While not all are simple to fix, after reading this you should have a good idea of what to do. I’ll rank them in rough order of frequency.

Before the list though, you need to do something unpleasant: make a close inspection of your dog’s body using both your eyes and nose. Pay particular attention to the crevices like armpits, groin, feet, ears, mouth and lips. We’ll use this information in a minute.

Skin Disease

The skin of dogs with chronic dermatitis almost always has a bad smell. You might describe it as ranging from an extreme ‘doggy’ smell to old socks. This is probably due to an overgrowth of secondary yeast and bacteria taking advantage of the skin’s weakness.

Affected skin often looks thickened or wrinkly, and may have a greasy or flaky surface. It can also become red or even black in colour.

Uncomplicated dermatitis on its own does not smell, and so an odour is a sign that the condition has progressed. The solution is never as simple as using antifungal or antibacterial shampoos. You will need to address the underlying skin problem, which you can read about here.

Ear Infections

Infections inside the ear canal are a specialised form of skin disease complicated by severe yeast or bacterial overgrowth. They nearly always smell strongly, and if you put your nose right up to the canal it there’s no mistaking the origin. Sometimes the infection is so deep that the ear canal looks normal on the outside.

Never, never just put cleaner into a smelly ear without your vet checking it first. As it’s probably infected by now, cleaning alone won’t work and it will sting harshly. Once you do this, your dog won’t trust you and treating the problem properly gets a lot harder.

Ear cleaners are great for prevention, but first read about the treatment of ear infections here.

Oral Disease

If you have identified the smell as coming from inside the mouth, there are still quite a few causes. The first is advanced periodontal disease, which is inflammation and infection of the junction between the teeth and gums. This is the most common cause of bad breath and tooth loss.

Once dental disease develops, you will need it treated under anaesthetic, but it can also be effectively prevented afterwards.

Any infection or ulceration in the mouth will also smell bad, so other causes I have seen include oral tumours, foreign material caught in the teeth or mouth ulcers from kidney disease. A smell from the mouth has never in my experience been caused by any area lower down like the stomach.

The smell from bad breath is often described as ‘fishy’ or ‘metallic’, leading to confusion with the next cause. The clue is to look at the location.

Anal Glands

Anal glands are special scent glands found just inside the anus. When a dog defaecates, they release an odour onto the poop which other dogs can detect. Anal glands malfunction when they release this scent at any other time.

The classic anal gland leakage situation is your dog sleeping on your lap and suddenly you smell a horrible rotten fishy odour. You might find a drop of brown fluid. Many of these anal glands are too full and not emptying by themselves.

If so, all you need to do is get your vet or groomer to express them every 3 months and the problem goes away. However others leak when they aren’t full, and these are much harder to fix. Some have infection inside, others just seem leaky. Read about their treatment here.

Skin Folds

Fold pyoderma is a localised infection in folded skin. It’s notorious in short-faced breeds like Bulldogs, but this is easy to see because the hair is short.

The more insidious form is found in dogs like Cocker spaniels and Golden retrievers. The lower lip often droops as they age and a fold forms which traps saliva in the hair. These can get very badly infected and smell like rotten meat.

The trick to finding them is to not just look inside the mouth, but also stretch out the skin on the upper and lower lips. Treatment involves antibiotic tablets or creams, then prevention with antibacterial wash and barrier ointments. Severe cases require a small facelift!

Flatulence

Passing smelly gas from the bowel is a common noxious odour, but at least no-one has trouble identifying it. The solution is almost always to find a food that agrees better with your dog’s digestion. Or put up with it, as the dog is usually untroubled!

Urinary Incontinence

Around 2.5-5% of dogs will develop urinary incontinence. In some females it can start very early, and may be more common after desexing. It is also common with urinary tract infections.

The stale ammonia smell is usually quite distinctive, but I see many dogs whose owners have got used to the scent until I point it out. These dogs can almost always be cured by either fixing an infection, removing a bladder stone or medications to prevent leakage.

Faecal Soiling

Having poop stuck in the hair might seem like an excessively obvious cause of bad smells. However, I see it regularly, especially with new owners of Poodles and Poodle crosses. The hair can quickly get thick and long around the anus to hide the buildup of soft faeces.

If this isn’t addressed urgently with a gentle bath and dry, you often end up at an overnight emergency vet. The faeces end up blocking the anus, and the resulting rash can be terrible.

Prevention is of course all about having a good relationship with a trusted dog groomer, and starting as early as possible. It’s also about avoiding soft faeces by the use of high quality diets.

Normal Doggy Smells

The last cause is the hardest and saddest. Never assume this is what is causing your dog’s bad smell unless you have consulted a vet first: it’s very rare.

Every now and again I see a dog owner who is disgusted by their dog’s terrible odour. Except that I can’t smell it at all, and neither can anyone else in the clinic.

These dogs smell normal. Nearly all of us with dogs have tuned out the natural odour of dogs and can no longer detect it. However, for an unlucky few it remains thick and intense.

I have no solutions for these people, as a bad smell can’t just be hidden under cologne or other scents. Putting a dog outside is definitely not the answer.

But let’s not be negative. Eight of the nine causes of bad smells on dogs are fixable, and the ninth isn’t a problem to the dog. Good luck working it out!

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here. The information provided here is not intended to be used as a substitute for going to the vet. If your pet is unwell, please seek veterinary attention.

In my vet practice we support raw feeding, but that doesn’t mean we don’t also have a watchful eye. I’ll cover the risks first. By knowing them and their solutions, you can do it more safely.

Afterwards, I’ll feature some of the first evidence to show a benefit for raw puppy foods.

Risk 1: Imbalance

Vets are a little obsessed with puppies getting a balanced diet, and if you know our history you’ll understand why. In the days before commercially balanced foods, many people got it horribly wrong. Prior to the parvo age, one of the leading causes of puppy death was an unbalanced diet.

We still see it from time to time (a milder case is featured here ). It happens when muscle and organ meats are fed out of proportion to a puppy’s calcium requirement. It’s sufficiently difficult to get right that you can’t just add back calcium powder either.

The solution can only be one of three things:

1. Using commercially balanced diets for at least 75% of the total energy requirement
2. Getting a veterinary nutritionist to formulate a diet for you (that’s an actual vet*)
3. Buying a commercially balanced raw food for puppies, if you can find it

Which brings us to risk #2.

Risk 2: Contamination

This is a sensitive topic right now but at least it’s obviously real. Pet meat is poorly regulated, and therefore you can expect all of these to be found in it at some stage:

• the wrong species (e.g. horse instead of cow)
• chemical residues illegal in human meats
• salmonella, campylobacter and other harmful bacteria

Salmonella in dog food isn’t just dangerous to puppies. It has also been shown to easily spread within in families and infect children¹.

