What Prednisone Does To Your Dog’s Body

The side effects of prednisone in dogs are not something you can afford to ignore when deciding if this drug is the right choice for your pup.

This article offers a case study of how prednisone affected an 18-month-old Boxer.

My pup had been healthy prior to the meningitis for which he was given the high-dose prednisone.

The meningitis was rough — but the prednisone treatment was equally awful. It has left us with a whole host of problems we’re still trying to fix to this day.


I am not a vet. This post is for general informational and educational purposes only. I encourage readers to see my full disclaimer here.


What is prednisone for dogs?

Prednisone is a steroid medication which can stop inflammation and, at its highest doses, suppresses the immune system.

It’s a very powerful drug. In one respect, it saved my dog’s life.

But prednisone causes many side effects, and they can be severe.

Prednisone is a double-edged sword. There is no getting around the fact that this drug does a lot of damage to the body.

Is prednisone safe for dogs?

Is prednisone bad for dogs? In many ways, yes. But, like I said, sometimes it’s a life-saving choice in an emergency, when vets don’t know what else to do.

Each dog responds differently to prednisone. There’s no telling how hard the drug will hit your dog. The side effects of prednisone in dogs will be much worse at higher doses. But even at low doses, prednisone side effects in dogs can be serious (see the skin condition calcinosis cutis below). The risk of serious side effects (even from low doses) goes up the longer your dog is on the drug.

This means two things:

  1. Keep the dose as low as possible.
  2. Keep the duration of treatment as short as possible.

Vets very commonly prescribe prednisone, usually mentioning only stomach upset and excessive hunger, thirst and urination as likely side effects.

It may be the only treatment for your dog’s condition. But check if there are alternatives that are gentler on the body.

My dog’s experience with prednisone

My dog took prednisone (prednisolone) for 11 months. He spent many of those months at very high dose. It was a godawful year. More than 10 months after completing treatment, we are still dealing with the consequences of this drug. I don’t know yet whether Shiva will ever be the same.

Prednisone or prednisolone for dogs?

The body breaks prednisone down into prednisolone. Give prednisolone and you save the liver that step.

What is prednisolone used for in dogs? All the same things as prednisone.

Prednisolone side effects in dogs are, unfortunately, the same as for prednisone. The two drugs will be referred to interchangeably in this article.

Which prednisone dose for dogs?

You can see from the pale blue chart below that the prednisone dosage for dogs varies widely, depending on what you’re trying to treat. This is because the drug has different effects at different doses.

Prednisone doses for dogs are described as milligrams per kilogram of dog weight per day. It’s well worth doing the calculations for the dosage your vet has prescribed so that you understand very clearly whether your dog is on a low or high dose and what kind of effect that is likely to have.

Prednisolone dosage for dogs is the same as for prednisone. Methylprednisolone doses are different. Methylprednisolone may achieve equal anti-inflammatory effect at lower doses.

What does prednisone do for dogs?

What is prednisone used for in dogs? Prednisone is very widely used by vets. They prescribe it for everything from itching to meningitis. It’s an ingredient in some ear drops for dogs.

At its lowest doses, prednisone basically supplements the dog’s own natural cortisol (in a dog with Addison’s disease, for instance). Slightly higher doses have an anti-itch (anti-pruritic) effect. At higher doses again it becomes anti-inflammatory. The highest doses switch off the immune system, as a way of treating “autoimmune” type conditions.

This is the riskiest level and comes with the most side effects.

Prednisone dosage chart
From supplementing the body’s normal (physiologic) level of cortisol to suppressing the immune system, the top section of this chart shows the different effects prednisone has as you increase the dose.

12 serious prednisone side effects in dogs

Prednisone messes with virtually every aspect of the body’s functioning.

There is almost no end to the disturbing changes you may well notice in your dog.

I observed at least 12 distinct effects in my one pup.

1. Liver damage is one of the side effects of prednisone in dogs

Prednisone is very rough on the liver. It can cause severely enlarged liver in a dog and drastically elevated liver enzymes in a dog.

At one point Shiva’s liver swelled to the point that you could feel it as a lump in his side. The specialist did an ultrasound because he thought the enlargement might be a tumor. In blood tests Shiva’s liver values shot up astronomically high. Ultrasound for a dog can mean sedation and even anesthesia, so it pays to be aware that prednisone can cause this degree of liver enlargement, so that you might be able to reach a circumstantial diagnosis and forego the stress of the procedure.

The good news is the liver is an organ that regenerates. So if you can limp your dog’s liver through the time on prednisone, it can recover.

What is Denamarin for dogs?

Anecdotal reports from owners indicate that milk thistle for dogs can help support the liver while on prednisone, as can the milk thistle-containing supplement Denamarin. Denamarin for dogs side effects? As far as I could work out, this was a fairly gentle supplement with no worrying side effects I could find. My dog was on it for quite a few months. Of course, anything you put into your dog’s already overloaded system is something else for his body to process.

2. Prednisolone side effects in dogs: gut damage

Prednisone does a real number on the gut. Gastrointestinal problems may be the most common side effects of prednisone in dogs.

It may well be the biggest problem your dog is left to battle —  potentially long after he’s finished his course of prednisone.

Can prednisone cause diarrhea in dogs?

Yes. Because of this, vets often routinely add a “stomach protectant” like omeprazole for dogs when prescribing high dose, long term prednisone. Of course, that’s yet another drug with its own suite of possible side effects. Some owners actually observe a worsening of their dog’s bloody diarrhea on omeprazole, so pay close attention to how it works or doesn’t work for yours.

At the very least, always give prednisone with quite a bit of food to offer some protection to the gut. Never give prednisone on an empty stomach, that’s for sure.

Regardless, you will need to rebuild your dog’s gut health once the prednisone is discontinued. We are now dealing with acid reflux that started just as my dog finished the prednisolone.

Here is a description of Shiva’s experience with acid reflux and how we’re slowly healing it.

3. Ravenous hunger, thirst & excessive urination

Prednisone makes dogs wildly hungry and thirsty. With that comes excessive urination — and weight gain if feeding is increased. Many owners find their perfectly house trained pet begins having accidents. Some dogs experience leakage in their sleep. My dog was appalled when this happened to him. Be gentle and patient and use pee pads if they help.

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Dog Heavy Breathing On Prednisone

If increased appetite, excess weight and peeing are your dog’s only side effects from prednisone, you are getting off very lightly.

4. Heavy panting at rest

Prednisone causes panting.

Your dog will be lying there almost asleep and puffing like a steam train. It’s quite distressing and something that often panics owners when it first happens.

I remember long nights counting Shiva’s breaths and googling “normal breathing rate dogs”.

Sometimes it can help to use cooling mats or a fan if your dog seems overheated. My pup stopped sleeping in his bed for several months while on prednisolone. He preferred to lie instead on the cool tiles of the bathroom floor. Beware the risk of hygromas  developing from too much lying on hard surfaces.

5. Psychiatric disturbances

Many owners — myself included — have noticed profound personality changes in their dog on prednisone. It’s one of the side effects of prednisone in dogs that you never hear about.

The drug is known to cause psychiatric disturbances in human patients.

That certainly seemed like what I was witnessing in my dog. My outgoing, confident pup became skittish and easily frightened. He would bark at shadows and seemed to be seeing things that weren’t there. He displayed some aggression towards other dogs for the first time in his life.

6. Depression / withdrawal

There’s a fair chance prednisone will make your dog depressed.

It’s a recognized side effect. Dogs become withdrawn and antisocial. Mine would leave the living room where the family was gathered, go downstairs and put himself to bed in the toilet cubicle. He clearly felt terrible and wanted to be alone.

Owners often report that their dogs stop showing affection and stop interacting. As the prednisone dosage is reduced, your dog will come back to you. Comfort him, give him space. Let him be where he feels most comfortable. Maintain a quiet environment so he can rest.

Diagram depicting Cushingoid dog, due to prednisone
This is exactly what Shiva looked like on prednisone, the classic “Cushingoid” appearance.

7. “Cushingoid” state

The adrenal glands produce the steroid hormone called cortisol. When the adrenal glands produce too much cortisol, this causes Cushing’s disease in dogs (hyperadrenocorticism), sometimes mistakenly called Cushing disease in dogs or just called Cushings in dogs. (By the way, there is a treatment for Cushing’s dogs.)

Administering prednisone induces this same excess of steroids. Which is why your dog on prednisone can develop an array of problems that match the symptoms of Cushing’s disease in dogs. Your dog doesn’t have Cushing’s, as such, but is said to be “Cushinghoid”.

Pot belly and fat rolls

A Cushingoid dog typically has a pendulous abdomen.

This unusual pot belly in dogs is due to the redistribution of fat that prednisone causes within the abdominal organs.

Your dog might also have:

  • hair loss or thinning
  • fat rolls on the back of the neck
  • bulging eyes

The drawing of the dog (above) from this article captures how my dog looked on prednisone.

He was 18 months old when he started the drug and aged 10 years in the space of a few months. He went from a bouncy puppy to looking and moving like an old, obese man. It was heartbreaking.

Have faith your dog’s appearance will normalize when the drugs are withdrawn.

NOTE If your dog has been so affected by prednisone as to become Cushingoid in appearance, he is likely to be more susceptible to adrenal insufficiency as the drug is removed (more on that later).

8. Adrenal glands

You’ll remember that, ordinarily, a dog’s adrenal glands produce the steroid hormone cortisol. And prednisone is a man-made version of cortisol.

How much cortisol the adrenals make is determined by a feedback mechanism.

So, when prednisone is present in the body, the body detects it as cortisol. In response, the feedback loop signals the adrenal glands to produce less of the hormone (since there’s already enough in circulation).

When prednisone is given in high enough doses for long enough, the adrenal glands stop making their own cortisol altogether. If this situation is sustained, the adrenals can shrivel up and atrophy. This is why it takes time for them to regain function when prednisone is withdrawn. You must taper slowly off the drug to let the adrenals gradually resume their cortisol-producing role.

Is once daily or twice daily dosing better for the adrenals?

What can you do to minimize the side effects of prednisone in dogs? Not much, other than use as low a dose for as short a time as possible. However, there is evidence that a once-daily dose of prednisone in the morning is less suppressive of the adrenals than twice-daily dosing. Read a study about that here. This means that at the point in the taper where you switch to once daily dosing from twice, the adrenals are likely to be waking up a little. It’s one of the reasons why a gradual taper is important.

9. Muscle weakness and muscle wastage

Prednisone interferes on a cellular level with the processes that build and maintain muscle. You will see muscle wastage. My very athletic male boxer faded away before my eyes. Spindly legs, no shoulder muscle to speak of. He was like a two-dimensional impression of a dog. At our lowest ebb he was so weak he couldn’t step up a single stair.

Owners often want to introduce a supplement to build muscle. It won’t do any good because what’s causing the muscle wastage is the prednisone, not any lack of nutrition. Giving a supplement will only burden the body with another substance to process. Hold fire and build back muscle slowly after your dog is off the drug. Some owners though say the muscle never returns to how it was before.

10. Calcinosis cutis and calcinosis circumscripta (skin lesions and lumps)

If your dog has skin lesions while on prednisone, check out our detailed article with photographs documenting this truly awful condition.

Calcinosis cutis and calcinosis circumscripta are often not immediately recognized by vets, so it may have to be you as the owner who diagnoses it.

The first sign of it in Shiva was on his tongue. You can see in the picture the white calcium deposits on the side of his tongue and underneath.

Unfortunately there is nothing you can do to resolve calcinosis. Nothing besides keeping the areas clean until you can get your dog off the prednisone. Then it will stop spreading and potentially resorb or push out through the surface and heal over. Antibiotics and other Hail Mary efforts will have no impact on calcinosis.

A biopsy can confirm diagnosis but this is probably an unnecessary stress (and an unnecessary anesthetic) for an already ill dog. If I had known what I know now, I would have been confident in diagnosing my dog’s skin lesions as calcinosis without the invasive procedure, which knocked him around.

11. Periodontal disease

Prednisone can wreak havoc with your dog’s dental health.

We’ve found success using raw meaty bones to bring Shiva’s teeth back to gleaming white after getting off prednisone.

While healthy dogs can easily neutralize the bacteria found in raw meat, I was never sure whether it was safe to raw feed a dog with a drug-suppressed immune system. We switched without problems to a raw, natural diet a few weeks after finishing prednisone.

How to raw feed a dog

12. Prednisone for dogs side effects: Infections

At its highest doses, prednisone achieves its therapeutic effect by suppressing the immune system.

Prednisone’s immunosuppressive effect means the body becomes much more susceptible to infection by pathogens that would normally cause no issue.

This can lead you down the path to multiple courses of different antibiotics to treat infection after infection. Although antibiotics may seem to clear the problem at least temporarily, they simultaneously inflict their own damage, particularly to the gut.

It’s a slippery slope and another reason to minimize the amount of time spent on prednisone and to use the lowest possible dose that gets the desired effect.

Vets and prednisone

Unfortunately, vets frequently prescribe prednisone without having much regard to managing the associated side effects. A specialist might prescribe the drug but then expect the local vet to deal with any complications.

“Get off the prednisone,” comes the advice. But your dog is on the prednisone in the first place to treat a serious and possibly life-threatening disease.

With the vets at a loss, you as the owner may very well be left with the task of deciphering the side effects and navigating all the various risks on your own.

It can be very scary. We felt completely at sea.

Dog recovering from steroid use
Coming back into the light. Shiva poses for a portrait on one of the slow walks we took during his convalescence — slow enough that I could carry a mug of coffee.

Getting off prednisone

You will dream of (and possibly fear) this day.

All the veterinary advice is that the prednisone taper for dogs must be done (painfully) slowly. This applies if the dog has been on the drug for any length of time longer than about a week.

“Addisonian” crisis

The risk of stopping prednisone suddenly is that it can send the body into an “Addisonian” crisis. In other words, the body’s adrenal glands, after being suppressed for so long by the prednisone, haven’t had enough time to switch back on properly and so can’t make enough cortisol when the body encounters a stressor.

A full-blown Addisonian crisis is an emergency that can lead to collapse and even death. Addison’s disease is the opposite of Cushing’s disease. Where Cushing’s is too much cortisol/steroid, Addison’s is too little. As well as the body’s fight or flight response, cortisol is needed to regulate all sorts of functions in the body. The treatment for Addison’s disease is — you guessed it — prednisone.

A typical protocol for tapering off prednisone after treatment for an inflammatory autoimmune condition. This schedule is known as the Mark Lowrie protocol. It amounts to a very long time on steroids.

Slow taper

The adrenal glands can take more than a year to fully recover normal functioning.

A quiet and predictable life is advisable during this time, with any changes introduced incrementally. Avoid over-excitement or too much physical exertion or stress. Stress can be caused by something as simple as a variation in routine or the addition of a new puppy to the household.

Steroid withdrawal / adrenal insufficiency

As the dose of prednisone is lowered, your dog might show signs of steroid withdrawal or adrenal insufficiency.

This is particularly likely if you step down the dosage quite a lot in one go. In some cases the signs of adrenal insufficiency mimic the symptoms of the disease for which the prednisone was originally given. Do your very best to avoid mistaking symptoms of adrenal insufficiency/steroid withdrawal for signs of relapse. Be aware vets can make this error too. If you bump the prednisone back up, thinking your dog is relapsing (when he is really just exhibiting signs of steroid withdrawal) this can set back treatment and unnecessarily prolong your dog’s exposure to the drug.

Whenever you lower the dose of prednisone, give your dog time to adjust. Some dogs can go a bit wobbly for a few days. But after a week or so their bodies should adapt to the new dose and you’ll see things stabilize.

The “physiologic” dose of prednisone

The potential for adrenal insufficiency heightens at the point in the prednisone taper where the dose dips below the “physiologic” level. (That’s the lowest possible dose of prednisone in that chart shown earlier.)

Lost? Let me explain.

Remember how I said prednisone is just a synthetic version of the cortisol produced naturally by the body? Well, the physiologic level of prednisone refers to the dose of the drug that matches the amount of cortisol the dog’s own adrenal glands would ordinarily produce. The natural level of steroid, if you like.

Below the physiologic dose, the artificial steroid provided in the form of the drug becomes low enough that the body’s feedback loop will detect a need for cortisol. In response to this trigger, the adrenals should reactivate, once again producing some steroid themselves — for the first time in a long time. This adjustment can be slow and it’s responsible for the wobbliness some dogs show at this point in the taper.

Limping

As we got to the lowest prednisone doses we experienced repeated instances of limps in both front and back legs. The limps came on suddenly. During this period my dog, on several occasions, injured himself during a walk. More than once he woke up limping.

In every case the limp would resolve after a day or two — or three — of rest.

There were so many prednisone-related weirdnesses that we got used to riding things out and not running to the vet every time something went wrong — which is what we had done at the start.

I now tend to think the limping was somehow tied to a detox process. When the drugs were withdrawn we also saw mucus in poops and paw cysts, which are known detox symptoms in dogs. All these things resolved on their own, without intervention.

Prednisone drug interactions with cyclosporine

If given together, these two immunosuppressant drugs can increase the effects of each other.

For a while my vet had my dog take both at the same time and his condition went rapidly downhill to the point that he could hardly get up. I insisted on discontinuing the cyclosporine and within half a day he was dramatically improved.

Beware anesthetic procedures after being on prednisone

If your dog has been on high-dose, long-term prednisone anytime within the past year and needs to have an anesthetic procedure, consider the need for a “steroid umbrella”.

This is where prednisone is given for a few days prior to, and after, the procedure. The idea is to support the body in case the adrenals’ ability to produce enough cortisol in response to the stress of the procedure is still impaired. It’s an approach used in human medicine too. You can read about it here. Vets mightn’t automatically think to do this with a dog. Make sure you do your own research. Make the vet aware your dog has been on prednisone recently. And make sure you know what is being done to account for that.

Explore whether the procedure can even be delayed to give your dog’s body more time to recover from the prednisone.

A dog after discontinuing high dose long term prednisone
Shiva after finally discontinuing prednisone. Still very skinny due to the gut damage caused by the prednisone. But a million times better than he was.

In conclusion: Day one of the rest of your pup’s life

Getting off prednisone is the first day of the rest of your and your dog’s life. Well done on making it through. There may well still be some hazardous terrain ahead, but at least now the drug can start clearing from his system.

What To Read Next

21 Ways To Detoxify Your Dog’s Life

Why I Stopped Feeding Home Cooked Food For Dogs

What To Do When Your Dog Is Sick

186 thoughts on “What Prednisone Does To Your Dog’s Body”

  1. This is the best article I’ve read whilst I’ve been on this preds journey with my Tibetan Terrier Disco. She’s being treated for IMPA and we are 4 months in. I wish I had read this right at the beginning as what you’ve described here is exactly what we are going through. Thank you so much for writing this – I have shared it within my IMPA Facebook group as I know there are many people starting out on the preds rollercoaster with their dogs who will benefit greatly from reading this.

    Reply
    • Emily I am so glad it helped. We’re now 9 months off all drugs after a very long and slow taper. Shiva’s body is gradually repairing the damage. I tapered even more slowly than recommended because I was concerned to make sure I gave the adrenals time to kick back in after spending so much time at high dose. In retrospect I think I might have been unduly worried about the possibility of “adrenal crisis” and wonder if there might have been more advantage in moving a little faster, to get off the pred sooner. You will get Disco through this and there will be new life on the other side. Don’t hesitate to reach out if I can help in any way.

      Reply
      • I was looking for research on Prednisone and found this article. But, it was too late. My Boxer passed away a few days later. I saw the Boxer in the pictures. My Boxer stomach and symptoms was exactly like that. I do hope your dog is well. Thank you

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      • I totally agree! Excellent article!
        My baby is currently undergoing treatment for ITP and has been on Pred for about 2 1/2 weeks now. This article gave me knowledge and hope

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        • I am glad to hear that Cheryl. Have you managed to get a sense of how your pup’s ITP came about? I was appalled to learn it’s been known for quite some time that vaccination can trigger autoimmune conditions in susceptible individuals. Dr Jean Dodds has done a lot of work on this and there are published papers going back to at least the early nineties. Immune-mediated ITP is one of the conditions she specifically links to vaccines. You know not to give any more vaccines ever to a dog that’s suffered from an autoimmune condition, right?

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      • My 9 yr old pit bull has been.put on this drug Wednesday will be two weeks do I stand a chance of her being ok if I stop it right now?? She can hardly breath pooping peeing can’t even jump on the sofa she looks at me like please help . I don’t even feel this was the correct choice being her cancer has NOT spread anywhere else in her body and everything the vet thought was a problem they were incorrect please help

        Reply
        • Hi Autumn

          Definitely the shorter time your dog is on the prednisone, the less damage it can do and the less need for tapering. If it’s been less than two weeks and the dose was low, it’s possible you could even stop cold turkey, or you might want to just reduce by a little over a few days before going to zero.

          Optimizing the diet to a fresh, natural raw one — if that’s not what you’re feeding already — and eliminating other exposures to toxins in tap water etc will set the best conditions to support your dog’s body to heal. Therapeutic fasting would be something I’d consider too.

          Wishing you and your Pit the very best,
          Jane

          Reply
    • Thank you for writing this article! My 2 weeks of prednisone for my Standard Schneider has turned into a nightmare. With vets not allowing us to attend the appointments it’s hard to get crucial conversations completed. I’m dealing with withdrawal problems now, but your article assured me that her time is not necessarily up, and these horror shows are just part of the process. It also assured me that I’ll ask for more natural treatments to problems that arise in the future.

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    • I totally agree with your statement! Out of all the articles I’ve read, instructions on how to and amount to give, plus the warnings and what-nots about prednisone, this by far is the best information I have received about this drug!

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  2. Hi,

    This is very accurate. It needs to be shared with anyone who’s dog is put on a steroid for any length of time, especially since vets downplay the side effects greatly…usually not informing owners of the full picture.

    My little dog was put on prednisone as an anti-inflammatory for a (unfortunately progressive) neurological issue. After the first week, she was miserable…throwing up, diarrhea, lethargic; a total wreck. It was awful. I called the neurologist multiple times over the course of the month. It didn’t improve her quality of life at all!

    Over 5-6 weeks of being on it she gained 15% of her body weight, experienced back end weakness, flares of the condition for which it was supposed to help (after never having any before), personality change, heavy panting, and a huge appetite. The dog that could go 3.1 miles in a morning (with breaks) became one that wouldn’t even walk two houses down the road. It was crazy!

    I began to research her disease and learned that the world’s leading expert on it recommends steroids as a last resort. Here we were right after diagnosis fighting the battle with them and being told that the steroid dose is the one to adjust to manage symptoms, not the one the leading expert stated was first on her protocol.

    Thankfully, I have a great primary care vet. She took all the information I had printed from the leading expert, listened to me explain all my dog had been through on the steroid, and listened to various other reasons I wanted her off of it. Many of the side effects mimicked her disease. Since symptoms are the easiest way to know what’s going on and the other option is another MRI, I definitely needed her off the prednisone.

    Thankfully, we were given the green light by primary care to medicate according to the leading expert’s protocol, and she would write the prescriptions so I don’t have to deal with the neurologist. They don’t even know what changes have been made, but I honestly won’t be going back to them after how they managed her care and refused to listen.

    We are 3 weeks off prednisone. Her body is still trying to adjust, but I believe it will get there in time. Current bigger issue is GI upset (again). Hopefully we will see turn around before I have to spend another $250 to get her system straightened out (again).

    This rollercoaster is not one I would wish on anyone. If I had known from day 1 that the neurologist wanted my 2 year old dog on steroids for the rest of her life, I wouldn’t have allowed them to start it in the first place. I naively assumed it would be a short tapering dose to get things under control. Lessons learned the hard way I guess.

    Reply
  3. Wow, seriously great article – thank you! We’ve been treating pemphigus foliaceus (PF), an autoimmune disease for almost 5 months with high doses of prednisone and then adding cyclosporine, doxycycline, denamarin and niacinamide. Watching the medication (prednisone) almost kill your dog is horrifying, and I found myself begging my vet to let us stop the prednisone. They insisted on not straying from the slow taper protocol, and as hard as it’s been, I’m getting my dog back and so far we haven’t seen any flares of her PF. I’ve seen all of the side effects you mentioned and wished I’d have this information at the beginning of the journey. I’m going to share on some support groups in hopes of helping others.

    Reply
    • Yvonne I’m so glad it helped a little. That was my hope in writing this article. That’s wonderful your pup is coming through the other side now. Thank you for sharing. The more dogs and owners we can help, the better.

