Allow it to sit for approximately 10 minutes. The kibble will swell and absorb the water. The dog will feel fuller, without extra calories, and the water will serve to satiate the pet's thirst.
In addition, feed smaller, more frequent meals. Pet owners can also increase the amount of exercise that the dog performs on a daily basis. This will burn calories and it will also help to combat another prednisone side effect: muscle wasting.
Muscle wasting is most commonly seen in dogs on prednisone long term, particularly in cases where the pet is on a high dosage. This effect cannot be avoided, but it can be managed by keeping the pet active with daily exercise and activity, which will maintain muscle tone. Also, feed a high-protein diet. Supplement the pet's food with items like:

• cooked beef;
• cooked chicken;
• cooked turkey;
• tuna fish; and
• other high-protein foods like peanut butter, served in an appealing form like homemade peanut butter treats.

Managing a Dog's Upset Stomach Due to Prednisone
Some dogs on steroid therapy will experience gastrointestinal upset, including vomiting, ulcers and diarrhea. One of the most effective ways to treat this particular side effect is to give the medication with food. The food dilutes the concentration of the drug in the dog's stomach, making it less likely to cause upset.
In addition, some dogs may do well with an anti-vomiting medication, given in conjunction with the prednisone. If you give the medication with food and the dog's vomiting and upset stomach persists, consult your veterinarian, as he/she can recommend an over-the-counter medication like Pepto Bismol or Pepcid or the vet may opt to prescribe a medication to treat the gastrointestinal upset. Always consult your vet before giving over-the-counter medications to a dog, as they may upset a pre-existing health issue or the OTC medications may interact with one of the dog's prescribed medications.
Fur Loss, Skin Problems and Staph Infections in Dogs on Prednisone
Poor coat -- including fur loss and thinning fur -- along with skin problems and infections are all common side effects of prednisone. This cluster of side effects cannot be avoided, but they can be managed.
Provide the dog with a daily multi-vitamin, a Vitamin E supplement and a liquid skin and coat supplement to improve the condition of the pet's fur and skin. Also, soak a piece of bread in olive oil or add a couple tablespoons to the pet's meal to combat dry skin and add sheen. Practice good grooming methods to keep the pet's coat and skin in the best possible condition.
Staph infections occur as a result of the immunosuppressant properties of the drug. Staph bacteria is normally present on the skin, but minor scratches can become infected in a dog with a suppressed immune system. What's more, thinning skin is a long term side effect of prednisone and this can make the skin more prone to injury. In some cases, the infections occur in the form of pus-filled blisters that arise suddenly and without any apparent cause. This creates a moth-eaten appearance to the dog's coat, as the fur overlying the wound falls off when the pustule breaks open. (See photo below.)
In addition, flea infestations are a major cause of staph infections in dogs on steroid therapy because the skin parasites are constantly breaking the skin. Therefore, it's important to prevent and immediately treat a dog's fleas while on prednisone. The only effective treatment for chronic skin infections is oral antibiotics, which may need to be administered for two to three months or longer.
A small number of dogs on prednisone may suffer from an itchy skin problem known as calcinitis cutis. (See photo below.) Small calcium deposits form beneath the skin's surface, resulting in intense itching and hard white lumps (calcifications.) Small deposits may be reabsorbed, while larger deposits will be gradually pushed out through the skin over the course of several weeks, resulting in chronic wounds that are prone to staph infection and opportunistic bacterial infection. The condition can be treated with daily cleansings, anti-itch medications and oral antibiotics.
Steroid therapy can also lead to diabetes, Cushing's disease and eye problems like glaucoma and cataracts. These side effects are most common in dogs on prednisone long term. If unusual symptoms are observed, contact your veterinarian to arrange for an examination.
To learn more, read "Prednisone Side Effects in Dogs on Steroid Therapy."
To learn more about staph infections in dogs, read "Dog Staph Infection Remedies and Topical Treatments for Skin Infections,"
Dog owners may also wish to read "Dog Skin Problems -- Antibiotic Treatment for Staph Infections in Dogs."