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I decided to cut the prednisone dose back to 1. A neighbor of mine also has a senior Addisonian terrier experiencing the same symptom.
My dog seems to be stable on 1. Or can I go even lower on the prednisone? I was reading about natural remedies for dog incontinence because I do not want to put the dog on Proin.
I am curious about trying corn silk since many have reported that there is success. However, my reading indicated that potassium supplementation may be needed when giving corn silk because a side effect is depletion of serum potassium even in humans - which I don't think would be something to play around with in an Addisonian. K ratio and in theory losing potassium would trend the ratio higher , I don't want to introduce another "active" to control incontinence that will potentially cause harm to or complicate his Addison's therapy, or harm another organ system dependent on proper serum K.
Any recommendations would be most appreciated, thank you! About half of dogs do fine on no glucocorticoid supplementation, but they should always have some "on hand" if anorexia or other signs develop.
Is your dog drinking a lot or does he just have the sleep incontinence? If the urinating problem is not associated with increased thirst or increased urine volume, I'm not sure that lowering the prednisone dosage wil help.
Have you done a complete urinalysis and urine culture to rule out a infection UTI? Thank you for the prompt reply. I will take the dog in this week for his senior bloodwork and an appointment, which will include UA, and if appropriate we'll do a culture too. The travel days I made sure to give him a slightly increased dose back up to 2.
However, my observations regarding the sleep incontinence have always been on days when he gets his prednisone. Otherwise, he has a pretty tight and steel drum bladder and sphincter. I am a second year vet student, and I would love some help with my own 2.
He has had diarrhea since the end of April. After an extensive GI workup, he was finally diagnosed with atypical hypoadrenocorticism by ATCH stim about one month ago.
Despite glucocorticoid supplementation, the diarrhea has not gone away. Attempting to reduce the dose resulted in a huge increase in frequency and loss of control. After this, we ultrasounded his abdomen and didn't find anything significant except small adrenal glands.
I was wondering where you would go from here? Would you recommend changing the glucocorticoid supplementation drug? Would an even higher loading dose and then tapering be potentially effective. Thank you so very much for your thoughts. Atypical Addison's in my mind is a "bad" term - these dogs either have primary or secondary hypoadrenocorticism. If your dog really has secondary hypoadrenocorticism or "atypical" disease with normal mineralocorticoid secretion , then the prednisone should control the diarrhea.
So either your dog has primary hypoadrenocorticism and needs Percorten, or the diarrhea is a separate problem most likely. We have a 2 year old 60lb standard poodle diagnosed with Addison's 2 months ago. He was started out on 20mg of Prednisone and is now at 10mg once a day and receives Percorten every 30 days. I actually have two questions concerning the prednisone. When we dropped him down to 5mg a day he actually became more lethargic. Should we have dropped him down slower in dosage to allow him to adjust better?
Ever since starting him in his current regime, he's started building back muscle though very slowly. He also has his energy back. However, his hair loss has continued. His fur is much more corse, wiry, and very thin. Is this a side effect of the prednisone? Your dog's prednisone maintenance dose is 2. Chronic administration of 10 mg a day will likely lead to muscle atrophy and other signs of iatrogenic Cushing's disease pot belly, enlarged liver, hair thinning, insulin resistance, predisposition to other infections.
It's possible that the skin changes you describe are related to the drug, Remember that giving prednisone will make the patient "full better" even if the original problem isn't cured. It sounds like there is something else going on - I can't tell you what it is-- but no dog weighing 60 pounds needs 10 mg a day to control Addison's!
You need to talk to your vet about further investigation into your dog's problems. Peterson, I just read an article about Prednisone and Addison's. My Saint Bernard, George, is 2 years old and weighs Just diagnosed with Addision's this past Thursday. My vet and I are learning more, we'd like to lower the Prednisone to 5 mg per day. He is suffering from cortisol overload Then sooner the better.
Considering that he hasn't been on it for even a week, how do I taper? Or can I just go to 5 mg? Here is how we've begun lowering it: Or is that too much danger without tapering? You should be fine to lower the dose to 5 mg per day now.
Remember that a 5-mg dose is the human replacement dose so we are still giving the amount that you or I would need to survive. So even for your large breed dog, that will still be plenty! I have lowered George's prednisone dose to 5 mg in the AM. His other pertinent info is at the bottom of my email. Here is how we lowered it: Only gave him 5 mg in AM For the last two days he has been pretty lethargic--he seems to rest until 4 pm or so. Then, after dinnertime, he has a burst of energy.