I’m afraid that until the whole pet industry is better regulated, we need to be wary even of the pre-formulated, balanced raw meat diets here. If you do want to use one, personally I would choose the larger companies likely to have better quality control..

The solution has to be paying extra for meat processed entirely within the human supply chain. There will still be risks with any raw meat, but if you stick to beef or lamb, contamination rates are very low.

Risk 3: Fussiness

A fussy dog sounds like a joke. It’s no joke to anyone who has one.

My experience with fussy dogs is that they learn to be picky by being offered raw meats or home-cooked foods. Suddenly the biscuits don’t seem so good any more.

The solution is to set an absolute line in the sand by making clear boundaries that your dog can understand. ‘Only this much and no more’, or ‘only at this time’, etc. It’s just like getting kids to eat their meals. They can’t learn that hunger striking gets a tastier option or they’ll do it again and again.

Now to the benefits.

Is A Raw Diet Good For Puppies?

Done well, there are probably some positives to feeding puppies raw foods. These could include:

• better skin & coat health
• improved gut function
• improved appetite

I say probably because up to now the evidence has been lacking. However I want to point you to a recent paper from Finland about raw puppy diets and skin problems later in life. Its results are shown here, and I’ll do my best to explain them afterwards.

Note that this is about prevention; a raw diet is very unlikely to fix your dog’s skin problem.

Raw Puppy Diets & Atopy

The common skin allergy of dogs is called atopic dermatitis. You definitely know a dog with this, even possibly your own. They get ear infections, itchy bellies, or lick their feet constantly. Diet is certainly not the main cause, but it might play a small role.

This study (linked below²) looked at the percent of adult dogs with atopic dermatitis based on their diet when they were 2 to 6 months old. The numbers across the bottom are the amount of each diet being fed. When there’s a statistically significant difference between dogs with and without skin problems, the bar is marked with an asterisk*.

What you can see is that there are multiple points where the likelihood of skin allergy is associated with:

• a lower percentage raw diet, or
• a higher percentage dry food

Ingredients Linked With Better Skin

The study authors went further and asked about specific ingredients. They found these three were associated with less skin problems:

• Raw tripe
• Raw organ meats
• Human meal leftovers

Why might that be? The authors suggest the ‘hygiene hypothesis’ whereby an overly clean and sterile early environment might lead to an immune system more prone to allergy.

This makes sense when you look at the three ingredients:

• Raw tripe will have the animal’s gut flora still present in many cases
• Organ meats are also likely to carry bacterial contamination
• Human meals are incredibly diverse (usually in a negative way of course)

A Raw Diet Plan For A Puppy

So let’s put all this together into a reasonable plan for a puppy diet.

Firstly, note that the actual amount of improvement is small, so nobody should feel that they have to feed any raw food at all.

Secondly, note that you don’t need to feed 100% raw to see a benefit. The authors recommend a diet:

• at least 20% as raw food
• below 80% as dry food

And in fact that’s a good place to stop. I would not go below 75% balanced commercial food. This is both to keep the diet adequately balanced and to avoid stomach upsets. One thing premium food is very good at is keeping the gut happy.

Thirdly, which ingredients? Raw tripe sounds ideal if you can get it, remembering to buy as fit for human consumption. It’s probably quite cheap too.

Human leftovers might be OK, but please look at our page on dangerous foods for dogs first. If you feed leftovers you need to do it in a very structured way, such as at a certain time in their bowl to avoid setting up bad habits like begging.

As for offal, it’s harder to do safely. You could add some liver or kidney, but no more than weekly to keep vitamin A levels down. Thyroid glands in mixed offals can cause excessive thyroid hormone levels. What you end up using will depend a lot on what you can easily buy and trust.

I also add raw bones from 10 weeks of age. It’s a personal choice, which you can read about here.

So in summary I’m advocating a diet that still relies mostly on good quality balanced commercial dog foods, but tweaks them a little by adding a small amount of selected raw foods. This approach is a typical ‘vet’ compromise, and I am resigned to it pleasing exactly no-one. But it’s what the best evidence** tells us.

As the owner of an atopic dog, it’s what I’ll try with my next puppy. And if better evidence appears in the meantime, you can bet that it will be posted here.

Big disclaimer: whenever you choose to go away from a 100% balanced, cooked diet, I can no longer guarantee complete safety.

* A quick note about online nutritional advice. It’s not a level playing field because the law uses something called ‘the reasonable person test’. In other words, if you follow ‘Joe Blow’s You-Beaut Diet For Puppies’, and your puppy dies, you may not be able to sue him. That’s because the courts will probably say that a ‘reasonable person’ would not be expected to trust this diet. Of course, if Joe Blow is a vet, then a reasonable person would be expected to believe him, and you can sue him. This is why vets generally play diets with a very straight bat, and the outlandish ones are not published by vets.

** The study is not without its flaws. By asking owners to remember their puppy’s food some years back, it will introduce a measure of recall bias. In other words, owners of adult dogs with and without skin disease might not recall the puppy diet in exactly the same way. It also relied on an owner assessment as to whether skin disease existed or not. This would be a problem if people who choose raw diets judge skin disease even slightly differently to those that don’t. Lastly, bearing in mind that significance is defined as less likely to have occurred by chance than one in 20, by asking about 46 different food variables, it’s nearly inevitable that some will achieve significance even by chance alone. Definitely more work is needed here to drill down on these individual ingredients in an intervention study.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

1. Behravesh, C. B., Ferraro, A., Deasy, M., Dato, V., Moll, M., Sandt, C., … & Urdaneta, V. (2010). Human Salmonella infections linked to contaminated dry dog and cat food, 2006–2008. Pediatrics, 126(3), 477-483.
2. Hemida, M. B., Salin, S., Vuori, K. A., Moore, R., Anturaniemi, J., Rosendahl, S., … & Hemida, M. B., Salin, S., Vuori, K. A., Moore, R., Anturaniemi, J., Rosendahl, S., … & Hielm‐Björkman, A. (2021). Puppyhood diet as a factor in the development of owner‐reported allergy/atopy skin signs in adult dogs in Finland. Journal of Veterinary Internal Medicine Full text.

It’s called a staring coat.

What Is A Staring Coat?

A staring coat is when the tips of a cat’s hair start to stick together, probably due to a buildup of grease. The hair doesn’t form a smooth ‘shell’ any more but is separated into rows or tiny clumps. It gives the coat a spiky, clumping appearance.

