Prednisolone Use In Dogs & Cats

Updated March 26, 2021

Is there any other drug that can be all of these?

  • 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
Steroids all have the same four ring structure

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:

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:

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 are welcome below and will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. These articles are from a series regularly posted on email and Twitter. Subscribe via email here to never miss a story!

Andrew

33 Replies to “Prednisolone Use In Dogs & Cats”

  1. Hi Andrew .
    My gorgeous 12yr old spoodle has just been diagnosed with pancreatic cancer 4 days ago (not sure if adenocarcinoma or insulinoma. She only had fine needle biopsy) have been told 2 x tumors either side of pancreas.

    my vet is a mobile vet and has not had a pancreatic cancer patient before. Have prescribed 30mg prednisolone indefinitely. She also has a compresses kidney from one tumor is there anything i can give her to protect her gut (she is very tummy sensitive and has developed ulcers previously after 3 days on meloxicam) or any other advice at this time would be so welcomed and greatly appreciated.

    1. Hi Jo. I’m sorry to hear that. I have two specific comments – firstly, we don’t get many gastrointestinal problems in dogs on prednisolone. If you do want to protect her, you could use an antacid but it’s not a necessity. The second comment is that prednisolone may not have a major beneficial effect anyway, so if you don’t see an improvement you may want to wean off the drug.

  2. hi my dog is 11 and she a American bulldog she started have vet thinks seizures although not like convulsing more where she was wobbly falling over not walking right panting badly sometimes last for 15 minutes sometimes a few hours although she was with it head wise only once head head tilt,vet not sure thinking maybe vesicular disease or lesion or stroke but when i told him when she had one last time i gave her a little honey and strawberry she seemed to pick up ,so then he did a ear prick to test her sugar levels which were 4.4 he saying was ok wasent concerned for diabetes as her pre anesthetic from surgery months ago were good so he has put her on prednisone 5mg now she been ok other than the drinking eating panting more and back legs seem a little weaker but she has this tremor in her front leg and shoulder comes and goes which worry’s me But im just wondering why he put her on that would like your thoughts

    1. Hi Adrienna. Vets often use prednisolone on a trial basis when they can’t see an easy solution to a problem, and it’s not always a bad idea. Sometimes it gives very good results. However, in your case, it sounds like it’s doing more harm than good. It also sounds like the underlying problem could be very difficult to fix. Good luck.

  3. Hi, my 13 year old pug was treated from skin cancer which was cut out. The vet put him on Prednisolone 20mg, one a day for 3 days, then half a tablet for 7 days. He was also on Amoxyclay 250mg, one a day for 7 days at the same time, half morning and half at night. Unfortunately he passed away suddenly a month later. I am just concerned this medication was too strong for a 10kg pug and may have contributed to his death. What do you think?

    1. Hi Adrian. Prednisolone is an unusual drug to use after cancer surgery, so I’m guessing it must’ve been of an unusual type. It does seem like a high dose but it’s likely that there was a good reason for it. Prednisolone is not associated with sudden death however; the signs are more of what you read this article which are usually quite visible.

      1. Hi Andrew,
        We used to be clients but have been living in Europe the past 6 years. Our nearly 13 year old Jack Russell X (~8kg) was diagnosed with heart valve failure 4 years ago. It’s gradually gotten worse (of course). A week ago the vet started her on to 20mg prednisolone a day (new) & her dose of Furosomide was doubled (from 40mg per day to 80mg) as palliative care. This is because her coughing and not being able to breath was so unbearable for her and us. Last Thursday night she couldn’t lie down & was so distressed that we thought ‘it was time’. A week on, she has no coughing and no obvious signs of discomfort. Little energy but normal appetite. Prior to last week she was also on 5mg of Elanco Fortekor, 5mg Vetmedin and still is.

        Would you have any comments about her treatment. We are dealing with French and Dutch vets for her care. The vet put her on the quadruple furosemide & started her on prednisolone as treatment to get her through her a special weekend we had planned for her at the beach (as a last visit). But since then she is so calm we are wondering what to expect now? It’s clearly not all over, or is it … With thanks.

      2. Hi Fiona. Prednisolone is an unconventional treatment and that is also a very high dose. As it can cause fluid retention, I would reduce it if the coughing stays under control. If it doesn’t you’d want to reconsider the cause of the cough!
        If you continue frusemide at such a high dose, it’s important to watch kidney function via blood testing.

    2. Hi Andrew, thank you for your reply. Oscar had squamous cell carcinoma and it was thought that prednisolone was useful for some types of cancer. He just went off his food one week in late June, and passed away in my arms at the Vets as he as about to go in for fluids. As he passed suddenly I wondered if any medication had contributed to liver damage per say, and was hoping I didn’t contribute to his death. I’m hoping it was just age related.

  4. Good day
    I have a cross border collie. She has awful itchy skin. Itches till she bleeds
    Vet has tried everything diets tabs etc
    Only thing that keeps her happy is 15 mg prednisone a day
    Will this be ok
    Ps she is ten years old
    Regards
    Ken

  5. My 55 pound 2Y goldendoodle was diagnosed with EBP (eosinophilic bronchoneumopathy?) she has been prescribed with 20 mg of prednisone daily for 4 weeks, at which the vet will take an xray and will reduce the dosage.
    its been 2 weeks and the EBP symptoms are controlled now.
    Should I be requesting to have a follow up after 3 weeks instead?
    or after 4 weeks should i push the vet to reduce to 50% ?

    Regards
    Fanny

    1. Hi Fanny. Eosinophilic pneumonitis is a life-threatening disease, and so although you may be able to reduce the dose sooner, the small difference in total dose is unlikely to be significant to your dog’s health versus the risks. 1mg/kg is not an especially high dose either (we use up to 4mg/kg in IMHA for example).

