Cortisone is a steroidal anti-inflammatory drug that possesses the same physiologic effects of naturally-occurring corticosteroids produced by the adrenal glands. It is a medication that is approved by the FDA for use in human patients, but not in dogs. However, veterinarians have been prescribing cortisone off-label to manage a variety of canine health conditions whereby inflammation is a major presenting symptom. While it may not be approved by the FDA for veterinary use, cortisone is one of those drugs that vets give to dogs with severe allergies compounded by pain and swelling. Because of its tendency to mimic the action of natural corticosteroids, it is best used under the supervision of a veterinary professional.
Cortisone for dogs is indicated for the following:
- Treatment of inflammatory conditions
Cortisone is usually indicated in the management of inflammatory conditions such as arthritis, osteoarthritis, and other inflammatory conditions. It should be noted that cortisone doesn’t treat the actual cause of the inflammation. For instance, if it is the result of an infectious process only an antibiotic can help kill the organism that is causing the infection. Cortisone will address the resulting inflammation.
- Suppression of immune response related to allergies
Allergies are mainly the result of a hyper-reactive immune system whereby even the most harmless substance entering the dog’s body is perceived as a threat. As such, the immune system mobilizes every single cell that it has to help get rid of the supposed ‘threat’. Sadly, this results in inflammatory changes. Cortisone can help by taming the response of the immune system so that it will not over-react to the presence of an ‘allergen’. It also works to reduce the inflammation as a result of the allergic reaction. This makes it an effective management protocol for severe itching, redness, and other manifestations of allergies in dogs.
- Immunosuppression in autoimmune diseases
Autoimmune diseases are very much like allergies that the immune system over-reacts to even a harmless particle. The main difference is that in autoimmune disease the immune system actually targets or attacks a specific type of cell in the dog’s body. Cortisone can help in the management of Systemic Lupus Erythematosus, Autoimmune Hemolytic Anemia, Pemphigus, Discoid Lupus Erythematosus, Immune-mediated Polyarthritis, and Immune-mediated Thrombocytopenia, among others. Cortisone acts by suppressing the immune system so that it will not attack normal cells.
- Alleviation of pain and swelling
The process of inflammation always comes with swelling and pain as two of its 5 cardinal manifestations. Cortisone acts like nonsteroidal anti-inflammatory drugs except that it is actually a steroid. Nevertheless, it helps in the alleviation of pain and the reduction of swelling.
- Adjunct to cancer treatment
Certain types of cancer have been shown to respond well to corticosteroid treatment. Cortisone inhibits the proliferation of lymphocytes which can help in the management of lymphomas as well as leukemias in dogs. It can also be used in the management of the side effects brought about by cancer chemotherapeutic agents.
Benefits of Cortisone in Dogs:
- Relieves signs of inflammation fast
- Alleviates pain, itching, and swelling
- Promotes optimum canine comfort secondary to the reduction of inflammatory responses
- Relieves symptoms of allergies
How Cortisone Works
Cortisone’s mechanism of action is closely related to the physiologic activities of naturally-occurring corticosteroids like cortisol. Generally, naturally-occurring cortisol plays an important role in cardiovascular, immunologic, homeostatic, and metabolic processes.
In the immune system, cortisone increases the expression of proteins that have anti-inflammatory properties. This is what helps in alleviating the various symptoms of inflammation. Additionally, it also reduces or inhibits the expression of proteins that are considered as proinflammatory in nature. Because it suppresses proinflammatory substances while promoting the activity of anti-inflammatory molecules, cortisone is considered one of the best when it comes to the management of inflammatory conditions.
Its immunosuppressant action is related to its ability to prevent the action of nuclear factor kappa-light-chain-enhancer. This effectively prevents the synthesis of immune response mediators such as cytokines as well as adhesion proteins. The inhibition of the nuclear factor dampens the immune system’s ability to effect an immune response. Cortisone also affects the proliferation of T lymphocytes, interleukins, and a host of other immune system cells.
Its anti-inflammatory action is attributed to its ability to induce the synthesis of lipocortin-1 which, in turn, suppresses that activity of phospholipase A2. This results in the temporary cessation of eicosanoid production leading to a reduction in phagocytosis, emigration, epithelial adhesion, chemotaxis, respiratory bursts, and many more. In short, cortisone inhibits the activities of leukotrienes and prostaglandins.