A staring coat happens very quickly when a cat stops grooming adequately. Every cat owner knows how much time their cat spends licking themselves, plus rolling and dust bathing. What they may not know is just how important these behaviours are.

While the staring coat isn’t a major health concern in its own right, it significantly reduces the insulating effect. It will also be associated with a buildup of dead hair, and increased parasite numbers in untreated cats. When this happens even a simple flea infestation can be serious.

The main issue with an ungroomed coat is that it might be a sign of something worse.

Why Do Staring Coats Occur?

There are six reasons why a cat might not be grooming enough:

• Sickness: any illness will reduce the amount of effort a cat can put into their coat, often before other signs occur
• Pain: musculoskeletal pain will reduce a cat’s flexibility, which is why a staring coat is a common sign of arthritis
• Dental disease: a cat with a sore mouth will not groom as effectively
• Stress: unhappy or anxious cats don’t spend time on ‘luxury’ behaviours like grooming (so you should be flattered that Tibby always wants to lick herself all over when she gets on your lap!)
• Age: good grooming habits sometimes take a few months to develop, and so some kittens under 6 months old can have staring coats despite being in good health
• Obesity: I’ve written before how dandruff is often associated with obesity, and staring coats are just the same: excess weight causes an inability to groom properly

What To Do If You Cat’s Hair Is Spiky Or Matted

If your cat’s coat looks like any of these pictures, ask yourself if it has always been this way. If it hasn’t then you need to get your cat a checkup.

This kitten looks fine, right? That’s true from the front, but his coat is the one in the earlier photos. He’s actually fighting a respiratory infection.

Almost all cats with staring coats have something that needs attention. Anxiety is very treatable, as is weight control, as is arthritis in cats.

Some might be normal, but we won’t know this without a physical or possibly blood tests. The purpose of this article isn’t to tell you what’s wrong, it’s to tell you there’s an abnormality and it needs investigation!

To finish up, here are a few more pictures taken all within a few days. Staring coats are everywhere when you look. However, I still don’t know why they ‘stare’- any ideas?

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here. The information provided here is not intended to be used as a substitute for going to the vet. If your pet is unwell, please seek veterinary attention.

Just a warning: this is no one-size fits all treatment!

What Is A Mast Cell Tumour?

Mast cell tumours (MCTs) are the second most common malignant cancer of dogs, and the most common on the skin. They can vary from a cyst-like lump under the skin to a nasty red raised mass, and affect up to 20% of dogs.

Certain breeds are more likely to develop mast cell tumours, but any dog can get them. The most at risk are:

• Boston Terriers
• Boxers
• Golden Retrievers
• Labrador Retrievers
• Pugs
• Staffies

Due to where mast cells are generally found, most tumours in dogs are located either on or just under the skin. More rarely they can be internal in the liver or spleen.

The pictures here and above give a good idea of what MCTs look like. However, there’s no way to be certain without a checkup and testing. 

Diagnosis Of Mast Cell Tumours

MCTs are one of the rare tumours where it’s possible to make a rapid diagnosis at the first visit. A simple fine needle aspirate (FNA) or needle biopsy is all it takes. Once stained and examined by your vet or a pathologist, it can show the characteristic granules inside the cells.

A better, but more invasive test is the incisional biopsy. This is where a small piece is cut out for laboratory analysis. Unlike an FNA, this will require at least a sedation and local anaesthetic. I’ll comment later on when this might be a good idea.

When vets are concerned that the tumour could have spread, they will recommend an ultrasound of the abdomen. They will also want to FNA and possibly remove local lymph nodes.

The benefit of all these tests is that we end up knowing a lot more about the tumour before we try to treat it.

Treatment Of Mast Cell Tumours

There are now four ways to treat mast cell tumours in dogs:

1. Surgical removal
2. Chemotherapy & radiotherapy
3. Tyrosine kinase inhibitors
4. Intratumoural injection

The choice of treatment will depend on the tumour’s location, its grade and the owner’s wishes. I’ll go through each in turn.

Surgical Removal

Whenever possible, surgical removal remains the treatment of choice. For solitary MCTs, removal is usually curative. This is possible for the vast majority of dogs. The local lymph node is also removed at the same time if there is suspicion of spread.

However, there are still two related decisions: whether to biopsy and how big the margins need to be. Margins are the rim of normal tissue we remove in order to take out microscopic tumours away from the main mass.

The size of the margins depends on the grade, or aggressiveness of the tumour. Therefore, a biopsy first is always a good idea, and especially in places where a larger margin is going to require planning or referral, such as for high-grade tumours on the legs or head.

On the other hand, for owners wishing to save the extra step, a biopsy is less important in areas where taking a good margin will be easy, like the first picture. This is especially true if the mass has been growing slowly and not causing any trouble.

Margin Size

There is a lot of debate about how big the margins need to be. The current consensus is called modified proportional margins where the margin is the same as the diameter of the tumour, with a minimum of 5mm, a maximum of 2cm, and one fascial plane deep.

Regardless of how successful we think the surgery was, the surgical site and local lymph nodes should always be watched afterwards. MCTs are well known to regrow even after supposedly ‘complete’ removal.

Lab Analysis

The main thing is to always get the tumour graded and the margins checked by a pathologist. This costs around $200 but is money well spent. Then if tumour is found near to the edges, or the MCT is high grade, further steps can be taken.

The decision to re-operate is a tricky one. Even with contaminated margins, low grade MCTs tend not to recur, and intermediate grade tumours only regrow around 33% of the time. I would make this decision based on how practical a second surgery will be.

High grade tumours have a strong tendency to recur, and survival is greatly enhanced by a post-operative course of vinblastine. This can also be a good idea for lower grade MCTs with incomplete removal or lymph node involvement.

Non-Surgical Options

There are at least three reasons why surgery can be the wrong treatment:

1. A high grade tumour is in an area where removal isn’t possible, such as the head, legs or around the genitalia
2. The dog cannot be safely put through the anaesthetic or surgery
3. The tumour has spread elsewhere

These are the dogs who need the next three options.

Chemotherapy & Radiotherapy

Chemo is helpful for certain dogs, but results can be disappointing. A combination of vinblastine and prednisolone +/- lomustine achieves some form of improvement in around 50% of cases. Even if suppressed, tumours will tend to regrow in time.

The use of radiation on the tumour has given improved responses, but it’s not available everywhere. Removal of the primary tumour before chemo also has some benefit even in cases where the disease has spread.

Chemo is probably most useful for tumours that have spread too widely to be able to control the individual masses any more. This is also true for the next treatment.

