The Importance of Gradually Weaning Dogs Off Prednisone
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.
Never Stop Prednisone Abruptly!
Call the vet if your dog is experiencing negative side effects.
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
If my dog has been taking 5 mg daily of Prednisone for 14 days, can I stop it abruptly?
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).Helpful 69
How long does it take to wean a dog off of prednisone?
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.Helpful 49
Can prednisone cause skin conditions due to long term use?
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.Helpful 29
Could diarrhea or soft stool be a sign of tapering your dog off prednisone too quickly?
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.Helpful 29
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?
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.Helpful 20
© 2013 Adrienne Farricelli