What’s the difference between prednisone and prednisolone?
Prednisone is actually a “precursor” to prednisolone. This means that once your dog takes prednisone it is converted by the liver into prednisolone. For this reason, vets often choose to give prednisolone to dogs who have poor liver function to avoid the need for conversion.
Prednisolone is also the best choice when your dog can’t take medicine by mouth as it is effective when given as an injection or even when applied topically onto the skin.
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Note: These recommendations should only be used as a guideline, your dog’s treatment should be carefully monitored and controlled by a professional. Never give this medicine to your dog without first consulting your vet for a dosage and treatment plan.
When you first begin treating dogs with adrenal insufficiency (e.g. Addison’s disease) a dosage of 0.05 – 0.18 mg/lb can be given by mouth once daily until the condition is under control.
A starting dose of 0.1 mg/lb is shown on the chart below:
When treating dogs with allergies a starting dose of around 0.25 mg/lb each day can be used. If relief is not achieved this can be increased gradually up to a total daily dose of 1 mg/lb spread evenly throughout the day. The objective of treatment is to find the lowest amount of medicine which relieves your dog’s symptoms (the “maintenance dose”). Once maintenance is reached you may be able to give the medicine to your dog every other day instead of every day which allows their adrenal glands to keep functioning.
The table below contains information for treating other conditions.
||Suggested treatment plan
|Canine Lymphomas *||Prednisone can be used for adjunctive therapy at 50 mg/m2 by mouth every day for 7 days, then 25 mg/m2 every other day.|
|Hypoadrenal crisis||Prednisolone sodium succinate can be injected at a dose of 1.82 – 9 mg/lb over a period of 2 to 4 minutes. May be repeated after 2 to 6 hours.|
|White Dog Shaker Syndrome||Prednisone can be used for adjunctive therapy at 0.11 mg/lb every 12 hours for 10 days, then once daily for 10 days, then once every other day for a further 10 days.|
* Be careful when treating cancer, this drug can cause MDR (Multidrug Resistance) which reduces the effectiveness of chemotherapy.
When treating coughing and itching conditions you should ask the vet about Temaril-P, a medicine which contains both prednisolone and trimeprazine. This combination can lower the required amount of corticosteroid.
Important: Stopping treatment suddenly after long periods of use could cause Addison’s disease or serious heart problems. For this reason you should always taper the dosage off gradually.
Is It Safe?
Not all dogs are suitable for treatment with this medicine. Some of the common side effects can be uncomfortable, and it is known to cause abortion when given to pregnant pets (which is also the case with other glucocorticoids). It should not be given to any dogs under 6 months of age as the immunosuppressant properties could be damaging.
Treatment may be unsuitable for dogs with:
- Systemic fungal infections (unless used as replacement therapy for Addison’s disease)
- Idiopathic thrombocytopenic purpura (when injected intramuscularly)
- Diabetes mellitus
- Heart failure
When dogs receive large amounts of glucocorticoid for long periods of time their body responds by shutting down its own natural production. If this happens the adrenal glands will atrophy and the dog’s body will then struggle to produce hormones even after you stop treatment. This is why it’s best to use an every-other-day dosing schedule whenever possible.
Here are some important reminders to help keep your dog safe:
- Speak to a vet before giving this medicine to your dog
- If possible avoid using this medicine until you have a diagnosis
- Avoid treating cancer with this drug before chemotherapy begins
- Notify the vet of any medication or supplements your dog is on
- Notify the vet of any medical conditions affecting your dog
- Avoid use in pregnant pets and those under 6 months old
- Avoid live vaccines during treatment
What Is It Used For?
Prednisolone and prednisone have a wide range of potential uses but are most often used for the treatment of Addison’s disease to supplement a pet with the glucocorticoids their own body is unable to create. Because of the drug’s ability to suppress immune system responses, they are also used to control allergic reactions and autoimmune conditions such as lupus and AIHA. Here is a larger list of the possible uses of prednisone:
- Adrenal insufficiency (Addison’s)
- Cancer (some forms)
- High blood calcium levels
- Central nervous system disorders
- Skin disease
Side effects from prednisone are common, but dangerous reactions do not occur as often when it is used correctly. Dogs who are taking immunosuppressive doses are more likely to suffer side effects. During treatment your dog may experience the following:
- Increased thirst (very common)
- Excessive urination (very common)
- Slower wound healing
- Increased appetite
- Infection *
- Behavioral changes
Call the vet immediately if you notice any of these signs.
- Shortness of breath
- Blood in stools
- Kidney problems
- Coughing blood
- Irregular heartbeat
- Serious heart problems
- Abdominal pain
- Cushing’s disease
- Addison’s disease
- Allergic reaction
* This is due to the suppression of the dog’s immune system.
Vomiting and diarrhea may signal that the dosage used is too high, whereas serious heart problems including heart attack are most often caused by sudden withdrawal of the medication after long-term use. If your pet develops any symptoms which you are unsure about make a quick call to the vet. Severe reactions to the drug require immediate veterinary care.
Signs of overdose from corticosteroids such as prednisone may include itching, seizures, loss of hearing, weakness, anxiety, depression and high blood pressure. In some cases heart abnormalities may be present. If you suspect an overdose seek veterinary care straight away. You can reach the ASPCA poison control helpline on (888) 426-4435.
Dr. E. Feldman
Plumb’s Veterinary Drug Handbook (sixth edition)