Tyrosine Kinase Inhibitors

The first major breakthrough in MCT treatment was the development of tyrosine kinase inhibitors (TKIs). The two drugs registered for dogs are toceranib (Palladia®) and masitinib (Masivet® or Kinavet®, not available in Australia).

TKIs are much easier to administer, and can be given at home. Sadly, however, results for these drugs are not much better than chemotherapy, and often at significantly greater cost. Side effects are also generally more of a problem.

All this being said, there are many dogs for whom a TKI has allowed a significant extension in lifespan. The problem we currently have is not knowing how to predict the response before starting.

Intratumoural Injection & Stelfonta

The latest development is the use of injections directly into the MCT. This is only suitable for dogs with small numbers of lumps that are easy to inject. There have been many drugs tried, but only two seem to work.

Triamcinolone is a potent cortisone drug, and may work to suppress or shrink MCTs. There is minimal evidence, but it’s inexpensive and worth a try if funds do not allow for anything else.

Tigilanol tiglate (Stelfonta®) is a new drug derived from a Queensland rainforest tree, which is ironic considering we seemed to be the last to get it. When injected into a MCT, it caused complete remission by 28 days in 73% of cases. Around half of the remaining 27% achieved remission with a second dose and only 7.5% of all the responders suffered a relapse.

Stelfonta is registered in many countries for:

1. the treatment of non-metastatic MCT anywhere on the skin surface
2. the treatment of non-metastatic MCT under the skin at or below the elbow or hock (in trials, injections higher up caused severe complications)

This only applies to MCTs that cannot be surgically removed and have not spread.

This is a great addition. While surgical removal is still best when possible, Stelfonta can treat MCTs that up to now have required amputations or extremely disfiguring surgery. If you’re interested in Stelfonta, please also scroll down to read about its side effects.

And that’s it. I’m sorry for such a complicated story, but this is the reality of treating mast cell tumours properly. And there will still be some cases that don’t suit any of these treatments. For these, don’t panic; I have a patient right now who’s one year out from a diagnosis of untreatable MCT. He’s doing well and this could be your dog too.

However, one thing always remains the same: the earlier we see tumours, the better the chances. A small lump anywhere can usually be removed, but once they grow you’ll quickly run out of easy options.

We’re lucky to be living in an age of innovations, and so are your dogs. But we still hope you won’t need them.

Also Read: Pictures of Common Lumps Found On Dogs Skin | Types Of Lumps Found Under The Skin

Image at the start by Joel Mills, CC BY-SA 3.0, via Wikimedia Commons.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

References

1. Case, A., & Burgess, K. (2018). Safety and efficacy of intralesional triamcinolone administration for treatment of mast cell tumors in dogs: 23 cases (2005–2011). Journal of the American Veterinary Medical Association, 252(1), 84-91
2. Chu, M. L., Hayes, G. M., Henry, J. G., & Oblak, M. L. (2020). Comparison of lateral surgical margins of up to two centimeters with margins of three centimeters for achieving tumor-free histologic margins following excision of grade I or II cutaneous mast cell tumors in dogs. Journal of the American Veterinary Medical Association, 256(5), 567-572
3. Grant, J., North, S., & Lanore, D. (2016). Clinical response of masitinib mesylate in the treatment of canine macroscopic mast cell tumours. Journal of Small Animal Practice, 57(6), 283-290
4. Hahn, K. A., Legendre, A. M., Shaw, N. G., Phillips, B., Ogilvie, G. K., Prescott, D. M., … & Hermine, O. (2010). Evaluation of 12-and 24-month survival rates after treatment with masitinib in dogs with nonresectable mast cell tumors. American journal of veterinary research, 71(11), 1354-1361
5. Jones, P. D., Campbell, J. E., Brown, G., Johannes, C. M., & Reddell, P. (2021). Recurrence‐free interval 12 months after local treatment of mast cell tumors in dogs using intratumoral injection of tigilanol tiglate. Journal of veterinary internal medicine, 35(1), 451-455
6. London, C. A., Malpas, P. B., Wood-Follis, S. L., Boucher, J. F., Rusk, A. W., Rosenberg, M. P., … & Michels, G. M. (2009). Multi-center, placebo-controlled, double-blind, randomized study of oral toceranib phosphate (SU11654), a receptor tyrosine kinase inhibitor, for the treatment of dogs with recurrent (either local or distant) mast cell tumor following surgical excision. Clinical Cancer Research, 15(11)
7. Selmic, L. E., & Ruple, A. (2020). A systematic review of surgical margins utilized for removal of cutaneous mast cell tumors in dogs. BMC veterinary research, 16(1), 1-6
8. Smrkovski, O. A., Essick, L., Rohrbach, B. W., & Legendre, A. M. (2015). Masitinib mesylate for metastatic and non‐resectable canine cutaneous mast cell tumours. Veterinary and comparative oncology, 13(3), 314-321
9. Weishaar, K. M., Ehrhart, E. J., Avery, A. C., Charles, J. B., Elmslie, R. E., Vail, D. M., … & Thamm, D. H. (2018). c‐Kit mutation and localization status as response predictors in mast cell tumors in dogs treated with prednisone and toceranib or vinblastine. Journal of veterinary internal medicine, 32(1), 394-405

Side Effects Of Stelfonta

The major side effect of Stelfonta is the development of an open wound at least the size of the tumour, which can also be painful for a few days. In rare causes, these wounds are very big indeed. You can see pictures of some in the USA product insert.

The wounds generally heal without complications and leave minimal scarring or disfigurement. Wounds appear to be larger when the tumour has spread, so checking the local lymph node before treatment seems almost essential.

Another potential adverse effect is caused by the release of histamine from mast cells. Deaths occurred in early trials, but these seem to be prevented by pre-treatment with steroids, antihistamines and antacids. Therefore this is also essential.

I will discuss it and other causes of lesions on the face of dogs afterwards.

Canine Eosinophilic Furunculosis

This is a rare condition whose exact cause is unknown, but believed to be hypersensitivity to bite from an insect (e.g. wasp, hornet, bee, mosquito, ant) or spider. In this dog’s case, the cause was probably bull ants.

Raised, swollen sores appear, and enlarge extremely rapidly. They are mostly found on the sides and top of the nose and muzzle, and more rarely around the eyes, on the underside or the legs. Eventually they become ulcerated, moist, crusty or even bleeding.

Dogs may find the sores very painful or itchy. Severely affected dogs can appear unwell and lethargic.

