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Steroid Use in Cats: Is it Dangerous?

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Steroid Use in Cats: Is it Dangerous?

Postby admin » Sat Apr 02, 2016 5:48 pm

http://felinedocs.com/dr-elyse-kent/ste ... dangerous/
Ms. Worry set up a consultation with me, Dr. Catz, to discuss the use of Prednisolone in her cat, Hershey Squirts. My manager, Ms. E. Calm held the phone far away from her ear as Ms. Worry screamed that she thought the prescription from Dr. Catz for steroids would shorten Squirts’ life. Ms. Worry said her mother’s face had become permanently bloated and she had terrible mood swings when she was prescribed steroids for her asthma.

What are steroids?

Steroids are natural substances produced by the adrenal glands.

Corticosteroids are the type used for therapy in cats. Anabolic (performance-enhancing) steroids are not used in feline practice.

There are also synthetic steroids that are used to treat a variety of feline diseases. The most common steroids used in feline medicine are prednisolone, dexamethasone, triamcinolone and budesonide. Methylprednisolone is a slow release “repositol” steroid that is largely no longer used in cats since the risk is much greater for potential adverse effects than with thee shorter acting oral steroids. Once given, a long acting injection can’t be reversed.

Steroids have potent anti-inflammatory and anti-allergic effects.

Some of the allergic conditions treated successfully with steroids in cats:

Allergic reactions to environmental stimuli, either by contact or inhalation
Flea allergic dermatitis
Allergic bronchitis
Allergic reactions to bee stings or spider bites
Inflammation causing acute or chronic pain can be treated with steroids:

Osteoarthritis
Trauma, especially to the head
Disc problems
Soft tissue injuries like sprains or strains
Gingivitis
Prednisolone is often used in combination with other drugs for cancer treatment in cats.

Steroids may be used to stop the process of immune-destruction by slightly reducing an overactive immune response.

Some of the diseases in this category are:

Stomatitis (inflammation in the mouth)
Pemphigus (skin disease affecting ears, nose and anus)
Autoimmune hemolytic anemia
Certain kidney diseases
Corticosteroids are not “strong” medicines and are commonly used very effectively in treating many disorders in feline medicine, ranging from minor to life-threatening problems.

Most of the time, relatively high doses are used initially to achieve an effect, then tapered to the lowest dose and frequency needed to keep clinical signs at bay. Tapering allows the body to adapt to having the steroids removed from the body. Sometimes steroids can be stopped entirely at the end of the taper and other times are they are required long term. Some are started up as needed on a “pulse” or temporary basis when a disease “flares up”

Fortunately, cats are extremely resistant to the side effects of steroids.

The annoying side effects that dogs may experience rarely if ever occur in cats unless a profound overdose of steroids are prescribed. The common side effects in dogs are increased hunger, thirst and urination, panting, pot-bellied appearance, lethargy, and thinning of the skin.

Adverse effects of steroids in cats are relatively uncommon and almost always reversible.

The most common potential adverse effect of steroids in cats is diabetes mellitus. This usually only occurs in cats that are already predisposed to diabetes, especially in those who are obese and/or on high carbohydrate diets. A feline doctor will require a baseline blood glucose level prior to starting corticosteroids and will monitor blood glucose levels periodically as long as the drug is continued. The interval between glucose tests is dependent on the risks in a given patient as well as the dose required to control disease in that cat. If diabetes does show up secondary to steroid use, it will almost always go away after the drug is tapered and discontinued. Some steroids have less systemic (whole body) side effects, notably budesonide when compared to the more commonly used prednisolone, and can still be used safely in some patients who have become diabetic while on prednisolone. Also, steroid inhalers used for allergic bronchitis (Feline Asthma) have fewer systemic effects than oral steroids.

A less common side effect of corticosteroid use is to uncover hidden congestive heart failure (CHF). If heart disease is undetected (occult), especially if a heart murmur is not heard, fluid can rapidly fill up the lungs causing labored breathing and distress after a steroid injection is given. If the patient is promptly seen by a vet on an emergency basis and CHF is diagnosed by a chest x-ray, oxygen therapy and diuretic injections generally cause the fluid to be urinated out and an echocardiogram can be performed to further define the heart condition.

One additional potential adverse effect is infection due to immunosuppression if high doses of steroids are needed to control an overactive/destructive immune response (diseases described earlier). Infections may develop due to less than optimal immunity. Frequently these are upper respiratory infections (cold symptoms). The combination of tapering and discontinuing use of the steroid and adding in antibiotics generally lead to resolution of the infection without complications.

Ms. Calm directed Ms. Worry to read this blog entry prior to her consult with Dr. Catz. Ms. Worry reluctantly started prednisolone daily for 14 days and Squirt’s diarrhea resolved. At his two week recheck, Dr. Catz began to taper the dose and frequency of Squirt’s medication and explained that half the original dose given every 48 to 72 hours is likely to be well tolerated without serious side effects for the rest of Squirt’s life.
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