  6. My dog seems slightly disabled, he s only 5 yo, and his gait isn’t right and very hard for him to get up when lying down. , he s had an XRay and vet couldn’t see arthritis or anything else. He was put on preds , and when he improved I was told not to suddenly take him off them. He s back on 5mg for an infected ear is it best to keep him on preds now please

    1. Hi Sue. That answer can only be found in a discussion with a veterinarian who knows your dog’s case intimately.

  7. Hello Dr,
    My 6.5kg moodle has been in 10mg pred for 12 days and is now on 5mg. How quickly can I safely taper his prednisolone?

    It was prescribed for ‘shaker syndrome’ but hasn’t seemed to help (he is an otherwise happy, energetic 2yo dog that shakes when he thinks we’re going to work) and the vet won’t give us tapering advice without coming in.

    Thanks,

    Angela.

    1. Hi Angela. Again, I am not able to advise you on when to taper the dose without an examination. Shaker syndrome is very hard to diagnose and often we have to resort to a treatment trial. I encourage you to read up about the disease.

  8. Hello Dr,
    My 6 year old German Shepherd who weights 40kg has had an infection on 2 of his paws for the last 2 months and has been limping a little. The vet prescribed amoxicillin 625mg and prednisolone 10mg twice a day for the first 30 days and tapered to once a day after 30 days. It appears to have become worse over the past week. There is some clear liquid discharge from both paws and the vet is asking me to continue the same medication for another week or two (after looking at photos of his paws). I’m concerned and do not have a specific diagnosis of the infection. He has had atopic dermatitis from when he was 7 months old and we’ve managed it with occasional prednisolone (2.5mg every 3 days). Please advise. Thank you.

    1. Hi Mohan. Although we all do it to some extent, using systemic prednisolone in association with infection is not a great idea if you can avoid it. In this case, I would wonder whether amoxicillin vs cephalexin would be effective against most bacteria found in interdigital dermatitis. I would also wonder about using topical antibacterials like chlorhexidine or betadine, and the use of topical creams such as those containing fucidic acid and betamethasone. These are just thoughts to consider.

  9. Our 10 year old 102lb malamute was put on 80mg /day prednisone for a few weeks for his unexpected onset of anemia. His blood tests have come back in the normal range and we are now on 40mg a day now for the past week but he has gone down hill with side effects. Weak hind legs, bloat, panting excessively, and now he is having trouble getting up all together. I could barely get him to the vet today. But His blood tests have come back as normal. I expressed my concerns with the increased muscle weakness but the vet told us that it’s just typical side effects of the prednisone and it would all reverse when he is off. I’m not sure she is right and I am now thinking she prescribed him too high of a dose originally. I want to get him off prednisone and would like to taper him to just the one 20mg a day for a week and then taper to half. But we are feeling hopeless and want to do something before our Poor boy can’t walk at all.

    1. Hi Jacqueline. It actually sounds like your dog has had a good response to a disease that is often fatal. We usually tolerate excessive side-effects at the beginning for the sake of their survival, but the dose tapers and the side-effects disappear. Read more about IMHA here.

  10. Hi Andrew, my active13yo tall Jack Russell 10.5kg has lymphoma and has been on Prednisolone for the past 20 weeks starting on 20mg and now on 5mg daily and he is doing well except for increased thirst and appetite. Do I need to keep it up daily or can it be every second day or 2.5mg daily would be ok? I would like him to be on the minimum if possible

    1. Hi Jo. It’s unlikely that such a low dose would work on lymphoma, but given there are many different types of this cancer, it’s best that you get specific advice from your own veterinarian.

  11. Hi. My 5 year dog is about 36kg ( about 80 lbs ?) He has been on 10mg prednisone daily -5mg morning and 5mg evening for almost 9 months ( he cant last 24 hours without it) He has polyarthritis/impa and wil need to be on it for life. Is 10mg a day safe?

    1. Hi Kevin. If 10mg is giving a benefit then he’s quite fortunate. As long as you aren’t seeing side effects and are aware of the need for slow withdrawal before stopping then I wouldn’t be too concerned.

  12. Hello and Merry Xmas!
    We have a 12 week old female kelpie x heeler with a very irritating itch. We’ve taken her to the vet and have tried bathing her in Malaseb medicated shampoo which didn’t really work. She’s got patchy hair loss and red- but not swollen skin. The vet has now put her on Prednisolone 5mg twice a day for 4 days then slowly reducing dosage from there. I’m just wanting a second opinion as to wether this is a normal/safe dosage for a puppy?

  13. Good morning
    Our shitzu was diagnosed with imha on tuesday with a blood count of 10.
    She has been put on prednisolone starting with an ijection as well as 3 5mg tabs. Next morn 3 more tabs then after blood test reduced to 1.5 2 times aday after her count went to 31. She is 11 years old . I will not let her suffer from this hideous didease could you please tell me if she will fully recover.
    Kindest regards
    Lea

  14. Our 5yo Cavoodle has been given PredX 20mg half tablet 2x day to treat Chronic bronchitis cough 5 days ago. Yesterday the dog was sleeping and began hysterically screaming.. Like howl/ screaming uncontrollably. We struggled to wake or console him. It was terrifying to watch and listen to. During the night he had another 4 episodes, along with continual panting and glazed eyes. The vet halved the dose today. Dog is still screaming, although less loudly. His eyes are dilated and he seems asleep with them open. As you can imagine we are wanting some insight into this situation. Dog is 13.5kg

    1. Hi Julie. Any symptoms that begin at the same time as a new drug should always be treated as potentially been caused by it, but what you describe is not something we normally see with prednisolone use. Therefore, I would keep an open mind that there might be another explanation. However, reducing the dose is sensible. Good luck.

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