Prednisone Alternatives so That Your Itchy Dog Can Avoid the Serious Side Effects
Treating Itchy Dog Skin
Since steroids first hit the market in 1949, many vets have used them as the best alternative treatment for dogs with itchy skin. They have become so popular that some clients expect to come into the vet clinic and get “that allergy shot."
Why do we use them so much? Well, one reason is that they do work. Prednisone and other steroids are a quick solution and often provide almost immediate relief. They are not a cure, however, and there are many problems and side effects associated with them. You may be wondering:
- What are the problems that can hurt your dog when prednisone is used?
- Are there alternatives so that you can avoid those side effects?
The Side Effects of Prednisone
- Many dogs drink more on prednisone. Since prednisone affects your dog's ability to control the water level in his body, he will drink more, and then he will have to urinate more. When a previously house-trained dog has to go in the middle of the night and no one will let her out, accidents do happen.
- Dogs are hungrier. Prednisone stimulates the appetite and dogs will want to eat all of the time. They do not burn up more calories, however, so weight gain is a problem.
- Your dog might mope around. One side effect you might notice is that your dog does not want to get up and go for a walk. His back legs might be weak from muscle wastage, or he just may be lacking in energy.
- Some dogs pant a lot. This is a common complaint for those people that allow their dogs to sleep in their bed.
- A dog's skin problem can actually grow worse. Dogs might be treated for an itching problem and then start losing hair, develop blackheads, thin skin, or even a large area of hairless and scaly skin known as “calcinosis cutis."
More Side Effects
The dog in the video above has a disease that mimics the side effects of long-term prednisone dosing in the dog.
Other side effects include:
- Your dog may develop new infections. Since prednisone depresses the immune system, some dogs will come up with an infection in the bladder or the gums.
- Dogs vomit and may have other GI upsets. This is not as common as the increased thirst and hunger, but when it happens it can be serious.
- Dogs may also have behavioral problems or uncommon reactions that are not included in this list. If your dog is sick and a steroid injection is suggested before other things have been tried, think about the side effects.
- Some dogs have even more problems with prednisone: muscle wasting, changes to the muscle of the heart, pancreatitis, and even blood clots and stroke can occur in some cases.
Alternatives to Prednisone
Steroids like prednisone are dispensed for many different problems and at times are the only medication available that will help a dog. If your dog is being treated for a skin problem, though, there are a lot of other things you can do that might help.
- Improve your dog's diet: Just switching brands is not enough to help your dog avoid steroids and deal with his skin problems. Learn how to feed your dog healthy raw food that contains the essential vitamins, enzymes, essential fatty acids, and other nutrients he needs to improve the quality of his skin.
- Shampoo: Some skin diseases will respond to frequent shampooing to remove the allergens that cause excessive itching. All dogs will respond to the cool water and a cleaner skin. No matter which product you use, most of them help.
- Flea control: The most common cause of scratching in dogs is still fleas. Some dogs are so allergic to the saliva of the flea that only one bite will make them chew their skin. Even if no signs of fleas are present, over half the dogs that are presented for skin problems are afflicted with fleas, so all dogs should be protected against fleas before starting a prednisone trial or even one of the alternatives.
- Natural alternatives: Some herbs and other natural substances can reduce inflammation of the skin, relieve itching, and make your dog comfortable enough to avoid prednisone. Most of them have few side effects and can even help your dog in several ways.
- Antihistamines: If your dog's allergies are not that severe, sometimes just an antihistamine will take care of his problem. The antihistamine may not be as fast, and it may not clear things up 100%, but your dog's health is a lot less compromised.
- Prescription allergy suppressants: Some of the drugs that have been developed for use in dogs with allergies may end up being as bad or worse than steroids. Natural alternatives should be tried first, but even if they fail there are new medications that can be tried.
Improving Your Dog's Diet
When presented with a dog suffering from itchy skin, the first thing I recommend is a radical diet change. If you want to try alternatives instead of prednisone, this is a great place to start.
