Adrienne is a certified dog trainer, behavior consultant, former veterinarian assistant and author of Brain Training for Dogs.
Sometimes, dog owners may feel tempted to stop their dogs from taking prednisone—either because their dog is feeling better or because of some annoying or scary side effect of prednisone. This article is to emphasize the importance of acknowledging the risks associated with stopping prednisone abruptly, especially when the dog has been on it for quite some time.
When I worked for a vet, I remember that sometimes, extra-long printouts about the medicine we prescribed would come out of our printing machine. Some warnings were so long that they'd span several sheets of adhesive paper, and I had to work hard to make the two labels fit on the bottle. Corticosteroid drugs like prednisone had the longest labels of all. Why?
Because prednisone is a tricky drug that has a very long list of instructions and warnings. As a dosage, it is usually given in a "blast" initially and then tapered off gradually. An example of prednisone instructions would be something like this:
Give 1/2 a tablet twice a day for 5 days, then give 1/2 a tablet once a day for 5 days, then give 1/2 a tablet every other day until all the medicine is gone.
But what exactly is prednisone, and most of all, why does it have such odd instructions?
Prednisone is a synthetic corticosteroid drug that is often used to suppress the immune system for the purpose of reducing inflammation, pain, swelling, or itching. It's often prescribed for allergies, inflammation, adrenal gland disorders such as Addison's disease, and several autoimmune diseases. Using prednisone for dogs with cancer can also help with appetite.
In many ways, prednisone is similar to the corticosteroid hormones cortisol and aldosterone, which are produced by the adrenal glands located along each kidney. Because of this, when taking prednisone, the adrenal glands start decreasing their production of cortisol, explains Dr. April Chang-Miller.
Why Should I Taper My Dog Off Prednisone and Corticosteroids Gradually?
Prednisone causes the adrenal glands to decrease their production of cortisol. If prednisone were stopped abruptly, it would be too shocking on the adrenal glands, which would suddenly need to produce cortisol in large amounts again. So by tapering the prednisone gradually, the adrenals are given time to resume their normal functionality.
Most of all, tapering off will help prevent prednisone withdrawal symptoms, which can be scary and even life-threatening. In the next paragraph, we will see some potential problems associated with tapering off your dog's prednisone too quickly.
The Signs of Stopping Prednisone Too Quickly in Dogs
There isn't a lot of information about what the symptoms of tapering too quickly are in a dog. However, for humans taking prednisone, these symptoms of tapering too quickly are widely recognized:
- Severe shaking, fatigue, weakness, and aching. For example, if your dog trembles, seems more lethargic than usual, is sleeping all the time, doesn't want to move much, or if they seem like they're in pain.
- Digestive issues. For example, if the dog seems nauseous, vomits, has diarrhea, or shows little interest in food.
- Lightheadedness. If your dog seems dizzy, has trouble walking, or flops down mid-walk.
- Increased thirst or urination.
None of these signs is a guarantee that your dog is weaning off prednisone too quickly—rather, these are some signs to be aware of.
What Are the Risks of Stopping Prednisone Suddenly?
The main danger of tapering prednisone dosage too quickly is Addisonian Crisis, which can be life-threatening and cause the dog to go into shock.
Addison's Disease (hypoadrenocorticism), which gets its name from Thomas Addison (who discovered the disease in humans), is a hormonal disorder caused by a slow and deficient adrenal gland hormones (cortisol and aldosterone). An "Addisonian Crisis"—or iatrogenic hypoadrenocorticism—is what causes the dog to go into shock. The word "hypoadrenocorticism" can be broken down as such: hypo meaning "low," adreno referring to the adrenal gland, and cortico relating to cortisol.
What Happens in a Dog's Addisonian Crisis?
- Addison's Disease results when the dog's adrenal glands fail to produce enough hormones for normal function. This can happen when the prednisone is stopped out of the blue and the adrenal glands respond too slowly because they were dormant and have not been given a chance to reanimate and become gradually active again.
- When this happens, the dog's potassium and sodium levels become unbalanced. The sodium levels start to fall, while the potassium levels start to rise. High potassium levels can have a detrimental effect on the heart and can lead to circulatory collapse. Affected dogs may appear weak and lethargic; they may vomit, have a low or irregular heart rate, and may go into shock and even collapse.