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  4. Thank you so much for writing this article. We have been on the immuno-suppressive prednisone train for over two months now after a really bad immune reaction to my girl’s vaccinations! Boy has it been stressful. We are in the process of tapering now and every time we decrease, I’m convinced something is going wrong. That adjustment period is extremely rough. If you don’t mind me asking, what did you experience during this taper decrease adjustment periods?

    Reply
    • Autumn, I am sorry to hear about your pup’s vaccine reactions. You probably already know this but make sure no more vaccines ever for a dog that’s had a reaction. You can do titers instead in some places if that’s required to satisfy authorities. Glad you are tapering off the prednisone now, though it is very nerve-wracking. When we reduced dose we would see a general sort of malaise and off-ness for several days to a week, sometimes even pain/yelping on stepping down from the sidewalk onto the road and pain on climbing into the car, for instance. Staring off into space, strange behavior in general, vagueness. It can present very much like the symptoms of the original condition for which you went on the prednisone. An overrreaction to this adjustment period and misinterpretation of these symptoms as relapse unnecessarily prolonged my dog’s time on prednisone and did a lot of damage, so I’d encourage you to persist with the dose reduction for a week before concluding it’s relapse and not just the adrenals adjusting. If it’s very difficult to manage, you can go in smaller increments, more often to step down a little more gradually, if that makes sense?

      Reply
  5. Thank you so much for your article. We are on our slow downward taper for SRMA, but the weight gain and muscle loss are hard for our poor pup. I try to walk her, but she isn’t interested, and cannot walk very far. Our girl is not even 2 yet, so I’m hoping she can bounce back after she is off prednisone. Thank you for outlining what to expect, and what to watch out for.

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    • Hi Lori, I certainly relate to the stage you’re at with your pup right now and SRMA is a pretty terrifying experience, isn’t it. Try not to worry too much about the walking right now. We could barely get out for a toilet break at our worst and could not even walk up a single step. This will pass. The muscle takes time to come back but it will, once you’re off the drugs. Sounds like you’re a similar age to what we were, but if you’ve been on the pred a lot shorter than us (11 months), the long term damage will be a lot less. What breed is your girl?

      Reply
    • Hi Dee, three weeks is a very short time compared to our 11 months, so you probably have a lot less to worry about than us, both in terms of damage from the pred and the risk of tapering too fast. The factors I’d consider in deciding how fast to taper are 1. what condition your dog was on the pred for in the first place i.e. is it something life threatening or something more minor like itching… and whether there is any danger of relapse of that condition if you come off the drug too fast.. and how disastrous that would be, or not 2. how high a dose your dog has been on. Lower doses for itching you can come off much faster as the adrenals are less likely to have been affected. Anti-inflammatory and certainly immunosuppressive doses you would taper more gradually from. The other major factor is duration on the drug but at three weeks, that’s pretty short, which is very good news. From memory anything longer than 5 days requires a taper not cold turkey.. but you don’t want to prolong the time on the steroid unnecessarily either. Hopefully that helps you think through the decision?

      Reply
  6. Hi,

    Can one expect withdrawal symptoms after 12 days off pred (after being on it for 6 weeks and having done tapering)? I ask, because some days he’s been less ‘normal’ than others (more lethargic and less hungry) since he’s been off.

    Reply
    • Hi Ramon, I would expect that is possible, yes. My understanding is after anything more than a week or so on pred, the adrenals can be affected. This would particularly be the case if your dog was on high doses, enough to suppress the immune system. Given the adrenals produce cortisol in response to stress, excitement and to regulate many processes in the body, after only 12 days off the pred and depending on what is going on day to day in your dog’s life, you might well see some lethargy and other “offness”. They say, for instance, that it can take more than a year for the adrenals to fully recover after you’ve been on pred for many months. In your case it’s obviously a much shorter timeframe, but the principle is there: that it takes time after completely discontinuing the drug for the adrenals and the rest of the body to normalize. I’d be aiming for lots of rest and as stress-free and predictable a routine as possible for the next few months. We’ve found feeding a fresh food diet also helps support recovery.

      Reply
  7. Thank you for this. This is one of the most thorough articles I found. Wish I saw this a few months ago when we started this process. We are in the process of weaning my dog off and are getting somewhat close to being done or so I thought as we are on an every other day now. And the last step we took, my dog had the limp during a walk which as you said resolved itself in 2 days. Big question though, since the last step and now this one, did your dogs appetite fade and did she become constipated and not lose any of the weight she gained? Unfortunately our dog is on yet a different med they added to try and get copper out of her liver. Hoping its just part of the whole adrenal glands needing time. Glad your dog is back to normal. I can’t wait for that! She is not even 3 years old yet. Oh and has lost I’d say 70-80% of her beautiful bushy tail. Any clue on how long until hair starts regrowing? Thanks again!

    Reply
    • Hi Claire, well done on getting your dog this far. We experienced all sorts of weirdnesses, both during the taper and during the detox after getting completely off the drugs, so yes I would say the fluctuations in appetite and gut issues are most likely just part of the process as the body recalibrates. It can take a long time to rebuild gut health after prednisone. All this will be more dramatic the longer your dog was on the prednisone and the higher the dosage. Remember to take life slowly during this period of adjustment and for many months to come, so that the adrenals aren’t overly stressed before they have time to get back to full function. Excitement, stress, change of routine etc all require the adrenals to make cortisol so the body can cope. We certainly have a quality of life again now but even 12 months after stopping all drugs we are not back to normal yet. The damage takes a lot of undoing. As for the hair, that’s one of the things that comes back quite quickly once drugs are removed. You might find a lot of shedding, which can cause patches to go bare for a while, but then new soft hair grows in. I don’t know what effect the other drug your dog is on will have on all this. Did you use Denamarin or milk thistle to help support liver detoxification at all? Don’t know whether that might be an option instead of pharmaceuticals, in order to help get you off the drugs sooner? I know our blood tests showed all sorts of strange things while on the pred, including astronomically high liver values and high phosphorus for quite a while. We went to all sorts of lengths to get the P level down but in the end it just sorted itself out as soon as we were off the pred. I don’t know whether prednisone can cause copper levels to read high? Just thinking aloud in case any of that helps to work through the options. Hang in there, better times are most certainly ahead once you’re off the drugs.

      Reply
  8. Great read! Thank you for writing it. My poor Westie has just finished yet another round of pred due to a back paw hurting so bad he licked it far too much and caused infection. A routine grooming seemed to initiate all of this. A bad patella in that leg complicated his pain and the cycle continues. Vet insisted on second round of pred, Clevamox and a cone to stop the licking – poor guy is losing all his hair and seems scared to death, even “lost” and shivering with fear. He never barks, but this morning barked frantically when we went outside this morning. Yesterday was his last tapering dose. Will we be back to normal soon? I HATE putting a cone on this already freaked-out dog. Allergy foot ideas? Any insight at all greatly appreciated!!!

    Reply
    • Jude, that’s fantastic that you’ve come off the pred now. Hopefully done with the antibiotics too. Re the barking, I definitely noticed that with Shiva. He is a quiet dog but began barking at shadows, as though he was afraid and seeing things. I noticed the same psychiatric disturbance when he first went on high dose pred and again when we came off it. You should find that will pass pretty quickly. With the foot, the drugs will only be masking symptoms, not addressing the actual cause. I would be looking at whether you are feeding kibble or other highly processed dog food and whether you’re giving any chemical wormers or flea and tick preventatives. These things, as well as drugs and vaccines (look up vaccinosis) all contribute to the toxic load on the body. When the toxic exposures are minimal, the body can keep up. The liver, for instance, is constantly working to detoxify the blood, and the lymph removes waste from the tissues. But when there are so many toxins that they overburden the eliminative organs (gut and kidney), the body resorts to using other organs (most often the skin) as a sort of pressure release valve, to get the toxins out of the body as fast as possible. That’s when you see things like itchiness, skin eruptions, ear gunk etc. These usually get labelled as “allergies” or “infections” but are really just signs of a toxic body. If you remove the toxic inputs, the body can work on clearing the backlog. Initially when you make improvements, it’s common to see an exacerbation of the symptoms but this is part of detox and afterwards, the problem clears up once and for all. Depending on how old the pup is and how much toxic accumulation there is, this can take some months or years. So, it’s not a quick fix but it is real healing. Not what you’ll hear from conventionally trained vets because they are taught to “treat” symptoms with medication, rather than get to the bottom of the causes, which doesn’t actually cost anything but does require the owner to make some pretty big changes. A fresh, raw, species-appropriate diet is a powerful way to start, if you’re not already doing that. This is what I do with Shiva. Fasting is also tremendously helpful at accelerating healing. You can add some plant (sweet potato and quinoa) or fruit-only days (bananas, mangoes, blueberries, apples, fresh pitted dates are all suitable) into the mix as well as they help lighten the digestive load and free up energy that can then be devoted to detoxification. Hope that gives you some ideas to work with.

      Reply
  9. My 14 year old Alaskan Husky mix was put on prednisone about 3 months ago to help with weakness in his legs. We are trying rehab exercises and that vet told us to wean him off of pred. He is down to his last two doses (quarter tab) every other day. But, yesterday and today he can hardly get up or walk without the helpemup harness. He is eating well, but is the rapid weakness in his rear legs part of the detox symptoms or will this be a permanent issue? He is so uncomfortable and all I do is cry. I don’t know how to help him. But, if I have some hope that he may regain some sort of strength after being off pred, that would help me.

    Reply
    • Given the weakness has come on suddenly right as you’re tapering, I would tend to think there’s a good chance it’s related. Getting off the pred is certainly a good thing. Prednisone causes muscle weakness and wasting — we experienced a lot of that — as well as all the other damage to the rest of the body. Are there any other drugs in the mix? When my dog could hardly get up, it was caused by cyclosporine given on top of the pred. Each increases the effects of the other. When I discontinued the cyclosporine he improved dramatically within the day. If he was my dog, I would proceed with the taper, lots and lots of rest and expect to see things go a bit wobbly in coming weeks as the body adjusts and the adrenals recalibrate. There is a lot you can do with food to support your dog’s healing. If you’re not already feeding a fresh, raw diet, I’d be starting there. Adding some fast days is something else I’d do to accelerate healing. Hang in there, I know it’s unbelievably rough.

      Reply
  10. Excellent article, pretty much everything I am experiencing with my 10 year old pup. The trailing comments on what others are going through interesting. This is a big help in knowing what to expect. He’s been on Prednisone for almost four months and started tapering about two weeks ago. An open sore about the size of a dime has developed on his front elbow and is now on antibiotics for this. This definitely has been a roller coaster experience, good days and bad days. Yesterday was good, active, outside roaming around. Today, bad, can barley walk without support, hind legs are very weak. His hind legs have been weak for some time now but today was the worst. The sore on his front leg is not helping. The Prednisone have been rough on him and from your article I see this is common. Hoping for better days.

    Reply
    • That’s good news you’re tapering. Definitely the ups and downs are part of it. The muscle strength should return over time once the drug is fully out of the system. Re the elbow sore, check out the picture of the sore Shiva had on his elbow, caused by prednisolone in this piece. The specialist failed to recognize it, and thought it was just a pressure sore, but it was actually one of the very first signs of the calcinosis that was caused by the pred. If that’s what it is for your dog, you very well may not need to put him through the antibiotics. The fact you’re tapering now should see it resolve on its own.

      Reply
      • The picture of the sore on Shivas’ back looks pretty close to what I’m dealing with, almost a perfect circle. On my dog , Blue, it is open up through his skin. Not putting him through the antibiotics would be great. I’m three hours from the closest Vet and because of Covid they are not letting people in with their pets on visits. It has been tough, but with an article like yours and the related comments I’m not blindly working my way through this. Very appreciated.

        Reply
        • I’m very glad to be able to help a little. I know how horrid this experience is at the best of times. The antibiotics damage the gut, and add to the toxic load your dog will have to detox from .. so if it was my dog I’d be inclined to avoid them, particularly given how close you are to the pred no longer being an influence. If the sore is caused by the pred, antibiotics are not addressing the cause anyway. You’re already doing that by removing the pred. I would just keep it clean and give it time. Our calcinosis stopped progressing and then began to resolve once we’d been off the pred totally for several weeks. Yours, if that’s what it is, is nowhere near as far advanced as ours, so the healing should be swifter.

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  11. My dog was diagnosed with a pancreatic insulinoma, she was given two months to live back in January and put on steroids to manage the blood sugar with that cortisol (She started having seizures last Thanksgiving due to her pancreas firing out too much insulin and dropping her blood sugar) But now that it’s been 9 months the steroids are taking it’s toll,
    she’s losing mobility in her back legs and experiencing all the other side effects (I think the demodectic mange is presenting now) I’m now exploring the ides of weaning her off of this (not with out a vet involved of course) I’m so grateful to have these extra months with her, I’d hate for the management medicine be the thing that kills her too…or I have to make a quality of life decision when she can’t walk anymore. Anyhow I’ll see where this goes but it’s truly difficult to know what to do!

    Reply
    • Cecilia I’m so sorry you and your pup are going through this. Certainly in our case the treatment did a lot more damage than the original condition. I don’t have direct experience with pancreatic insulinoma but as I understand it, this kind of tumor is not cancerous and usually doesn’t spread to other organs? Is low blood sugar the worst of the symptoms caused by the insulinoma itself (as opposed to symptoms caused by the pred)? If so, I gather low blood sugar can be managed with small, frequent meals? From a whole body point of view, getting off the pred as soon as possible is always a good idea, tapering gradually. If you’re at the point of considering end of life, I would absolutely not give up until you’ve tried getting off the pred and given her body time to recover, which — based on our experience — could take many months to a year after so long on the drug. At this point much of what you’re seeing could well be from the pred (it was in our case), not the tumor. Once you’re off the immunosuppressants, for the tumor itself I would be looking at diet and fasting to help reduce its size and support the body to heal from the pred. I can highly recommend this group for guidance on how to feed properly. Their way of feeding has reversed many serious diseases, where drugs have failed — including in dogs with cancer and dogs “sent home to die”.

      Reply
  12. My Golden Retriever puppy was on 20 mg of prednisone for two months because of puppy strangles. The vet has started him on cyclosporine about a month ago. Increasing that dosage to 75 mg while we slowly taper off of the prednisone. He will be 5 months on Nov. 1 and he looks awful. The puppy strangles has gone away but the effects of the prednisone are horrible. He hasn’t grown up only out. He has the potbelly appearance. Small head. Bulging eyes. We are down to 5 mg morning and night. Will continue to taper for another month to six weeks. He is also on Flocazanole (may be spelling that wrong)
    Will he ever grow or be a normal looking golden retriever? I might sound shallow for caring about his appearance but to be honest I do.

    Thank you.

    Reply
    • Hi Kelly, this must have been incredibly stressful in such a young pup. Appearance is definitely concerning and on more than a superficial level – it reflects what’s going on inside your dog’s body, so I can understand your worry. It’s a positive step that you’re tapering the pred. Cyclosporine is also a very powerful immunosuppressant drug with serious potential side effects long term. My question would be: given the puppy strangles have gone away, why the need for any more drugs, whether pred or cyclosporine or Fluconazole which I think is an antifungal? I’d be exploring whether they can all be discontinued and your dog’s body supported to heal in natural ways.

      Reply
  13. Hi! Thanks for the article. Hard to find so much info on prednisone. Wondering if you have any experience with this- my dog had a aural hematoma and was given a large one time dose in her ear, under the skin not the muscle. It’s been 10 days and we are still experiencing many side effects- panting, accidents in the house, excessive thirst. Any idea how long it could take to get our of her system?

    Reply
    • Hi Haley, since your dog’s was a single dose, you’re much better off than those of us who were on pred long term which is much more damaging. Shows how strong this drug is though, that it can have such a long effect. It can take several weeks. You can accelerate the body’s detoxification processes by fasting your dog. If it was me, I would add a fast day. If the hematoma ever happens again, fasting would also be a good first response to that, instead of drugs. This Dr Karen Becker article might be helpful.

      Reply
  14. Hi I’ve just been reading all of the above, I am at my wits end I had no ide how this could be so horrible, my gorgeous 14 year old Jack Russell has only been on the pred for 2 days and her whole happy lively personality has changed, I wanted to stop them immediately but vet said i should Taper off . she has a constant honking cough and general antibiotics didn’t work, the cough has subsided but my poor baby seems so unwell its like she has given up and I am beside myself. I just hope she will come out the other side, she is urinating in the house and has never done this before and she is like she is just not there! but reading the above has given me at least some comfort. Thank you

    Reply
    • It’s stunning how quickly and dramatically pred has its effects. A few days is a very short course so your Jack Russell should bounce back once it’s removed. The urinary incontinence is a very common effect of pred and will stop, so don’t worry about that. Please let us know how you go?

      Reply
  15. Wonderful site you have created and an awesome article and comments above.

    My little man (25kg Border Collie cross) is 14 and a half years old (not a bad innings as they say I know). He had a stroke pretty much bang on three months ago and was immediately put on Delta Cortef – a name for preds. The dose was low to start at 20mg per day. Initially the vet wanted it to be given as 40mg every second day but it knocked him around so much we ended up moving to 10mg each day morning and night. This eventually got whittled down to 7.5mg morning and night. Some 10 weeks later I started noticing blood in his stool, dark blood which apparently indicates bleeding in the upper gastrointestinal tract.

    The last two weeks have been a nightmare. Dog go and I took a runny piece of his bloodied poo in to the Vet. Verdict was stop the preds for 24 hours then start back at 5mg morning and night until his stools returned to normal colour.

    A day or two later and he was getting picky at eating and seemed constipated. He was getting tired and seemed to be in pain from trying to poo without luck so I rushed Him back to the vet. This time I got another vet (his regular wasn’t available) and she said stop the preds immediately (he had only just restarted them), gave him a shot of buscopan and gave me antibiotics (metrogyl) for his tummy. Another day or two passed and now he wasn’t eating at all. Back to the vet we go.

    This time we had a shot of antibiotic, found some maggots under his bushy tail, had his bum shaved, cream for his sore bum, an enema (which was absolutely horrible for him, I have never heard him in so much pain) and four 600mg gabapentin tablets. One every eight hours, oh and get back on the preds he said. So I trusted him.

    Anyway, 600mg turns out to be excessive in my mind, it knocked him out for 16 hours – terrifying. I halved the dose for the next one, went to the vet on my own to discuss it and then gave him another half. I could see that the gabapentin was giving the tired little fella full and complete rest, no more gabapentin after this though.

    Another couple of days pass and we went back to the vet to share the story. This time it was basically the last throw of the dice. I asked if they could help hydrate him which they did (2.5L in all including vitamins and glucose).

    I haven’t given any preds since last visit. He has been drinking on his own but I am feeding him with a syringe. He was still walking fine after the enema but after the gabapentin and coming off the preds he is struggling. I just cracked and gave him 2.5mg of preds and might try that for the next few day to see if it will soften the edge for him.

    Thanks for your article, I never realised the effect preds have post stopping, even at low doses over a longer term. If this little change doesn’t work I fear I need to do the unthinkable.

    So hard, so confusing, so deflating for doggo and his friends. Our story might seem silly to some but that is the path we followed at the time. Any suggestions welcome.

    Reply
    • Josh thanks for the lovely comments and I’m glad the article was useful in some way. Your story does not seem silly in the slightest. I’m so sorry you and your dog are going through this.

      This strikes me as a LOT of medication, with one drug’s side effects leading to the introduction of another drug and so on.

      I’m not clear on how steroids are intended to help a dog that’s had a stroke? Do you have an understanding of that? Or is it just a stab in the dark by the vets? The standard response seems to be to throw steroids and antibiotics at a problem, without regard for the damage these drugs do. I would be asking myself whether the pred is actually helping and is there any reason the Delta-Cortef cannot be discontinued.

      Is it possible much of what you’re seeing right now is due to the effects of the drugs and not the stroke?

      Before you give up, I would be inclined to try:

      1) Stopping the drugs. You may well have to taper the pred rather than stopping suddenly if it’s been in the mix for 3 months.

      If pain is an issue, which it sounds like it is if they’re giving Gabapentin, CBD oil is a more natural alternative that many report provides significant relief.

      2) Fasting — this is incredibly powerful at supporting healing and helping to reset the body. I know it’s hard when giving steroids as they need to be given with food to mitigate gut damage, but if you get off the drugs, then fasting will be available as an option. Here’s an article on the benefits as it relates to dogs and here’s a broader article with some more information, focused on humans but the same mechanisms are at play in dogs and humans.

      3) What are you feeding? If it’s kibble or any other highly processed commercially manufactured dog food I would be getting your dog off kibble and onto a fresh, raw natural diet as a matter of priority. I can point you to some how-to resources if you’d like. You literally just need a butcher or a supermarket. We are made to think raw feeding is complicated but it absolutely is not. This will lift a huge burden from your dog’s whole system. This group was nothing short of life changing for us and well worth joining and posting your situation. Members have reversed many serious conditions including cancer and seizures using proper feeding alone — including in dogs “sent home to die”. If you do one thing, join and ask for advice and follow their guidance. The admins know their stuff.

      Hope this gives you something to work with?

      Reply
      • Hi Jane, thank you for your reply. We had tried all of your options in some way and my Little Man did love his raw meat.

        Unfortunately he could not take to eating on his own again and yesterday evening he went down hill quick. He was fine to the level where he knew what was happening and was happy to take 20 minutes of pats and massage but he was suddenly having trouble standing on his own. I was hoping he was tired and would bounce back in the morning. Unfortunately this morning he had not improved and I made the decision to get him to the vet ASAP. I took him for a drive through a bush area right next to the beach and he did manage to lift his head when he smelt where we were, a nice moment. As a very dear friend said to me on the weekend it is better to be a day early than a day late. I think we arrived right on time for my gorgeous adorable friend who left our realm at about 710 this morning.

        What started this? A stroke. What gave him three months of life? Preds. What made him bleed internally? My guess is preds but who knows maybe there was a tumour inside too. What drugs won’t I rush towards at anytime with any future pets? Prednisone and Gabapentin.

        Jane, this post and comments is the best information we found on prednisone over the last three months. Preds are a true minefield to manage and there should be more clarity around them (which your page supports). While I am at it, it is time the Federal Government put some standards in place for pet food quality in Australia, long overdue.

        Thank you Jane and all who have posted, happy joyful barks for all!

        Reply
        • Oh Josh, I am so sorry for your loss.

          It’s taken me a day to muster a response because I know how inadequate any words I offer will be.

          I am only glad that you were able to share a last moment getting the bush and beach in his nostrils.

          Thank you for your kind words at such a sad time, and for having the strength and generosity of spirit to share your experience and insights here so that others might benefit from what you and your dog have experienced.

          I am with you on the pet food industry and believe many problems start with what is fed, day after day, over a lifetime. I now never set foot inside a pet store and feed straight from the butcher, sticking as close as possible to a natural canine diet without preservatives and all the mistakes of commercially-manufactured dog foods that really bear no resemblance to what dogs are designed to eat.

          I have no doubt any future pets will benefit from what you’ve learned.

          Sending love your way.

          Reply
  16. First off, thank you so very much for this article and everyone’s comments/input! It has helped me understand the horrible side effects of prednisone that I am seeing in my two year old Boston Terrier. She has only been on prednisone for five days! Tapering off starts tomorrow! Thank you, Jesus, Mary and Joseph! Seriously, she is a completely different dog…..constant hunger, racing heart/panting, non-stop thirst, peeing and pooping constantly because of the amount of food/water intake, whining, weird stares, lethargic, fearful and sometimes shaking and tender footed. Most bizarre experience with one of my many dogs that I’ve ever had. Our awesome vet is on vacation this week but boy, he’s gonna’ hear from me! My sincere sympathies for anyone that’s dealing with their dogs on prednisone! Again, this article and everyone’s comments were incredibly helpful and very much appreciated. My questions were answered and I hope this article stays posted, forever! Happy Thanksgiving! Keep safe, all! 💕🐶

    Reply
    • Denise thank you so much for this comment. It’s a wonderful thing that you and your Boston can get on and off it fast. With such a short course you should get your pup back quickly once it’s out of the system. I’ll keep it posted, I promise!

      Reply
  17. Thank you so much for this article. My 13 year old terrier was diagnosed with IMHA back in August and after a blood transfusion and medications (including prednisone), his blood count is normal (low-normal, but I’ll take anything within the normal range any day), we started tapering off the prednisone yesterday, from two dosages to once a day. Today, he’s not eating, and is sleeping much more. I’ve emailed my vet with no response, but now seeing your article, I see that this is what my baby will be experiencing. It breaks my heart to see him slow down from one day to another. Hoping that within a few days, his body will get used to the decrease dosage of prednisone. He had gained weight from the medication and now, after reading your article, I understand that this medication really caused a lot of changes. Please keep him in hour thoughts for a successful ‘prednisone tapering off’ period.

