Allergies And Prednisolone

[zayda_asher]

I'd like to hear from the people who use Pred for their allergy dogs... People I'm thinking of specifically here are Sas and Stormie, but anyone is welcome... I just thought of them because I know they've had to use it for their dogs' relief as not much else has worked. I'm wanting to know what your experiences is with side effects: have you had many, are they strong, anything you've found helps cope with them, etc.?

I try to save Pred for the "really needed" situations with my guys, and I'm fortunate that I've been able to work up treatment and maintenance plans that have allowed me to do so. However; Asher's symptoms have morphed over the last year and a half or so and he has these terrible reactions with a lot of swelling, drooling and pain. If its a milder reaction, then an extra dose of antihistamines help. We've also found that olive leaf extract definitely helps keep them to a lower level (both in how often and how chronic). When he does have a chronic reaction, however, we have to use Pred. We are not using it long term: its a single one off 25mg dose when he has the reaction, this helps to settle it and then he's good to go. My problem is that even this is causing side effects that are quite strong: increased hunger to distraction, sometimes lack in concentration, sometimes depressed and lethargic, excess drinking and panting (which he gets from the reaction anyway, so it is magnified and he's also a big drinker naturally). Its not all the time that we see all these reactions (the hunger, panting and drinking are consistent, not always the others though), he had one last night and he's quite perky this morning, but I do see them. Once they are in his system, they do knock him out as well, but that's not ness. a bad thing as he can sleep through the remains of the reaction. We know he is chemically quite sensitive, so I'm wondering if he is just extra sensitive.

Of course I am going to discuss this with our Derm, but I just wanted to see what other's experiences were like.

[stormie]

Here I am!

Yep, Porp has been on regular pred since he was about 4 months old. It's quite ironic, because before I even bought him home, I always told my Vet how he would never be over medicated/vaccinated and would never get cortisone unless he had to. I think I well and truly jinxed us

I was something I really didn't want to do, but the extent of his itching was pretty bad, and getting worse every day, to the point he barely slept and was doing a lot of damage to himself.

We started with a normal tapering course, but once that stopped the itching started up again and we then started on working towards a diagnosis, but he still needed pred to keep him comfortable. In fact, probably the longest he's managed to go since that time (he's now 2 1/2) is about 4-5 days of no pred.

His dose has generally always been maintained at the lowest dose possible, every second day. He's about 55-60kg and we get by on about 20mg eod. I recently started him on Cyclosporin and find that with a combination of that and pred, we can sometimes get by on 10mg pred every 3 days or so, but still have flare ups where he needs more.

In terms of side effects, I have to say I think we've been lucky in a lot of ways. I'm lucky in that I've been able to take him to work with me every day so have always had vets keeping an eye on him for the more serious side effects. One of the major things we've seen is that he is much lighter in frame than his brothers. Whether he would be any different without it I guess we can't know 100%, but for a dog that was kept entire until 18months of age, he is still relatively small and never really 'chunked up'.

Otherwise, that's pretty much it. His coat has always been a little finer, but since getting him on the cyclosporin and reducing the pred even more, it's gotten a bit thicker and generally looks well. When he was castrated and gastropexied, we had no problems at all with wound healing and all went as normal. His skin is maybe a tiny little thinner than normal, but he's never had the pot bellied 'cushinoid' look to him that I've seen on other dogs on constant cortisone.

On his 'pill days', mainly I just see the increase in thirst and urination and not much else. I can't say I've ever noticed a change in his temperament or anything. But, I do believe it can be a side effect in some dogs for sure. Again, I think we're lucky.

My understanding is that when using pred for the first time, side effects are often greater, (and your 25mg dose is relatively high so I'm not surprised hearing those side effects), but after a couple of days and probably also over long term, they seem to fade off a bit. It's probably because it remains in their systems perhaps, hence probably why I see results with using a dose as low as 0.2-0.4mg/kg, which normally wouldn't really touch the sides if given as a once off dose.