Treatment Of Eosinophilic Furunculosis

Treatment is very successful via anti-inflammatory corticosteroids (‘cortisone’), and antibiotics for secondary infection. However, as corticosteroids can just as easily be the wrong treatment for some skin conditions, it’s best to get a diagnosis first.

Therefore, before starting the prednisolone I took a biopsy; that’s the single stitch you can see in later photos. The speed of improvement was as fast and impressive as the speed that it initially worsened. By the time the results were back, it was already 80% better.

Canine eosinophilic furunculosis is an incredibly dramatic and rare reaction that your vet might not have seen, and (like me) might fear the worst. However, if you recognise what it is, it’s not nearly so bad.

What Else Causes Facial Sores?

Here are three much more common causes of swellings on dogs’ faces.

The lesion below is a solitary, circular and much drier lump we call a granuloma. Sometimes it has a hard crust. They also mostly appear on the nose or face but cause less discomfort and irritation. These granulomas appear to be infections, and respond slowly to antibiotics.

Then there’s the classic bee sting. This causes a rapidly developing swelling of the affected area, usually the lips, eyelids and muzzle. There should be no specific sores visible. Such dogs are shown below.

You can read all about the treatment of bee sting here.

Lastly, there’s the tooth root abscess. These mostly appear underneath the eye like in the picture below, and will eventually burst. Again, you can read more at the link.

There are far too many other causes of facial sores to be able to document them all. Some will be specific to certain parts of the world. That’s why, even if your dog looks like the pictures here, you always need your local vet to confirm the diagnosis.

Here are just a few extra examples:

• Nasal solar dermatitis (‘collie nose’) in high UV places like Australia
• Leishmaniasis in South America, the Mediterranean basin and East Africa
• Autoimmune diseases like discoid lupus erythematosis, pemphigus and uveodermatologic syndrome
• plus any of the Skin lumps of dogs can also be found on the head

Related: Causes of Ear Tip Sores In Dogs

Much gratitude is due to Alaska’s mum, Kate for taking and sharing these excellent pictures.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here. The information provided here is not intended to be used as a substitute for going to the vet. If your pet is unwell, please seek veterinary attention.

• Is my dog is at risk of skin cancer?
• What do I look out for?
• What do I do if it happens?

By ‘skin cancer’ I mean only those tumours caused by sun exposure. Visit this page if you want to see a larger list of lumps on dogs’ skin.

Dogs Breeds Prone To Skin Cancer

Any dog with areas of pink skin lacking pigment is at risk. Common examples are:

• American Staffy
• Border Collie
• Boxer
• Bull Terrier
• Dalmatian
• Jack Russell Terrier
• Staffordshire Bull Terrier

The second crucial factor is the amount of ultraviolet exposure. That means skin cancer is rare in dogs in the UK and northern Europe, and common in dogs allowed to sunbathe throughout the Americas, Africa, Australia and New Zealand.

The picture above shows a simple guide to see if your dog is at high risk. Lightly pinch an area of pink skin, and compare the width of the fold to an area of black skin. If the pink skin is thicker, it’s telling you your dog’s skin is being damaged. You need to act.

Types Of Skin Cancer & Pictures

There are only two common types of skin cancer caused by the sun. They mainly occur in areas with little or no hair coverage, mostly on the belly and inner thighs.

Squamous Cell Carcinoma

Squamous cell carcinoma, or SCC, is the most common and serious. Because it rarely forms a lump it fools dog owners into thinking it’s just a wound or injury.

An early stage SCC looks like any small skin cut, except that it doesn’t heal. There is usually a dark scab over the top like the first picture. Note that it sits in the pink, unpigmented area, not the black spots.

As they grow they often become raw and open, with an ulcerated surface. The second image shows the classic appearance of a circular wound with a distinct edge, quite unlike the ragged edge of a cut or scrape.

This photo shows an SCC that has been left too long. Letting it get this big risks it spreading into the local lymph nodes, from where it’s difficult to stop.

Although there’s no guarantee, it should still be OK as long as it’s taken out soon.

Cutaneous Haemangioma

When small, a haemangioma looks like a small red bump or berry. Here’s one pictured on a dog’s leg, again starting in the pink skin.

Unlike SCC, a haemangioma (hemangioma in the USA) rarely spreads to the lymph nodes. However, they are often rapid-growing and can still cause death if left too long.

They also have another unpleasant feature. As haemangiomas enlarge, their surface breaks open and bleeds with even the slightest knock. Such an example is shown in the second image.

Once again, this can still be safely removed. Note also how unhealthy the rest of the pink skin looks due to years of solar radiation.

Other Skin Cancers

Unlike in people, a melanoma on a dog’s skin is rarely caused by sun exposure. They are also far less likely to spread or metastasise. Most should still be removed, especially on sensitive places like the head or legs.

You can read here about melanomas in the mouth of dogs, which have very different behaviour. Other skin lump pictures can be found here.

Prevention Of Skin Cancer

Once skin cancer appears, there is no good alternative to speedy removal, so I won’t discuss this further. Much more important is preventing skin cancer.

Step 1: Get your dog out of the sun. Whenever the UV index is at 3 or greater, skin damage is likely. This is when susceptible dogs should be kept in the shade or inside.

You can’t trust dogs to do the right thing, especially on those cool, sunny days in late spring and early summer. It’s not only smart, it’s cost-effective to build a shady fenced area if your dog is a sunbather. What ends up causing the death of many dogs is the unsustainable financial burden of repeated operations.

Step 2: Use sunscreen. Here’s Loki’s nose. The pink area gets a dab of sunscreen . He also has a lot of pink skin underneath, but it’s not very practical to put creams there due to the way it picks up dirt. However, if you’re prepared to bath your dog each time, it’s fine there too.

Step 3: Sun shirts. Personally, I think these are very hard to do well, as the highest risk area is the hardest to cover. If you can fit one that covers the groin but still allows for urination and doesn’t just ride up each time they lie down, then go for it.

A normal hair coat protects the skin almost as well as a shirt. This is a reminder to be especially careful if you’ve shaved your dog for summer.

The main message is (of course) to get those small lesions checked before they become large ones. Have a safe summer!

Related: Common Pet Emergencies Of The Summer Holidays

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

This is an opinion piece, not a regular clinic article. I have been seeing itchy dogs for nearly 30 years and have yet to see one who cannot be helped. Here I’m going to boil down all the conflicting advice into my simple step by step approach.

First, let’s define what makes an itchy dog.