- Affected dogs need immediate emergency treatment (supportive care consisting of fluid therapy and careful monitoring) to correct their electrolyte imbalances and possibly low glucose levels. Rapid-acting corticosteroid medications such as prednisone sodium succinate or dexamethasone sodium phosphate may be needed, according to the Merk Veterinary Manual.
How to Prevent a Dog's Prednisone Complications
This whole ordeal can be easily prevented by tapering the dog off the steroids very carefully, slowly, and deliberately. Dogs that have been taking prednisone for quite some time, especially, need to be tapered very slowly. Your vet will tell you how.
Ultimately, the best way to prevent prednisone withdrawal symptoms in dogs is to strictly adhere to the and the label's instructions and ensure that the vet's tapering-off instructions are followed exactly.
For How Long Should a Dog's Taper Last?
Prednisone is generally tapered off anywhere between two and five weeks, but how it's tapered off varies depending on
- how long the dog has been on the drug,
- the condition being treated,
- and how the dog reacts to a lowered dosage
(According to Vet Info.) You'll need to consult with your vet to discuss their expectations for your particular dog.
Even after the dog has tapered off, it's important to watch for clinical signs of trouble and report them to the vet immediately.
Always Consult Your Vet
This article contains the results of my research and should not to be used as a substitute for professional veterinary advice. If your dog is on steroids, follow your vet's advice on proper tapering off. If you suspect signs of prednisone withdrawal, see your vet immediately as this can be a life-threatening emergency. If you have any doubts, consult with your vet.
This article is accurate and true to the best of the author’s knowledge. It is not meant to substitute for diagnosis, prognosis, treatment, prescription, or formal and individualized advice from a veterinary medical professional. Animals exhibiting signs and symptoms of distress should be seen by a veterinarian immediately.
Questions & Answers
Question: If my dog has been taking 5 mg daily of Prednisone for 14 days, can I stop it abruptly?
Answer: It is my understanding that there are no general rules of what constitutes a "low enough" dose for a "short enough" time to stop prednisone cold turkey.
It is best to err on the side of caution when in doubt. It's worth a call to the vet who prescribed it and ask what to do especially if there weren't clear directions printed on the bottle.
What to do next also depends on what condition is being treated. If you are thinking of stopping the medication due to side effects, your vet may feel it's important to keep your dog on this drug because the benefits outweigh the side effects.
However, for some severe types of side effects, the vet may feel it's important to stop cold turkey to prevent further damage (e.g., dog vomiting copious amounts of blood from stomach ulcers).
Question: How long does it take to wean a dog off of prednisone?
Answer: Weaning a dog off of prednisone is a very delicate procedure. Only your vet can really provide this information. Usually instructions are provided on the bottle (they are very long instructions on a bottle usually for short-term uses), but if your vet has instructed you for a faster weaning protocol due to the awful side effects, then you need to follow those carefully. Please give your vet a call to clarify. Restlessness, panting, increased drinking and increased urination, increased appetite, are common side effects of prednisone.
Question: Can prednisone cause skin conditions due to long term use?
Answer: Prednisone can cause several skin conditions due to its immunosuppressive properties. Here is just a general list. Because steroids such as prednisone lower the immune system's defences, it is possible for opportunistic bacterial or fungal skin infections to set. You may see a thin hair coat, blackheads and thin skin in some cases. Possibly though, the skin condition you are referring to is though is calcinosis cutis which causes the development of hard plaques on the skin which are due to the deposit of calcium crystals on the skin.
Question: Could diarrhea or soft stool be a sign of tapering your dog off prednisone too quickly?
Answer: This is difficult to answer and you should really voice your concerns with your vet. Weaning a dog too fast off steroids may cause what's known as an Addisonian crisis. The symptoms of this though are quite vague, including lethargy, loss of appetite, intermittent vomiting, and diarrhea, shaking, increased drinking and increased urination and episodes of weakness. As you can deduce, there may be several disorders causing these symptoms. Please consult with your vet.
Question: My vet failed to mention weaning my dog off his prednisone. He has been on it for 18 months or more. He has been off for 10 days or so. Do I need to put him back on and then wean?