Love it, but trying to keep him calm for now. Could this be because he only gets AM prednisone? If so, should I experiment with 2. Twice a day prednisone would be better than only once daily.
If you aren't doing so, you might want to lightly salt the food too. That might help increase his sodium a bit I'm worried that he could be loosing electrolytes in the stool due to the diarrhea. I have a 13 year old Maltese who has Chronic Bronchitis. He is about 3. Seems that 1mg is the appropriate dose of Prednisolone?
For the average-sized Maltese, 1-mg should be enough for Addison's glucocorticoid supplementation. We did the same thing in July was given 5 mg of pred every day and she then began to show addison symptoms in the beginning of September. Am I correct in my understanding that she needs both the percorten and the pred? From other sites I have found, it seems like she should only be getting 1mg of pred a day and the percorten dose is correct.
I don't want her to keep yo-yoing between too much meds and no meds and having symptoms, it's not healthy for her or me or my wallet! Yes, based on your dog's body weight, 1-mg per day would be a good maintenance dose of prednisone. Portuguese Water Dog with Addisons diagnosed 2 years ago. Initially with his prednisone and percorten shot he was better. But his hip dysplasia has gotten much worse and also has bouts of pancreatitis and perhaps IBD. In addition, he now has low thyroid. Daily he takes 10 mg of prednisone, mg of gabapentin,12 mg of soloxine, mg of tramadol, and 40 mg of Pepcid.
In July, he underwent Stem Cell therapy and he has had some improvement with his pain levels - and his brown hair which had almost become white is now growing back brown. I think based on his improvement that I should also talk to his vet about decreasing his pain meds.
I have also read that stem cell therapy might help with Addisons. Do you have any info on this or have any recommendations on his dosage of meds? I would definitely recommend lowering the prednisone dosage to 5 mg per day. If the polyuria and polydipsia continue, you might even be able to lower the dosage to 2. My 4 year old toy poodle, Bailey, was just diagnosed with atypical Addison's this morning. She had been in the hospital overnight.
I spoke with my vet this morning and she administered Percorten-V and will be giving her prednisone. My concern is that after reading many articles along with your article and all the blogs, why did she give Bailey Percorten when from my understanding if she has atypical Addison's, she only needs prednisone? The vet even told me this morning that she rechecked her bloodwork and her sodium and potassium were in the normal range.
Will this hurt her? There are 2 causes for naturally-occurring hypoadrenocorticism in dogs: Atypical Addison's disease is generally thought by most veterinarians to be an early stage of primary adrenal disease. So your vet is probably thinking that Percorten injections may be a good idea.
That may or may not be correct, however, and without either measuring a plasma ACTH level or doing an ACTH stimulation test and measuring basal and post-aldosterone values , one can't tell the difference between primary, secondary, or atypical Addison's. I would recommend completing the workup to determine if your dog has secondary hypoadrenocorticism pituitary ACTH deficiency , in which prednisone alone would be the treatment, or if your dog has primary hypoadrenocorticism with normal serum electrolytes, in which case the eventual need for mineralocorticoid treatment is very high.
You are providing a great resource, thanks for taking the time to provide so much valuable information! I have a Basset who was diagnosed in March of He is currently on 1. I took him in today for his injection and asked about follow up blood work, and I was told that they don't recheck until a year after diagnosis.
From what I am reading here I am wondering if I should accept that answer. He seems to be doing well, his appetite is good, he is active and overall seems great. Should I insist on blood work to make sure everything is where it should be? Is there anyway to find a local vet that has experience treating Addison's dogs? Thanks for your help.
First of all, I'm happy to hear that your dog is doing well on treatment for Addison's disease. We generally monitor serum electrolytes at least monthly for months until we are confident that the Percorten dose is right, then recheck every months or so.
Your vet may be correct in the end But if you don't monitor, how would you know unless your dog became very ill? I believe that you can search for a vet internist on the ACVIM website, but you might have the call them to find such a vet in your area. Is significant tremoring, particularly when sleeping or relaxing, worrisome for an "atypical" Addisonisn yr old jack russell after one week of being on increased pred dose 2.
She had vomiting with tremors last weekend. Also, what are symptoms of switch from secondary to primary? First of all, the continued tremor is troublesome. Diagnosis of Addison's in an year old dog is unusual - most of these dogs are young adults - not seniors.
In addition, atypical Addison's is not a final diagnosis -- it just means that the workup hasn't been finalized, at least in my mind. Atypical Addison's disease is generally thought by most veterinarians to be an early stage of primary adrenal disease but that may not be correct.