Signs Of Pruritus In Dogs

The sensation of itchiness on its own (called pruritus) only causes the skin to look pinker than normal. That would be as far as it went if it wasn’t for two unavoidable consequences:

1. Dogs are unable to resist the temptation to bite, scratch or lick at an itch
2. Dog skin quickly gets secondary infections with opportunistic yeasts or Staph

It’s these two effects that really create the typical appearance of an itchy dog. This could be any of the following:

• Ear infections
• Licking the feet and chewing at the paws
• Red-brown saliva staining in the coat
• Hotspots and skin infections
• Hair loss and a doggy smell
• Thickened or black skin

8 Steps To Stop A Dog Scratching

The following is my approach towards a more comfortable dog, and could be your pathway too. Each is a trial: we keep what works, and keep going until everybody’s happy. Some steps are for you alone, others are in partnership with your vet.

When I do this in my clinic I will often change the order or overlap the steps depending on the situation. Your vet is likely to do this a whole different way, and that’s fine too.

Step 1: Eliminate Secondary Infections

Stopping a dog from itching, scratching or biting is impossible if there’s any secondary infection or if they are in a vicious cycle of repeated damage. Therefore, you need to see a vet straight away if there are signs of the following:

• Broken, moist or greasy skin
• Crusts or scabs
• Red bumps, pimples or rings
• Smelly or mucky ears

Then come back to this list!

Step 2: Parasite Control

Let me be blunt. There is no place for “my dog is scratching but he doesn’t have fleas“. Not in an age of excellent, affordable flea control. Especially not when mange mites can be eliminated in the same step.

Allergic dogs carry fleas in numbers that are too low to detect, and you’ll never see mites. Therefore, whether you believe in it or not, please, please start out by using a good parasite prevention. Think of it like an insurance policy.

I personally only use one of:

• Simparica
• NexGard
• Credelio
• Bravecto

You can view a larger list of registered dog flea products here. These products can be game-changers for itchy dogs.

Step 3: Shampoo

Never underestimate the effect of bathing done properly. The myths about bathing dogs too often are outdated and based on bad shampoo choices. Every dog should get the opportunity to see if bathing can help.

Bathing will work if it can remove the offending allergen or irritant without disturbing the skin’s barrier function. I ask owners to use soap-free shampoos like Aloveen at least once a week, but preferably twice. For yeast I will use Malaseb.

Dogs prone to ear infections often benefit from a flush with the right ear cleanser afterwards.

Then there are the moisturisers. Each good shampoo company has a matching conditioner or spot-on treatment. These aren’t always necessary, but definitely worth trying.

Step 4: Food (Part I)

I’ve discussed before the reasons why food is over-hyped in itchy dogs, but it still plays an important role, twice.

Here and now, we want to try food as a form of medicine. So I ask you to use a diet specifically formulated to reduce itch in dogs. These are not quite elimination diets. Three examples are:

• Royal Canin Skintopic
• Hills Sensitive Skin
• Hill’s Prescription Diet Derm Complete

Skin foods work by containing all the known nutritional supplements that can help reduce itch in dogs. They are not spectacular, ever, but they always help a bit.

If you don’t want to change the diet, then at a minimum add fish oil to the diet at a rate of one gram per 4.5kg bodyweight. Stop immediately if it causes tummy upsets.

Step 5: Corticosteroid Trial

After all this is done (and still being done) I will sometimes try a short course of prednisolone. You can read more about the approach here, but what I’m looking for is that third of dogs who will tolerate its side effects while achieving relief of symptoms.

Here I’m getting controversial, and in fact I skipped this step with my own Jack Russell. However, if you can get it to work, prednisolone is a far, far cheaper option than what is to follow.

Another way of using corticosteroids is via creams, lotions, sprays and ointments. These often cause more harm than good due to dogs licking them off, but they can be helpful for small areas.

Step 6: Food (Part II)

A lack of response to prednisolone at regular doses pushes food allergy higher up the list, enough to justify the next step. Now we perform a strict elimination diet. These are not for the half-hearted as you’ll see at the link.

I am very tired of seeing poor dog owners who’ve been told at the beginning that their dogs have a food allergy (usually wrong) and then put on a different food (that almost never works). I often only learn of this six months later after they’ve given up.

There is a widespread lack of understanding about what constitutes an effective food trial. Just changing brands it is certainly not. It’s an eight-week highly controlled diet with very limited chances of success. That’s why it’s this far down the list: important to rule out, but not high priority.

Step 7: Cytopoint or Apoquel

At this point, we’re out of simple options, and the problem looks like it’s here to stay. Only five years ago, such dogs had only Atopica, but now we have two more effective choices:

• Apoquel is a tablet that suppresses a range of inflammatory cytokines involved in inflammation
• Cytopoint is a monoclonal antibody injection that binds to interleukin-31 and prevents it initiating inflammation

These drugs are generally well-tolerated and extremely effective. I find that both work best if they are started early in the course of dermatitis, before secondary skin changes develop. The disadvantage of both is price; indications of each can be found at the links.

Step 8: Referral

If all the treatments we’ve tried so far haven’t given enough relief, now is the time for a veterinary specialist dermatologist. Hopefully you’re lucky enough to have one nearby. Here in Adelaide we can arrange referral to one of two vets who deal exclusively in skin problems.

Of course. this step doesn’t have to be last. At any stage you can ask for referral, and we will happily provide it. However, my own approach is to pick all the low-hanging fruit I can before sending you away.

Costs only go up, which means this isn’t for everyone. But it’s usually worth at least just taking the first appointment to see if there’s anything simple that’s been missed.

Other Options

These 8-steps are a very individual approach. Not unconventional, just my personal take on a complex problem. Here are some other treatments you’ll also get advised:

• Antihistamines are often added early in the process. I don’t think they work very well, but I can’t criticise the attempt. We’re all trying our best.
• Natural remedies are heavily promoted online. You are welcome of course to try them but we see very little effect.

A Plug For Insurance

I once heard from a pet insurance company that their number one payable condition is dermatitis, and I’m not surprised. But if your dog already has symptoms, it’s too late to get them covered. This is what we call the pre-existing condition exclusion.

Therefore, if you’re the owner of a young, healthy dog, do consider pet insurance. I can think of no better example of its effectiveness than all the dogs with atopic dermatitis. If your dog is unlucky enough to get it, then insurance means being able to take all these steps without hesitation.

Even if this isn’t an option, and funds are limited, a way can usually be found to make your dog comfortable again. So don’t suffer in silence!

Related: The Causes Of Atopy In Dogs | A List Of Dog Skin Medications

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here. The information provided here is not intended to be used as a substitute for going to the vet. If your pet is unwell, please seek veterinary attention.

Blue dogs have lots of skin problems

I have heard this said about white dogs in the past, but blue was new. But never being one to assume hearsay is wrong, I did a bit of research. I looked at papers which studied the risk factors for dermatitis in dogs.

