What exactly are steroids?

Corticosteroids (also known as steroids or cortisone) are a type of testosterone cypionate for sale that is produced naturally in the adrenal glands. Corticosteroids play a variety of roles in the body, including stress response, immune system response, inflammation control, nutrient metabolism, and blood electrolyte maintenance.

Corticosteroids are produced by the adrenal glands in two forms:

• Cortisol and other glucocorticoids These regulate carbohydrate, fat, and protein metabolism and reduce inflammation via a variety of mechanisms.
• Aldosterone and other mineralocorticoids These regulate electrolyte and total body water levels by causing sodium retention in the kidneys.

What are the benefits of corticosteroids?

Corticosteroids are a valuable class of medications due to their anti-inflammatory properties. They are frequently used to treat mild inflammatory conditions and/or to suppress the inflammation caused by an allergic reaction. When taken in large doses, they act as immunosuppressant drugs, suppressing or preventing an immune response.

“Corticosteroids are a valuable class of medications due to their anti-inflammatory properties.”

Prednisone, prednisolone, dexamethasone, triamcinolone, and methylprednisolone are the most commonly prescribed corticosteroids. These synthetic corticosteroids are many times more potent than the naturally occurring forms found in the body and typically have a much longer half-life. Because of their increased potency and duration of action, synthetic corticosteroids must be carefully monitored in order to reduce the risk of serious side effects.

This class of drugs has benefited both humans and animals for decades. They are an essential component of many life-threatening disease treatment protocols. In most cases, the benefits far outweigh the risks. When used correctly, there are very few side effects.

What are the potential side effects of corticosteroids?

Corticosteroids can have both short- and long-term side effects in your dog, causing a variety of issues.

Temporary side effects

Short-term side effects are those that we would expect a dog to experience when starting on corticosteroids. These side effects vary depending on the type of steroid used and the dosage administered, and they include:

• thirst and urination have increased
• heightened hunger
• panting
• general energy depletion
• Infections may develop or worsen (especially bacterial skin infections)
• nausea or vomiting (less common)
• Corticosteroid use may cause some pre-diabetic dogs to develop diabetes. In many of these cases, once the steroid is stopped, the diabetes resolves.

If any of these side effects occur, they can usually be avoided by reducing the dosage or frequency of administration. In some cases, your veterinarian may prescribe a different type of corticosteroid to try to reduce the side effects. The goal is to find the lowest dose of medication that will control the condition with the fewest side effects.

Long-term consequences

Some diseases and medical conditions necessitate long-term corticosteroid treatment, either anti-inflammatory or immunosuppressive. Additional side effects become a concern when corticosteroids are used for more than three to four months, especially at immunosuppressive doses. The following are the most common long-term side effects:

• Urinary tract infections (UTIs), which affect up to 30% of patients. Urine cultures are performed on a regular basis to monitor the development of UTI. Because steroids suppress the inflammation and discomfort associated with a UTI, a patient receiving steroids may not experience the typical symptoms of a UTI. A urine culture may be the only way to detect an infection in many cases.
• development of thin skin, blackheads, and a hair coat that is poor or thin
• a lack of wound healing ability
• Obesity development as a result of increased hunger
• muscle weakness caused by protein catabolism (breakdown)
• Calcinosis cutis is the formation of hard plaques or spots on the skin. These plaques are caused by calcium deposits in the skin.
• increased proclivity to opportunistic or secondary bacterial infections
• heightened susceptibility to fungal infections (especially of the nasal cavity)
• the emergence of adult-onset demodectic mange (skin mites)
• diabetes mellitus predisposition

Corticosteroids, I’ve been told, can cause Cushing’s disease. Why is this the case?

Cushing’s disease may be caused by an overdose of corticosteroids. When a dog is given high doses of glucocorticoids for an extended period of time, he or she is more likely to develop iatrogenic (medication-induced) Cushing’s disease. Cushing’s disease is characterized by increased thirst and urination, an increase in UTIs and skin/ear infections, a pot-bellied appearance, thinning skin, and hair loss. The risk of iatrogenic Cushing’s disease is unavoidable in the treatment of some diseases. To reduce this risk, corticosteroid doses are gradually reduced over time, or a combination of drugs is used.

How can I lower my dog’s risk of experiencing any of these side effects?

Most dogs, thankfully, can use corticosteroids safely if a few simple guidelines are followed, such as:

• Except when specifically instructed by your veterinarian, avoid using glucocorticoids on a daily basis. Only life-threatening immune-mediated diseases necessitate long-term daily steroid administration. During the initial treatment phase, most corticosteroid protocols necessitate daily use. If your dog is on corticosteroids for itching or musculoskeletal pain, you should try to give them every other day. Inform your veterinarian if you believe your dog requires daily corticosteroid use; he or she may recommend an additional or alternative treatment combination. Stomach protectants (e.g., omeprazole) are frequently used to prevent stomach upset in dogs on higher doses or frequencies of corticosteroids.
• If your dog’s condition requires more than three to four months of corticosteroid treatment, the condition should be re-evaluated or other treatment options should be considered.
• Dogs on long-term corticosteroids should be examined quarterly and have urine cultures and blood tests every six months.

Corticosteroids can save lives and improve the quality of life for many dogs. Working closely with your veterinarian, you can safely administer these medications while also providing your dog with the high-quality care he requires and deserves. Please contact your veterinarian if you have any questions or concerns about your dog’s medications.