In addition, iatrogenic Addison's from treatment with glucocorticoids such as prednisone could induce a form of secondary hypoadrenocorticism too. This is actually the most common form of the disease. Has you dog been on steroid in the past? To differentiate between primary and secondary hypoadrenocorticism we need to measure a plasma ACTH level or doing an ACTH stimulation test and measuring basal and post-aldosterone values. You need to talk to your veterinarian about the workup and diagnosis, and you may need to get a referral to a specialist for another opinion.
If you are certain we aren't dealing with iatrogenic hypoadrenocorticism, I would recommend completing the workup to determine if your dog has secondary hypoadrenocorticism pituitary ACTH deficiency , in which prednisone alone would be the treatment, or if your dog has primary hypoadrenocorticism with normal serum electrolytes, in which case the eventual need for mineralocorticoid treatment is very high. Yes, she has been on steroids before. She usually would go on steroids twice a year for allergy-related reasons.
So, her use of pred throughout her life may have induced her hypoadrenocorticism? Glucocorticoid use, depending on the type of steroid dose, length of treatment, route of administration, and the individual, could indeed lead to the suppression of the pituitary-adrenal axis and iatrogenic hypoadrenocorticism. What were the results of the ACTH stimulation test?
Based on the response, we can generally get an idea if we are dealing with iatrogenic vs spontaneous hypoadrenocorticism. My 4 yr old toy poodle has had atypical addison's since October 28, No percortin for now because her sodium and potassium levels are in the normal range. We will continue to monitor that because we know that that will probably change. My question is that we receive a 5 mg tablet of prednisolone and have to cut it into quarters, which is extremely tricky.
There is probably never a day that she gets an exact dose because they do not cut without some crumbling. First, she is a ravenous eater and finishes her meals way too fast. She is always hungry. Should her prednisolone dosage be lowered to help with the appetite issue? Not to mention that many of your bloggers have their dogs at much lower levels which, I know, would be better for her overall health as she will be on this for the rest of her life.
Second, is there any other tablet or form of prednisolone that would be easier for us to administer to her so that she gets the proper amount each day? Yes, your dog is on much too much prednisone. The daily maintenance dose is only 0. In contrast, you are giving 1. Prednisone tablets are available as 1 mg and 2. All of these formulations are human-labeled products so your veterinarian may not be familiar with them; your local pharmacy will know about them, however.
Or use the liquid and give 0. This was extremely helpful. Just one more question, my dog has been on this 1.
You suggested I bring the dose down to. Do I need to gradually taper her down to this level and, if so, how do I do this or can she just begin. You should be able to just decrease the dose immediately to 0. If the appetite falls off, however, then go back up to 1.
Peterson, My beagle was diagnosed with Addisons in Dec ; Over the past year, we have lowered her dose of Pred to. I forwarded my vet your blog article on reduced dose pred, and a few weeks ago, he further lowered her daily dose to. She acts fine on this amount, but she still seems to drink and urinate just as frequently. I have another beagle about her size and age--her half brother, actually--and the difference is so striking.
In December we tested her urine to make sure she had not developed diabetes. My vet seemed convinced that she did not. She is also on a weekly dose of Estrogen as she sometimes leaks urine. Could she be on too much DOCP? I live an hour away from Cornell Vet school, and although I fear it would insult my vet-who I generally think it terrific--I'm wondering if I should bring her to an endocrinologist there for a second opinion.
Is there something we are missing? It does sound like you need any opinion. If your vet can't figure out what's causing the increased urination, then they may welcome some help. I'd go to Cornell to get another opinion. Thank you very much for this website and your help. She was put on 1. After reading your comments, I lowered the dosage of prednisone first to 1 mg and then to 0.
Her second injection was after 45 days, we were checking her electrolytes every week. For the last three months her injection are every 25 days. Her next shot is not due for another 2 days, but she vomited twice after dinner on 5th and 3rd night before the next shot. Please advise if I should check her electrolytes a.
Mika was diagnosed with Lyme disease in the summer of asymptomatic and with hypothyroidism in the summer of She is taking Synthroid 0. Thank you very much. Yes, if your dog is ill, the serum electrolytes should be checked to make sure that the Percoten-V dose doesn't need to be adjusted. I have an 8 yr old Standard Poodle who was recently diagnosed with Addison's.
He has had three injections, so far. He is doing great, back to showing in agility and obedience. His weight is back up. He does eat and drink more than he used to but is not incontinent or anything.
He does seem to be losing hair, though. Both are over now. The Alk Phos is normal, however. Abdominal ultrasound is normal. They are wanting to do liver biopsies. I have read that liver elevation can be caused by to much Prednisone or that switching to another type of corticosteroid may be helpful. Do you think this could cause the liver enzyme elevation or what is your thoughts?