    Reply
    • Maria, I know the feeling of waiting for the vet to call back and worrying about your dog. Sleep and lots of quiet days are just the right response as he tapers. He’ll let you know what pace he needs to go at. It may take more than a few days but bear with it. Not eating is actually more than okay — fasting is something dogs do naturally and it promotes detox from the drugs, and healing. And with the weight gain from the drugs he’ll have plenty of reserves, so don’t worry about that part of things. Wishing you both well. You will get there.

      Reply
      • My dog was was diagnosed with tumours in her kidneys and has been on this for 3 months she actually gained loads of weight and one side of her tummy swelled out allot so I have decided to take her off it as I feel it’s causing more damage then good she is 10 years old we have had all the tests done ultrasound etc and we no there’s no good ending to this so we will cater to her with pain meds as and when I wish I knew all this before allowing them to give me them they haven’t even asked for a review on her or called me to ask how she is I am so disappointed with my vets 😢

        Reply
        • Hi Selina, that is disappointing to hear that your vets have not been more involved. All too often they are happy to put dogs on meds but then hands off when it comes to the consequences of those drugs. If she were mine, I would get her on a fresh, natural raw diet (as soon as she is no longer immunosuppressed by the prednisone) and use some extended fasting to support detox from the prednisone, give her body optimal conditions and its best chance to heal what it can. Let me know if you’d like to be pointed in the direction of info on how to do this.

          Reply
  18. Hi Jane,
    Thank you for your article – it’s incredibly insightful. Our dog Fogle was diagnosed with steroid responsive tremors (shaker syndrome) in June. We’ve slowly tapered his dosage. He started at 20mg a day and is now at 2.5 mg every other day until early Jan.

    Fogle has had a variety of side effects, 2 of which don’t seem to be going away. The first is his hunger, the second is his aggression and general aversion of other dogs. He barks excessively, is aggressive towards other dogs and runs the other direction when he sees a group of dogs in the park. We were advised this would lessen as the pred was tapered.

    I’d be interested in knowing if similar side effects in your dog have slowly gone away now off the pred or if they are still existent? There isn’t much in the way of articles around what to expect once your dog is off the prednisone so I’d be interested in your experience. Thank you!

    Reply
    • Hi Samantha, that all sounds very familiar. The hunger will definitely normalize, so don’t worry too much about that. We had the aggression too and it does improve as well, but in our experience there can be some lingering behavioral issues because those behaviors become a bit of a pattern. But they can be worked on later, once Fogle is feeling better. First things first. I found just working around the behavior for the time being was probably going to produce the least stress for both dog and owner. Do you/the vets have any idea what caused the tremors in the first place?

      Reply
  19. Thank you so much for this article. I wish I would have found this prior to giving this to my dog. He was prescribed 10mg of this awful drug for upper resp infection. We just started Wed. of 1 every 12 hrs and then for 5 days 1 a day. I had to call my vet on Monday because he is not the same dog. He was the most high energy boston terrier ever and after a day he was hiding under the bed, sleeping for 20 hrs ago. Besides the thirst and excessive water drinking he now has started to become manic, he will start staring off to space so to speak and get manic if he needs to potty and starts running around the house. I asked to tamper off and she said go to 1 every other a day till gone. We have a week left of this drug. I also notice he is so weak I have to lift him on the couch. I am just so scared I will never get the same dog back again. He refuses to play with his fur sister and its breaking my heart. Never again will I give this drug. It worked and he is no longer having upper res issues but now his personality is gone. Im so worried and I am at least glad by reading comments to know Im not alone. I just pray this goes away.

    Reply
    • Coty you are very welcome. Your dog will come back to you once the drug is out of the system and he starts to feel more like himself, though it can take some time to totally clear. Fantastic you are almost there.

      Reply
  20. Thank you so much for the time you put into this article. It helped ease my mind quite a bit. Shiva sounds like an incredibly lovely dog who’s lucky to have you. 🙂

    Reply
  21. Thank you so much for this article! My puppy (mixed breed) was put on 20mg prednisone for meningitis when he was 3 months old. He is now 1 year. We have tried tapering about 4 different times without luck. He spikes a fever, trembles, starts severally limping and won’t eat. The vet always recommends to boost him back up to the full dosage again and try again after a couple weeks. We have tried going down from 2 doses a day to 1 3/4 to 1 1/2. The first couple times we tapered he made it down to 1 pill for about 3 weeks before relapsing again. Recently he only made it 1 week at 1 3/4 doses before relapsing. The vet also put him on azathioprine about a month ago to help with the prednisone tapering. The side effects have been horrible. He has open sores, rapid breathing and is extremely lethargic. It’s heartbreaking to watch. The vet thinks as his immune system matures more the tapering should start to work. Hoping there is light at the end of tunnel.

    Reply
    • I’m so sorry you and your little one are going through this. They do say that dogs can “grow out of it” with SRMA, so don’t give up.

      Have you considered that the symptoms you see when tapering might be adrenal insufficiency rather than relapse? They can look the same. I made that mistake the first time we tried to taper and the vet advised us the same thing, only to find later that the CRP test showed no elevation in systemic inflammation ie it was not a relapse. So we’d unnecessarily prolonged the time on high doses, resulting in more damage to the body that could have been avoided. I would be inclined to see what happens, next time you taper, if you give the body time to equalize over a week or so before concluding it’s relapse an upping the drugs.

      The other thing I would be doing is making sure you’re eliminating all possible toxic exposures ie. make sure you’re not giving your pup chemical wormers/flea preventatives, not using chemicals or scented products in the home, no pesticides/herbicides/lawncare chemicals, and an SRMA dog should never again receive vaccinations. As much as you can do to reduce the toxic load your dog’s body is carrying will help and of course all the drugs add to this.

      It’s hard when the immune system is artificially suppressed but once you’re through this I’d be highly recommending a raw, natural canine diet too, to avoid the preservatives and chemicals and other problems with kibble.

      Reply
  22. Hi!

    My little dachshund had a slipped disc 4 months ago.

    She has been on prednisolone all this time.
    I tried to wean of the cortisone 4 times now. Every time I manage to stop it fully, after 4-5 days, she cannot use her back legs anymore. My vet sees that she is not paralyzed at all and can feel her strength. But when I go back to the prednisolone, she gets back on her feet and can walk.

    She is loosing hair on her back, she has a pot-bellied appearance and a runny nose.

    I did many researches on Google, but your article is the most complete one.

    I took my chances again and slowly stopped the cortisone (after reading your article).

    It’s been 7 days now.
    2 days ago, she started walking on her back legs without falling. What a joy!
    But today, on the 7th day, she started to fall again. Her back legs are back to very weak.

    She is on Gabapentin only. Half a pill in the morning and half a pill before bed.

    She is also taking CBD oil twice a day and Omega-3 fish oil once a day.

    Do you think this is a normal behaviour after 7 days?

    Thank you so much for this webpage.

    Reply
    • Hi Mat

      I’m so glad she was showing positive signs during this taper, until today. While I don’t have direct experience with slipped discs, given she’s been on the prednisone for a significant amount of time, it’s possible some of the symptoms you see during tapering, including back leg weakness, are due to adrenal insufficiency rather than the disc issue — particularly if your vet thinks the disc should be healed by now.

      If she were my dog I’d be considering proceeding with the taper, perhaps more slowly. So, you could stay on the dose you’re currently at for a little longer than planned, to give her body time to adjust to the lowered dose. Or you could go back a step in the taper, stay there for a little while and then reattempt the rest of the taper.

      If the way the prednisone removes the symptoms is by suppressing inflammation, I would be doing all I could to reduce inflammation naturally, via a natural canine diet ie. a raw meaty bone-based diet. I can direct you to some resources on how to raw feed if that’s helpful. If the prednisone dosage has not been at immunosuppressive levels you could start that now. If it’s been high enough to suppress the immune system you might want to wait until the pred is out of her system before transitioning to raw feeding.

      Fasting is also known to have an anti-inflammatory effect, and is a natural part of how dogs eat in the wild, so I’d be incorporating that into her routine ASAP — again, hard to do while on pred given you have to give it with food, but once you’ve discontinued it.

      7 days is certainly enough time for the adrenals to be feeling the effects of reduced pred dose, and if you have always gone back to full pred dose when this happened in the past, it could be trying something different and seeing if it might just be the adrenals.

      Another idea: it possible some of what you see might be Gabapentin side effects that are masked by the pred but appear as the pred is reduced? Is she in pain or can you begin to get the Gabapentin out of the equation too, so you can see what is really your dog and what is the combined effect of all the drugs?

      Hopefully that gives you some ideas to work with.

      Please let me know how you go.

      Reply
      • Hi Jane,
        Thank you for the reply!

        I think I wasn’t clear enough.

        Zoe is at her 8th day without prednisolone. The tapering was completed 8 days ago.

        The first 4 days were very hard for her. Unable to walk. Then, on day 5 and 6, she started walking again, but very weak. On the 7th day, she couldn’t walk anymore. Today is the 8th day. She didn’t fall and was able to walk.

        She doesn’t seem to be in pain or show any anxiety. Overall, I think its extreme weakness. The first run in the morning is always the best one. Then I start giving her gabapentin. She gets weaker throughout the day. I don’t feel safe yet to reduce the gabapentin.

        I’m thinking about helping her with hydrotherapy. I bought a life jacket. I could make her swim in the bath. I am not sure if it’s a good idea.

        My vet asked me to stop the cortisone and wait a month for blood tests.
        I cannot go back.

        I still have hopes she will get stronger every day.

        Reply
        • Ah, I’m following you now. Sorry, Mat!

          In that case, this sounds like what’s to be expected as the prednisone clears from the system and the body readjusts.

          I think this sounds very promising and you will see some ups and downs but a general improvement in coming weeks and months.

          Swimming is certainly a low impact form of exercise if she’d be comfortable in the bath? Otherwise I don’t know whether you have access to any natural environments – waveless beach or lake? – nearby that might be more enjoyable for you both?

          Good on you for getting her through it. Please let us know her progress.

          Reply
  23. I don’t know if you believe in miracles, but I do. My “stumbling” upon this article today is no coincidence, it’s a God send! Our entire life was upturned on November 30, 2020, when we took our Beagle, Kenzie, to our primary vet thinking she must have eaten something over the Thanksgiving weekend that left her feeling icky and not wanting to eat. In less than 5 minutes, he rushed her back out to our car and told us to take her to the ER immediately as she had a temp of 104.5 and her gums were stark white. The urgency in his voice concerned us and 2 hrs later, we were told that our sweet furbaby had a very serious condition called IMHA. Shocked, I listened to the ER Dr. as she attempted to explain what this was and exactly how it was affecting our girl. Her PCV was down to 13, she was icteric and in critical condition. My baby was dying and I didn’t even have a clue! She said that Kenzie was most likely in need of a blood transfusion and they didn’t have it there, so we had to transfer her to yet another Emergency care facility the next city away. Once admitted, she was given her first blood transfusion and a treatment plan was initiated. In was nearly impossible to leave her there but we had no choice. As my husband and I drove home without our precious girl, we were in a state of complete shock. The next 6 days and nights were hell. I prayed every minute that God would save my baby. I hardly slept a wink and every night I feared that phone call nobody wants to get. On the 5th day, she still wasn’t responding to treatment and we were forced to approve a 2nd blood transfusion in the hopes that it would bridge the gap and that she would soon respond. The following day, her PCV rose from 26 (post BT #2) to 34. They felt fairly confident that Kenzie was finally responding to treatment and that afternoon, we were able to bring her home to continue the recovery process. Praise the Lord! This was everything I had prayed for and my prayers were answered! We rushed to the hospital to scoop up our baby girl, along with 8 medications to be administered 5 different times a day for the first week. I was terrified and completely overwhelmed, but this was no time for falling apart. I sucked it up, put my big girl panties on and began on the next part of the God awful IMHA journey.

    I’m sure anyone reading this already knows what a continuing rollercoaster ride of ups, downs and loopy-de-loops having your beloved pet on Prednisone is. Our 35 lb. Beagle has been on a moderately high dose of it (20 mg. twice daily) for exactly 3 weeks now. It is most definitely taking its toll on her little body, both inside and out. Our first appt. with a new Internal Medicine Specialist on 12/14 revealed a mixed bag of news. Her PCV was up to 43–fantastic! However, her labs showed elevated liver values due to the high dose of Pred. Since then, I’ve noticed an increase in the adverse effects of her required medications. We completed her 2 week long Rx of Metronidazole (for diarrhea), which didn’t improve her diarrhea at all. Since then, over this past week, her BM’s have actually become much more solid, consistent she is no longer straining. I also noticed the very disturbing rapid eye tremors she was experiencing while on Metronidazole seized to exist almost immediately and she isn’t stumbling as much. Ok, great! But she is still on that high dose of Pred, as well as a high dose of Cyclosporine (100 mg twice daily) and I’m really worried about it. Our next appt. with the Internal Med Dr. is 1 week from today on 12/29 and they say if she is continuing to do well, we can discuss starting the weaning of Prednisone. However, I’m quite concerned that she is actually being over-medicated with the Prednisone and the Cyclosporine. Additionally, she is taking 18.8 mg of Clopidogrel (Plavix), which again, has a whole array of possible side effects. This week, I’ve noted her activity level has declined some, her muscle mass is visibly less, though she is still wanting to go for a walk and sniff around the yard with vigor (I’m on her like white on rice every second we’re outside). Her appetite is BEYOND. She obsessively searches the floor for a morsel of anything, apparently. She’s taken to trying to eat slugs every chance she gets when outside, something she never did before. She does well during the day, but is super restless at night and wakes up staring into space or jumping up and wandering around aimlessly every couple hours all through the night. A few times, in the very early AM hours, she has had acid reflux episodes, which I am really starting to think is due to the Pred and Cyclo together. As much as I know these drugs initially saved her life, we are no longer in the acute stage of her disease and with her body seemingly regenerating red blood cells on its own, I feel that she may be receiving too much immunosuppressant drugs.

    After reading your story, I see you also had major concerns about your sweet boy being on Prednisone and Cyclosporine simultaneously, and for good reason. Can I ask for your input regarding our situation in this area? Should I voice my concerns about the Cyclosporine to the Dr. at our check up next week? I know that their current protocol is to keep her on the same high dose of Cyclosporine, while starting to reduce her Prednisone dose in 20-25% increments, checking everything every week as we go. However, I feel like if her bone marrow is regenerating her red blood cells on its own, which it appears to be, then why are we continuing to suppress her immune system to such a high degree and seemingly, forever? They act like she will have to be on Cyclosporine for life, but I don’t think so. Also, we already have a homeopathic treatment plan in place to begin as soon as it arrives (it’s safe to do while still on Rx drugs) which is specifically designed to treat IMHA and similar autoimmune diseases. I want to try to get her off everything and control her IMHA as naturally as possible. And of course, now that I’m so much more informed about the weaning process of Prednisone, I realize it will be our greatest battle. TIA for any input or suggestions you might be willing and able to provide.

    This article provides so much more information than all of the Doctors who’ve been working with Kenzie/us, combined! There is just SO MUCH they don’t tell you and I’ve discovered that it really is up to me, as my dog’s owner and advocate, to research and find out all I can on my own. That is why I say your article is a God send (not to mention the Raw Food Diet article). I don’t think anyone would have told me anything as thoroughly about the weaning process of Prednisone. Certainly not to the extent you have. Thank you so much for the time and consideration you’ve taken to share your story and to provide so much unique and detailed information. It’s quite comforting to feel like I now have a head start on knowing what to expect in the next stage of our journey as we begin to wean off of and detox from Prednisone, and, hopefully, all other drugs, ASAP.

    Reply
    • Linsey, I am so sorry you and Kenzie are going through this. You’ve been through the wringer and I relate to the feeling of your mind racing a million miles an hour, full of worry and questions and searching for answers that don’t feel like they’re being provided by the traditional avenues.
      I’m sorry I missed replying before your next specialist appointment.

      I don’t have experience with IMHA so I can’t offer any well-founded advice on the combination of meds and what’s worth getting off/staying on but I had a look on Facebook and there seem to be a couple of groups of owners with dogs going through this that might be worth connecting with if you haven’t already?

      https://www.facebook.com/groups/6228146980

      https://www.facebook.com/groups/1323597764385389

      I learned an enormous amount from similar groups for my dog’s condition and you might get some clues about what’s worked for other dogs.

      What you’ve described definitely aligns with our experience of the side effects of prednisone and Metronidazole too is a drug that seems to be prescribed at the drop of a hat for but which can have nasty side effects including causing meningitis. Good that you’re off it now.

      If you can satisfy yourself from the information you’ve been able to turn up from the vets and other owners and your own research — checking Google Scholar etc for research papers can be worthwhile too — then I think the general principle of getting off the drugs as soon as you can is the right way to be thinking, given all the flow-on effects that cause for the body.

      Even cyclosporine I think long term is associated with an increased cancer risk, which makes sense given it’s an immunosuppressant. I do know that cyclosporine and pred each increase the effects of each other, so that will be going on as well.

      Glad you found the raw feeding information. I wholeheartedly believe that is the answer to healing and preventing disease, once you’re in a position to transition.

      I would have no hesitation in pointing you to this group as well https://www.facebook.com/groups/healingdietfordogsandcats — join and post your dog’s situation and see what advice admins can give. This group will be invaluable in terms of using diet to heal long term too, and offering a truly holistic counterview to the standard allopathic approach of diagnosing and suppressing symptoms with drugs.

      No real answers but hope that helps some?

      Reply
  24. Thank you so much for this extremely informative, concise, but very personal article. I have just given my 10 year olds boxer his 2nd dose of prednisone. The specialist, after a sonogram, is not completely sure if he has pancreatic cancer, or enlarged lymph nodes mimicking a mass, caused by systemic lupus ( or immune disease caused by cancer. The treatment for all of these are the same- prednisone, so we will not be having a biopsy done as chemotherapy at his age, and given his terror of crates ( he was a rescue) make invasive methods impossible. We had to wait 4 days for Rimadyl to leave his system before starting the steroid and in the meantime was told to give Prilosec
    ( Omeprazole) in the interim to counteract stomach issues. My Dino had been unable to walk, has oozing, crusty, lumpy sores all over and inside his ears, face, paws, pads and body. He was basically in a catatonic state for the 4 days we waited for the Rimadyl to leave his system. To our amazement, last night at 2:30am, 17 hours after his first steroid dose, we were awaken by him walking to the door and scratching it to go out!! This morning he is alert & focused, this 2nd dose given earlier. ( 2 20 mg pills, once a day for my 79 pound dog)
    I thank you so very much for caring enough about others to put together this article – I wish someone has posted a similar one prior to your journey with Shiva- in time for me to be well aware of all the pitfalls of Prednisone. For Dino, it is a necessary evil and I would like people to know it is a post- Christmas miracle in his case. This steroid is probably only a way to prolong his life a bit and make him comfortable in the meantime, not used as a long term treatment.
    We wish Shiva and all the dogs mentioned in the remarks good recoveries , continued health, and their owners a most Happy New Year!! Sending love from NYC

    Reply
    • Thanks so much for your kind words and well wishes Carolyn and I’m glad your Dino is doing better.

      I definitely saw prednisone work like a miracle on Shiva initially too. It’s the effects you start to see with prolonged use, particularly prolonged high doses, that are the killer and which don’t always rear their heads immediately.

      I can understand the choice not to put Dino through the stress of the testing and invasive methods when it won’t change what you do.

      I’m not sure what you’re feeding now and whether transitioning to raw is advisable when immunosuppressed (I waited til we stopped pred to do it) but if you’re feeding kibble, even shifting from highly processed commercial dog food to home cooked fresh, real food would be worthwhile in terms of relieving some of the load on the body — if you’re open to that?

      Reply
  25. Thanks for writing this up! I wish we knew about all these possible side effects although we still needed to use prednisone for my dog’s IMPA. Pred has worked almost immediately within hours on my dog when she first showed signs of limping from IMPA and she was doing quite well on it without showing any side effects until about 8 mths in, she had clostridial overgrowth, and then AHDS (1 severe episode, 2 minor). And throughout all these GI + metronidazole issues (and still on a very limited diet), we’ve been slowly weaning off pred with no issues until today where she’s limping after a week of us dropping the dose down from everyday to every other day 🙁

    Was leflunomide an option for your dog rather than cyclosporine? We’re now just discussing our next steps of trying a second agent drug to see if it’ll help wean off pred completely, and both these names came up although I think our vet is recommending leflunomide.

    It’s been a really long year and pretty depressing to think that we were so close to dropping pred completely but now have to add another drug. I hope we will be drug-free eventually! And at the very least, pred-free soon!

    Reply
    • Hi Jen, you’re most welcome.

      Leflunomide I think was mentioned among the many immunosuppressants the neurologist began mentioning as an alternative to prednisone.

      By that point I had come to the conclusion that it was better the devil we know and stuck with the prednisone rather than introducing another drug which I figured came with its own set of risks. I’d be wanting to get as good an understanding of the side effects of any drug before going with it and would be inclined to opt for natural approaches or even homeopathic ones over convention approaches using drugs that may well suppress symptoms, but do nothing to address the original cause of the condition.

      Vets seem to throw up their hands at cause and just go with “autoimmune”. I now increasingly see conditions labelled this way as having their origin in an overload of toxins, through process of toxic accumulation and even vaccinosis.

      I don’t have experience with polyarthritis but it seems to certainly share with our condition the fact that it’s inflammatory and regarded as immune-mediated.

      With IMPA is the expectation that your dog remains on some kind of drug forever? Or given that you were tapering the pred, is the thought that eventually you come off all drugs?

      I certainly wish we had discontinued drugs much sooner than we did: at the time I was more frightened of relapse than cognisant of the damage the pred was doing. Now I would be more likely to prioritize getting off the pred and other drugs, righting the conditions for health in terms of proper feeding, avoidance of chemical wormers, vaccines etc and approaching health through those natural means rather than staying with the drugs. I know it’s so difficult though when you’re trying to balance all the various risks.

      I would definitely be thinking there’s a fair chance the limping is a symptom of pred withdrawal, as the body adjusts — and in that sense may not be anything to indicate reversing course or adding other drugs, as it may not relate to the IMPA. We had limping during the taper that was initially misdiagnosed as relapse of the SRMA, but which I saw in subsequent tapers and which resolved when we stayed the course, continuing with the taper. If necessary you could slow the taper. How is the limping now?

      Check out the Healing Diet for Dogs group I always mention because it’s been so life changing for us. Here’s the link:

      https://www.facebook.com/groups/healingdietfordogsandcats

      Wishing you and your girl a healthy 2021.

      Reply
  26. Hi, Thank you so much for taking the time to write this excellent article. I have learned so much from reading it. Our handsome 3 year old Labrador Retriever was diagnosed with Meningoencephalitis (MUO) 5 months ago. He has been on Prednisolone all this time, albeit we have been reducing the dose every 5/6 weeks on the advice of our vets. It has been quite an emotional rollercoaster having to deal with the different side effects that this drug causes; something if I’m honest I was not really prepared for. A few weeks ago he started to develop sores. They have now erupted all over his body. Calcinosis Cutis has been diagnosed. Fortunately over the past few months we have been able to taper the dose down to a level which enabled us to finally stop the Prednisolone a couple of days ago. We are hoping now that his skin will slowly recover. He is very tired and his legs weak. Thankfully having read your story I realise that this is part of his recovery process and not a relapse. I wish vets were more honest about the serious side effects of this drug at the beginning of the treatment.

    Reply
    • Penelope that is WONDERFUL news that you’ve gotten your boy to the point of being pred free. It’s no small feat.

      The calcinosis will certainly stop and eventually clear but it can take some time as the drug clears from the system. I’m assuming you’ve seen our experience with calcinosis, which was more the circumscripta form, as lumps, but which has the same cause as the cutis type: prednisone. Here it is just in case: https://shinyhappydoggy.com/calcinosis-cutis-in-dogs/

      You spent less than half as long as us on pred so you’re recovery and return to condition should be a lot easier than ours.

      Very glad we could save you making the mistake of making the mistake we made of allowing the specialist to make a misdiagnosis of adrenal adjustment/pred withdrawal as a relapse .. which led to many more months at high dose pred, and so much more damage.