Answer: You should never do anything with prednisone without consulting with your vet first. I would give your vet a call and discuss your concerns about your dog being on prednisone for so long and not being weaned. Your vet may tell you to watch him closely or he/she may suggest running an ACTH stimulation test to determine whether his adrenal glands are functioning properly.
© 2013 Adrienne Farricelli
Maggie on January 27, 2020:
Certainly would be interested in hearing from another veterinarian. She is seeing a couple vets now, of course, though I do not know if they qualify as specialists. Steroids began at 50mg roughly 10 weeks ago. As I mentioned, platelets went back to normal. Started to wean steroids and platelets dipped a little. So went back to 50mg. Stayed on 40-50mg for 9 weeks while what I interpretted as side effects worsened. My daughter, a nurse, noticed abdominal distension and suggested they check her liver, and sure enough enzymes were highly elevated. So, they just reduced steroids to 30mg 4 days ago. Rest assured, we are in constant communication with vet, and she is receiving round the clock attention and care, including subcataneous fluids. I am just a believer in exploring all avenues, researching, 2nd opinions, etc.
Adrienne Farricelli (author) on January 27, 2020:
It is certainly frustrating when treatment appears to be worse than the underlying disease process. Yet, it is difficult to prove whether a worsening of a possible underlying issue or the concomitant use of steroids is to blame for what you seeing. Is it a coincidence? Or are the steroids true to blame for the loss of muscle mass? Certainly, the increased drinking, increased urination and panting is likely due to steroids and this can have an impact on quality of life, but it sounds like the inability to get up and walk is what is impacting her the most.
About the muscle wasting, loss of muscle mass can be seen with prolonged use of high levels of steroids. Other causes of reduced muscle mass can be seen in dogs with cancer, but as well in older dogs when they have existing back or hip problems or arthritis.
If you want to stand by, I can ask a veterinarian about your case and see what they tell me just to get a second opinion, however, I still think your best bet is seeing a specialist who can better assess your dog's situation and see what can be done since you're in such a delicate situation.
Maggie on January 27, 2020:
We agree and acknowledge the underlying cause of the low platelets, and understand the implications. However, the steroid treatment seemed to increase her decline. As a matter of fact, there was no evidence of "decline" at all until the steroids were started. Certainly there is the possibility of the effects being coincidental to the underlying cause's effects, but as we have decreased the steroids we have seen slight improvement. With that in mind, the low platelets did not seem to affect her quality of life as much as the steroid treatment has. If these are to be her last days, we just feel that they shouldn't be under the effects of the steroids, since they don't appear to be helping. Again, at this time she shows no evidence of pain, eats, drinks, wags her tail, lets us know when she needs to go out, and is slightly more physically active since reducing steroids. What we are trying to understand is if lost muscle mass can come back after weaning from steroids. If not, if there is no hope of that, then we need to consider humane euthanasia, which is an incredibly difficult choice considering she seems her old self with the exception of the weakness we attribute to the steroids based on online research. She is due for weekly steroid reduction with accompanying blood tests at this time.
Adrienne Farricelli (author) on January 26, 2020:
Panting, increased drinking and increased urination are common side effects of steroids in dogs. I had two dogs on this drug, and they both were drinking and urinating more on top of panting. Both dogs also got extra hungry and one started even eating stools which he never did in all his life.
Adrienne Farricelli (author) on January 26, 2020:
Hi Maggie, so sorry you are going through this. The big question in the scheme of things is: what is causing the low platelets in the first place? Are the steroids helping? How are her platelets now? This would be important to get an idea of what you may be dealing with and determining the role of the steroids and whether other meds may be needed. The skull prominence and skinny appearance can be seen in dogs with cancer cachexia so this would be important to rule out. I think at this point, you would be in better hands seeing a board-certified veterinarian specializing in internal medicine since this sounds like a complicated case.