Like in all these stories, there’s a grain of truth. So let’s dig it out.

Do Blue Dogs Get Skin Problems?

Firstly, if we’re talking about the most common and troublesome skin disease of dogs, the answer is no. Atopic dermatitis, the skin allergy I see all day every day, is no more common in any blue dog.

Since this is what people seem to be talking about in the dog parks, owners of blue dogs can relax. But where has the idea come from? There are two answers:

Firstly, just think about the common dog breeds with a blue coat colour: French Bulldogs and Staffies. I would estimate that members of these breeds have a 50% risk of suffering from atopic dermatitis. So both being blue and being itchy are breed-related, one doesn’t cause the other.

This mistake is even made in supposedly good science, like saying tortoiseshell cats are more likely to be aggressive. The confounding factor here is gender, and you can follow the link to learn more.

Secondly, the grain of truth is that there is a skin disease of blue dogs. It’s called Colour Dilution Alopecia.

What Is Colour Dilution Alopecia?

Dogs with dilute coat colours, especially blue and fawn, are at risk of a genetic fault in hair growth. It starts between 6 months and 3 years of age, and causes the hair to gradually fall out. Sometimes, secondary bacterial infection can cause the skin to be itchy or scaly, but most of the time it’s only a cosmetic issue.

Colour dilution alopecia is seen mainly in blue Dobermans, but it has also been seen in Chow Chows, Whippets, Poodles, Great Danes, Chihuahuas and Dachshunds. No mention at all of Staffies and Frenchies.

It is a very rare genetic disease. Being blue or fawn may be a risk, but virtually all dogs of these colours are unaffected. In fact, it’s so rare that I’ve never seen it. But it’s probably behind the story that blue dogs get skin problems.

Now let’s get on to colour number two…

Do White Dogs Get Skin Problems?

It’s always been said that dogs with a white coat are more likely to get dermatitis. And just like the blue story, there’s a bit of myth and a bit of truth to it.

The myth is exactly the same as with blue dogs. Three of the most severely affected dog breeds are white: West Highland White terriers, Jack Russell terriers and Dalmatians. They aren’t affected because they’re white, they’re affected because they have a genetic fault.

The truth appears to be in the Bull terrier. In this breed, it does appear that dogs with white hair coats are more likely to have atopic dermatitis. But even here, there are plenty of white Bullies without a problem.

So Are Dog Parks Full Of Myths?

No. The information that’s found at the dog park is nearly always a benefit to dogs and their owners. Yes, I’ve seen some cases of ‘thin-shaming‘ but mostly what’s being shared is going to lead to better dog care.

In fact, I really hope you keep bringing me these snippets. They not only keep me in the loop, they often highlight something worth knowing. And they aren’t always wrong, either.

Sometimes I am. Just read Fact Check #2 and you’ll see what I mean.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

Now I use it far more in cats than dogs. Keep reading on to see why.

What Is Atopica?

Atopica is a brand name of cyclosporin, which you’ll also see spelled cyclosporine, ciclosporine or ciclosporin. It’s a reasonably targeted immune suppressant that was first used in people having organ transplants. However, due to unpleasant side effects, it was never widely used elsewhere.

In dogs however, its release marked a watershed moment for veterinary medicine. Atopica was the first drug specifically licensed for atopic dermatitis, which until then had only been treated with prednisolone. For the first time, dogs could expect to get relief from constant itching without suffering excessive side effects.

Its greatest disadvantage was its cost. At the time I predicted a great future when it came off patent and became a cheaper generic. That never happened, partly due to the inherent high cost of manufacture, but mostly because no one saw what would happen next.

Atopica vs Apoquel In Dogs

Vets struggled on, treating atopy with cyclosporin for ten years. Then Apoquel came like a bolt out of the blue and almost overnight Atopica was forgotten. You can read about Apoquel here; most vets would agree that it:

• works better
• starts working faster
• costs about the same
• has fewer side effects (see these later)

Since then, Cytopoint also appeared, giving just one more reason not to use Atopica. 

Nowadays, cyclosporin is mainly used for dogs with unusual immune-mediated or autoimmune diseases like:

• Perianal fistula
• Lupus diseases
• Cutaneous histiocytosis

And perhaps still for atopic dogs when Apoquel and Cytopoint don’t work.

Atopica In Cats

Cats are a very different story. A poor cat suffering from allergic dermatitis still mostly only gets treated with prednisolone. That’s because Apoquel is unlicensed in cats, and Cytopoint being a dog antibody could cause a dangerous reaction. 

Long term prednisolone use in cats puts them at risk of diabetes. So I was grateful when Elanco developed Atopica for cats, even though the economics must be marginal. It’s great to have a choice.

Uses for cyclosporin in cats include:

• Allergic dermatitis (this is its only registered use)
• Eosinophilic granuloma complex
• Pemphigus & other autoimmune diseases

But cyclosporin isn’t a wonder drug. It has important drawbacks especially for cats.

(Note: this article gets quite technical from here so feel free to skip the rest unless you’re keen.)

Atopica Side Effects

The common side effects of cyclosporin in dogs and cats are listed below. 

Most of the time, vomiting will improve over a few weeks if you keep using the drug. However, symptoms can be severe enough to need to stop the drug. Giving cyclosporin with food can decrease gastrointestinal adverse effects but may reduce absorption.

Additionally, the following side effects also occur at a lower rate:

• Gingival hyperplasia (overgrowth of the gums)
• Hypertrichosis (thicker hair)
• Warts & verrucas (dogs only)
• Muscle cramps and weakness 
• Acute bullous keratopathy (a cat eye disease)

Cancer is often discussed but it’s very hard to tell if cyclosporin changes what is already a very common problem. Cats however have one more very specific and important risk: opportunistic infection.

Cats, Cyclosporin & Toxoplasmosis

When cats are taking Atopica, their immune system is unable to defend them against certain common diseases.

Herpesvirus cat flu is one. A previously vaccinated cat is safe, but if an unprotected cat catches herpes, it could be fatal. Therefore we won’t use Atopica without prior vaccination. Future vaccination is safe but we avoid live vaccines.

FeLV and FIV are two others. Cats carrying these viruses should not be given cyclosporin so we always test them first. Then it’s a good idea to vaccinate or keep cats indoors to prevent future infection.