      Reply
  27. I have a 7 almost 8 year old bullmastiff. Who has been on no other medicine went to the vet because She had an aural hematoma. So they put her on prednisone. Not even 4 days into it she had a full blown seizure (never had happened before) so she spent the day at the vet- getting all the tests and X-rays the whole nine yards done..they said her heart beat was very quiet, her heart rate was 40 bpm and she had an afib heart beat. Now you can only imagine the concern and how upset one would be when your dog is absolutely fine one day and then she’s knocking on deaths door. So they send her home and say to start weaning her off medicine and she also had another mild seizure the next night. They said she needs to get an ekg done, that the seizures are because of her heart not because of her brain. They thought she had a 3rd degree av block – which means if that is the case she will need a PACE MAKER in order for her to live long or her heart would just stop at some point. So a few days go by she is now off the medicine and I’ve been going through the stress and hating myself because I can’t afford a 10k$ pace maker,and I finally find a emergency vet an hour from my home to give her an ekg because the one at the normal vet broke! I bring her there crying the whole time waiting to hear the worst. they take her in, check her vitals give her the ekg and call me to tell me “she is absolutely fine.. her heart rate, there no valve blockage no afib..” as one could imagine my jaw drops and I’m like are you sure you called the right person? They say nope she will be right out.. since then she has had no other issues 🙏 and she is back to her normal self. The vet still has no idea what happened.. I can tell you one thing I will never give my pets prednisone ever again.

    Reply
    • Ema thank you for sharing this and how astounding. I am so glad your bullmastiff made it through this and that you were able to discontinue the pred fast enough to avoid losing her. The vet might say no idea what happened, but you would think it’s pretty clear what happened: prednisone.

      Re aural hematoma, my first response to something like this — and to most health issues — would be fasting. Side effect free and the results in terms of resolution of symptoms are usually quite dramatic.

      Here’s a link to more information on fasting in dogs:

      https://healthypets.mercola.com/sites/healthypets/archive/2018/05/27/pets-therapeutic-fasting.aspx?v=1609114900

      I would also be looking to optimize the diet by avoiding kibble and other commercially-manufactured dog foods which are highly processed .. and feeding instead home-prepared fresh, raw whole foods to prevent recurrence of the ear issue and to support overall best possible health.

      In case it’s helpful, here’s how we approach raw feeding:

      https://shinyhappydoggy.com/raw-feeding-a-dog/

      This group may well be of interest to you:

      https://www.facebook.com/groups/healingdietfordogsandcats

      Wishing you and your bully the very best.

      Reply
  28. My dog has multiple mast cell tumors in her prescapular lymph node. The cytology report said metastic. Sehe has been on prednisone for eleven weeks. 20mg for three weeks, 15mg for three weeks and 10 mg for the past five weeks. The size of the tumor has increased greatly and the side effects are very unpleasant. I want to wean her off the prednisone. I plan to give her 5mg for 5 days, then 2&1/2mg for five days, and then 2&1/2mg every other day for a week. Am I tapering correctly? I know she wont be with me much longer but I want her to be happy and comfortable in her final days. Am I doing the correct thing?

    Reply
    • Hi Bob

      Without being a vet, but based on my experience tapering my own dog off prednisone for a different condition, that seems like a reasonable taper to me.

      You’re following the general principle of tapering which is to drop gradually and stay at each dose for enough time for the adrenals to adjust but no longer than absolutely necessary.

      It’s always a balance between management of the symptoms for which the prednisone was originally given, and trying to minimize the significant damage the pred itself inflicts on the body especially when given at high doses or over prolonged durations.

      Tapering can be faster the shorter the dog has been on the pred and the lower the dose has been. I don’t know the breed/size of your dog so hard to judge whether that’s been a high dose for her weight. 11 weeks is long enough to require a taper but not so long as to suggest it should be any slower than normal.

      You can always commence and adjust depending on how you observe her coping. Bear in mind wobbliness and all kinds of strange symptoms can be part of the adrenal adjustment and should pass by giving it a little time and if necessary slowing the taper or even going back a tiny increment if things are really terrible, but then proceeding with the taper.

      I should say I have no knowledge or experience with prednisone for the treatment of mast cell tumors.

      I also have no experience with this group but I’m aware of its existence and the success some seem to report having with it, so I just draw it to your attention in case it’s something you want to research, especially if you feel you’ve exhausted other avenues:

      https://www.facebook.com/TagametBenadrylCancerRemissionProtocol

      My approach to cancer would be a more holistic, natural one involving optimization of the diet and the the use of fasting to support the body to regenerate.

      If you’re feeding kibble you’ll want to get off it and onto a natural canine diet (based on raw meaty bones, muscle meat and organs) ASAP.

      Many owners in the Healing Diet group I often mention have healed cancer, including in dogs “sent home to die” without drugs but simply by use of proper feeding and fasting. They can ably guide you in doing it but you’ll find feeding dogs their species-appropriate diet is much simpler than we’re led to believe.

      This is the group:

      https://www.facebook.com/groups/healingdietfordogsandcats

      If it were me, I would be posting your situation there and taking full advantage of the experience of the admins.

      Reply
      • Thank you Jane for all that information. The dog is a Kelpie/Pit mix. She weighs 45 pounds. I have no idea what is a large dose for her weight.. She started on 20 mg.per day lowered to 10 over 11 weeks. Is that a large dose for her weight? I put her on 5mg for 1 week. And today started her on 2&1/2 which I’ll do for 1 week and then do 2&1/2 every other day. Don’t know whether thats a slow enough taper. Interested in your feeling about that.

        Reply
        • Going by the dosages listed in the top of the blue table in the article above, her starting dose of 20mg per day (and converting her weight from pounds to kgs, she’s 20kg) that dose works out to be 1mg/kg of dog bodyweight per day, which means it would have been having an anti-inflammatory effect at the original dose. That’s not the highest dose possible, which would be 2-6mg/kg/day, at which level the effect on the body would be immunosuppressive. Taper seems reasonable to me. You can always adjust as you go depending how she copes, but you’ve been slowly tapering for quite some time so you should be in good shape in that regard. Hope she begins to feel better as you get down to lower and lower doses.

          Reply
  29. Thank you so much for this article, it has helped a ton during a scary time with my dog. I am currently weaning my 10 yr old hound off prednisone and its been a nightmare. Watching him suffer through the God awful side effects has been extremely stressful and depressing. I wish I read this article prior, maybe this could have been avoided. I feel he has no quality of life right now, but reading your article has given me hope that he will be back to his old self eventually. Thank you!

    Reply
    • Stephanie I’m so glad it helped. A nightmare it definitely is, but the only way out is through and you’re on your way. Hang in there for him and the quality of life will gradually return. Try to look after yourself too as they pick up on our energy and feed off it, so the more positivity the better. Easier said than done, I know.

      Reply
      • My dog has changed a lot in his behavior. The worst one is that from about 3 on he wants a treat and barks by my side of the bed. Any suggestions for combating this?

        Reply
        • Hi Julie, is your dog on prednisone? It is known to create artificial hunger and can also create more restless and even aggressive behavior and is known psychiatric disturbance in humans so likely does in dogs as well. He doesn’t actually need any extra food. Both his appetite and his behavior should return to normal once you get off the steroids.

          Reply
  30. Wow! I am both horrified and amazed that I found this site, this article and all of these comments! I am in this boat right now. 2 year old Golden acting a little off, for a few days took him in, they anesthetized him in order to get an x ray and bloodwork because I thought he ate a sock or something. We get him home and he couldn’t move or eat for three days, got a call saying he probably has cancer, the blood work is consistent with cancer. ..here’s 60 mg of prednisone to make him comfortable. What? Well, we did that for 2 weeks, I had enough, muscles gone, head shrunk lethargic and you know the rest. I cut it to 30 mg, he was then able to run around and play and I noticed his ears had some color again and some warmth. After 9 days of that I noticed blood in the poop. I suspected that it was poisoning my healthy dog. I demanded that I get a continued tapering schedule that is safe and effective , as I do not believe for a second that he has cancer. So the Vet said you can cut in half again, but he may succumb to his condition. We dropped to 15, and he threw up for the last 2 nights. So far so good today, hasn’t thrown up since 1 am last night. No other pups in his liter are sick. I am baffled. If he has cancer, he doesn’t know about it. These side effects are horrifying and I feel are not warranted. I am so sorry that all of these lovely people are having to watch their pups suffer. Thank you so much for writing this awesome article. I feel there is hope and that what I am seeing is in line with withdrawal symptoms. Any additional advice for overall tips, now that I am at 10-15 mg per day…its hard to break the pills perfectly. I really don’t want to go back there. With Covid, they require drop off so you really don’t know what’s going on. Also, I found bubbles that are non toxic, made for cats and dogs. It gets him moving around and he loves it! Just a fun thing to add.

    Reply
    • Erin this sounds horrid, I’m so sorry you two have had to go through this. Good on your for using your gut. You know your dog and you’re right to advocate for his best interests when things don’t add up. I remember stressing about the pills not breaking properly, yet another thing to worry about on top of everything else, right? The pills used to just shatter on me, so I hear you. I had a pill cutter for a while and it helped with some of them but not others. Just do the best you can, it will be close enough. I think I eventually ended up asking the vet for pills that were a lower dose so I didn’t have to chop them so much to get the right amount, but I can absolutely understand not wanting to go back there and just working with what you have. If it’s making life really difficult you could perhaps ask over the phone for pills that contain fewer mg per pill and just drop past and pick them up without your dog having to be involved? If he’s having fun and feels well enough to run around after the bubbles, that’s a wonderful sign! Given you were only on the highest dose for 2 weeks before starting to taper, the adrenals shouldn’t need overly long to adjust to the pred withdrawal as long as you keep reducing in steps. Sending you and your boy healing energy.

      Reply
      • Thank you for the encouragement Jane! I will ask for a lower dose pill so I can do this slowly. He has times of total limpness, and then times where he wants to play. I do think now that I dropped the dose too quickly, 60-30-10mg. I just couldn’t bear to watch it anymore. Now I am riddled with how to proceed. The red blood striations stopped in the poop, and was normal for a day, but today it was a bit darker and kind of sticky. Again thank you for this awesome reference. Thank you to everyone that has commented.

        Reply
        • Did you have the blood in the poop prior to pred? From what you’ve said I’m thinking it only started once you were on the drugs? In that case, I would be hopeful the gut will heal as the prednisone is removed, so keep going! Notoriously rough on the gastrointestinal tract as you know. Not that I’m keen to recommend even more drugs but a medication called Omeprazole is sometimes prescribed alongside pred as a gut protectant. (Not everyone finds it works, some find it makes things worse.) Are you making sure to give the pills with plenty of food to offer at least some buffering to the gut?

          Reply
          • Yes! He gets the prednisone with food. No prior issues with blood or anything in his poop. He was a healthy happy boy, until this mess. I am so confused as this whole thing came on so fast! Can it really be that a 60 mg dose of Prednisone (2 weeks) and 30 mg for 10 days, and now 10 mg for about a week, can cause so much damage so quickly? I think I read above that healthy dogs can suffer a lot from withdrawal. Honestly I am pretty freaked out at the idea of bringing him to another Vet, in fear that they’d want to give him more meds. So my next question is, what do you give your dog in the way of supplements? I bought Dr. Marty’s food, probiotics, and his joint supplements. He gets other fresh foods and some dehydrated organ meat snacks. I give him Omegas and VetSmart Turkey Tail mushroom, mix with milk thistle. When we were told he has cancer, this was the route started on, so here I am trying to wean him off the prednisone . I don’t know if there is anything I can do to stop the damage other than keep on keeping on, making him comfortable. Any ideas for supplements to stave off the muscle wasting? He stumbled for the first time today. And I am guessing that I will have to stay at the 10 mg dose for awhile before we can visit tapering down any further. I just don’t know how long he can take it. I blow bubbles outside a few times a day for exercise. He stopped chasing the ball… thank you for listening.

          • I reached the point where I consulted a homeopathic vet and he just wanted to start us on a whole ‘nother set of supplements and remedies which seemed to me just another, albeit gentler and less damaging, version of traditional vets wanting to drug us to the eyeballs. It was at that stage that I discovered this facebook group https://www.facebook.com/groups/healingdietfordogsandcats and it was our game changer. No supplements (far better for the body to get the nutrients in whole food form), just a fresh biologically-appropriate canine diet and the use of fasting to trigger deep cellular repair and regeneration. Many members including the founder Nora Lenz have reversed cancer in dogs without drugs or supplements of any kind. I would highly recommend joining, posting your situation and doing what they say. Life changing. It’s about getting out of the body’s way so it can detox and heal. I can wholeheartedly attest that their method, called rotational monofeeding, works. Many members have arrived there after exhausting all veterinary avenues.

  31. My little cavalier mix suddenly got an allergic reaction from god knows what, and got all swollen in her face. Because I was worried about her breathing I gave her a rather high dose of prednisolon during that day only (after vet contact) and she improved within 24 hours. Another 24 hours later she has been puking constantly for the whole night but the vet seems to think it’s not connected. They are asking if she ate a sock or something like that. It’s very frustrating. I could find vomiting as a side effect within a few google searches. I really hope this will go over soon.

    Reply
    • Seems unlikely to be a coincidence, doesn’t it. Regardless of what exactly has happened, fasting her would be a good course of action. No food until at least 24 hours after the stomach upset has stopped will not only avoid putting more food in a stomach that is trying to empty itself, but give the gut some digestive rest and support the body to clear the toxins from the pred. Of course, keep fresh, pure water available. Lots of rest.

      Reply
  32. Hi Jane,
    My Standard Poodle Holly is 5 yrs old and was diagnosed with IMHA last October. This came on her literally overnight.
    Her PVC was 18 and then 23. Ultrasound was done, bloodwork sent to NCS Vet School to rule out any tick born diseases. She was immediately put on Prednisone 60 mg, blood thinner, pepsid for tummy.
    Blood work every week and PVC is stable at 30 now. We have started slowly lowering Prednisone and are at 3rd decrease of 25 mg. Oh she is also on Azathioprine now since lowering Prednisone. Liver is showing slight jaundice.
    My vet is keeping a weekly check on her.
    Am I missing anything that the specialist had to say that you contacted or any thoughts on what we are doing?
    What exactly would you feed her?
    We give her Fromns with parboiled chicken livers.
    Sue Stormzand

    Reply
    • Hi Sue

      I don’t have direct experience with IMHA so am not sure I can see anything you’re necessarily missing. But some thoughts in case it’s helpful:

      1. Both IMHA and the condition my dog had are considered “autoimmune” and vets use immunosuppressants like prednisone to treat both.

      I have come to understand the causation of these “unexplained” diseases as less a random aberration that you can’t do anything to prevent and more related to a combination of various toxic exposures that accumulate in a kind of “stacking” effect until one day you get the straw that breaks the camel’s back and you see an outbreak of disease.

      I believe in my dog’s case the major contributing factors were misfeeding including kibble and other processed dog foods, vaccination, use of monthly chemical wormers and chemical flea/tick products, which I’ve since learned are known to be toxic to dogs and to cause “adverse neurologic events” to the point that the FDA issued a warning about it.

      2. I have been reading Dr Jean Dodd’s work on canine vaccines, which she researched over decades. She names standard poodles as one of the breeds at heightened risk for suffering severe and lingering adverse effects from vaccines.

      She specifically links IMHA and other immune-mediated diseases to the use of MLV (modified live) vaccines. All the 3 “core” vaccines (parvo, distemper and hepatitis) are MLVs. The rabies vaccine is regarded as one of the worst in terms of provoking adverse reactions.

      Here’s her site: https://drjeandoddspethealthresource.tumblr.com/post/32291451370/canine-vaccines-when-too-much-turns-bad-part-2#.YAzzBXczZpw

      Just in case your vet hasn’t mentioned it, you know a dog that’s suffered an autoimmune condition must never be revaccinated, right? The only legally mandated vaccine is rabies and you may be able to get an exemption if a vet will state that the vaccine poses an unacceptable risk for Holly.

      It’s not just the adverse reactions that can happen at the time of vaccination or in the weeks and months following. There is a syndrome called vaccinosis that holistic vets recognize but which conventionally-trained vets still seem to mostly poo-poo the existence of. It can take years to develop and involves chronic disease that often doesn’t get traced back to the vaccine because it was so long ago.

      3. It’s great news you’re tapering. You mention another immunosuppressant drug in the mix. For IMHA, is the plan that she comes off all drugs or has to stay on them at some level, long term?

      4. Re food, I think it’s a huge part of the equation in terms of getting well and staying well.

      I’m unclear whether feeding a natural canine diet ie raw meaty bone-based diet is at all problematic when the immune system is artificially suppressed.

      But certainly you want to avoid kibble and other highly processed dog food. Once you’re off the drugs I would wholeheartedly recommend a fresh, raw diet involving edible bone, muscle meat and offal.

      This might be helpful: https://shinyhappydoggy.com/raw-feeding-a-dog/

      Hope that helps in some way.

      Reply
  33. My 5-yr old English Lab was recently diagnosed with immune-mediated meningitis. She’s on 2-mg 2x/day prednisone – today is day 13, we will be tapering over the next 2 weeks (or possibly longer). I give her a good dog food without fillers (duck & pea protein with Veges & fruits). She received an infusion of a chemotherapy/auto-immune drug last week. They are recommending another round in about 2 wks.

    It’s been a rough go, she’s peeing all over herself because she’s sometimes too weak to stand up. She’s wasting away. I’m trying to get her up and move around because I just discovered some skin breakdown.

    Wondering about adding CBD oil for her? Would this be a good time to start on a raw food diet? Any other tips??

    Reply
    • Hi Lezlie

      I’m so sorry you and your dog are going through this and glad to hear you’re tapering.

      The muscle wastage is directly due to the effect of the pred. Remember I’m not a vet but as I understand it, the muscle wastage is caused at the cellular-type level, so not due to lack of exercise or something you can necessarily avoid with exercise etc. Based on our experience, the muscle should mostly come back (we are still working on it!) once the drugs are out of the system. Maximum rest for now is okay. Maybe an orthopedic bed or similar to ease the pressure from lying down so much?

      I have not used CBD oil but considered it at one point. I think from memory you need to check possible interactions with the other drugs. I hear of people having success with it as a less toxic alternative to pharmaceutical pain killers but she’s probably not necessarily in pain now, is she? I gather you have to be careful about where you source it to make sure you’re getting the real deal. I know dog trainer Mike Ritland recommends a certain CBD product but haven’t looked into it.

      Re food, kibble is definitely sub par nutrition, regardless of brand unfortunately, because of the way it’s made. Raw food diet, I am 100% certain is the most optimal way to feed dogs: fresh, whole foods rather than highly processed shelf-stable product. What I’m not sure of is whether it can be fed while immunosuppressed. Dogs ordinarily have no problem with the natural bacteria etc in raw meat but don’t know how that’s affected when the immune system is suppressed with powerful drugs. I ended up home cooking for a period and then starting raw as soon as the drugs were stopped. That could be a way to go? Canned food can be marginally better than kibble too, as an option. This relates to Boxers but gives you an idea of the issues with kibble: https://boxerdogdiaries.com/should-boxer-dogs-eat-kibble/

      Do you know about the Facebook groups for owners? Dogs with Meningitis and Surviving SRMA. On the web you can also look for CIMDA (Canine Immune Mediated Disease Awareness) and ask Jo who runs it questions directly.

      Hang in there, you will get her through it.

      Reply
    • If she were mine I would definitely discontinue the heartworm meds as they are an added source of toxic load, and they kill heartworm because they are neurotoxic. Depending where you live and what the weather/temp is like the risk of contracting heartworm may be very minimal. It’s transmitted by the bite of an infected mosquito and the parasite larvae can only survive in sustained warm temperatures. Are you giving any flea/tick meds? The FDA has warned that brands containing the isooxazoline class of drugs are associated with “adverse neurologic events” — and that’s in well dogs. Definitely no more vaccines ever for a dog that’s suffered an autoimmune condition.

      Reply
  34. Thank you for this article. Our Kato is almost 9 years old and had a STS removed in August and then had radiation in October because they were unable to get clean margins. The tumor was also a grade 3. He went on prednisone in early December because he developed pneumonia. It took a long time for his chest x-rays to show improvement in his lungs and the vet said to continue the dosage. 1-10mg tablet/12 hours. Over the last month, I’ve noticed the hair thinning on his back end and the weight loss. He also started yelping and quivering about 3 weeks ago and the diarrhea started about 2 weeks. He had been on prednisone for almost 2 months.
    He has been weaning to one pill for 5 days. Now every other day for 3 dosages. He’s eating, but has trouble going number 2. We have found accidents in our house 3 mornings this past week. I am going to get diapers for him, but how long will it take for him to have a normal bowel movement? It has been loose and mucous and he cannot hold it through the night. I hate seeing him in pain and he’s not himself. When will he turn a corner? Reading this article, it seems it will take months. The x-rays have also shown 2 lesions in his lungs, and our next step was to look into metronomic chemo for the STS which was removed. It just never ends.

    Reply
    • Aimee it’s wonderful you are tapering Kato off the drug now. Well done on getting here.

      What you’re describing is certainly the kinds of effects you get as you come off prednisone. Gut damage is a very common result of the drug, but two months is recoverable from.

      Mucus is actually a good sign in the poop at this point, indicating detox. We had exactly the same thing at exactly this point. As the dosage is reduced, the gut sheds the mucoid plaque it had built to protect itself from the medication, as it’s no longer needed. Vets often misinterpret this mucus as a sign of “infection” and prescribe an antibiotic like Flagyl for it, which doesn’t work and causes other problems. Wait it out and you’ll see the mucus clear in a few weeks. I think ours took abut 5 weeks to clear up. It may come and go a few times after that. Have you seen our article about mucus in the poop? It documents what it was like for Shiva at the point of discontinuing pred/the final stages of the taper.

      We are still recovering gut health and body condition including muscle more than a year after being off the pred but remember we were on it for 11 months, 3 of them at very high dose. You will be in a much much better situation and he should bounce back faster.

      Rather than more drugs I might be considering alternative approaches. I can hear the exhaustion in your words and totally relate to the worry you’re feeling. If you’re open to addressing things with diet, I would recommend joining the Facebook group I’ve mentioned elsewhere called Healing Diet for Dogs and Cats. It’s been life changing for us and I know members including the founder Nora have reversed cancer without drugs, including in dogs vets gave up on and sent home to die. You definitely as a priority want to be feeding a fresh, natural species-appropriate canine diet — as opposed to processed kibble or the like.

      The other thing I would definitely be exploring if he were mine — and the above group is very experienced with it — is fasting. You probably initially recoil from the thought because Kato’s already thin, but it can be hugely powerful in supporting healing and in detoxing after heavy duty drugs like prednisone. Actually there is research showing a three day fast in humans “resets” the immune system, other research showing fasting during chemo in human patients both enhances the effectiveness of the treatment and protects against the toxicity of the drugs. I have a chapter on fasting in the book if you’re interested and go into the fasting research in depth there, or let me know if I can explain more here. I use fasting with Shiva.

      Hope that helps in some way?

      Reply
    • So Kato is now on meds to help with his diarrhea. It’s much better, but he still has no energy and only gets up to go outside to do his business. He is still so weak and when he walks he often falls down because his back legs collapse. We basically need to hand feed him too. It’s just so hard to see him like this.

      Reply
      • Hi Jane, I missed your reply. I will take a look at that facebook group. I’d love to hear what we can do for his diet. As far as fasting, Kato didn’t really eat for a 24 hour period. He did eat some today, but I guess we can not force the food on him. Thank you so much for your input.

        Reply
  35. We are currently tapering our senior lab off of prednisone he has been on for about 1 year for heart and lung conditions. We are just past the physiological level and we have also experienced random limping! We also have had issues with urination and bacterial skin infection. Did you notice that during the taper too? In any case we are very happy to get him off the prednisone as he hasn’t been able to grow back any hair and definitely has the addisonian “look”. Thank you so much for this article I have so much more hope!

    Reply
    • Hi Jessica, so sorry to hear you’ve had to take this journey too.

      You are getting there if you’re at the physiologic level. Keep going!

      Yes, issues with urination are common during detox from drugs like prednisone. What exactly are you seeing? Both incontinence and difficulty urinating can be due to drug detox. This will pass. UTIs and skin infections can be due to the immunosuppression from the pred, but these won’t be an issue once your lab’s immune system reactivates which will have been happening slowly as you’ve gotten to these lower doses. The hair will absolutely regrow so that’s one less thing to worry about. And the Cushingoid appearance will go away too. If you have muscle wastage, I’ve noticed that’s something that can take longer to restore.

      I am glad the article helped. You are in just the right spot to think about what changes you can make whole of life, once you’re off the pred. I’d be thinking seriously about the food especially. I can go into more detail here if it’s helpful or it’s all in the book where I go through the ways I overhauled Shiva’s care after pred. Good timing as I just put it out this week. If you do check it out please let me know if you have any questions or if I can help in any way.