The liver changes we see with glucocorticoids lead to enlargement of the liver and increased brightness of the liver on ultrasound evaluation. The glucocorticoids also induce an isoenzyme of alkaline phosphatase that can lead to marked elevations on that enzyme.
In your dog, it's certainly possible that the prednisone dose is too high. If you giving more than 0. Switching to prednisolone or methylprednisolone Medrol would be a good idea so the liver doesn't have to metabolize the prednisone. Overall, if this doesn't work, I agree that a further workup eg, bile acids, liver biopsy would be indicated.
Hello, I posted a comment almost a year ago about my 13 yr old neutered male Vizsla who is Addisonian. His Addison's appears to be well-managed Percorten, and hydrocortisone tab as needed. My present question is, is it possible that an Addisonian male could also be showing signs of acromegaly?
For some time, I have noticed some body changes that are making me wonder. This is just not senior fat. His rib cage seems enlarged, his tail is very thickened and it looks more like the tail of a Lab not a vizsla , he has noticeable skin folds on the back of his neck where he routinely gets his Percorten injection and his upper teeth are more widely-spaced and more "bucked" out than his younger years with gumline receded alternatively, this could be more an issue of dental health.
I understand that the condition is connected to somatotropin hormone levels and is more prevalent in unspayed females. Is a general vet practice equipped to run a specific blood chemistry that would measure my dogs growth hormone levels and it is a reliable diagnosis? When I showed some of the symptoms to my former regular vet the very thickened tail and overall beefed up look to the dog's rib cage area he dismissed it as the dog being older, carrying more fat.
There are internal medicine specialists in the DC area, but none like yourself with an endocrine specialization. Can long-term Percorten administration since bring any of these changes on?
The dog weighs 58 pounds, which has been his weight for many years. Thank you for any guidance. Acromegaly would be very unlikely. We can't easily measure growth hormone GH levels, but we can measure insulin-like growth hormone IGF-1 , which is an indirect measure of GH secretion. So you could do that as a screen to rule out acromegaly.
However, have you check thyroid function? Hypothyroidism might explain some of your dog's signs. Percoten shouldn't cause the signs you describe. As for your question about having tested the dog's thyroid function the answer is "yes". On a typical senior blood panel that was run a few years ago that measured free circulating T4 he came up as below normal. Then the vet had me run a more extensive thyroid screening that went to U Michigan if I remember correctly.
Those results came back showing normal levels. Based on those results the vet said "your dog's low reading on the free T4 is therefore secondary to his Addison's disease and he is really not hypothyroid, and we will not continue to re-assess if he is hypothyroid because of the results of the extensive screening which gives a more complete picture of thyroid function".
If these are the conditions, should I have his thyroid function re-tested or is that unnecessary? Talk to your vet about your concerns. I have a 41 lb english setter that was diagnosed with atypical addisons.
He is an agility dog that competes on the weekends. We have done follow up blood work since starting his meds and the numbers are perfect. Please note we caught his addisons early and he never had a crisis. My question is about giving extra on the weekends. I ran him one weekend and was fine Saturday but was very stressed on Sunday.
We then tried giving extra 1. What I didn't count on was the high stress on Saturday, he was better on Sunday with dealing with stress. Would it be safe to start giving him extra amounts on Friday to carry him into the weekend? And how much extra, 1. I am trying to level him out over the two days.
I currently have to deal with different behaviors each time he runs because his levels seem to go up and down. I know it's all trial and error at this point but if you have any suggestions that would be great. My vet is not even sure at this point. He was diagnosed in February so we are still early on in the process of figuring out what works best. I think your approach is reasonable.
You might want to switch to prednisolone which doesn't have to be converted in the liver prednisone is converted to prednisolone. That would help, since prednisolone has an effect within an hour or so; if he's having a bad day, giving an extra quarter tab during these times of extra stress would also be fine. Just over 2 years ago my dog Niki had stem cell treatment for her hip dysplasia, instead of using her own stem cells her vet used donor cells. A couple of months later she became very ill, lost her appetite, lost copious amounts of fur and her pain was so bad she could barely walk.
She was put on 2. Over time her vet reduced her Prednisolone to 1. Niki weighs approximately 28 kgs and is a 10 year old Border Collie X Kelpie. We do not have methylprednisolone Medrol available in Australia. Appreciate any advice you can offer. Thank you, Mary Pittas. Have you considered splitting her dose of Percoten and giving it every 3. That may help lower the serum concentrations of the Percorten, which seem to be contributing to the signs. Other than lowering the pred dose or going every other day, I don't have any great suggestions about other glucocorticoids.