Potential Side Effects
While cortisone for dogs may be very effective in the management of inflammation, its effects on the immune system as well as other target organ systems of the body can lead to a variety of potentially serious side effects. This is especially true for its immunosuppressant activity whereby the immune system is effectively dampened from performing its optimum function. That being said, the main concern here is the risk of infections since a simple cold virus can turn deadly because of suppression of the immune system. Other side effects that you may want to know include the following:
- Weight gain
- Increased water consumption with increased thirst
- Reduced energy level
- Nausea and vomiting
- Frequent urination
- Increased appetite
Dogs that are given cortisone for extended periods are at risk for developing the following side effects:
- Cushing’s disease
- Recurrent bladder infections that are resistant to treatment
- Demodectic mange
- Thyroid dysfunction
- Muscle weakness
- Thinning of the skin, ligaments, and bones
- Fatty liver disease
- Increased risk for diabetes mellitus
- Pot-bellied appearance
- Skin plaque formation
Things You Should Know about Cortisone
Cortisone is not approved by the FDA for use on dogs or any other animal. As such it should only be given under the strict guidance and supervision of a veterinarian. It is primarily indicated in the management of inflammation as well as allergies because of hyper-reactivity of the immune system.
What You Should Tell Your Vet before He Prescribes Cortisone
If your dog has poor liver function, cardiac problems, high blood pressure, liver disease, diabetes mellitus, systemic infections, or a compromised or weakened immune system, it is imperative that your vet knows about them so that other treatment options can be established. Most vets also don’t want to administer cortisone to pregnant or nursing dogs or even on puppies that are aged 6 months or less as the risks far outweigh any purported benefits.
How to Give Cortisone to Your Dog
It is important to understand that cortisone is a very powerful drug. And since it doesn’t have the approval of the FDA for veterinary use, it is critical to adhere to your veterinarian’s instructions.
Cortisone is available in many forms. Some come as topical applications which are preferred for skin allergies and other inflammatory conditions of the skin. Its side effects are less severe, too compared to systemic cortisone. Oral formulations in tablet or pill forms are also available and are generally considered to be a lot safer than injectable preparations. However, cortisone pills or tablets may require larger doses to exert their effects since they have to pass through the digestive tract. Severe allergies will benefit a lot from injectable cortisone as this has rapid action. Unfortunately, it also increases the risk of side effects.
When cortisone is given to your dog, your vet will often start with a relatively high dose of the drug. This is to quickly eliminate the problems that the drug is supposed to address. Over time the cortisone is halved. For instance, if it started with 100 micrograms for the first 5 days, it can be halved to 50 micrograms on days 6 to 10. On days 11 to 15, the dose can be halved further to 25 micrograms and so on. This is to prevent steroid withdrawal, although this is not usually a problem in topical formulations.
What to Do If You Miss a Dose
If you missed giving a cortisone dose to your dog, administer it at once as soon as you remember. However, if it’s already near or close to your dog’s next cortisone dose, leave the missed dose as is and just proceed with the next dose. Whatever you do, don’t ever make the mistake of doubling on your pet’s next scheduled dose.
What to Do in Case of Cortisone Overdose
If you double on the dose of cortisone simply because you missed a prior dose, there’s a chance that your pet might have overdose. This can be manifested as increased agitation, itchy skin, convulsions, extreme sleepiness, and high blood pressure. It is imperative that you seek veterinary consult immediately.
Some Drug Interactions
Cortisone for dogs should not be used in conjunction with aspirin, insulin, diuretics, ketoconazole, cyclosporine, warfarin, phenobarbital, and phenytoin. Any other medications, supplements, and nutraceuticals should be consulted with your vet prior to the administration of cortisone to minimize any untoward drug interactions.
Cortisone is a powerful anti-inflammatory drug that can address many health problems in dogs where the main issue is inflammation and overstimulation of the immune system. Unfortunately, it’s not FDA-approved; hence, it should always be used with caution and under the direct supervision of a veterinarian.