      Reply
  36. Thank you for writing this Jane. I’m beating myself up now for putting my trust in my vet. My beagle Bentley was put on pred for a stiff neck and itchy skin two weeks ago. Now he can barely get out of bed. This medication also turned his stool black. I was told reduced his dosage from twice a day for 5 days, once a day for 5 days and once every other day( 30 tabs) . It’s when I started the every other day that we ran into a huge issue. I started to notice heavy panting during the once a day cycle. We didn’t even make in through his once every other day because he vomited, drank two full bowls of water and was shaking so badly. I called the vet and apparently this is normal? I don’t see how. If I felt like my Bentley probably feels I would be in the ER. I ended up giving him a half a pill which stopped the shaking. But he is so restless and uncomfortable still. He is 8 years old and I’m so worried some of these side affects may be irreversible. I will be contacting my vet again tomorrow and we are definitely not going to be adding 3 more medications because of the side effects of 1 medication like vets normally prescribe.

    Reply
    • Monica, thanks for writing. I know what it feels like but don’t be too hard on yourself! It’s the vets who we trust to have this knowledge to advise us correctly. You’ve caught it early. Two weeks on pred is still short term and there’s every reason to think Bentley can recover from this, and probably faster than you think.

      Black stool can be a sign of bleeding in the upper GI tract, as opposed to bright red blood in the poop being a sign of bleeding in the lower digestive system.

      That taper sounds standard and, from an adrenal gland point of view, I would have thought no need to go slower since he’s been on the drug such a short time.

      Definitely some of the upset you’re seeing during the taper may well be nothing more than the body adjusting to the withdrawal of the drug — especially if the dose was very high? Although for itchy skin it’s usually low dose?

      If he were mine I would slow the taper for a day or two by staying at the same dose and then proceed with the taper. I agree more drugs will only complicate the picture.

      Upping the dose will always appear to resolve things because prednisone masks many symptoms, without addressing the underlying cause.

      As for a plan to resolve the symptoms for which you originally went on the steroids, I’d be looking at the whole dog. For instance, what are you feeding? What chemical wormers/flea and tick products does he ingest etc. These things can be at the root of the issue. In the book just published a few days ago I go through the seven or eight big changes I made with Shiva in this regard.

      Let me know if I can help you think anything through further.

      Reply
  37. Thanks so much for writing this Jane. I am completely beside myself, my wonderful, otherwise very happy and healthy 15-lb Cairn Terrier girl Rori, who is 13 years 8 months old, has been on an anti inflammatory dose of 10 mg (5mg every 12 hours) a day of Prednisone for one week and 2 days. She had an MRI the first day (Friday, Feb 5) that shows SRMA. She had gone from dragging her right hind leg about 6 months ago to losing the ability to stand on both hind legs, and basically drags herself by her front paws but is able to get around surprisingly well and had been surprisingly happy until starting Prednisone. Before starting, she was profoundly weak in the rear with essentially no muscle, and unable to hold herself up to urinate or defecate, but after a day of Prednisone she started to hold herself up enough to urinate, but no other improvement. On Friday February 12, the neurologist added a huge Immunosuppressive dose of Cyclosporine (100 mg/day), enough for 34-lb dogs!! and a 34-lb dog dose of Denamarin. By Sunday morning, she refused to eat and was having tremors and threw up like nothing I had ever seen before. An ER vet told me to skip the next dose of Cyclosporine, and the tremors stopped, and by evening she was eating again and perked up, but still on Prednisone. She seems tired and depressed, is sleeping a lot and deeply and not on her bed, and has had a very high liver ALKP even before starting the Prednisone. I can feel her liver very significantly bulging, and I am very reluctant to ever give her Cyclosporine again, and frankly want to stop the Prednisone after reading your article. The neurologist said it’s her only chance to walk again, that 85 % of dogs will. He would not give me a time frame, only saying that he wanted to test her blood 30 days after starting Cyclosporine in case she is losing bone marrow, and that she will need to be on a high dose of Prednisone that will eventually taper down to a low dose every other day for the rest of her life. I don’t know what to do. The Neurologist says if it works she could still have years of quality of life, but others say she can live for years and manage with the SRMA without the prednisone but will not be able to walk normally again. The neurologist is out until Tuesday, and the ER vet told me to restart the Cyclosporine today (Monday February 15). They also told me there is no need to give her Pepcid or Omeprazole for her stomach, but having gone through nightmare and pain is ulcers and an esophageal stricture myself, I don’t know what to think. Do you have any suggestions? Please let me know, thank you so much – Mark

    Reply
    • Mark, I’m so sorry to hear you’re in this situation with Rori. I can understand your distress.

      A few thoughts in case they’re helpful.

      SRMA typically affects young dogs so I’m wondering whether it might be worth considering that your dog’s meningitis is more MUO? There is a facebook group “Dogs with Meningitis” that has owners of dogs with this form of meningitis, and a fb group called “Surviving SRMA”that is more focussed on the SRMA specific form. Not that it probably really matters, but just mention in case it’s in any way helpful.

      Why the cyclosporine? Was the prednisone deemed to not be working on its own? Standard treatment for SRMA is prednisone alone, with other immunosuppressants like Cyclosporine added if the pred is not sufficient on its own, or if the aim is to replace the pred with cyclosporine. Certainly cyclosporine and pred combined increase the effects of each other, including side effects, so the two together can really knock a dog around. I know my guy went downhill on cyclosporine and I discontinued it for that reason and he was immediately much improved as you describe.

      It’s very difficult to know what to do. If the meningitis is under control I would be inclined to think go with the fewest drugs possible, since they’re all so heavy duty and all can trigger not insignificant side effects. If the meningitis is under control I would be thinking to go with just the prednisone and to commence the taper as soon as you can.

      I would be looking to the whole picture of Rori’s care in order to address the underlying cause of the SRMA in the first place, as well as to now support detox and healing from the damage inflicted by the treatment.

      By that I mean: no more chemical wormers/flea and tick treatments, no more kibble, definitely no more vaccines for an immunocompromised dog and a dog with an “autoimmune” condition. An eight year old dog likely has lifelong immunity from previous vaccines anyway. I would also be looking to remove all possible toxic exposures in the home and environment (cleaning chemicals, scented plugins, room deodorizers etc), all of which I would see as combining to create a level of toxic accumulation in the body that likely played a role in the original outbreak of the SRMA, though vets shrug their shoulders and say we don’t know what caused this.

      Difficult to do when pred is in the equation and needing to be given with food, but I’d also, long term, or as soon as you get off the drugs, be looking at fasting as a healing modality. It can work absolute wonders with zero side effects.

      This is the approach I’ve taken. Does that make any sense/give you something to go on?

      Reply
      • Jane, thank you so much for your thoughtful and helpful response on Rori. All I know is that the Neurologist said, based on her Spinal fluid analysis, her Meningitis is not from any type of infection, but from her own immune system attacking her spinal cord. He said that based on how bad her hind legs are, there is a 15% chance that she may never improve, and it’s so bad that he does not think that Prednisone alone will help her, and that once she tapers down, she will have to remain on a low dose of Prednisone, every other day, for the rest of her life. The only good thing is that she is not in any pain, and it may be limited to only her hind legs.
        I tried cyclosporine once more on Sunday night, and she began to hyperventilate and shake terribly, it was a terrifying experience. Miraculously, she eventually calmed down, but again threw she threw up the next morning, and the neurologist agreed to stop the cyclosporine. She is already doing much better. Now he wants to check her bloodwork on the Prednisone at 30 days from her start of it, evaluate her progress, and possibly start the next in line immunosuppressant, a substitute for cyclosporine called Mycophenolate. But this drug seems to have the same side effects as cyclosporine, and I don’t like the sound of it.

        I will try the Facebook posts, and absolutely agree about the chemical free house and avoidance of vaccines and worm/flea treatments. In fact, I always practiced this, and my Shepherd/Husky/Rough Collie mix made it 17 years like this. I did not know about Kibble, which is what Rori eats. What would you suggest I replace her kibble with?

        Even though she is almost 14, she has been otherwise very healthy and happy and “young” to this point. It kills me to think that she will have to be on Prednisone for the rest of her life, as its long term use seems to physically and mentally destroy dogs, and my goal of course is to maximize her quality of life.

        Do you think it’s worth giving her something for her stomach for the Prednisone? Or the liver supplement Denamarin for her Alkp value and Cranadin cranberry supplement to help prevent urinary Tracy infections? I’ve been told the liver supplement has only anecdotal evidence of help, and a human doctor told me it’s better not to overload her little aging system with extra drugs, and that Cranadin can cause stomach upset, but she may need something like Pepcid to protect her stomach long term.

        Most importantly, if the Prednisone does not help after 30 days (there has been very little progress after 10 days so far) and her SRMA does not attack her brain, do you think it’s smarter to simply taper off the Prednisone and let her be happy and healthy but with messed up hind legs and possible hind leg paralysis? Or do you think the side effects and destruction of the eventually lifelong lower dose of Prednisone do not outweigh it if it helps her hind legs and allows her to walk and maybe even run and play again? I’d love to know your opinion.
        Thanks again so much. Sincerely – Mark

        Reply
  38. Excellent article and a lot of information that you don’t always see when researching this drug, or hear from your vet. I lost my cavalier king charles at 13 last month. Always a healthy happy dog – but in June 2019 he had surgery to remove an adrenal gland that had a tumor (so it was causing Cushing’s). I was assured by the surgeon that if they were able to successfully remove it, he was cured. Seeing the horrible effects cushing’s was having on him, I made the tough decision to try the surgery. He came through it with no complications, but they put him on 5 mg prednisone/day saying it was temporary until the remaining adrenal gland kicked up a notch to compensate now that he only had one. A few months later as we started weening him off, he displayed much of what you talk about here – the limpness, plus tremors, lack of coordination. When I told my vet, he said my dog would be on it for life then, but that it was fine because it was such a low dose. I was so tired from months of what we went thru and researching cushing’s and the adrenal surgery, and from not sleeping much to let him out a few times during the night – so I maybe didn’t question and research as well as I should have. I did notice over the next year or so many changes you discuss, personality – not as snuggly, somewhat depressed, not as interested in going places he used to love, struggling with stairs, getting into car, preferring the cool floor, the thirst, the panting, the constant peeing, the hunger. Some of which we dealt with prior to the surgery because of the cushing’s. I knew some of this was the prednisone, but the behavioral/physical stuff I mistakenly figured was hey, he’s getting old and he’s slowing down. I had mentioned it all to the vet, he never said prednisone could be the culprit. Then the Calcinosis cutis went from one or 2 to 10 about 6 months ago, but the vet again did not mention prednisone, just called them old man warts. I feel like I failed my pup for not being more educated. It’s pretty clear that although yes, he was getting up there in age, the prednisone did a number on his little body and maybe had I known to be more patient with weening off successfully back in 2019 he would have had more time and the time he did have would have been happier for him. At the end of December 2020, once the warts had multiplied (and one was bleeding on his paw) the vet finally said to cut the prednisone down to 1/2 of one every other day and added an antibiotic, Clavamox. Over the next 2-3 weeks, my dog declined very quickly. I have no way of knowing if the decrease in prednisone is the reason and I’m going crazy with guilt over the whole thing, I am broken by this. Within a few days of cutting back and giving the antibiotic as well, he couldn’t manage stairs at all, was taking few steps, lying down, going out to go potty, lying down in the grass, laying in a back room he’s never laid in. At first I thought he might just be sore from going splat whenever he tried the stairs, so I had a ramp put on the back deck. No longer up for going for walks, car rides, nothing. Slight tremors. Panting. Hind end sometimes weak. Definitely seeming depressed. I e-mailed my vet all this, spoke on the phone with him he said he’d look into another medication to treat the cushing’s. At this point I’m like, wait, I was told my dog was cured of that! I made an appointment at another vet for the next day. But that night I could tell him body was shutting down. I knew by his eyes he had had enough. So I stayed by his side and let him go. Was not about to rush him to emergency vet, strange place where because of Covid they would not have allowed me in. He wasn’t suffering, and I wanted to let him pass in his own home with his family. I knew there was nothing to be done to save him. I question over and over hoping I did the right thing. But I literally can’t sleep trying to understand what happened for him to decline so fast and did the long term prednisone or was the sudden cut back to half every day too much for him? Any input is appreciated and I am grateful to have come across this article. I will know better in the future but in the meantime I’ve lost my best friend and feel like I let him down.

    Reply
    • Stacy, I’m so sorry for the loss of your boy.

      It’s possible the taper had something to do with what you were seeing, but it’s also possible there was a more complicated disease process going on underneath it all.

      It’s very easy to beat yourself up over what ifs but you were working with the best information you had at the time. We should be able to rely on our vets to know these things and to guide us correctly. It doesn’t always happen.

      I certainly understand your decision that enough was enough. 13 years is more than many dogs get and you obviously loved him well. I know it’s no comfort but I think all we can do now is vow to use the knowledge we wish we’d never had cause to come into, to raise the next pup the very best way we know how. That’s why I wrote Supercanine, to hopefully pull together everything about how to raise a dog from day one, in hopes that every future dog in our care can benefit. I try to focus on pouring my anger and grief into setting those things in place for the future, so we can turn suffering into something positive? I wish the absolute same for you. Be gentle with yourself, you did the very best you could in the circumstances and from what you describe, your dog knew he was loved, I’m sure of it.

      Reply
  39. Hi my 81/2 year old westie/yorkie was diagnosed with SNRA on New Year’s Eve after an MRI CT scan and spinal fluid. He has had 2 lots of cytosine arabinoside overnight stay on both occasions.this was given 3 weeks apart.
    Sammy has been on Prednisolone 10mg for 6 weeks and we started to reduce by 1/2 tablet last Friday. Sammy is very tired and limping more and staggering around and doesn’t want to walk ! Is this a normal reaction ? The vets want to repeat the cytosine arabinoside next week and 3 weeks after ! We don’t feel there has been any improvement in Sammy in his walking or limping ! We were told he has muscle wastage and we took him for hydrotherapy on Sunday to see if this would help. But reading your article I am now totally confused as to what is the best course to go dine for Sammy. He has had no increase in appetite a bit more thirsty but nothing huge. But is very agitated especially in an evening. He does whimper and he absolutely hates being picked up now. Amy advice greatly appreciated.

    Reply
    • Vivienne I am sorry you are going through this but beginning the taper is progress. Can I ask, what were the original symptoms at the time of diagnosis? Are they the same as what you’re seeing now, or is the limping and staggering something that’s started since the treatment, or since you began the taper?

      Re the hydrotherapy, it may be a little too soon for it, as the pred causes the muscle wastage on a cellular level — it’s not just lack of exercise. I would be inclined to think right now rest is the ticket, and you can work on building back the muscle once the pred is out of the system or at least at very low doses and he’s feeling better.

      The agitation certainly fits with the psychiatric disturbance pred can cause. It will go away as you get to lower doses.

      Reply
  40. Hi I was wondering if anyone had/has a similar experience to my 1 year old Labrador on this horrifying drug.

    He was admitted to hospital early jan as he was hypercalcemic. All tests done at the cost of £10k came to no conclusion so we still don’t know what caused it. They think either cancer or vitamin d poisoning.

    He was put on prednisone to bring his calcium down but the calcium came down rapidly the same night anyway (day 4 of hospital) (so no need to keep him on). He made miraculous recovery and came home and his calcium levels have been fine since but he’s had slightly damaged kidneys ever since due the illness.

    They made us keep him on 30mg a day and taper down weekly. After a couple weeks on it we noticed following symptoms:

    – short breathing (not quite panting with mouth open) but breathing rate increased noticeably
    – general lethargy and slowness
    – no interest in going for a walk (which he used to love)
    – pot belly
    – weight loss, was 32kg healthy, went into hospital 28kg after not eating for days, came out of hospital after eating for one day 29kg but is now down to 28kg
    – complete loss of muscle and only big pot belly looks skinny everywhere else
    – ravenous eating and drinking

    He’s on 10mg now but we want to take the next steps of tapering slowly to avoid crisis. Has anyone else experienced these symptoms (I have read the post and find a lot of similarities) but was wondering how common this is??

    I don’t want to give up on him but obviously he isn’t very happy and can’t live like this forever. Is it just the steroids ?? How quick can we taper off from 10mg. He’s only been on it around 1 month

    Reply
    • Hi Baylee

      I think it’s virtually impossible to know how common these adverse consequences of prednisone (or any other drug) are, because there simply is no accurate record kept. None of my dog’s experience, for instance, would have been logged anywhere other than maybe in the case notes, which don’t leave the clinic or get reported anywhere. I’m assuming it’s the same for everyone else’s’ dogs too.

      Regardless of how common it is, it seems clear your dog’s symptoms are pred related.

      He’s only 1yo and given he’s only been on pred for 1 month total (and most of that not at the highest dose?) I think there’s every reason to think he will make a good recovery once the drug is out of the system. Longer than 5 weeks is generally considered long term pred, so your taper probably doesn’t need to be overly slow — at least as far as the adrenals are concerned.

      If he were my dog I would proceed with the taper the vet has advised, so he doesn’t spend a moment longer on the drug than necessary. Be aware once it’s out of his system there can be some detox symptoms, but these will pass. You’ll have your dog back soon.

      In terms of what caused the original illness, I would be looking now to optimize his diet and his overall care, starting with feeding a fresh, natural canine diet and removing all possible exposures to toxins i.e. chemical wormers, chemical flea/tick treatments, vaccines/medication, chemicals in the home etc. I can point you to more info on this if you’d like.

      Reply
      • He had a really decent lifestyle on healthy raw premium food and was never fed any processed treats as such. Lots of healthy additives too.

        He’s on about 7.5mg-10mg dose daily now of prednisone so I was wondering should he still be experiencing an increased breathing rate on such a low dose?

        What’s your thoughts on this? The vet also mentioned it usually takes months to lose muscle on the steroids.

        It’s a horrible situation really I’m a final year undergrad and worried sick about him!

        Reply
        • It’s possible you could still get the breathing weirdnesses, muscle loss and other strange effects at low dose and after several weeks, as the drug is a powerful one and some dogs can be very sensitive to it. Generally though, you’re right: lower doses and shorter durations mean lesser side effects.

          It’s a very good thing to be tapering and you should see these effects normalize once the drug is out of the system.

          Re feeding raw. Prepared grinds can introduce some mistakes into the diet (they are very high in fat, for instance) and when you say additives, do you mean supplements? These can be worth eliminating to really simplify the diet. Whole cuts from the butcher/supermarket are more optimal when you’re able to move in that direction and it doesn’t have to be labor intensive.

          Definitely very stressful time and good on you for managing it all.

          Reply
  41. Hi there, I was wondering if you had any advice for me, I’m so stressed about my dog and I just don’t know what’s the right thing to do for her.

    I have a 4year old Maltese x Shihtzu named Ruby.
    Ever since she was 2years old she has had tremors or shaking whenever there’s a storm or any sort of loud noise.
    We originally put it down as Noise Anxiety and tried to keep her calm whenever a storm was happening.
    Last year, unfortunately her shaking became more frequent, it was happening every day, several times a day, with no storms or anything bringing it on.

    Ruby had to have her teeth cleaned mid last year, so my vets were able to see exactly what she’s been doing. They said it looked a lot like White Shaker dog syndrome or Generalised Tremors Syndrome/ GTS . She had a full blood count done and since that came back all good, the main treatment for this condition is Prednisone.

    As soon as Ruby started the prednisone, she was a completely different dog, and I mean in a good way. Her mood was so much happier, she was eating better and more frequently ( before prednisone she barely ate ) and her shaking stopped.
    The whole time that she was on the prednisone, her only side effects were increased hunger, thirst and pooping and weeing more frequently.

    Once it came to weaning her off the prednisone, once we got her to half a tablet, her symptoms started up again, so we went back to giving her a full tablet, so 5mg once daily, and that’s where we stayed.

    Ruby had been doing great until the first week of December 2020, we noticed blood in her urine, I took her into the vets, a urine sample showed a tonne of bacteria in her urine a long with the blood proteins. So when was put on antibiotics.
    Not even 2weeks after finishing them, we noticed the blood again, so then Ruby had an X-ray, Ultrasound and a sterile urine sample was taken straight from her bladder.
    The scans were all clear, her bladder and other organs are healthy other than the recurring UTIs. So Ruby was put on a 20 day course of Antibiotics to then see how she went.
    I’ve been wondering if it’s the Prednisone that’s been causing these UTIs, so I started slowly weaning her down. I got her down to a quarter of a tablet, and mid February ( this month ) we noticed the blood again and then she started having urgency with urinating, so she was back on the antibiotics again.

    I finished weaning her off the Prednisone exactly 1 week ago, so last Saturday and she’s been a misery since. Sunday and Monday she was fine, but Tuesday she refused to eat or drink all day, I had to give her water with an eye dropper just to get fluid in her, she was clearly uncomfortable, she just wanted to sleep all day but couldnr get comfortable and she was constantly stretching and twisting her neck ( it’s something she’s always done with being a symptom of her illness ).
    She came good on Wednesday, like how she was on the prednisone, eating and drinking well and happy/wanting to play ect.
    Thursday she was unwell again, not wanting to eat and twisting her neck, being in discomfort, she started dragging her back legs, like she couldn’t move them, so I rushed her back into the vets.
    My vets think she may need to go back on the prednisone and see if how she’s been behaving resolves, but then we still don’t know what’s causing the UTIs. My vet had a look at her downstairs and apparently her vulva is premature and something to do with her skin folds down there, apparently this is also something that can cause recurring UTIs, so now we don’t know if it’s the prednisone causing them or if it’s her anatomy.

    A lot of the symptoms she’s been having I know are from her GTS / GME , but she’s having a lot of discomfort with her stomach , she seems like she can’t get comfortable at times, we can hear her belly making noises , not wanting to eat ect.
    I’m just wondering if this is from stopping the steroids or is something going on.
    She had a partial blood test on Thursday, it showed a little bit of inflammation, but other than that it was fine. Thursday evening her stools were black and tar like, so that has me worried, again I don’t know if it’s the antibiotics or steroids or both.

    She’s still in discomfort with her stomach right now, even though her blood test was fine, I’m not sure what’s causing her stomach upset. Her last two stools were normal, I just don’t know whether to start the prednisone again and see if she improves or what, and then if the UTIs start up again, I don’t want her continuously on antibiotics like this.

    I’m just panicking trying to figure out what’s best for her and what to do. Any advice wot help , I’d really appreciate it.

    Reply
    • Hi Shari

      I’m so sorry you and your dog are having such a hard time.

      How long total was Ruby on the prednisone? It’s certainly a known side effect that it causes gut damage (so do antibiotics) and makes UTIs and other infections more likely because of the way it suppresses the immune system.

      It’s encouraging that she’s had some good days since discontinuing the drug.

      Black and tar like stools in general are said to indicate bleeding in upper GI tract whereas bright red blood indicates bleeding in lower GI tract.

      Detox after prednisone can also cause blood in the urine and poop due to irritation as toxins exit the body via the kidneys and bowels.This is similar to how owners often observe mucus in the poop after discontinuing drugs. This happened to Shiva. If that’s what it is, it will pass as the drugs clear from her body.

      With so much in the mix it’s hard to tell what is causing what and what’s the best course of action, but I would absolutely be starting by optimizing the diet. This will set the conditions for healing, no matter what is causing the issues.

      A fresh, natural canine diet is the best you can do and if you get that right, you may see her body sort itself out. Check out the link to see how we approach it but let me know if I can help further on that front?

      Reply
  42. I have an almost 17 year old Staffordshire Bull Terrior and I think he is suffering from anxiety. He sleeps really well at night, 12 hours, eats well, good bowel and bladder.
    He paces and and is restless in the day, it all started when my granddaughter came to live with us and our house became extremely busy and noisy.
    The vet has recommended this drug but Im worried.
    He had a really bad reaction to a drug that was given to him when he fell, the vet said it was like an opiate and she said this one is too.
    Im giving him hemp oil and another natural supplement.
    What do you advise?

    Reply
    • Hi Sandra

      17 years is a ripe old age so you’re definitely doing something right in your care, well done.

      Given the way prednisone messes with every body system and tends to create as many problems as it solves, I certainly wouldn’t be touching it (or any other drug, really) for anxiety or anything short of an unavoidable life threatening situation where there is no other option.

      I think you’re on the right track exploring gentler treatments like CBD oil.

      Rather than drugging for anxiety, I would be exploring ways you can adjust his living situation to relieve the anxiety. If you think the cause is the noise and busy-ness, can you provide him with a quiet nook to retreat to, somewhere he can go to escape? Can you restore some of his old routine with you by making sure the two of you still have your time alone? If there’s something about your granddaughter’s activities that’s upsetting him, can you find a way to insulate him from that? That kind of thing.