I am not talking about buying a different brand of dog food. The processed dog foods sitting on the shelf of your grocery store may each be different, but one thing is the same: They are all processed and have been sterilized enough to be sitting out on a shelf.
So what does a dog with skin disease need? There are suggestions, but we probably do not know. We know a lot more about skin problems than we did 100 years ago, but does that mean we know everything a dog needs? Foods that announce that they are 100% complete are formulated based on research that was done years previously, and it may be inaccurate. A natural diet made up of the raw components described below provides more than that.
Does a diet change always prevent a dog from needing prednisone?
No, your dog food can have every known essential nutrient required, and in excess, and if he is allergic to some things, he will still have symptoms on an improved diet. So why even bother trying?
We try an improved diet because it will help some dogs. Dogs that have been fed a cheap food, or even a good food that is marginally deficient or deficient in ways that we do not even know about, may improve dramatically.
No, we do not know everything yet. What we do know is that your dog's diet should be made up of:
- About 50% raw meaty bones: Grass-fed beef, chicken carcasses, tails, etc.
- About 25% soft meat: Beef cheeks, beef hearts, beef tongues, and other cuts of meat available cheap from your butcher.
- 10% organ meat: To provide the other vitamins and minerals your dog needs, add some kidneys, liver, lungs, and other internal organs.
- 10% vegetables: As long as you are willing to blend your dog's veggies so that he is able to digest the cellulose, you can supplement with broccoli, green leafy vegetables like spinach, and carrots.
- About 5% eggs, fruits, and fresh fish: As an added source of calcium, you can give the eggs with the shells, add some fresh fruit like papaya or avocado, and once a week or so give a fresh fish like mackerel or sardines to supplement his omega 3 fatty acids.
These amounts ARE NOT exact. You do not need to get out a scale and figure that your dog needs 1 kilo of meaty bones, 100 grams of vegetables, etc. Just make sure that you are feeding your dog a varied diet.
Supplements are not usually necessary for a healthy dog since this diet will provide what a dog needs. With a dog suffering from allergies serious enough to warrant prednisone therapy, however, it is a good idea to give some of the anti-inflammatory natural therapies that I have described elsewhere. (Licorice, coconut oil, sulfur, and omega fatty acids.)
When you are ready to switch your dog's diet, do some research before switching. There are many good sources out there, and the more you learn the better for your dog.
Bathing Your Dog
Is there one kind of shampoo that is always going to help a dog suffering from itchy skin? Unfortunately, there is not. If the itching is caused by dry skin, oatmeal shampoo is most effective. If your dog smells like yeast and has thickened and greasy skin, a benzoyl peroxide shampoo is best. If your dog has a secondary infection, then a shampoo with chlorhexidine will help.
If you are not sure of the source of the allergy, the most important thing is to bathe the dog regularly and remove any potentially irritating substances. I cannot give you a definite interval. Some dogs will develop dry skin if they are bathed too often, some will get greasy and start itching if you do not bathe them often enough. I usually recommend about once a week to start and then increase or decrease the frequency based on how he or she responds.
Try a good cleansing shampoo (labeled for dogs, like benzoyl peroxide) and use it about every week to start. If it works, stick with the same product. If it does not, try another shampoo.
Many natural alternatives are available. None of them are going to work as fast as prednisone, so be prepared to watch for any changes for several weeks:
- Licorice: This is the alternative that I encourage all clients to try before steroids. It has a glycoside (glycyrrhizin) that works similar to steroids, although not as effectively, but does not have many of the side effects. (If you do try and use this plant, be sure to buy the product that makes licorice tea. You can make about one-half cup with a teaspoon of licorice root powder each morning and then give your dog about 1.5 ml for every 10 pounds of body weight. Some holistic vets do not recommend giving it more than a few weeks because of the potential for potassium loss, but since many allergic dogs will need help for longer than this during the allergy season, it is okay to give it longer. Just make sure you supplement your dog's daily potassium intake, like giving her a banana every day.)