Maggie on January 26, 2020:
My dog was pretty lively for her age (9 years) but it was discovered that she had very low platelets. She is overweight at about 65lbs, always has been an issue for her. Vet prescribed 40mg prednisolone daily to get platelets up. It worked, but the steroids have decimated her. Over the course of two months she has lost muscle and had trouble getting up and walking. She lost all of the tissue around her head do her skull is extremely prominent - you can feel every contour of it as though irs literally skin over bone. Her legs are noticeably skinnier, but the rest if her is bloated. She pants, has labored breathing, is constantly thirsty and urinating 10x as much as pre-steroids. The vet did not agree to reduce steroids until after liver problems were detected (high enzymes diagnosed pre-vet visit by my daughter, a nurse) and we insisted the steroids were causing side effects (after reading identical descriptions of the effects online). The vet said they'd never seen steroids have this effect, which I found odd as a minimal amount of online research described them so precisely. The vet blames an underlying cause like whatever is causing the low platelets, which we acknowledge but believe is a separate issue. (She's been tested and no cause for low platelets has been found yet.)
Now the schedule is to drop from 30mg to zero over SIX weeks. She seems like her old self on the "inside" - eats, drinks and produces normal stool, but she no longer stands or walks on her own as her legs can't support her weight. I don't believe she will make it six weeks. My questions are: Is there any chance of recovery after such severe side effects from steroids? Is this six week schedule reasonable or could it be accelerated to, say, four weeks with 5mg drops every five days?
Adrienne Farricelli (author) on January 24, 2020:
Debra, glad you were able to get to the root of this and that your dog is now much better!
Debra Mclellan on January 20, 2020:
i HAVE A 10 YEAR OLD 90 LBS KING SHEPPARD WHO SUFFERED FOR MORE THAN SIX YEARS. SCRATCHING OPENING WOUNDS.TRYING EVERYTHING, SPENDING THOUSANDS OF DOLLARS ON DIFFERENT MEDS NEEDLES FOR ALLERGIES INCLUDING 16MG APOQUEL NOTHING WORKED TWO DIFFERENT VETS. I HAD BIOPSY DONE FOUND OUT ALL THIS TIME HE HAS LUPUS (DLE). PREDNISONE SEEMS TO BE HELPING AFTER SIX YEARS OF SUFFERING (CRYING) I STARTED 1 50MG PREDNISONE EVERY 12 HOURS FOR 3 WEEKS OR SO, DOWN TO HALF A PILL EVERY 12 HOURS MORE THAN A WEEK. DOWN TO HALF A PILL EVERY OTHER DAY. DOWN TO A HALF A PILL EVERY 3 DAYS I AM NOT SURE IF HE WILL HAVE TO BE ON PREDNISONE FOR THE REST OF HIS LIFE. HE IS DOING A LOT BETTER. HE HAD A GOOD CHRISTMAS THIS YEAR. HIS HAIR IS GROWING BACK. HIS SKIN HAS HEALED HE GOT TO PLAY IN THE SNOW IN THE BACKYARD HE LOVED IT
Adrienne Farricelli (author) on June 02, 2019:
Only your vet can give directions on weaning your dog off prednisone, please do not wean your dog off on your own.
Prachi25 on May 09, 2019:
My 26 pound beagle has been prescribed 10 mg Prednisone twice a day for and inflammation of his throat due to vommiting. It's been two days of giving him this medicine as prescribed but upon research I am doubting whether such a high dosage was required for a seemingly small issue. His side effects include an increased thirst, increased appetite and slight behavior changes. Should I wean him off and how?
Lisa on January 16, 2019:
My dog suffered some sort of paralyzing trauma 12-14-18. Cscan showed no spinal injury, yet he was unable to use legs. Prescribed Prednisone. 01-01-19 he just got up and walked and has been improving in balance ever since. 01-14-19 was his last second day wean off Prednisone tablet. Since then his water consumption has increased=frequency of urination=and once daily elimination (great quality/firm) has increased to 3. Alert, active, involved, doesn't appear to be in pain walks now 1/2 to mile daily struggles with balance. Trots gracefully and runs normal. Appetite good. Picky, but good. No sign of pain. Why the increase of thirst? Urination and bowel movement? Is it Prednisone related?
Adrienne Farricelli (author) on April 18, 2018:
You may have several options that you may want to discuss with your vet as he/she is the expert here and has access to your dog's medical history. I am not a vet but worked initially as a receptionist and then as a vet assistant, so please don't take these as recommendations. They are just some ideas you may want to discuss with your vet that come to mind.