I read with interest about the dog that received a stem cell transplant from another dog. Do dogs have concerns with graft vs host disease as with humans? Peterson, Thank you so much for sharing your experience and information!
Original symptoms were lethargy and her hair grew long, curly and unruly, she did not have a crisis, eating problems or diarrhea. We are in the process of lowering the pred, it's currently on 1. She is acting much better and is bright eyed. My question is this: She pants a lot for no reason and sometimes her breathing is extremely fast. This is especially noticeable when she is sleeping in the evening.
Is this related to the pred or should I be asking my vet to look into something else? That said, the dose you are giving now is pretty low.
I'd discuss the situation with your vet - you might want to at least get a chest x-ray to make sure it's nothing serious. Thanks so much for the speedy response. I have an appt for a consult with an IMS in about a week and will talk to her about this as well as my vet. My fifteen pound, 4. On April 17th he began taking 0.
I have alternated doses for him since he began the lower dose of liquid Prednisone so that we do not trigger another crisis, i. The problem is, he also now urinates on the couch, and in other undesirable areas in the house. I understand that too much Prednisone will cause an increase in urination. From the information I have researched online, it does appear that he is receiving too much Prednisone and needs to be weaned down to an acceptable dose of Prednisone for his weight. Do you think that his current dosage in conjunction with 0.
I would be grateful for any input that you share. Based on your dog's body weight 15 pounds or 6. I have no idea how much pred 0. Some dogs just cannot receive any pred or they will drink too much so this will be trial and error to determine the ideal dose for your dog. Peterson, thank you for your reply. His dose is 0. I was told that the liquid dose is equivalent to 1. In this post, I'm certainly not talking about the use of glucocorticoids for testicular swelling!
This is not my area of expertise, but I cannot think of any reason why prednisone would help. If the steroids don't help within a few days, I would consider castration and biopsy. Thank you so much for this blog, it is wonderful. My border collie tested positive for primary Addison's but remains going on 3 years now in atypical Addison's. He is 42 lbs and I was giving him 1.
He didn't show outward signs of PU but lost his coat! I feed a high quality food, he is a competitive obedience dog.
I couldn't think of another reason for his coat to look so horrible. I decreased his predinsone and he is now stable on 0. Very occasionally I have to give a little extra- twice in the last 3 months. My question is how much is too little?! I don't want to stress his adrenals. I also supplement with standard process canine adrenal support. If you don't give enough prednisone, your dog will develop a decreased appetite, vomiting, or diarrhea.
So if that doesn't happen and your dog is acting normally, the dose should be adequate. My 4-year-old pound puppy Manchester Terrier mix?
Our first followup visit was today July 1 and I told the vet that Jack seemed to show signs of too much prednisone: The vet insists that he wants to stay with this high dose for several weeks--in spite of any side effects--and only then consider lowering it.
Jack weighs 15 lbs, which would translate to something like. I'd love to go ahead and reduce his dose on my own, but I'm wondering if there's anything to the notion of "loading" an Addison's dog in the beginning before scaling back.
And if not, how would you suggest that I begin to sensibly lower the prednisone to an ideal level, please? Thank you SO much for this invaluable resource, Dr.
Almost all vets seem to think that they have to use glucocorticoid loading, but it doesn't make any sense physiologically. Prednisone has a short half life and it's not really stored in the body, so how can you "load" it anyway? Why make an Addison's dog Cushingoid before we drop back the dose to normal? It is simply wrong, at least in my opinion.
Now if you look at any medicine textbook, it might say to do what you vet is doing, but I'm just seen too many dogs like yours! In general, you can immediately cut the dose down by half. If that's too much, the appetite will decrease below normal remember that right now it may be artificially increased due to the excess steroids. If the appetite isn't right or vomiting occurs, give a bit more.
In general, we can drop relatively fast because the high doses haven't been given that long. I slightly reduced the Percoten and am inclined to reduce further. Have your vet do a complete urinalysis and culture if not already done recently.
Low dose pred shouldn't be causing those clinical signs. Talk to your vet about what you can do -- maybe medicated shampoos or conditioner would help.
Electrolytes have been normal and he is maintaining well on 2. Going forward, what type of monitoring other than signs and symptoms would you suggest? Our vet is suggesting quarterly UTI assessment.