- Coconut Oil: This natural product improves your dog's skin and may be all that he needs. Coconut oil has some natural antibiotic effects and may reduce a mild skin infection secondary to allergies. It also has a high level of antioxidants that will moisturize your dog's skin, and since the itching may just be to dry patches that you are not able to notice, coconut oil will provide relief.
- Sulfur: This product is normally just sold as a solution for killing mites, but I recommend it for many dogs with skin disease of unknown origin. For best results mix the sulfur powder with virgin coconut oil (about 1 part sulfur to 2 parts coconut oil) and apply it to any inflamed areas of the skin. If the dog is allergic to mites or is itching secondary to a mild bacterial infection, the sulfur will help. (When using this product, I think it is a good idea to apply it outside and make sure it is all absorbed or removed before coming back inside. If you do not and your house has carpets, he will roll around and stain them.)
- Fish Oil: This supplement takes some time to work but makes the skin less likely to produce the components of inflammation and itching. Cold water fish oil is best since it contains a high level of omega-3 fatty acids. I am not talking tiny amounts, like those available in dog foods labeled “extra omega acids added.” Your dog needs at least 70mg/kg per day of omega 3 fatty acids, and if he is getting a source of omega-6 acids (like coconut oil) he will need even more. The best way to provide it to him is by giving fish oil in the form of fresh mackerel or sardines, but if you do not have a good source then fish oil capsules can also be given.
- Yucca: Some holistic vets have tried this herb and found that it is helpful as a prednisone alternative, but there are side effects. It can upset the GI tract of some dogs, and since it has not been used a lot, it may affect many dogs.
Antihistamines and Prescription Alternatives
The next step to help your dog is not as mild as a diet change or a shampoo. To provide quick relief, however, it is sometimes better to give him an antihistamine. Benadryl (diphenhydramine) is not approved, but it is an antihistamine that has been used for many years and is safe when used in controlled doses. An itching dog can be given about 1 mg per pound. (The pills are small and easy to hide in a piece of cheese or other favorite treat.) Benadryl tends to make dogs a little sleepy, but that is a good thing since he will not be scratching when taking a nap.
Unfortunately, diphenhydramine is only effective when it happens to work. Antihistamines work in a lot less than a third of the cases, so some vets that use them instead of natural substitutes for prednisone will have a series of drugs to try and find out which one might be effective.
If the antihistamine is not enough, you will need to talk to your vet about some of the other potent new drugs available for itching. Some dogs will do better with a cyclosporine pill (Atopica), but it is a potent immunosuppressant and does cause upset stomachs and other problems in some dogs. Others do well on a drug called Apoquel but it too can have a lot of side effects and should be avoided if possible.
Has your vet prescribed prednisone for your dogs itchy skin?
The Best Thing for Your Dog
If your dog is scratching, it is a sign that he is in great discomfort. Some people will search for help at the first sign of problems, while others will wait until their dog is chewing all night and has irritated his skin.
Do not wait. Dogs are stoic animals and will not let us know about many of their problems until they are already serious. If your dog has started to chew on his skin, he is already in great discomfort. Learn everything you can about skin diseases in dogs, get him into your local vet for an exam as soon as possible.
- Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA), Thierry Olivirry et al, BMC Vet. Res., 2015
- Double-blinded, placebo-controlled study to evaluate an antipruritic shampoo for dogs with allergic pruritus, Schilling, Journal of Veterinary Research, 2012 Jul 28;171(4):97
- Biagi, Giacomo & Mordenti, Attilio & Cocchi, Massimo. (2004). The role of dietary omega-3 and omega-6 essential fatty acids in the nutrition of dogs and cats: A review. Progress in Nutrition. 6. 0-0.
- Rational Uses of Glucocorticoids in Dermatology. Ettinger and Feldman: Textbook of Veterinary Internal Medicine, 6th edition. St. Louis, 2005, Saunders.
- Dr. Ian Billinghurst. Give Your Dog A Bone. Warrigal Publishing, 1993.
- Therapeutic use of fish oils in companion animals. Bauer JE. J Am Vet Med Assoc. 2011 Dec 1;239(11):1441-51.
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.
© 2018 Dr Mark