1) If prednisone is what is needed to keep your comfortable long-term, then it may worthy keeping him on it, especially if he is an elderly dog with a chronic condition. Tell your vet the problems you are encountering and ask your vet whether you can keep him on it and perhaps give pepcid to prevent stomach issues. Perhaps you can keep him on the lowest dose necessary to keep him comfortable. I do not know what condition your dog has or whether he is having complications so not sure whether this is a feasible option.
2) Another option is keeping him on a lower dose of steroids while using another drug for pain that can be used along such as Gabapentin and/or tramadol. Perhaps, your vet may suggest then trying weaning him off the steroids more gradually again once these meds start working.
3) Finally, you can try waiting 48 hours (or more as suggested by your vet) after finishing the prednisone to start another drug such as NSAID drug such as carprofen or metacam. The 48 hours is needed as a washout period to prevent complications.However, the negative aspect of this is that it may take time for these new drugs to reach their therapeutic level.
Consult with your vet on resuming the steroids as there may be special directions to follow.
Donna on April 18, 2018:
My dog has been on prednisone for almost four months. He does fine tapering until he gets to the point of skipping a day and then goes down in full blown pain, but does well up until that point. As soon as you give him the half again then he goes back to be okay. At my wits end on getting him off without pain coming back. Any ideas?
Adrienne Farricelli (author) on March 09, 2017:
Kathleen, so sorry you are going through this, perhaps it may help consulting with an internal medicine specialist? This sounds complicated.
Kathleen on March 05, 2017:
My 1 year old Boxer is currently on Prenisone, due to Immune system from Lyme Disease , we have tried tapering her off it down to a Quarter piece an then down to a quarter piece every other Day , once she gets down to the quarter piece , to skip a few days so she can get Spayed , she get sick, its like we can't get ear off it without her getting really sick, I am unable to get. Her Spayed no way , what Ian th eproblem here , how can I get her Spayed if we can't get her off the Prednisone .??? Please I need some really good Advice .!!! Now , they also put her on Atopica to help taper her off the prednisone so she could have the spay , but as soon as we tried getting her down from th eprednisone she gets ill .?? Pulling my hairs out , Vet won't spay her unless she has been off the prednisone but if I can't get her off it , then what do I do, There has got to be a way ..!!!!!!
Adrienne Farricelli (author) on November 25, 2013:
Thanks Eiddwen and Tillsontitan, yes, it looks like the longer the dog has been on it, the more carefully it should be tapered off, thanks for the votes up!
Mary Craig from New York on November 25, 2013:
Certainly a useful warning. My dog was on prednisone for a year so tapering off was very important. I didn't know about Addison's Disease as a result so I am very glad I followed instructions. I know others will find this useful.
Voted up, useful, and interesting.
Eiddwen from Wales on November 25, 2013:
Very interesting and useful for sure alexadry.
Adrienne Farricelli (author) on November 23, 2013:
Epbooks, thanks for stopping by. Following label instructions is very important and it's unfortunate some owners fail to follow them. I remember one day at the vet a lady called and asked if she could use the dog's left over antibiotics from last time the dog was sick for a possible UTI, which was an alarming statement, because it meant last time she didn't give all the antibiotics till gone!
Elizabeth Parker from Las Vegas, NV on November 23, 2013:
Wonderful and informative hub. My dogs have all been on prednisone for one reason or another at separate times and though I never knew the side effects, I've always adhered to the advice and I saw the importance of it when my vet told me never to just take them off of it on a whim. Educational. Thanks for sharing!
Adrienne Farricelli (author) on November 23, 2013:
It's amazing the number of dog owners who give it without tapering off, I was inspired to write this because I just saw a post on a website by an owner that gave it and then stopped and was asking why his dog was not feeling well. A simple search revealed many others dog owners doing the same.
Linda Crampton from British Columbia, Canada on November 23, 2013:
This is an important hub, alexadry. I have had two dogs that have been prescribed prednisone, so this article is very useful and interesting for me. In each case the prednisone helped my pet, but your warning about withdrawing the prednisone treatment gradually is vital .