We were under the impression that we are replacing physiological glucocorticoid- would there be substantial enough immunosuppression at these low levels to merit such testing? Secondly, wouldn't periodic electrolyte testing be prudent to monitor for disease progression and need to mineralocorticoid therapy? First of all, Addison's disease mean complete adrenocortical insufficiency so that doesn't fit your dog's diagnosis. If cortisol secretion is subnormal with low pituitary ACTH secretion, then the diagnosis would be secondary hypoadrenocorticism.
In that case, glucocorticoid therapy alone is sufficient. There is no real reason to closely monitor serum electrolytes unless you don't believe the plasma ACTH result. Was that sample taken before any treatment was given? If taken after steroid treatment, then the result would be invalid. I would not routinely monitor for UTIs in your dog unless there has been a history of past infections. The low dose of pred shouldn't be an issue for UTI development. Peterson, Very informative Blog.
Thanks so much for sharing your knowledge. My question is regarding my dog who has been diagnosed by a dermatologist as having Endocrine Alopecia.
Hair loss began 2 years ago. He is also Hypothyroid but this is controlled with thryoid replacement. T4's have been normal for years now. We tried monthly injections of Medroxyprogesterone. We were supposed to give it for 4 months but stopped after 2 months because he became reclusive. The same thing happened when we tried Melatonin the year previous.
ACTH test was performed and was normal. I am wondering if you are aware of Dr. I had his blood work done and my dog's Total Estrogen is high Blood was drawn at 2: Suggested treatment is 3 injections of 70 mg DepoMedrol IM at 10 day intervals.
Then recheck labs, if IgA is above 58 start 4 mg Medrol daily. I am concerned about giving him Medrol and the potential side effects but if he is cortisol deficient or if he has defective cortisol then I presume replacing that with Medrol, similarly as I am doing for his thryroid would be warranted.
What are your thoughts on this protocol and potential harmful effects it could have on my dog? If I were to try this for months and then weaned him off of it could it cause his existing cortisol production to permanently shut down?
Thanks in advance, Steve. It's likely your dog has Alopecia X. We do not know the exact cause for that disorder but it's believed to be a primary disease of the hair follicle. It's not an immune disorder or an endocrine disorder, although some dogs for unknown reasons will regrow hair after growth hormone injections.
It's clear that they do not have growth hormone deficiency. I don't want to say anything bad about another veterinarian. But giving large doses of glucocorticoids -- enough to induce iatrogenic Cushing's disease -- makes no sense and is just plain wrong in my opinion.
You can't diagnose cortisol deficiency on baseline test - you need to do an ACTH stimulation test to document that. Estrogen is a very difficult assay to do in dogs and most results I see are suspect and likely falsely high.
Is your dog sick? If he feels fine and just has hair loss, I'd leave him alone and not induce any more problems. Thanks for your reply Dr Peterson. He is not symptomatic aside from some muscle atrophy, some arthritic changes in his hips and spine and borborygmus. Also, his hair loss and his skin is hyper-pigmented where the the hair is missing.
His appetite has always been very good and he drinks normally. His USG is normal. If he eats more than his regular amount per meal he may vomit. Lastly, he walks around constantly. He has always been a very "busy" dog but now it seems like he is anxious or possibly uncomfortable and he pants a lot.
We do CBC and chemistry every 6 months and everything is always in normal range. He has been on this for years. His Free T4 equilibrium dialysis and his Total T4 are always in the middle of the reference range. I have two final questions. Do you ever measure Immunoglobulins in dogs and if they are low is there anything that can be done about it?
If you feel it would be warranted I would like to have a consultation with you and my Vet. I read on your site that you offer this, I am in Canada and my Vet is extremely cooperative. I really want to do whatever I can to make sure that I am not neglecting something for my dog.
I know he is old but I want to keep him as comfortable and healthy as possible. Should I contact your office to arrange a consultation? Thanks so much, Steve. No reason to consult with me. I don't think your dog has adrenal disease. I am not an immunologist. In my practice, I don't ever measure immunoglobulins.
I would have your vet talked to an immunologist or someone who specialized in immune-mediated disease. I have a 90 pound hound mix who got diagnosed with addisons in may. If i bring her back up what could i do for the hair loss. Thank you so much for all your help. For a pound dog, 2. It certainly would not be expected to cause hair loss at that dose, unless you are also giving large doses of Florinef.
Have you excluded hypothyroidism? Talk to your vet. You have treated two of our dogs Skat and Atticus both with adrenal tumors. Now our dog scout has been diagnosed with Addison's.
She stopped eating for a week before her electrolytes showed her addison's. Our vet in upstate NY has prescribed 3 -. Her ratio was today showing 28 after a day and a half of the florinef. Should she be on anything besides or along with florinef? Some dogs will do fine on Florinef alone, since this drug does have some glucocorticoid activity. However, since dogs with Addison's disease do not make any cortisol, I like to supplement with a very low dose of prednisone. If the dogs develop side effects such as excessive thirst, then we can stop it or give it only when needed.
