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.

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.

Dog on prednisone with swollen cheek
This was the first sign that prednisone was messing with Shiva’s body. A swollen cheek a few months in.

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.

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

Shiva heavy breathing on prednisone.

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.

Dog exhibiting depression as one of many prednisone for dogs side effects
Hangdog look: Shiva has hung his head low ever since being on steroids. Less and less as time passes.

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 showing Cushingoid appearance in dog on prednisone
This is exactly what Shiva looked like on prednisolone. Cushing’s Syndrome is caused by an excess of steroids, either naturally occurring or induced by drugs.

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.

Calcinosis circumscripta on dog's tongue, caused by prednisone
Calcinosis circumscripta on Shiva’s tongue, caused by prednisolone. You can see the white lumps starting to deposit on the underside of his tongue. A biopsy identified it as calcium-phosphate.

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 overweight as a result of side effects of prednisone in dogs

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.

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.

A typical protocol for tapering 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.

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.

Very thin dog bearing the scars of side effects of prednisone in dogs, which include gut damage
Starting to regain a quality of life, 6 months post-prednisolone. He’s very thin as we strive to heal acid reflux caused by the drugs. Shiva’s body is still working at resorbing the calcinosis lumps (you can see one on his shoulder), another side effect of the steroids.

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.

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

40 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
    • 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.

      Reply
  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.

      Reply
  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.

    Reply
    • 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.

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  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.

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  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
  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

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