What are ‘steroids’?
Steroids are hormones naturally found in the body and are produced by small organs in the abdomen (tummy) called the adrenal glands. There are many steroid hormones, one such is cortisol. These steroids have a number of functions and are essential for life. Steroids can be used as a medicine for many conditions as they have a number of very important beneficial effects.
The steroids most commonly used at Willows are prednisolone and dexamethasone they can both be given as injections or tablets.
How and Why are Steroids Used?
Steroids have a powerful anti-inflammatory effect and are often used to reduce inflammation. Steroids can be used in the treatment of allergic conditions such as flea allergy dermatitis (skin inflammation and itchiness), asthma-like diseases, food allergies and bee stings.
Steroids can also suppress the immune system. The immune system normally fights infections, but in some conditions it becomes overactive and starts to attack the normal tissues of the body – this is called, ‘immune-mediated disease’.
Examples of immune-mediate disease include:
- Immune-mediated haemolytic anaemia (damage to the red blood cells)
- Immune-mediated thrombocytopaenia (damage to small cells in the blood called platelets, which help the blood to clot)
- Immune-mediated polyarthritis (damage affecting the joints)
- Meningitis (damage to the brain)
- Glomerulonephritis (damage to the kidneys)
- Inflammatory bowel disease (damage involving the stomach and intestines)
In these conditions, steroids are given to dampen the overactive system response and stop the destruction of normal tissue. Steroids can also be effective in stopping or slowing the rate of growth of some, but not all, cancers.
What are the Possible Side Effects of Steroid Treatment?
Whilst steroids are one of the most effective drugs to treat immune- mediated and inflammation they can be associated with a range of side-effects. These must be balanced when being used clinically against their beneficial effects. There are however some side effects that your Vet will try to minimise. These range from merely being troublesome, through to some which are potentially very significant. The degree of side effects tends to be related to the dose used, but some individuals are more susceptible to side effects than others.
Possible side-effects include:
- Dramatic increases in thirst, hunger, and urine volume. Some dogs will become incontinent due to the volume of urine produced.
- Muscle weakness; particularly wasting of the muscles over the top of the head
- Hair loss over the trunk, or slow re-growth after clipping
- Pot-bellied appearance
All of these steroid-induced side-effects are reversible and diminish when the dose of steroid is decreased or stopped.
Additional side-effects which may develop include the increased risk of infection (due to suppression of the immune system), stomach ulcers, blood clots and diabetes (particularly in cats). In some dogs and cats, determining the appropriate dosage of steroids can be challenging, and it can be difficult to ensure that the right amount of medication is given to control the disease without having significant side-effects. Sometimes it is necessary to use other drugs to compliment the use of steroids, allowing the steroid dose to be reduced whilst still controlling the disease. Larger dogs tend to require a slightly lower dose of steroids than and cats usually tolerate the effects of steroids better than dogs.
Handling Steroid Tablets
It is sensible to wash your hands after handling any drugs, including steroids as these can be absorbed through the skin. However, you should avoid handling steroids if you are pregnant or suspect that you may be pregnant.
Outcome and Benefits of Steroid Use
Steroids are very effective drugs, and enable us to treat and resolve many complicated medical conditions. In many cases they are life-saving. Side-effects are common, but these are generally mild in most situations. Their benefits usually outweigh their side-effects and are worth tolerating for that reason.
Tapering the Dose of Steroids
The body becomes used to the level of steroids being given, and so the body responds to this by reducing the production of its own natural steroids from the adrenal glands.
When the specific disease is under control the steroids can be reduced or stopped. This must be done gradually and with some caution. Tapering the dosage is generally so that the body can gradually resume its own normal levels of steroid production. Rapid withdrawal of steroid treatment can result in the patient suddenly not having sufficient steroid in their circulation. As a result, animals receiving steroids will have careful and clear plans for gradually reducing the steroid dose over a number of months to prevent the life-threatening complications that can occur if steroids are withdrawn too quickly.
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Find out more
To assist owners in understanding more about Internal Medicine we have put together a range of information sheets to talk you through the some of the more common Medicine conditions seen and treated by our Specialists.