We've had a tough time trying to diagnose and treat a dog that started to "fail" ten months ago. After much frightening trial and error, our current theory is that the dog developed hypothyroidsim, and the thyroid meds cause him to flush cortisol too quickly, causing Addisonian symptoms.
He has small adrenal glands and tests just barely in the normal range on the ACTH test. Our theory is he crashed on the thyroid meds he tests as needing thyroid, zero on test because the Addisons symptoms get so much worse when he's on thyroxine cortisol tests at zero. After an "Addisonian Crisis" while being boarded at the vets , he responded well to injected prednisone, leaving us with a diagnosis of hypothyroidism 1 mg thyroxine daily and atypical Addisons 10 mg prednisone daily. The dog was pounds before the crisis not overweight, large breed dog , pounds after the nearly fatal crisis.
Since our theory is the thyroxine causes increased metabolism and subsequent cortisol loss, and our goal is to balance these two meds, is a higher dose of prednisone indicated?
We worry that we won't be able to establish a safe balance between the two meds. We would be grateful for any suggestions. It should not be a problem to give both thyroxine and prednisone. Right now, you are giving huge doses of both supplements, which could suggest that something else is going on. You may need a referral to a specialist. Dogs with Addison's do not secrete any cortisol, a glucocorticoid hormone that is essential to life. Prednisone is a synthetic form of cortisol.
I believe that it just makes sense to replace the hormones that are deficient, and that's why I always give both mineralocorticoids florinef or Percorten and glucocorticoid prednisone or cortisone acetate to dogs with documented Addison's disease. Hi dr Peterson It's now been three weeks since Scouts last blood test. She is due in on Monday nov She is as I stated above about 65 lbs.
She is taking three. She has been doin great actually until last night. She threw up in the middle of the night. Ate breakfast and lunch. But threw up dinner about an hour later. She had taken her nighttime pills just before dinner. We have been given by the local vet a few 10 mg prednisone pills for emergency situations. Do you think it could be she needs the prednisone?
I would give 5 mg of pred to start to see if that helps. Call your vet and schedule an earlier appointment! Thanks we did give her 5mg of prednisone last night and she seems better. More energy and ate breakfast and so far has not thrown up. She got up this morning and trotted down the stairs and ran outside.. I will ask him if we should give her prednisone daily. Thanks so much for answering on this blog site. It is much appreciated.
We are great admirers of your approach and expertise. Kind of crazy that our last three dogs have had adrenal problems. Peterson - I only want to thank you for all of the time you have taken to answer questions regarding Addison's disease.
In just these few months, we are now on our 3rd vet. Thank you SO much!! Lowering his dosage has taken away all symptons. She seems to have responded well to the treatment of percoten and prednisone. Through the last month she has become dehydrated 4 times and her platelet count is dropping which was low when diagnosed. My vet increased her prednisone from 2. This doesn't seem to be a common problem in addisons dogs from what I have read and am concerned.
Any insight you could give me would be greatly appreciated. Sounds like something other than Addison's. With treatment, those dogs do not get dehydrated and low platelets have nothing to do with Addison's. Talk to you vet and maybe get a referral to an internal medicine specialist. I have a 17 lb dog that has been well-treated for Addison's for nearly 8 years. I administer her shot. I am going away and am leaving 8 days prior to get shot date. I could have her pet sitter take her to a vet for the shot but I am hesitant.
I just had her semi-annual lytes done. Peterson, I had a question about my 12 year old chocolate lab. He was diagnosed with addisons 8 years ago. Mostly everything has been fine. He get percorten every 28 days at 1. He usually does not take pred unless at times of stress and it's usually only 2.
My dog weighs 85 lbs. He is eating fine and drinking. I gave home 5 mg of pred to see if he would snap out of it then 10 mg the next day he still is acting the same. I was wondering if I should wait to see if the pred will take affect soon and he will snap out of it.
Or if I should temporarily increase the dose. While on 10 mg he did not show any signs of overdose excessive urination and thirst. Usually 10 mg would make him go constantly. Any advice would be a great help. Thank you in advance. Sounds like some other problem, unrelated to Addison's is developing. Talk to your veterinarian. Simply giving too much prednisone is not the answer!
