It’s that time of year when itchiness is on the rise. This misery means dogs chew themselves raw because of irritating summer allergies.
Increasingly, I find clients don’t want steroids prescribed for their pets; they’ve heard about the side effects and know alternative drugs are available. This is true — on both counts — but steroids still have an important place in the management of many medical conditions, including allergies.
Let’s consider why steroids get bad press, how they are life-changing (in good and bad ways) and how to use them safely. Oh, and anyone concerned about steroids should read this excellent article by Dr. Debora Lichtenberg, VMD, who wrote about when her own dog was prescribed steroids.
Why Steroids Have a Bad Rap
Any drug, even the humble aspirin, has potential side effects. For steroids, these can be immediately obvious in the short term, with the added thumb’s down of causing long-term problems.
Let’s look at those downsides:
- Increased thirst: The patient drinks more, their bladder fills more often and so they need to pee more often.
- Urinary accidents: When the dog’s home alone and can’t get out to go to the bathroom.
- Increased appetite: This is a trick of the dog’s mind rather than an actual need for more food. The dog “thinks” they’re hungry (which is why they can become food obsessed), but they don’t actually need more calories. This leads to weight gain.
- Risk of infection: Because steroids down-regulate the immune system, there’s a greater risk of catching infections.
- Inducing disease: Sadly, high doses or long-term use can induce other health problems, such as diabetes or Cushing’s disease.
However, think of steroid use like this: When your neighbors play rap music too loud, you learn to hate the sound of Eminem booming through your walls. The same goes for steroids. When they’re overused or used incorrectly, the knock-on effects are unpleasant.
But that doesn’t mean Eminem should be banned, period. No — more responsible usage is what’s required.
Why Steroids Help With Several Diseases
Steroids reduce inflammation (for skin allergies, read “itchiness”). They also calm the immune system. Now the latter may sound like a bad thing if it means switching off defenses against infection; however, in autoimmune diseases, the immune system becomes the body’s own worst enemy.
Conditions such as inflammatory bowel disease, pemphigus, sterile meningitis, rheumatoid arthritis and AIHA (autoimmune hemolytic anemia) are all the result of a faulty immune system that attacks its own tissue. Using steroids to switch off this reaction is potentially life-saving.
And in case you feel skeptical, let’s consider a world without steroids, which exists in a condition called Addison’s disease. The body needs to produce steroid — it helps the body cope at times of stress. Without steroid (such as occurs with Addisonsian pets), even a slight change in daily routine can lead to muscle tremors and weakness, diarrhea and even collapse, coma and death.
Sensible Use of Steroids
The important thing is to use drugs sensibly. Going back to those itchy dogs, yes, other drugs are available, but Apoquel or Atopica are very expensive.
So rather than have a dog who scratches themselves red raw, the sensible use of steroids is a good alternative. The secrets to doing this are:
- Start early: Giving a low dose in anticipation of the itch stops the inflammatory cycle, which ultimately means lower doses for shorter times.
- Lowest effective dose: Chat with your vet about how to regulate the dose at home so your pet receives the lowest effective dose.
- Alternate day therapy: It’s better to give 2 x 5mg tablets every other day than 1 x 5mg daily. This has the same anti-inflammatory effect but gives the body a “steroid holiday” on the off-day. (Again, discuss this with your vet, as some conditions require a daily dose.)
- Give with food: This reduces the risk of stomach ulcer formation.
- Don’t combine meds: Always speak to your vet before giving another medication in addition to steroids.
Watch these itchy dogs find some short-term relief:
Should We Ban Steroids?
No. There is a middle path. We must never go back to the days of prescribing steroids as a first-line treatment without an adequate diagnosis.
But once we have a diagnosis, and that itchy dog has been treated for parasites and had their yeast infection cleared, then sensible use of steroids can stop life from being miserable.
So don’t run shy of steroids — just be sure to use them in an appropriate and responsible way.
This pet health content was written by a veterinarian, Dr. Pippa Elliott, BVMS, MRCVS. It was last reviewed June 2, 2017.