The greatest threat is Toxoplasma. If a cat acquires this parasite for the first time while on Atopica, it’s usually fatal. But as dramatic as this is, it can be prevented. Here’s how:

• Perform a Toxoplasma titre before commencement. If there’s an existing antibody level, your cat has already been exposed to Toxoplasma and therefore should be safe (like vaccination). 
• Keep cats with negative titres and all their housemates inside. Feed them on commercially prepared tinned or dry foods only, and control mice in the house.

Read more about toxoplasmosis in cats here.

Atopica Doses For Dogs & Cats

Cats are given an oral liquid which allows for accurate dosing. Cyclosporin is started at 7 mg/kg once a day with or without food until the skin improves, usually in 4-8 weeks. Then the dose is tapered to every second day or, when possible, to twice weekly. 

Dogs receive Atopica capsules in either 10, 25, 50 or 100 mg. Cyclosporin is given on an empty stomach at 5 mg/kg once daily until improvement, typically for 4 to 6 weeks. After this, dose reduction is possible in around a half of dogs. Treatment is then trialled at every second day and if this also works, a further reduction to twice weekly is tried.

In both species, cyclosporin is slow to reach its full effect. After 1 month, around 50% can expect to get at least 50% improvement in their signs. There is usually further improvement until it plateaus at 2-4 months. 85% of dogs can expect to get at least 50% improvement by this time. Cats are probably similar.

Thanks for making it to the end. You might also be interested in reading about the two related conditions, food allergy and flea allergy. The picture at the start shows how similar the patterns in cats are for these important skin problems. It’s just as hard in dogs.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

• Overused,
• Underused,
• Harmful,
• Essential

Love it or hate it, prednisolone is the most misunderstood drug in veterinary medicine. Its uses and side effects are too varied and complex to understand easily. Here I’ll help you to get informed.

Prednisolone is a steroid hormone. Even just that fact is confusing enough.

What Are Steroids?

The term ‘steroid’ is often used as shorthand for anabolic steroids, but the reality is very different. There are many different steroid molecules in the body. Some of the most famous are:

• The sex steroids oestrogen, progesterone and testosterone
• The corticosteroids aldosterone, cortisone and cortisol
• Cholesterol

The one we’re interested in here is cortisol. Artificially synthesised as hydrocortisone it was the first medication of its class. These days we rarely use it, thanks to newer, more potent relatives. They include dexamethasone, prednisone and of course prednisolone.

Before moving on, it’s worth mentioning that prednisone and prednisolone are almost the same. If your pet has been prescribed prednisone, everything I say from here is just as true.

Effects Of Prednisolone

All the effects of prednisolone, both good and bad, can be put in two categories:

1. Immunosuppressive
2. Metabolic

If we like the effect, we call it a use. If we don’t like it then we call it a side effect! Although this is a very artificial divide, I’ll stick with it to describe everything that prednisolone does, both good and bad.

Uses & Doses Of Prednisolone

Prednisolone comes in 5mg and 20mg tablets for veterinary use. It is most commonly employed for its anti inflammatory effect. This is very useful for itchy skin diseases like atopic dermatitis, flea allergy, insect bite and hot spots. The dose here typically starts at 0.5 to 1 mg/kg per day.

What prednisolone also does here that’s just as important is stop self trauma. These dogs often get rapidly worse due to the damage caused by licking and scratching. Prednisolone helps them forget the itch so that the skin can heal.

Prednisolone at similar doses is also one of the few drugs which can reduce swelling. That’s essential for many diseases of the brain and spinal canal to reduce the pressure caused by swelling in a closed space.

At doses of 1 to 2 mg/kg once to twice daily, the immunosuppressive effect becomes great enough to treat autoimmune diseases. Without prednisolone we would have much more trouble controlling conditions like these:

• Immune-mediated haemolytic anaemia
• Immune-mediated thrombocytopaenia
• Lupus & pemphigus
• Inflammatory bowel disease
• Chronic active hepatitis
• Rheumatoid arthritis
• Shaker dog syndrome
• Asthma

Prednisolone at similar doses can also be used as an anti cancer drug, mainly for lymphoma. Lastly, at very low doses prednisolone can be used in Addison’s disease as a replacement hormone, though at Walkerville Vet we prefer cortisone.

Prednisone Side Effects in Dogs

In order of how often we see them, the adverse effects of prednisolone are:

• Increased thirst
• Increased appetite
• Weight gain
• Panting and heat intolerance
• Excessive urination or incontinence
• Abdominal enlargement
• Loss of muscle mass
• Lethargy and reduced fitness
• Urinary or skin infections
• Glucose intolerance and diabetes
• Thin, fragile skin and hair loss
• Poor wound healing
• Demodex mite outbreaks
• Gastrointestinal ulcers leading to vomiting or diarrhoea
• Behaviour change, especially aggression
• Infertility
• Worsening of existing heart disease symptoms
• Dependance and adrenal crisis if stopped suddenly

An adrenal crisis is a self- induced form of Addison’s disease caused by feedback suppression of the adrenal gland. After 14 days or more of daily treatment, dogs and cats should be weaned off corticosteroids gradually by changing to every second day dosing for at least two weeks.

In cats, we generally see milder side effects, but diabetes appears more common.

With all of these problems, you’d wonder why anyone would use prednisolone. Of course, with careful management, and only using it for selected cases, we usually only see the top few, and only mildly. Sometimes the disease is so severe that we willingly accept some of these effects as the price to pay for control.

Does Prednisolone Shorten Life?

There is no evidence of reduced lifespans in dogs or cats taking prednisolone. There is also no theoretical reason why this would occur. In our clinic we observe that animals on prednisolone live well into old age as long as side effects are kept under control, especially weight gain.

Some other side effects reported by others that I don’t see are liver damage or pancreatitis.

How To Make Prednisolone Safer

Here are the important ways you can reduce prednisolone side effects in your pet.

1. Use the lowest effective dose
2. Use it every second or third day if possible
3. Use the shortest course possible
4. Stop if side effects are excessive, as long as the condition is not life-threatening
5. Attend regular checkups at your vet and get urine checked each time
6. Use dose-sparing strategies

Dose sparing strategies are anything that allows you to get away with a lower dose. Examples in itchy dogs might be:

• Bathing and flea prevention
• Cortisone skin creams or sprays
• Special diets

In other diseases, it might be choosing a second drug alongside prednisolone.

Prednisolone will always be an integral part of veterinary medicine. If you’re concerned about it, that’s normal. I hope I’ve given you enough to make an informed decision with your vet.

I’ve also covered the specific case of using prednisolone in allergic skin diseases at Can I Give My Itchy Dog Prednisolone? You’ll see comparisons with the other common skin medications.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

Note: comments are now closed, but you should be able to find the answers to many common questions by looking through previous replies.