Dr Peterson - I have a 14 year-old lab who was diagnosed with atypical Addison's at the age of two. He did not tolerate prednisone frightful incontinence and so has been on 0. His veterinarian at the time now retired suggested we consider every-other-day therapy, but he seemd to be stable, so we lef him alone. Recently, though, he has developed a number of symptoms that make ne wonder if we should reevaluate either his dose of dex or the frequency it is given.
He is drinking even more than usual, is perpetually hungry, very dry coat, pacing, panting and whining. I was reminded of our old vet's question re dosing by a chance conversation with a people endocrinologist when we were discussing our pets and he mentioned incidentally that dex is much longer acting than prednisone.
Would there be any value in doing an ACTH test at this point? Is there any way to assess whether the dex dose may be more than he needs in his old age? Dexamethasone is a very long acting, potent glucocorticoid and is never used for long term replacement therapy.
Doing an ACTH stimulation test now is unlikely to be helpful. I'd consider switching to a shorter-acting preparation and see if the signs resolve. At 14, this could also be due to a multitude of other problems. Talk to your vet about a checkup. She is Addisonian and was doing very well on fludrocortisone. Now she had been diagnosed with a splenic tumor.. Atticus ,scouts old partner that you saw also died from bleeding adrenal medulla what are the odds?
In my opinion, Addison's disease has a good prognosis and is not a reason in itself not to treat a concurrent condition. That said, I'm not here to judge if you should or should not do surgery for the splenic tumor. You will have to have a discussion with your veterinarian about that decision. Is lowering the prednisone dose a option in this case even though at low end of the usual maintenance dose? Why did you convert? You can certainly try lowering the pred dose further or even stopping it completely for awhile to see if that helps.
Percorten has no glucocorticoid activity and would not cause that problem. I posted before but it never came up. I have a Golden Doodle that is an Atypical Addisons patient. The owners travel with him and he is happy doesn't seem stressed etc. When they travel cross country with him he always has bouts of diarrhea and everything else seems fine. He is on maintence pred only. My question is even though he is not stressed in how we percieve it could this be a stress issue requiring us to increase his prednisolone dose while traveling AND if so do they need to keep it up for the whole trip?
Just looking for the best way to manage. I think he is on a daily dose of 5 mg maintence still with a lot of side effects but managable, so if we increase how much to go up? Therapeutic Class Adrenocorticosteroid hormone. Species Dogs, cats and horses. May Be Prescribed by Vets for: Prednisone is commercially available as a tablet, 1mg, 2. Search for Available Dosage Forms.
Prednisone is a synthetic corticosteroid used for many conditions in both human and veterinary medicine. Its anti-inflammatory activity is approximately four times that of hydrocortisone. Corticosteroids are extremely effective anti-inflammatory drugs because they affect the inflammatory process at so many different levels. Prednisone is rapidly converted to prednisolone in the liver and, in most instances, these drugs are considered to be roughly equivalent.
Corticosteroids have strong beneficial effects but a definite potential to cause negative side-effects if abused. Prednisone may be given by injection, orally, or topically. Prednisone is used for a wide variety of conditions in both dogs and cats. It may be used in emergency situations including anaphylactic reactions, spinal cord trauma, and many forms of shock. It is used to manage and treat immune-mediated disease such as immune-mediated hemolytic anemia or thrombocytopenia, many CNS disorders, some neoplasia, dermatologic diseases, allergic reactions such as asthma, hives and itching, inflammatory orthopedic diseases, endocrine disorders including Addison's Disease, respiratory disease with an inflammatory component, inflammatory bowel diseases, and many other conditions.
Cats may require higher doses than dogs in order to achieve clinical response but they are less likely to develop adverse side-effects. Prednisone is given systemically to decrease inflammatory and immune responses. Recent work has demonstrated that horses do not absorb oral prednisone although they do absorb oral prednisolone.
Other corticosteroids are preferred for intra-articular use. Short-term administration of even large doses is unlikely to cause serious harmful systemic effects due to adrenal suppression. Problems associated with long-term administration of prednisone relate to suppression of normal adrenal function, iatrogenic Cushing's Disease and metabolic crisis due to abrupt withdrawal.
Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania.
The Importance of Gradually Weaning Dogs off Prednisone
Prednisone and prednisolone are steroids that can be used for dogs to treat Closeup of a female veterinarian giving a pill to a brown labrador in a clinic like hot spots or itches from allergies may be treated with a topical form of the drugs. The body manufactures a natural corticosteroid called cortisol in the adrenal Do not stop giving your pet prednisone or prednisolone abruptly; particularly if it has been receiving high doses or has been on the drug for a long period of time. Prednisone is used for a wide variety of conditions in both dogs and cats. Chronic or inappropriate use of corticosteroids, including prednisone, can cause .