      A raw meaty bone to chew can do wonders in terms of providing stress relief and psychological soothing. Lamb necks are great.

      Hope that helps some?

      Reply
  43. Thank you for this article. My 8 year old labradoodle was just diagnosed this week with ITP and she has been put on a 20mg twice daily dosage of Pred. With 125 mg atopica (cyclosporine) also twice daily.

    After reading all the side effects and about the weaning process from the emergency vet summary, I have been freaked out! What I thought was going to be a simple round of meds I now realize is going to be a rough road ahead and will have a lot of ups and downs. Picking her up I thought I was going to getting my bright eyed, energetic pup back and instead she was just out of it. It was heart breaking and a wake up call that although she is out of the hospital we still have a long way to go.

    She came home from the hospital today and I have not slept a wink all night. The effects are already starting. She is so restless tonight and can’t seem to get comfortable when she tries to sleep. She also seems to get hot really fast. We turned the heat down in our house and I have a fan running in our living room so that she can lay in front of it if she needs. I’m not allowed to take her to a groomer so I am going to have to figure out how to cut her hair at home… She was in need of a haircut before all this and now…I have cut her hair before but I know she hates it and I don’t want to cause her any more anxiety or discomfort if I can avoid it.

    Her thirst is definitely increased and I am letting her out about every 2-3 hours to go to the bathroom.

    She seems weak already. Jumping into the couch or even going up and down the stairs seems like a chore for her. Did you experience this when your baby was on pred? Was it a constant weakness or did it come and go?

    She was already a little jumpy before the meds but today I noticed that she just seemed extra anxious and would start to bark at nothing. Did you find anything to help your baby deal with the restlessness/anxiety? I have been up all night with her and started to research this med more after seeing how it is already affecting her. Hence how I arrived at this site! I have never seen her so restless. She comes to me like she needs something but I have no idea what she wants/needs. She just walks around, lays down, then gets up and starts all over again.

    This article gives me an idea of what to expect as we start this journey. Seeing the list of meds when I got her home from the hospital was overwhelming to say the least. But it’s time to put on my big girl pants and do the research so that I can be her best advocate. I am one of those people who over analyzes every little reaction and blows it out of proportion so it will be a learning curve as go through this with her.

    I just hope that she reacts to treatment quickly and we can get her off of this med as fast as we can. Minimum, she is going to be on the high dose of pred for a month, but the vet wants her to have normal platelet counts for a month straight before we start weaning her, so I just hope we can hit that normal count asap and hold it steady so that the weaning process can begin and we can limit the damage it does to her body. She is already an older dog and I don’t want the choice of being on this drug to be detrimental to the longevity of her life.

    I will be back to read and reread this article and the comments over the next week as all of this information starts to sink in. Thank you again for taking the time to write this out and share your experience. I will probably have more questions as I continue this pred rollercoaster.

    Reply
    • Hi Andrea

      I am so sorry to hear you’re having to go through this with your pup and my apologies for the delay in responding.

      When I was researching the book I found papers linking ITP to vaccines. Here’s vet Jean Dodds on the topic. You sound like you’re on top of it, so you’re probably already aware no more vaccines for a dog with any kind of autoimmune condition but I just mention it in case.

      The restlessness and anxiety are horrible and psychiatric disturbance is a known effect of prednisone in humans. We certainly had the jumpiness and the barking at shadows. Not a heap you can do other than comfort her, keep additional stressors to a minimum and keep a really predictable, calm routine until you’re through this and can get the drug out of her system. Shiva took to sleeping in the toilet cubicle on the tiles because he felt so out of sorts, and it must have felt safer and cool in there. Let her do what she needs to do, which I know you are.

      Yes we had constant weakness. It got so that Shiva could barely step onto our landing from the sidewalk.

      You will get her through this. I can feel the strength in your words on the page and she will pick up on that. I wish you the absolute best and hope she’s getting closer to getting off the drugs. Please reach out if I can help in any way, especially as you get to the point of rebuilding condition post-drugs. Fasting and a optimizing the diet will be helpful in detoxing and healing from the treatment.

      Reply
  44. Great article.
    Our 5 year old Goldendoodle has been diagnosed with Addisons and was started on Florinef and Prednisone (6 Florinef and 1 5mg Prednisone per day). After a week the Florinef was stopped and the Prednisone was cut back to 2.5 mg per day with his morning meal (following blood work). He can’t seem to get enough food, pants more that normal, but other than that he seems more like his old self; playful, loving, etc. Prior to the Addisons diagnosisj vomiting was common, energy was low, and getting him to eat at times was a challenge . Blood work will be done ever so often and our vet seems to have a good handle on Quincy’s problem.
    Quincy has had his problems with Bloat being the real big issue. Emergency surgery was performed in the middle of the night and probably saved his life.
    Our pets are family and you gotta to do what you gotta do.
    Prior to Quincy we had another Goldendoodle which tore both rear ACL’s, tore a meniscus, had cellulitis, a tumor removed, congestive heart failure and lived to 14. Thank god for partial insurance coverage.

    Your article was great and gave us a much better understanding of the pros and cons of steroids in dogs.

    Reply
    • Mke, I really appreciate you taking the time to comment. I am glad to hear Quincy is doing well overall. Well done on getting the prior bloat seen to in time, as well. I’m pleased the article was helpful and wish you and Quincy all the best. 14 years is a good long life, so Quincy has a way to go yet 🙂

      Reply
  45. Hi Jane my 1 year old rough collie Alfie has discoid lupus on his nose from sunburn we think.Our vet has just put him on cortisone tablets and cream,he licks cream of immediately.Im worried he is getting a double dose.He has been on these 3 days,already drinking the well dry and two accidents over last two nights.After reading all of this I’m terrified,what should we do,I want his nose to get better.He just had op to take scrapings of his nose to test and this is what the vet has given us.Im afraid for Alfie,I don’t know how to help him and vets are quick to test and charge a fortune with no clear results,Just assumptions.Please help

    Reply
    • Hi Amanda

      I don’t have direct experience with discoid lupus but I understand that humans diagnosed with lupus have had success resolving it with nothing but dietary improvement so that’s where I’d be going with it.

      Are you feeding a highly processed diet such as kibble? You can optimize the diet and lift a lot of the burden from Alfie’s body by instead feeding a fresh, natural canine diet. Let me know if you’d like to be pointed to some good how-to resources for how to do that.

      As I understand it, this is an autoimmune condition (as was my dog’s), aggravated but not caused by sunlight? I would be sure to avoid any further vaccinations, which have been implicated in causing a range of autoimmune conditions and a syndrome holistic vets know as vaccinosis. Eliminate the ingestion of chemical wormers/flea and tick treatments etc and minimize chemicals in the home environment like scented plug ins, fabric sprays, chemical cleaners, fragranced candles etc. All these things add to the toxic load on the body, which is known to be a major factor in disease and ageing (not just for our dogs but for us too).

      Fasting is another powerful tool to accelerate healing and support the body to clear toxins without the harmful side effects and additional toxic load that accompany drugs. Fasting is a natural part of how dogs have always eaten and its absence from the lives of pet dogs is a major contributor to ill health. Science is catching on, with an increasing evidence base now on the benefits of fasting to both prevent and heal all kinds of disease.

      Hope that’s helpful? If you’re interested in more detail the book has whole chapters devoted to each of these topics. Just let me know if anything sounds too out there or doesn’t make sense. My experience has been that these simple things work and I would always go the natural, minimally interventionist route rather than medicating, if you possibly can.

      Reply
  46. Jane,

    Reading your article saved my sanity. I have forwarded your article to so many dog owners as well. I made all my family members read it to understand what our dog is experiencing. Dallas, our 3 yr old golden retriever, was diagnosed with immunosppressed meningitis in March. He was placed on heavy doses of prednisone as well as another immunosuppressant that he takes every other day. He has experienced almost every side effect you have described and his condition seems to worsen by the day to the point where is having significant difficulty getting up. I have called his neurologist numerous times with different symptoms. They are going to try to taper him quicker than originally planned because he is not having the neurological(seizure like activity) episodes from the meningitis. Hopefully he will not relapse. It is heartbreaking to watch my “velcro” dog shy away from the family and be so adversely affected by this drug. He has aged exponentially. So happy that you wrote this article. It truly gave me hope that we will get our Dallas back.

    Reply
    • Carole, I’m so sorry you and Dallas are going through this. I’m glad our experience could help you to at least know you are not alone. It’s definitely hard for others to understand what it’s like. I was constantly calling the neurologist too, it’s such a horrible feeling isn’t it. Please excuse the delay in responding. I hope your boy is now tapering and you’re starting to see some easing of the worst symptoms from the pred and the other immunosuppressant?

      Reply
  47. The section of “vets and prednisone” was spot on. I could relate to a lot of what you wrote with regard to our baby. My little Maxipoo passed away three weeks ago and I am still struggling to accept it and I keep playing his life over and over again in my head to find out what I could have done differently. Maxipoo was on prednisone for 6 years. From the moment he had his stroke to the day he passed. After four years on pred (and cytosar which is a form of chemotherapy injections he received once a month), the neurologist increased his pred to 10mg which was the highest dosage he had ever received (in the first year he was on 5mg, tapered to 2.5mg and then increased to 10mg). After a year on 10mg he developed Cushings disease and needed insulin twice a day. The diabetes was so difficult to manage and the neurologist told me to find a local vet to manage his diabetes yet no local vet (not our original vet nor any other) would attempt to give us their opinion because they did not know how it would affect his brain disease and they did not want to be the cause of any further complications. At our third local vet appointment, the vet called in a panic after the blood test and told us to take our dog to the emergency room because his liver was failing and he was overdosing on insulin, to which we immediately called our neurologist and was told that our dog was just fine. A couple of years before this incident, our local vet suggested herbal medicines and our neurologist at the time (the residents change every couple of years because we were at UC Davis Veterinary Teaching Hospital which is a school and our first neurologist finished her residency after two years) straight told me, “is your local vet a neurologist, because I am a neurologist and I know what is best for your dog”. I am so sorry to lay this all out, but it feels a bit therapeutic for me to do so. Anyway, UC Davis ended up bringing together a team of doctors – the neurologist, an internal medicine doctor and a cardiologist – to make sure Max was treated from all aspects of his disease and effects of the medication he was on. He seemed to be doing well until one night he just howled in pain and three days later he was gone. He didn’t sleep the first night but he was still eating. When he didn’t sleep the second night we took him to a local vet and they said he was in severe pain. We called our neurologist who approved the pain meds the local vet prescribed but when we did not notice a change from the pain meds, the neurologist told us to give him 5mg of pred which made no sense to me because the pred which we already gave him each morning counteracts the insulin and every other month the internal medicine doctor kept increasing his insulin dosages (we started out at 0.5cc and were at 5cc in only 10 months). We tried to give him the pred pill but he would not take it, even when he tried to hide it in cheese. He would not eat at all. And his pain howls increased. He could not sleep nor eat and he just wanted to be held. We made the decision to end his suffering. I do have to admit that UC Davis went above and beyond when we arrived on the worst day of my life. They had blankets laid out on the lawn where he loved to run after his chemo shots and they had his favorite aerosol cheese that they said they would use to bribe him when they gave him his chemo injections. Students and techs and doctors who had treated him over the last six years came to say goodbye and they provided us with his paw prints in cement. I keep thinking I could have done more to save him. I miss him every second. I hate prednisone. I hate what it did to his little body. But I found comfort in reading your story. Thank you for posting it.

    Reply
    • Oh Cheryl, I’m so sorry for your boy’s suffering and for yours, and for your loss. You sure went through the wringer together. I understand the going over and over things in your mind. It’s a torment, isn’t it. There is nothing that makes it easier. Thank you so much for your kind words about the article and for sharing everything that happened, I’m sure it helps others. You are always always welcome here. Always.

      Reply
  48. Hi Cheril, breaks my heart to read your story, I can only see you as a loving and concerned mom that did all she could and was able to get him seen by several veterinarians. You could not have done more. The decision to let him go was wise after you tried your best and surely spent agonizing months of worry and concern not to mention vet bills.
    Maxipoo sure knew you love him you were with him all the way. We are not vets or experts we have to trust them, if you did not, you would blame yourself for not listening to the experts.
    Sending you hugs from Toronto,
    Fanny D.

    Reply
  49. Hi
    We have an American Bulldog who is one year and 4months old. She got spayed one week before her 1st. Birthday and a week later she was diagnosed with meningitis. We are four months into the treatment and her dose is 1 1/2 tablets twice a day. Yesterday suddenly she got a fever and had diarrhea, she is very weak and can barely stand. Today while taking her to go to the washroom she saw another dog friend and got up and actually ran a tiny bit. As I am writing this she is laying down not moving and it is breaking my heart. Did your dog have this problem walking 4months into this? We are dropping the dose to 1 tablet twice a day this Sunday and I always have some issues at least a week and a half into dropping the dose. I just read and re-read your article and was hoping you could advise about our current condition.

    Thank you

    Reply
    • Hi Katherine — I’m so sorry to hear you’re part of this prednisone club.

      Yes definitely Shiva experienced the same thing while on prednisone, probably after a similar number of months. For many weeks he could barely step off the landing of our apartment building onto the sidewalk, or back up again.

      At one point he could barely stand — though I think that was due to the neurologist putting him on a second immunosuppressant, cyclosporine, in combination with prednisone. Each of those drugs increases the effects (and side effects) of the other and I think it was too much for his liver, which was already enlarged from the prednisone. I insisted we stop that second drug (cyclosporine) and things improved noticeably within half a day.

      The wobbliness after dropping the dose is definitely part of the process and due to adrenal adjustment as the prednisone lowers and the adrenals start reactivating and having to produce cortisol again, after being suppressed for so long. Good on you for recognizing this is just a period of adjustment and not a relapse — that can be a trap.

      It’s so hard isn’t it. Stick with it, things will improve dramatically once you get to once daily dosing, and thereafter your pup will begin coming back to life.

      Hope that helps a little. Don’t hesitate to reach out if I can help further now or down the track.

      Warmest wishes
      Jane

      Reply
      • Hi Jane
        The ONLY reason I recognized the symptoms was because I read your article at least 10 times and I refer to it when I come across something new that is happening to “Bailey”. I have your article saved under favourites so I can access when I feel unsure about her progress. This has actually saved her unnecessary trips to the Vet.
        Thank you
        Katherine

        Reply
  50. Along with all the others, I wish I had seen this article a few years a go. Great article. Our baby got diagnosed with SRMA December 2018. Since that time she has been getting Cytostar treatments and taking daily Prednisone. Her Neurologist has tried several times to lower her Prednisone dose in hopes to get her off of it, but she has always relapsed or so we thought (not sure after reading your article). She got the Cushing’s from the long-term Prednisone use and her tummy is so big that she can at times have difficulty walking. I really want to get her off the Prednisone and it seems the only way would be to add Cyclosporine and then gradually try to lower her Prednisone dose. I’m scared to not do it and I’m scared to do it. I just want my baby to have the best quality of life she can. I truly hate this disease and the life it has taken from our precious girl. If you have any recommendations or thoughts on what we can do, please let me know.

    Thank you!
    Daphne

    Reply
    • Daphne I am so glad you found your way here. This is exactly the situation I was in with Shiva and what the neurologist was telling me was the only way out. He went as far as to start the Cyclosporine, at which point Shiva went rapidly down hill.

      Our neurologist also failed to recognize adrenal insufficiency and misdiagnosed it as relapse, setting us back months and resulting in a lot more pred damage.

      I insisted we come off the Cyclosporine, stepped back from the medicos, who only seem to have a very limited toolkit, and started doing my own research and making some different decisions.

      I am not a vet but vets frankly failed us on the prednisone, particularly our neurologist.

      If it were me, I would strongly consider beginning a new taper, now that you’re attuned to the role adrenal insufficiency plays as the prednisone leaves the system — and it certainly will be a factor after 2.5 years and where the dog has become Cushingoid because of it. Go slow and steady but no slower than you must as you don’t want to prolong time on the drug.

      It’s possible that your girl’s condition may not be permanent “Cushing’s” and more the “Cushingoid” syndrome that lasts as long as the drug is used. The Cytosar in the mix will be having its own effects too. It’s hard to tell what’s what when the body is under the influence of these heavy duty drugs.

      I have learned the body is capable of amazing healing, but is a slow process and the immunosuppressive drugs need to get out of the system for that to begin.

      How old is your girl? What breed is she?

      If your existing vets won’t support you to taper and you don’t feel comfortable doing this on your own — I know how scary it is — you could try to find a really good holistic vet if you have the option. Some do long distance phone consultations and I know of one if you can’t find any. But the principles for tapering are the same regardless: gradual, incremental reductions, staying at that level for some weeks to give the body time to recalibrate, and then reducing again. If you’re still on twice daily dosing, the sooner you get to once daily in the morning the lower the impact on the adrenals and they can begin starting to wake up and trying to function again.

      Hope that helps you think it through some.

      Sending you all the strength in the world.

      Reply
  51. Hi Jane,
    Thanks so much for sharing your experience. Our 7 month old boxer Clark was diagnosed with steroid responsive meningitis about a month ago. He’s on 20mg of prednisone for 5 weeks now and we’ve seen all of the typical side effects that you mentioned in your article. It’s truly heartbreaking to see how our energetic outgoing puppy has aged years right before our eyes due to this medication. He still has moments of energy which makes us hopeful about him coming back to us once he’s off, but it’s hard to see right now. We start tapering this Friday from 20 to 10mg. A little nervous about the side effects of tapering after reading many people’s experiences. One of my bigger concerns is around the behavioral changes we’ve noticed with him. He’s definitely been more anxious and velcro (even for a boxer), and started getting a bit reactive on the leash towards other dogs with barking and raising hackles. And sometimes just barking at other people. I’m not sure if it’s just him feeling unwell and anxious on the meds so he reacts more out of fear and uncertainty. He had previously done so well at daycare with other dogs and does well with friends and families dogs. I just want to know if this will calm down as we taper. Additionally, he is crate trained and sleeps in his crate no problem at night, and prior to the prednisone we could crate him for a few hours a day if we had to leave or just to practice having down time. He’d whine here and there, but eventually settle and sleep. Since prednisone, the couple times we tried to crate him to leave the house for errands he was okay until the kong toy peanut butter was gone and then immediately began barking heavily and could not settle to sleep. Of course we barely let it go on for more than 10 min, because we have a camera on him and we rushed home right away. We were concerned that it was maybe his anxiousness around trying not to urinate in his crate (but he sleeps all night in there) or maybe around being anxious and away from us? Either way, we’re just trying to understand if we will have our confident pup back, and if these behavioral issues will pass as we taper and come off the prednisone. At this point, we can never really leave him, because we don’t want him to stress himself out to a point of potentially hurting himself in the crate. Any experience with this you can share would be greatly appreciated.

    Reply
    • Hi Andrea

      I am so sorry to hear of another young Boxer going through this.

      Aggression is definitely a side effect of prednisone so I think you can be confident that will subside as you taper. In humans it’s known to cause psychiatric disturbances so I’d be putting the anxiety and all and any other weirdnesses down to it as well. We certainly got barky all of a sudden when we’d never previously been that way. Several instances of aggression, too. It could be worth trying to give Clark space from the situations that seem to spark that, so there’s less chance to repeat the behavior and have it become any kind of habit. I think we’ve been left with some residual effects in that way. But the shorter time you’re on the pred, especially on the highest doses, the less chance of lasting damage.

      It’s great you have the camera and are keeping such a close and responsive eye on him. I think you’re very much right to understand he’s not himself right now and may, under the influence of the drug, behave in ways he ordinarily wouldn’t.

      You’ll get there.

      Have you gotten any sense of what may have triggered the SRMA in Clark’s case?

      Sending warmest wishes your way,
      Jane

      Reply
      • Thanks so much for your response, Jane, and the reassurance. No sense of what triggered it. He had already had his vaccinations completed well before it occurred. They said it’s something that certain breeds (including boxers) are more susceptible to. Happy to say that we’ve had some playful puppy antics return here and there with Clark in the last week since his first taper. The restlessness is still definitely there, and he’s always on high alert when we leave the room, but just hoping his confidence comes back as we keep tapering. Thanks again for your time and words.

        Reply
        • Glad to hear it, Andrea.

          Keep in mind the vaccinations can cause reactions many many months (and years) later due to the way they affect the immune system and the way the adjuvants contribute to toxic load on the body, via a “stacking” effect. Holistic vets refer to a syndrome called “vaccinosis”.

          With toxicity, one or two exposures to the toxins of daily life (everything from chemicals in the home to lawncare chemicals to what they ingest in wormers/flea and tick chemicals, medication, kibble) are usually detoxed fairly easily by a healthy dog’s liver. But when they build up, the system can reach the “straw that breaks the camel’s back”.

          For Shiva I believe the ultimate trigger was exposure to roadside weed sprays. But I had also been doing a whole heap of things wrong in his basic care, including kibble feeding for a time in his puppyhood. Here is why you don’t want to do that.

          Hopefully your vet has made you aware that a dog that’s had any kind of “autoimmune” condition should never be vaccinated again. If you need an exemption any of the vets involved in the SRMA should be able to write you one. You can titer test in lieu of vaccines in most places too.

          I would be avoiding all chemical wormers/flea and tick treatments etc and optimizing the diet once you’re off the pred as well.

          I remember at the point that Shiva came off the pred, a holistic vet told me “You are going to have to make some big changes to repair this damage.” I go into how I did that with Shiva in Supercanine if you’re interested once you’re at that stage and have less on your plate. First things first, deal with the taper. Plenty of time for the rest once the drugs are out of the system.

          You might find my Boxer-dedicated site Boxer Dog Diaries useful going forward with Clark. Don’t hesitate to reach out if I can ever help.

          Reply
  52. Dear Jane,
    Ty soooo much for this website! I have learned so much about prednisolone and my vet only told me it would cause excess thirst and urination.
    I took my 13-14 year old rescue, Pepper (not sure of his age as he was a rescue but I’ve had him almost 11 years) to the vet one week ago today for a chronic cough and incessant paw licking. He had an X-ray which showed a mild form of bronchitis. The vet prescribed 5 mg of prednisolone twice a day for 5 days, 5 mg once a day for 5 days and then 5mg every other day. He was also prescribed 100 mg of doxycycline daily. After the first day of the meds, mass improvement-no more coughing or licking. Yesterday he threw up his breakfast so I called the vet and he prescribed pepto and withhold his food for 24 hours. The vet said it was probably due to the doxy but to keep giving him the doxy and continue with tapering the prednisone. This morning he had some yellow vomit so I’m going to withhold his breakfast and discontinue the doxy completely. Surely his vomit can’t be related to the prednisone as he’s only been on it 5 days! Should I continue with the tapering down? I am so grateful for this forum – I had no idea prednisolone was so powerful! 😩😩😩
    I have been feeding him ground turkey, cooked, with some kibble for 2 years now but I am going to look into the raw diet Facebook post that you shared. Ty so much for all your information!!! 🐾❤️

    Reply
    • Hi Lisa

      I’m so glad I was able to give you more information about this drug. Did the vet put the paw licking down to bronchitis as well? Paw licking can be a sign the skin is using the skin to push out toxins when the primary eliminative organs (kidneys and bowels i.e. pee and poop) are overburdened. Which can be caused by diet and exposure to chemicals via chemical wormers, flea and tick treatments etc. Prednisone will cut that symptom but doesn’t do anything to address the underlying cause in that case. Paw licking can also be a sign of fat overconsumption.

      Generally there is no need to taper pred when it’s given for such short duration, so I’d query the need to have it in his system for 3 weeks rather than 1 just for the sake of a taper. Tapering is generally necessary when the drug has been giving long enough term for the adrenals to switch off.

      Switching to a fresh, natural raw diet will be enormously helpful all round.

      Reply
    • Hi Lisa

      Is this the link you meant?

      You didn’t mention what breed/s Pepper is but I have a Boxer-specific site that has a lot of content relevant to all breeds, including a lot of information about raw feeding, and rotational monofeeding is the approach I follow.

      Here is a basic overview of how to raw feed. I also created a free, 7 day raw feeding eCourse that may be helpful for you. It’s written for Boxers but all the same principles apply to any breed.

      Hope that helps. Sing out if you need anything else 🙂

      Reply
      • My beloved rat terrier died a horrible death in my arms exactly 4 months to the day she was diagnosed with tracheal collapse. God awful drug. Knowing what I know now about Prednisone I would never have allowed it. The side effects were awful. In fact after weight loss her breathing improved but I was stuck on that damn drug. I could go on but I truly believe the only apt use of this drug is emergency use after a accident or injury. And then only for a very very short duration. It was as I said god awful

        Reply
        • James, I am so sorry for your loss. I feel the same way about prednisone on the basis of our experience. May future dogs in our care benefit from this suffering and the lessons our dogs have taught us.

          Reply
  53. Such a helpful article, thank you so much. My little 22lb pug had a couple strokes and they put her on prednisone. She’s been on it for a month and we’re on Day 2 of no more after a week’s tapering. The last two days she’s barely moved, just so lethargic and seemingly weak but still eating and drinking. I myself have been on prednisone and I know its horrible, but reading about the process you went through made me feel reassured that the side effects and symptoms we’re going through are normal. Thank you, thank you, thank you.

    Reply
    • Hi Tara, I’m glad it was helpful. Thank you for your kind words. Yes the lethargy could certainly be consistent with adrenal adjustment (although that shouldn’t be a huge factor after only a month, depending on how high the dose was) or with detox from the drug.

      The good news is that a month is a relatively short duration and so the body should recover. Lots of rest!

      Please let us know how she progresses? Hopefully you’ll see her body normalize with lots of rest.

      Now would be a great time to optimize the diet if you’re not already feeding a fresh, natural one, and a good time to get rid of all possible toxins e.g. flea/tick, chemical dewormers etc.

      Let me know if you need help with how to do that as it’s what I needed to do with Shiva post prednisone.

      Reply
  54. Thank you for this wonderful article! My 14 months old mini-doxie fell ill two weeks ago and was hospitalized with a diagnosis of Auto-Immune Menioencephalitis. She was put on 10MG Pred a day. (5MG Morning and 5MG) evening. She was also put on the Atopica at the same time. One Tab in the morning, and one tab in the evening. Her symptoms of neurological damage started to slowing go away. She was at the point where her balance was so off she couldn’t walk. After one week, we were told to reduce to One Steroid (5MG) a day and One Atopica (capsule) per day. After day two I noticed she was started to tremor again so the Neuro told us to go back to the 2 per day on the pred but keep the Atopica at one per day. Neurologically she seems better but oh man she is not my happy puppy anymore. This dog had so much life and now all she does is plop down on the floor wherever she is, does not play, is not affectionate like she was. It literally breaks my heart. Now I’m wondering if the tremors were her body detoxing a bit? She honestly wasn’t on it long enough though so I’m not sure. She is scheduled to go back on week 3 for her Cytosar shot (2nd one) and hopefully they will start reducing her pred somewhat. I’m praying she will come back to us. This has been a very difficult time as my 13 y/o doxie was just diagnosed with CHF at the same time. My question is this: I know we cannot give her vaccines for life. My vet strongly stands behind the heart worm and flea/tick. To be honest I believe the flea/tick is what brought this illness on to begin with. I struggle with the heart worm as I know that’s so important for them. What do we do without it? Is there a natural solution? Or is it just a gamble? Thank you for your time!
    Laurie

    Reply
    • Hi Laurie

      I am so sorry you and your pups are going through this. It’s distressing in a way I don’t think people who haven’t been through it can truly understand.

      From what you’re saying, that’s 3 different heavy duty immunosuppressants, so her body would be under a huge toxic load and her immune system whacked.

      If I’m understanding it right, you began to taper after only 1 week on the drugs? So early in the piece, I would tend to think it’s more likely that the tremors were a return of the original symptoms than the adrenal insufficiency that could explain it if she’d been on the pred longer. That shouldn’t be a factor after only 1 week, as I understand it. But I don’t know what difference being on the Cytosar and the Atopica would make to that.

      I do know that Atopica and prednisone, when given in combination, each “potentiate” or increase the effects of the other i.e. it’s like you’re giving an even higher dose of each because they strengthen each other’s effects. In our case, with SRMA, the Atopica (Cyclosporine) on top of the pred caused Shiva to go dramatically downhill and when I insisted the Atopica was stopped, even though the neurologist didn’t consider it a problem, his mobility was significantly improved within half a day.

      To your question: the FDA issued 2 warnings about flea and tick products containing the insecticide isoxazoline in 2018 and 2019 due to the potential for “neurologic adverse events” in dogs and cats.

      The FDA warned the products could induce seizures in animals without any prior history.

      None of them was removed from sale.

      The still-available products include many popular brand names, like:

      Bravecto (both oral and topical)
      Nexgard
      Simparica
      Credelioin

      They would seem to me particularly bad news for dogs already dealing with tremors — particularly given fleas are easily dealt with if/when they occur, which may well be never depending on your dogs’ lifestyles. You’re probably already aware there is a fb group with 26K members, full of owners whose dogs have suffered from these products, including seizures and death. Do your dogs even have a flea problem or any exposure to catching fleas/ticks?

      Heartworm is transmitted by mosquitoes and so there are ways to manage the risk by controlling exposure to mosquitoes. You most certainly don’t need to give heartworm chemicals year round, depending on where you live, as the heartworm larvae require a run of warmer temperatures to survive in the mosquito i.e. mosquitoes can’t carry it when it’s cold. When the temp dips below 57 degrees Farenheit/13 degrees celcius the incubation of the larvae inside the mosquito stops and they take 2 weeks to incubate when uninterrupted. This timeframe is variable as it’s cumulative heat that matters. As well as the temperature requirement, it’s only certain species of mosquito that can transmit it, and they have to have bitten an infected dog (or wild dog). So, a lot of things have to line up for a dog to contract heartworm.

      Of course, the natural solution, and absolute best way to make your dogs as unappealing as possible to parasites of all kinds is to feed a fresh, natural canine diet i.e. a raw diet, properly fed.

      This is exactly the kind of stuff I go into in Supercanine if you’re interested. It basically collects all the information I gathered when rebuilding Shiva’s health post SRMA, from what to feed to how to minimize the toxic load on the body including non-toxic ways to approach parasite control. I believe this is not only the way to recover from the drug damage, but the way to avoid relapse or the development of other inflammatory, “autoimmune” disorders in future.

      With heartworm I think it’s a multipronged natural approach: 1. feeding the natural canine diet to create the most vitally healthy dog, 2. mosquito control around the home by tipping out stagnant water and there are also some great garlic based products you can spray on the yard around the house that are non toxic, 3. avoiding being outdoors at dawn and dusk or whenever you notice mosquitoes. If you wanted to do more there are some “less toxic” options on the market, but depending on your level of risk/exposure to mosquitoes/proximity to other dogs that may have heartworm, the cost/benefit analysis might come out in favor of gambling on those measures rather than on the gamble that it always is to have your dog ingest chemicals.

      I know the fear of god is put into us about heartworm but I believe you’ve got to consider each individual dog’s situation and what is the greater risk: the heartworm or the chemicals?

      Hopefully that helps you think it through a bit?

      Making those kinds of changes to diet and toxins etc could only help with the CHF too.

      Sending strength!

      Reply
  55. Hello and thank you for your very informative article. My 14 month old Irish Wolfhound X Paddington is being treated with prednisone for SRMA. Prior to that he had a seizure, the same day I gave him Simparica flea and tick treatment. I believe this was the cause. A few days later he had four more seizures in the same day and the emergency vet put him on Phenobarbital. He then later experienced terrible pain where he was screaming out at any movement, he had spinal pain and was in a bad way. We were beside ourselves with fear for him. Due to his seizures and symptoms we were referred to a Neurologist and after four days in hospital and running every test and tap and scan, the only thing he definitely had was a UTI! They sent him home with antibiotics and a short course of prednisone with the notation that if his symptoms returned it was probably meningitis. His symptoms did return but not as severe (thankfully) so that’s when they put him on a long course, tapering off over 5 months in total. He isn’t a huge dog and is on 30mg morning and night. He has been on that dose for a few weeks when he developed a UTI and our local vet checked with our Neurologist to see if we could begin the tapering off regime three weeks earlier to help with the infection. They agreed so I reduced the dose according to instructions down to 15mg morning and night. Within a couple of days he was limping, crying, which were both symptoms of what brought us to the Neurologist in the first place. We freaked out and rang the neurologist and they said put the dose back up and we had an appointment a few days later. At that time the Neurologist decided to give Paddy an extended high dose…another 8 weeks before starting to reduce.
    Now, after reading your article I am wondering if he should even be on it at all and that the first time after leaving hospital could have just been his adrenals adjusting and or withdrawals, and also when I reduced it from 30mg twice a day to 15mg twice a day. We too have watched our Very cheeky loving fun pup age before our eyes. I would hate to think he is on that stuff unnecessarily. There is no way to know is there? Another thing he has developed is two lesions on his lower leg where he was licking but it looks like he has been chewing at it also. We have been bathing it and bandaged it to keep it clean as I don’t think there is much the vets can give him, he is already on antibiotics. We have an appointment with the neurologist again in two weeks and I am going to send him your article and discuss our options. Thank you once again.

    Reply
    • Hi Neane

      I am so sorry to hear you and your Wolfie pup are going through this. It’s truly hideous.

      Given the large number of owners whose dogs have suffered after ingesting flea and tick treatment, I think your feeling about where all this started is likely to be spot on. Are you aware of the Facebook support groups for users of these brand name products? Search in FB for the brand name and “dogs” and it should come up. There are also FB groups for dogs with SRMA and dogs with meningitis in general. And there is a website called CIMDA run by someone called Jo who is very helpful and knowledgeable. Re the flea and tick drugs: though still deeming them safe, in September 2018 the FDA issued an alert warning owners and veterinarians of “adverse neurologic events” associated with flea and tick treatments containing drugs from the isooxazoline class which includes the Bravecto, Nexgard, Simparica and Credelio brands. Those adverse events include:

      • Muscle tremors
      • Ataxia
      • Seizures (in animals without a prior history of epilepsy)

      Did the battery of tests include a C-reactive protein (CRP) test? It’s a blood test that shows whether there is systemic inflammation. If it’s abnormal that would support a diagnosis of SRMA, although a spinal tap would also confirm it, and it sounds like you had one of those as well, but at the time it didn’t lead them to say SRMA, as they only found the first UTI at that point?

      How long had he been on the prednisone when you first tapered, resulting in the limping and crying? It’s my understanding that it would normally take several weeks of being on high dose prednisone for the adrenals to switch off, and therefore for adrenal insufficiency to be a potential cause of those symptoms upon tapering.

      Is that 8 weeks on the highest dose of pred? If so, that is a very long time and yes I would be concerned about the damage pred would do at that dosage for that amount of time. How long total have you been on the pred right now?

      The way to know whether it’s adrenal insufficiency or the SRMA is to taper more gradually — if it’s adrenal insufficiency, that should be enough to give the adrenals more time to kick back in and avoid the symptoms. If it’s SRMA relapse, the symptoms would happen regardless of how incrementally you tapered.

      Have you considered whether the lesions on the leg might be calcinosis? It’s a known side effect of prednisone, which we ended up with. Is there a white chalky discharge? Here is what our calcinosis looked like, in case you haven’t found this article. If it’s calcinosis, you’re right: there is nothing you can do for it except get off the prednisone as soon as you can, tapering as you go.

      Hopefully your neurologist has a better appreciation for the serious and lasting side effects of prednisone than ours did. Ours was, I’m sorry to report, 100% disinterested in dealing with the consequences of the drug he’d prescribed and made several mistakes that we are still paying for. Don’t be afraid to assert your right as the owner to make the decisions, taking the neurologist’s advice into account, but not feeling obliged to blindly follow the course he recommends. If I had been more educated earlier, I believe Shiva would have been a lot better off. In the end I managed the taper myself, without the neurologist’s involvement.

      BTW Make sure you have stopped all toxic inputs eg. no chemical dewormers of any kind, no more vaccinations ever for dogs with “autoimmune” conditions and once you’re off the pred, optimize the diet to a fresh, natural one i.e. no kibble or other dog food — it is highly processed and full of junk that only adds to the toxic load on the body. You have enough on your plate right now, but once you’re through this, Supercanine goes into all the ways I overhauled Shiva’s care in the wake of the SRMA, in case it’s helpful.

      This might sound pretty woo woo, depending on your worldview, but if I knew back then what I know now, I would have used extended fasting at the point the symptoms first appeared. It is the most powerful and side effect-free way known to support the body’s natural detoxification pathways in the liver — and so, the fastest way to clear the flea/tick chemicals. There is a considerable body of scientific evidence supporting its anti-inflammatory effects. I don’t know if I would have had the confidence to use it back then, but now it would be my first port of call. The holistic vet Dr Richard Pitcairn and others make use of therapeutic fasting for a wide range of illnesses and diseases.

      Fruit feeding (on its own, not with meat or kibble) is almost as good as fasting when you have to feed something, as you do when giving pred, and its hydrating effect can help flush toxins too. Just mention these things in case they give you more options in your armoury.

      After we had spent 11 months on pred, I had a consult with a holistic vet Dr Henry Stephenson who told me that the SRMA would have been treatable without prednisone. Granted, he would have prescribed his own potions in the form of homeopathics, but I daresay the damage would have been considerably less. His vet clinic is Australia-based but does phone consults. To find it, you would google The Natural Vets on the Sunshine Coast, Queensland, Australia. I mention this not because I think homeopathics are necessarily the answer, or that you should do a consult, but just so you’re aware the traditional veterinary approach to load up on drugs is not the only approach — I had been under the impression that prednisone or a cocktail of other immunosuppressants was the only way to deal with SRMA. You do have choices, even though it doesn’t feel like it and it’s very scary to take a path other than the one that’s being advised by those who we trust to know the answers. There are certainly homeopathic treatments for meningitis if you have a search online. The truth is vets don’t know what causes SRMA, and I think toxic accumulation (and the phenomenon of vaccinosis) has a huge role to play. Lasting recovery, I believe, must involve addressing and minimizing those exposures.

      Hope that’s not too much information all at once, but just in case any of it helps your thinking.

      Let me know if I can help any further and I’ll do whatever I can.

      Warmly
      Jane

      Reply
      • Oh Jane. I found your article too late to help my Paddy, he passed away last night, one day shy of 15 months old. Too young…
        A week or so back he had his heart worm injection…I didn’t know this would do him harm! I hope this wasn’t a part of the reason for his death, I would never forgive myself. As it is I’m not real happy with myself as even though I had not yet read your article I knew in my gut that he shouldn’t be on such high doses. I use prednisone when I have asthma and I hate the stuff, and a high dose for me at 55kg was 50mg, my doctor preferred 37.5mg and Paddy only weighed 32kg. Especially too, even after every test and tap and mri and xrays they could think of it wasn’t a definitive diagnosis.
        Yesterday I took him to my local vet regarding the sores on his leg, she shaved the area which revealed more than we knew and there were more lessons noted a little higher up that may or may not have deloped into the raw, awful looking sores Already there. It looked like there were holes in his skin and both vets who saw it were baffled. They did note the lack of muscle and bloating of his stomach. He is quite a lean log otherwise. I swore to them then that I was going to speak to Paddy’s Neurologist and demand we begin tapering immediately as the poor boy had nothing in him to fight. We had Paddy booked in for first thing this morning to take biopsies and send them off for analysis and then begin two strong antibiotics but he didn’t even make it to his appointment.
        After yesterdays vet appointment Paddy seemed fine, jumped back into the car and we went home. I sadly Left him for a few hours to catch up with a friend. Paddy was home with my partner and later on he rang to say come home as Paddy is very sick. I told him to take Paddy straight to emergency and I would meet him there but I got home while he and a neighbour were still trying to get him into the car. He did not respond to me at all and his toungue was hanging out of his mouth. I didn’t stop to check anything I just wanted to get him in the car but in hindsight, I think he had already passed. We all carried him in a blanket to the car and broke the speed of sound getting to the vet. Once there they told me His heart had stopped and despite their efforts could not revive him. I hate myself for him dying without his Mumma, he was my boy and we had such a bond I have never experienced before.
        Thanks again for sharing your invaluable information.
        Best wishes
        Neane

        Reply
        • Neane, I am so incredibly sorry to hear this. Thank you for letting me know and for sharing what’s happened to Paddy, even though your heart is breaking. We can only work on the basis of what we know at the time. No words can make this any better but I am sending love your way.

          Reply
      • Thank you so much Jane for your advice. I thought I have already sent you an email but it is not showing. I will keep this one short as I am emotionally a wreck…Paddy died last night.. we don’t know why. He vomited, didn’t want his dinner and went downhill from there. We were certainly not prepared for the outcome..
        Thank you again for taking the time to help us all.

        Warm regards
        Jeneane

        Reply
        • Jeneane yes I got your message and responded. I am so sorry to hear of Paddy’s passing and know there is no comfort to be had when he is gone. Thinking of you at this time.

          Reply
  56. Hi Jane,
    I very nearly lost my 5 year old greyhound in February after he developed polyarthritis.
    He has been on Prednisone ever since. Originally on 50 mg a day ( 25mg twice a day) and is now on 30 mg daily.
    I read in your piece how tapering can sometimes look like withdrawal and this so struck a chord!
    The first time I noticed a ‘relapse’ I took him to the vet and they took his bloods and they showed his proteins were elevated so we put his steroids back up.
    Is that normal? Will his blood levels be increased while he is adapting to the lower dose?
    I have continued to think he is relapsing and just put his dose back up to the one where I saw him as stable 🙈
    I’m terrified of ignoring signs of a relapse and then it’s irreversible but then I’m also conscious of it not being a relapse due to what you have written.
    I’m scared of leaving it a week to find out if his body adapts or if he is relapsing

    Reply
    • Hi Karen

      So sorry to hear you and your boy are having to deal with this and so glad you didn’t lose him.

      When you say proteins were up, I’m assuming you mean C-Reactive Protein (CRP)? If so, yes CRP detects systemic inflammation and so is generally regarded as the way to track recovery.

      I don’t have a clear answer for you I’m afraid.

      Certainly an elevated CRP would be consistent with a relapse but based on my experience with my own dog (keeping in mind I am not a vet) I don’t think an elevated CRP on its own it means you’re DEFINITELY relapsing. I would take into account whether it’s slightly elevated or hugely abnormal.

      I don’t know whether it’s recognized that CRP can show as elevated due to adrenal insufficiency during the taper but I know for sure that adrenal insufficiency symptoms can look exactly like relapse in the case of SRMA, so I think it’s possible. I seem to recall that CRP can bounce around a bit during the taper as the body is all over the shop and we definitely got all sorts of wild readings for all manner of things in blood tests. I remember watching the CRP numbers like a hawk and they’d make me worry when they went up after previously going down — in the end I stopped measuring it and instead proceeded with a very incremental taper and just gave his body time to equalize. So, I guess what that means in practice is I would take the whole dog into consideration, and perhaps even place more emphasis on that than on the blood test result.

      I haven’t dealt with polyarthritis so I’m not sure whether there would be a disastrous consequence to giving it a few days to hopefully let the adrenals adjust. Could you not just then up the prednisone after a week if the symptoms persisted? Has the vet said it can reach a point that’s irreversible? (Certainly while the vets worked on diagnosing our SRMA, they were happy to let it go on for several days without starting the pred, so with SRMA I think you can wait and if it does turn out to be relapse, give the pred then and it will work, even after a delay.)

      I get the fear of relapse. I definitely think I was fixated on it as the threat, at a point when the real damage was coming from the pred.

      Have you made sure to eliminate all toxic exposures e.g. vaccines, chemical wormers, flea/tick treatments etc? If you’re feeding kibble, the sooner you get it out of the equation, the better as it’s another source of toxins from all the additives. Tricky to feed raw when he’s immunosuppressed but as soon as you’re off the pred I would be looking at optimizing the diet to a fresh, natural one.

      I wish I could be more definitive. But if you’re getting stuck in a constant loop of apparent relapse leading to putting the pred back up — particularly given the damage pred does — there could be a case for trying something different to see if it works better than what’s been done several times already so far.

      Please keep me posted on his progress.

      Warmest wishes for you both,
      Jane

      Reply
  57. Hello, thanks so much for your article it is really informative. Your poor dog and what he went through.

    I have an eight years old Pomeranian, Dolly. She has been prescribed Prednisone after being diagnosed with ITP. She has been on the steroids for almost two months. At first she lost a little weight and now she has gained. She is overweight which I am aware of, she had a DVT in her hind leg several years ago which left her partially lame and she is very reluctant to walk. Her symptoms apart from extreme heavy panting and hunger have been heartbreaking. She will hardly lay down, she falls asleep sitting up and her head hits the floor and startled she wakes up again. She is terrible at night I am awake most of the time with her, trying to calm her. She walks up and down panting heavily and is very stressed. I do all I can all night to keep her calm to no avail. She is very anxious and she is scared, like she doesn’t understand why she feels this way. I asked the vet to check her blood pressure today and she said it is high. This has really worried me, the vet said she will monitor it. We are waiting the blood test results to see if her platelets have stayed up. Could the high BP be due to the steroids? She also is very weak and her legs are slipping a little at times. I just can not get her to relax. The vet has not suggested any vitamins etc to support her through this period. After reading your article I am really worried about the effect the Advocate she has been taking monthly has affected her, also her yearly vaccine which was last June? She has gone from a happy, tail wagging girl to being stressed with her tail always down in the last month. The vet is tapering the steroids and she is now down to 4mg per day, reducing to 3mg after and so on, until every other day. I do wonder about withdrawals too? My concern also is that if her platelets do not stay up, then she will need to go back to a higher dose of steroids. It’s heartbreaking seeing our dogs go through this.
    Many thanks and best wishes,
    Emma Jane

    Reply
    • Hi Emma Jane,

      I am so sorry you and your Pom are going through this. It’s unbelievably stressful. I have no experience with ITP so I don’t know what its symptoms are, other than the bruising, but everything you’re describing could certainly be caused by prednisone.

      I would be looking to get her off it ASAP, which you’re already doing by tapering. That is movement in the right direction. What is the long term plan for how to deal with the ITP? Is the expectation she can come off the pred and all drugs totally? If so, fantastic. Once the drugs are out of her system, you can work on rebuilding her health from the ground up. I would be overhauling everything from her food to her general care. That’s what I did with Shiva the exact things I did are outlined in Supercanine, which you can check out here: https://www.amazon.com/gp/product/B08W9Z2HPF/ref=as_li_tl?ie=UTF8&camp=1789&creative=9325&creativeASIN=B08W9Z2HPF&linkCode=as2&tag=boxerdog07-20&linkId=d5096dc76d44fb409bd84f82cf757c91

      I’m assuming you read in the comments on the prednisone article that ITP is one of the “autoimmune” conditions that vet Dr Jean Dodds has specifically linked to vaccines? The fact her last vaccine was a year ago doesn’t rule it out as a cause as the effects are not always immediate. I would stop the chemical wormers/flea and tick immediately and no more vaccines ever. Boosters are actually not necessary — it’s been shown dogs likely have lifetime immunity from a single puppy vaccine given at the right time, so the rest is just more toxins without any extra benefit. If you’re being pressured to revaccinate, titer test to prove your dog still has immunity. Put “Nexgard dogs” into facebook and you will find a group full of owners whose dogs have suffered as a result of these chemicals. There is no need for the Nexgard, and certainly not given all her body is dealing with right now.

      Once you’re off the steroids, I would recommend a fresh, natural canine diet i.e. a properly fed raw diet. This is the key to healing. I’ve also found fasting extremely powerful. A three-day fast, for instance, is thought to reset the immune system — something that may help Dolly enormously.

      Can you try propping her up on pillows so she can remain in a sitting position but relax and sleep without falling? I’d try that.

      Shiva could hardly walk at one point from prednisone (and even worse when they had him on another immunosuppressant at the same time) so the mobility issues definitely would not be helped by the steroids. It’s likely you will see your girl come back to you as you lower the dose. Keep in mind that what looks like relapse may just be adrenal insufficiency as they adjust. Sometimes it takes a few days to a week to even out. Tapering in small steps is the way to avoid this. I found it was necessary to reduce in even smaller increments than what they usually recommend i.e. reduce the dose more often but by a smaller amount each time, so it’s less of a change for the body, rather than just halving each time, if that makes sense?

      I don’t know if that helps at all or gives you anything to go on?

      Hang in there through the taper, eliminate as many of Dolly’s exposures to toxins as you can, whether in processed food, the home environment (eg. no scented plugins, chemical cleaners etc) or ingested in the form of those chemical dewormers etc. And then work on a fresh diet as soon as she’s no longer immunosuppressed by the drugs.

      Sending strength,
      Jane

      Reply
  58. Jane,

    This is the most informative article on long term prednisone use in dogs on the entire Web and more info than our vet shared or as I now suspect knows.

    Our Springer Spaniel Charlie (6yo) was on high dose prednisone 50mg twice daily for Immune Mediated Thrombocytopenia. It resolved his platelet deficiency quickly but we had to taper off for 3+ months.

    During this time he looked like he was on death’s door. We felt like we were poisoning him but knew stopping prednisone cold turkey would be more problematic. He got really bad hot spots requiring iv antibiotics and fluids, tongue and lip calcinosis, weight loss, muscle wasting, bloody stools, fatigue, a bit depressed, etc. It was not fun at all watching our normally happy, active and friendly pup waste away.

    But after months weaning off, as we got down to a quarter of a pill once a day, he started to act more like himself becoming friskier, more energetic, not as weak, was able to jump on and off the couch, climb stairs etc. Charlie was almost back. When that taper sequence was completed and his blood work continued on a normalizing trend we were advised it was time to stop the prednisone, continue follow up blood work every 2 weeks for a bit and watch for signs of relapse ( bruising, bleeding gums, dark stools). We were both excited and scared since he seemed to be responding well the past few weeks.

    About a day or two after his last dose which we were told was low enough that it wasn’t therapeutic anymore, he developed a limp in his front right leg. We attributed it to him jumping out of the truck (something he hadn’t done in months) the day before at his blood work appointment.
    Then the following day he became extremely weak in his hind legs, followed by his front legs, became very unstable, unbalanced (wobbly), increased thirst and hunger again, lethargic, dizzy etc. What the #@&*!. How can he decline so fast a day after stopping prednisone?? We decided to wait a few days and monitor before running to the vet.

    Well we couldn’t wait, panicked believing he was suffering from an Addisonian crises and could die. All blood work was better than the results a few days prior. No relapse, no crisis. Were told his neurological exam was normal as was his pulse and heart rate. No stroke or anything similar. Vet felt it was attributed to Charlie now feeling pain from muscle wasting from stopping prednisone and that prednisone causes ligaments to stretch making walking difficult. He prescribed gabapentin. We gave it to him one day but stopped because of the sedative effect it was having on him. He was dealing with enough. Plus we weren’t convinced with the vets diagnosis.

    We’re still worried something else is going on but your article has given us some hope it’s just due to his adrenals kicking in causing a storm before the calm.

    My questions to you are…

    How long does the storm last? Days? Weeks? Months? Will his brain fog, balance and strength return? And when?

    When you say wobbly in your article are you describing the weak, unbalanced, uncoordinated walking Charlie is exhibiting? If so, how long does that last? It’s been a week now and very little Improvement seen. Even standing still he wobbles like he’s trying to get balanced before moving again. He even eats lying down because he sways while standing and eating.

    How long to get strength back to where he can go for a bit of a walk in the neighborhood?

    And how can he be jumping onto couches one day while on prednisone and unable to go up and down steps a day or two after stopping?

    Again, thank you for sharing your experience. It’s helping a lot of people like myself! Looking forward to your response.

    Reply
    • Hi Gino, I am so sorry that Charlie is going through this, and you with him.

      I think there is a lot to be optimistic about in what you’ve relayed. I would be taking a lot of confidence from the latest bloodwork and the ruling out of both relapse and adrenal crisis.

      I think the ligament stretching caused by prednisone and the return of the ability to feel pain and discomfort now the prednisone is out of the system is likely to be a significant contributing factor to what you are seeing. With three months total on prednisone, most of this should be repairable with time and if you optimize feeding and care — which I am confident you have the wherewithal to do. You are clearly a switched on owner.

      I think you’re right in your assessment that what you are seeing is adrenal adjustment but also combined with the damage prednisone does to the body — not just ligaments and muscles and gut but virtually every bodily process is touched by this drug.

      A third and major factor is detox. Charlie’s body will be experiencing detox now as the prednisone and other drugs work their way out of the system, which can take weeks and months (and for us, years). A lot depends on what you do next. The nature of detox is that things often appear to get worse, sometimes a lot worse, before they get better. In the case of detox, this is not deterioration, but more along the lines of a healing crisis, a necessary part of the process and one that will pass. Every chemical and drug that went in to his body has left a toxic residue. When the body is under stress, detox can’t happen. So, those toxins have been parked by the liver in adipose (fat) tissue. As the internal conditions of the body improve, with the cessation of the medication, the organs can begin to clear the backlog. This clearing process produces the symptoms associated with detox. As long as you are removing new sources of toxicity (in food and other inputs) these symptoms are productive, in that they are part of the body expelling the junk and trying to cleanse. Productive symptoms and detox are difficult, but are to be celebrated because it means you’re on the road to healing. The only way out is through and the most important thing is to stay out of the body’s way i.e. as your instincts and observations have told you, don’t medicate and add additional toxic load with more drugs, supplements, herbs, potions etc of any kind.

      To your questions first.

      1. How long this lasts varies from dog to dog. The further the pred gets in the rear vision mirror the better. I would certainly expect his mental clarity, balance and most of his strength to return. We were on prednisone for 11 months total and so you should have an easier path back than we’ve had, and even we are managing to regain these things. Charlie is middle aged and so that may mean a slower recovery but he’s by no means old so that is in his favor.

      Remember you have multiple processes at play — so while the damage from the pred is healing, the detox is also going on and this can create the appearance that things are going downhill, when really they are going up. If you stay the course and ride the waves of detox, you’ll find they come and go, and after each uptick, Charlie will arrive at a better and better level of health.

      2. Wobbly — yes I mean the weakness and all the other weirdnesses. With adrenal adjustment I would ordinarily expect that to equalize after half a week to a week. So perhaps that means most of what you are seeing is from detox more than from adrenal adjustment. Certainly limping can be detox. We’ve had plenty of rounds of limps that come and go on their own. Rest when it happens and do the rest of the optimization of care I’ll talk about in a sec and the body will handle this.

      One caveat (other than me not being a vet) is I don’t have direct experience with ITP, so I can’t speak to which of these symptoms might be particular to recovery from this condition. But all things considered, I think it’s reasonable to think that in Charlie’s case he is just recovering from everything he’s been through.

      3. Re walks — I would suggest as much rest as you can manage and a very quiet, predictable and even dull routine until he signals he is ready for more. Don’t worry about walks other than toilet breaks if he’s not wanting them. That will come. You could drive him to his favorite spots so he can experience them to help his mental health, but without it causing physical exhaustion by having to walk all the way there like he maybe used to.

      4. The decline in mobility and strength after stopping pred I think may well be explainable by all of the above. I would keep an eye on it but unless something happens to suggest otherwise, I would work on the basis that it’s detox, adrenal adjustment and damage from the pred, damage that was there before but is now being felt by Charlie full force, without the masking effect of the pred which certainly covers up almost everything — which is no doubt why it’s so overprescribed.

      Here is what I would do if Charlie were mine:

      1. Optimize the diet. Under no circumstances should Charlie be eating kibble or other processed dog food. Now that Charlie is no longer immunosuppressed from the prednisone, you can feed a fresh, natural raw canine diet. This is the food that will best support his recovery and future health. I can help you make the transition. We started Shiva on raw 2 weeks after stopping pred. It’s important you feed a home-prepared raw diet composed of raw meaty bones, muscle meat and a little offal. Are you open to this? Let me know and I’ll point you to some resources.

      2. Get rid of all Charlie’s toxic exposures e.g. you probably already know no more vaccines ever for a dog that’s had a life threatening “autoimmune” condition. You might also be aware that there is some evidence of vaccines as a cause of immune-mediated ITP in particular. Are you giving chemical dewormers, flea/tick treatments, heartworm drugs etc? If so, stop and never restart. I can help you work through alternatives but depending on location and lifestyle most pet dogs’ exposures are very low and, in any case, a fresh, raw diet is your number one best protection.

      3. Eliminate environmental toxic exposures like chemical cleaning sprays in the home, scented plugins, room deodorizers, fabric sprays. Keep him away from grass treated with lawncare chemicals and especially weedkiller.

      4. Get therapeutic fasting, including some extended fasts, into Charlie’s routine. Along with feeding a fresh, raw biologically appropriate diet this is the single most impactful thing you can do. Fasting triggers detox, so I would go easy given he’s likely already experiencing heavy detox, but it’s definitely an otherwise side effect-free tool in your armory and one you can use in different ways as Charlie goes through the different stages of recovery.

      5. Feed some fruit only days — this goes along with feeding a natural canine diet, helps flush lymph and aids in detoxification and vitamin and mineral replenishment. We can talk more about how to do this.

      This is not only what I would recommend but exactly what I have done with my own dog Shiva. It’s actually all outlined in Supercanine if you’re interested to have it all broken down, with detailed referencing to the scientific evidence base for this approach. In fact I wrote the book exactly for you and Charlie, this precise situation: healing a drug damaged dog.

      Hang in there, things are going to get better —
      Jane

      Reply
      • Jane, thank you for taking the time to write such a detailed response. At this point were just overwhelmed and knowing that this is part of detox and will pass is what we needed to hear. As for the change in diet I think that’s something we’ll consider in a bit. Right now just helping him get around all day is all we want to deal with at the immediate moment. And I’ll look into your book! Thanks again Jane. Hoping I can reach out again here if we need more advice or reassurance.

        Update…

        Thanks again so much. He hasn’t deteriorated since the symptoms came, he’s been the same. It’s been 9 days.

        BUT today he’s shown signs of improvement! Went up and down our deck stairs (3 of them) on his own every time he went out to pee. And his eyes don’t look glazed over and more focused. Fingers crossed this continues tomorrow and going forward.

        I just want to sleep in my bed upstairs again and not downstairs on the couch anymore. He’s 95 pounds and too heavy to carry up and down the stairs several times during the night when he has to go pee. I miss my bed 😁.

        Thank you for your support.

        Reply
        • Excellent news, Gino. Well done for having the fortitude to stick with it and give the body time to equalize, rather than leaping to re-medicate. Go Charlie!

          Reply
  59. Omg! Wished my pup’s dermat or vet had referred us to this information earlier. My pup was on atopica and predx for a week and my pup lost all her energy and playfulness. Her body went in tremors and excess thirst and peeing was part of t it. On day 8 she yelped out of tremors that’s when we knew we had to call the vet or emergency. The dermat suggested to stop the atopica immediately and keep the predx on as prescribed. My husband insisted we stop the predx too.

    Cut 2 : day 9 onward of completing being off both atopica and predx my dog has aggressive hunger wherein she’s asking for food all the time.

    So I emailed the dermat over the weekend and today she says.. Oh you shouldn’t have stopped predx as now she’s at life threatening side due to various reasons. Now I’m here crushed that had we been told the importance of weaning predx slowly I hadn’t done that to my pup. My husband is now saying nothing will happen but I’m really worried 😢 please suggest

    Reply
    • Hi Ankuta,
      My understanding is that if your pup was only on prednisone for one week, tapering should not be necessary. It’s only when it’s been longer than a few weeks that the adrenal glands are affected, and particularly when the dose has been very high.
      It’s this adrenal aspect that makes tapering necessary, to give them time to switch back on.
      Remember I am not a vet but with only a week of prednisone I wouldn’t expect adrenal insufficiency to be an issue and stopping cold turkey should be fine, especially if the pred dose was low.
      Hope that helps,
      Jane

      Reply
  60. This article is the only one I have read that describes exactly what we are going through. My 10 year boy collapsed in January this year and couldn’t walk. My vet referred him to a specialist and after multiple scans, x-rays and tests they could only tell that it was an inflammatory disease but could not pinpoint what was causing it. Here in the UK I’ve read that it can be referred to as MUC – Meningoencephalitis of Unknown Cause. He was started on 25mg of Prednisolene and Doxycycline but had several setbacks, plus the diarrhoea, and the dosage of steroids kept going up and down. In March the specialist decided to try Cytarabine injections every 3 weeks but by the third treatment it was taking him longer and longer to recover and he was spending 2 weeks out of 3 being miserable and very weak. We had weaned him down to 15mg of steroids per day but he could barely get up again and the specialist put him back up to 25mg. My primary vet and I decided that the Cytarabine was reducing his quality of life and with the agreement of the specialist he is now on Cyclosporine and is down to 20mg of steroids. My vet has been amazing and has kept a close check on his blood levels and urinary function and even tested his bowel muscles as he was having accidents in the house. The weakness in his back legs is getting worse and we are back to the specialist this morning for another check up. After reading your article I’m beginning to wish we had ridden out the relapses instead of the steroid dosage going up and down as I think it’s made him worse. The plan is to get him down to 10mg of Prednisolene but I’ve been told he will probably be on it for life and that worries me. Just another note to add, my dog was on a prepared raw food diet and had dried pig ears and chicken feet for treats but my vet advised that while he was on the immunosuppressant drugs he shouldn’t have anything raw. Thank you once again for this article as it and the comments have been really helpful to us.

    Reply
    • Hi Lorraine, I’m glad the information has been helpful.

      I agree it can be worth riding out any wobbliness that you experience during the taper. If you see Gino’s story a few comments before yours, his dog Charlie appeared to get worse for 8 days after finally discontinuing prednisone and then on the ninth day turned a corner.

      Adrenal adjustment and detox can account for symptoms that look almost exactly the same as relapse. If you are stuck in a cycle of apparent relapses it could certainly be worth trying something different to see whether it is in fact relapse or more to do with the body adjusting as drugs are reduced.

      Prednisone messes with the gut so may explain accidents in the house.

      If you can manage to get your boy off the immunosuppressants you will be able to resume a fresh, natural raw diet which will be more supportive of healing than anything cooked or processed. Make sure you’re not giving any chemical dewormers or flea/tick treatments or vaccines either as these will only add to the toxic load on the body.

      Wishing you the very best.

      Reply
  61. Thank you for your detailed experience. Sadly my dog was diagnosed with a malign tumor and one of the medications is prednisone. This article is giving me some idea of how to prepare and watch for signs effects. One information I was looking for, it is the dosage to evaluate if my dog is taking too much. Thanks

    Reply
    • Hi JL,

      I’m very sorry to hear about the tumor.

      Have a look at the first section of the blue/green table towards the top of the article. It gives the ranges for the typical prednisone doses, depending on what effect you are trying to achieve e.g. anti-inflammatory, immunosuppression etc.

      You can calculate the dosage by entering your dog’s weight.

      Let me know if that doesn’t make sense.

      Hope that helps some,
      Jane

      Reply
  62. Hi,
    Thank you for such an informative article. I have a 13 yr old Basset Hound ,who has just been diagnosed with Lymphoma. We are not going to do any chemo, and our vet recommended 30 mg of Pred. for 1 week and then decrease to 15 mg daily for maintenance. She is on her last day of 30mg and I have never seen her sicker. How long do you think it would take to wean her off completely and do you have a recommendation on dosing to get to zero mg?

    Reply
    • Hi Claire
      I’m sorry to hear about your Basset. After one week only, it’s my understanding that tapering is not necessary. Durations longer than three weeks are where you definitely need to taper. However, to be sure, you could just decrease slightly each day for a week rather than going straight to zero.
      Hope that helps,
      Jane

      Reply
  63. Wow…this article and the comments are so helpful! Seriously, thank you so much for putting so much into it. Vet recommended prednisone for our 85lb 3.5 year old boxer who was suffering from a inflammation (goopy eyes, red skin etc). 80 mg/14 days, then 60 mg/14 days and now 30 mg/ every other day for 14 doses. The inflammation is gone but she has all the side effects (panting, thirst, urination, hunger and lethargy). She recently started limping and has been extra tired (not interested in walks, laying around all day, standing and staring etc). It’s been heartbreaking to see her acting like such an old dog in just a few weeks. Had the vet check the limp and they said she likely has tear in her knee ligament. They are recommending expensive surgery with 8-12 weeks of recovery time. Crushing to hear given everything she’s just gone through with the prednisone.

    After reading this article and Q&A, we’re going to give her some time after prednisone taper is done and see if the knee issue is real or side effect of the prednisone. Would hate to do unnecessary surgery for a side effect.

    I think vets should be required to give more information when prescribing prednisone…we got nothing, just the pills. We were not prepared for the side effects and the last two months have been so hard. But I now have some hope as this article confirmed some of the strange behaviors I was seeing and that there’s hope for getting our dog back once the medicine is done.

    Best wishes to everyone whose dog is struggling…I know we all just want them to be healthy and feel well.

    Reply
    • Sarah, I’m sorry for what’s happened but I’m glad you’re here now.

      That is a hefty dose of prednisone for goopy eyes and red skin and seems a heavy handed approach. It’s unfortunate that conventional vets are so quick to reach for drugs, rather than assist owners to identify and remove the cause of the problem. While prednisone will certainly suppress inflammation, it does absolutely nothing to address the underlying cause of the inflammation, while simultaneously setting in train its own cascade of problems, as you’ve discovered, which are all too often more serious than the issue for which the prednisone was originally prescribed. If there is a ligament tear (I’m assuming they’re saying CCL), then the pred may well have had a lot to do with that.

      But, after a relatively short duration of pred, even at high dose, let’s hope it’s to do with detox or possibly adrenal adjustment and will heal with time. Based on our experiences, and the experiences of others who’ve commented here, limps after pred are common and almost always a passing phase.

      Is she completely off the prednisone? On what basis did they say it’s her knee ligament and surgery is required? Did they do scans?

      I think waiting and giving her maximum rest and time for her body to equalize is a very reasonable course of action. If she were mine, I would also be optimizing her diet and other care ASAP, to both support healing from the damage of the pred, and to address the source of the original issue. Things like, most importantly, not feeding kibble, but also not having her ingest chemical wormers or flea/tick treatments, repeat vaccines etc. If you can manage it, getting rid of tap water is also a good idea as it’s another contributor to the constant drip drip of chemicals into the body. All of these add to the toxic load on the body and can produce eye gunk and itchy and irritated skin. In fact, that’s the classic result of these kinds of inputs. You might find this article on so called “allergies” in Boxers useful.

      As a Boxer owner, you may find our main site (when I say our I mean me and Shiva!), Boxer Dog Diaries, useful.

      I’ll help in any way I can, just let me know.

      Warmest wishes for your wigglebutt,
      Jane

      Reply
  64. Hi,
    Am I ever grateful that I came across this blog!
    My Bindi, a 12 year old Cockapoo who was diagnosed with SARDS, an autoimmune disease that causes sudden loss of vision, hypothyroidism, and a hundred other things in the body to go wrong, including potential liver and kidney failure, has been diagnosed with Horner’s syndrome. This happened on Wednesday, August 25. Not sure what caused it. Her right is drooping, and sunken in, the third eyelid is raised, pupil is constricted and pushed to the top right.
    The Opthamologist’s recommendation was to start her on 5mg Prednisone twice a day for 5 day, then 1x per day for 5 days, then every other day for 10 days.
    Bindi has been on 1 mg Medrol once a day, prescribed by a holistic doctor, for her autoimmune disease for around a year now.
    I am afraid to give her the Prednisone. She is going through a lot already.
    I am not sure if and how Prednisone can treat Horner’s Syndrome.
    After reading about the horrors of thus drug, I am very concerned.
    I would appreciate any and all suggestions you may have.
    Thank you very much.

    Reply
    • Hi Sheryln

      I am sorry Bindi is having such a rough time. I don’t have experience with SARDS or Horner’s but as with any “autoimmune” and inflammatory condition, I would be seeking to clean up the feeding and overall care to eliminate all toxic inputs i.e. get off kibble onto a fresh, natural canine diet and eliminate chemical wormers, flea/tick treatments, revaccination (which is not necessary at 12yo anyway due to lifetime immunity at this point). This would lighten the load on the body and support what healing is possible.

      A 20 day course of prednisone is fairly short in the scheme of things so the damage will be not as severe as extended durations.

      The question I would be wanting clarity on is, given Bindi is already on the steroid Medrol, also known as methylprednisolone, how does more prednisone sit with that? I would be getting the holistic vet to clarify for you.

      I’m sorry I don’t have more direct insight to offer but hopefully that helps your thinking somewhat.

      Warmest wishes to you and Bindi,
      Jane

      Reply
  65. Hello,
    Our dog, Whiskey, is a rescue pup that we adopted when she was about 2 months old. She is a boxer/terrier mix. Her mom was a stray. She is now 7 1/2 yrs. She was an athletic energetic pooch until Aug 29, 2021. In the morning she was fine, by afternoon she would not get up, eat or drink water. After a night with the vet and IVs she was eating again.

    She was treated for ehrlichosis about 5 yrs ago; therefore, has antibodies to ehrlichosis (a tick born disease). Her vet doesn’t know if she has ITP (immune thrombocytopena) or a re-infection of erhlichosis. We live in the woods and have had her on flea/tick medication and heart worm medication. We started her on the new heart worm med, Proheart last May and changed to Braveto (flea/tick) in June. I don’t know if these two new meds initiated the platelet destruction. Her platelet count dropped to 38,000. At this time the platelet count is up to 100,000 (normal about 148,000 to 484,000 for the testing our vet uses). She has not had any bleeding issues to date.

    She has been on a high dose of prednisone 60 mg / day (she weights about 74 lbs) which we have slowly tapered off to 30 mg / day. She is weak, can no longer jump in the car and has a huge pot belly. But, she is alert and tries to continue on her activities although she gets tired quickly.

    My questions for all of you who had a dog on prednisone:
    1. Will the pot belly go away? How long after the prednisone dosage is lowered or stopped?
    2. How did you help your pups be-build their muscles?
    3. Has anyone had an ITP issues after Proheart or Braveto?

    This is a wonderful website and has given us a lot of valuable information.

    Thank you,
    Shari

    Reply
    • Sharon, I am incredibly sorry you and your dog is going through this.

      The pot belly certainly goes away almost instantly once the prednisone is out of the system.

      Rebuilding muscle takes time but happens gradually with a return to normal activity levels. If you manage to stay on the steroids only a very short time the damage will be contained. With longer durations, not all muscle and body condition returns.

      I think you are right to suspect the role of the flea/tick and worming products. Are you aware of the facebook groups of owners whose dogs have gotten sick after using these products? Vaccines have also been implicated in triggering autoimmune disorders including ITP.

      I’m assuming you have now discontinued these drugs?

      Thank you for the lovely comments about the website, I’m glad it can be of some help during a horrible time.

      Get well soon Whiskey,
      Jane

      Reply
  66. Hi!
    Thank you so much for this article! My 5yo Lab was on high dose prednisone for about a month for lameness in the hind end, frozen tail and some bizarre spine inflammation and spinal fluid abnormalities. Occasionally still has an issue physically, but not often. But…the steroids made him insane. We’ve been off for a year and he’s ridiculous. Ravenously hungry stealing food, barking at literally everything and very edgy, skiddish and even snappy at times. I say the steroids ruined him, since he was mentally fine prior and now we have a crazy dog. It’s awful.

    Reply
    • Megan, thank you so much for sharing your dog’s experience.

      I’m so sorry this has happened.

      It’s shocking how quickly prednisone can do lasting damage. Certainly some of that damage is psychological/mental.

      If you haven’t already, I’d encourage you to switch to a fresh, raw diet so that he has the best possible chance to rebalance and heal. Raw meaty bones are incredibly psychologically soothing to carnivores, so that aspect will also be helpful.

      Hope that helps a little,
      Jane

      Reply
  67. This is the greatest article I’ve ever read. My German Shepherd was prescribed prednisolone 20mg half a tablet twice a day. After He was restless grunting and breathing heavy I called the vet and they said do 1/2 a tablet a day. So I did. He’s still the same. In fact his thirst and urination have increased but not his appetite. His poop is runny and he is so withdrawn. My heart is breaking for him so badly right now and I’m calling his vet in the morning to discuss this. Luckily It’s only been 2 days since we started treatment for his ear infection along with antibiotics. He’s breathing heavy all day and all night and I can tell it’s exhausting him. I just can’t sleep when he’s laying there breathing so heavy I know it’s gotta be uncomfortable. I hope i can get this resolved. Thanks again for the amazing article.

    Reply
    • Reid, I’m so sorry you German Shepherd is going through this, and you with him.

      I agree, the good thing it’s only been two days, which is a very short duration. My understanding is you can stop cold turkey without tapering when the duration has been so short.

      Prednisone and antibiotics are unfortunately a common but heavy-handed response to ear infections. If this was the only reason the drug was given, you have non pharmaceutical options for healing the ear.

      Ear gunk can arise as a result of kibble feeding, use of chemical wormers, flea/tick products, vaccines etc, as an attempt by the body to detox or rapidly push out an overburden of toxins when they overwhelm the normal avenues of elimination i.e. kidneys and bowels (pee and poop).

      I can tell you I have resolved ear “infections” with nothing but time, fasting and proper feeding. You might find our experience helpful.

      Is your boy eating a fresh, natural canine diet i.e. a raw meaty bone-based diet? If so, you can ride out the ear gunk and it will clear on its own.

      You likely won’t hear it from a conventionally-trained vet, but fasting your dog will accelerate the clearing. Here is some more information.

      Hopefully this is of some help. Please let me know how you go.

      Cheers
      Jane

      Reply

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