Overall, I think we manage him very well. According to the specialists, giant breeds generally don't tolerate pred as well as smaller dogs and tend to show side effects at lower doses, sooner. So with that in mind, I think we do very well. I don't think many people would know he was a 'cortisone kid'. He gets daily antihistamines, oils etc which I think help to keep the dose down to a minimum, along with regular bathing and keeping him indoors where possible.

Cortisone is so often poo poo'd on dol and I do understand that it's not always a nasty drug, but I know that we've tried everything we can and it's now our last resort. Sometimes a simple course can fix a bad bout of contact irritant, breaking the cycle and fixing the problem.

The way I see it, is that Orbit isnt worried about being on it, or that his life might be shortened. All he cares about it being comfortable and wanting the itching/pain etc to go away. Yes, it cuts me that he may very well die sooner than the average life span, but I'm not going to put my worries onto him by holding back a drug that provides him with total quality of life NOW. I have said this many times - I would rather he lead a 'normal' life, like most other dogs, by taking cortisone and only life till he's 5, than have him live suffering and uncomfortable until he's 12, just to make sure he's around longer for me.

Edited January 8, 2010 by stormie

[Loraine]

My Zedley has itchy skin and from time to time I have to give him Pred. I hate doing this as it brings on Cushing's type symptoms (water guzzling, food gobbling, constant hunger) and it can lead to Iatrogenic Cushing's. Having had a true Cushdog I had no intention of putting Zedley onto pred, BUT when it gets bad it is the only thing that calms his skin down. I have done the food elmiinimation things, tried homeopathic remedies, bashed my head on a brick wall - all to no avail. If he is going to itch I have to give him pred, I try to keep it as short as possible, I amke sure he has enough water and I refuse to overfeed him, as Pred-weight is hard to remove.

[cowanbree]

I have had 2 dogs on long term pred use, 5mg once a day for a 6-8kg dog and at times twice a day. One was for autoimmune issues including skin and the other cancer, it gave her 18mths of quality life. Other than an increased appetite I can’t say I noticed any significant side affects. We did run full bloods every now and again to monitor it

[~tj~]

LOL I would give you my human experiences but nonoe with a doggy - I take pred myself Yukky medicine lol

[sas]

Pred user since 4 months old, now appraoching 3 years of age.

We went through 3 different Vets until we came to Stormie's Clinic, prior to this Dante was being prescribed a higher dose than neccessary, he's now on 20mg every second day which is pretty good for a Giant Breed and we don't see any bad side effects.

He has been in a bad state at one time when he was getting Cortisone every day for a short amount of time, symptoms included very thin skin, bruising, weight gain, poor coat condition etc.

The things we do see are a thinner coat and increased water consumption....mind you because he's been on it most of his life the water consumption is normal.

As long as you have a great Vet/Derm who will help you with the correct dossage you really shouldn't be seeing horrible side effects.

Dante is also on Phernergen twice a day throughout Summer.

We choose quality of life now, I prefer to think that he enjoys his life now rather than him suffering because I don't want him on Cortisone.

Edited January 8, 2010 by sas

[Danois]

As you know I have just started a short course of cortisone for allergies - 20mg twice a day for 5 days. I saw an improvement within several hours and by the following morning, considerable improvement.

I have not seen more than a minimal increase in thirst and urination. Only thing I noticed was the first morning, he woke me at 6am to go outside and normally he would hold on til around 9am.

I have seen a little increase in appetite but that is a good thing for Boo!

No difference in energy.

I was apprehensive about using cortisone as my last dog was on it for 9 months and at high levels - average dose was between 60-80mg a day for immune mediated issues though and not allergies. At that dose and period I saw typical cortisone effects - muscle wastage, thin skin, weight increase and lethargy. These were unavoidable regardless of careful management.

However I have confidence in my vet with regards to appropriate use of cortisone in giant breeds and will use it if it means my dog is not suffering/ uncomfortable etc

[zayda_asher]

Thanks for taking the time to respond guys... I really appreciate it. I do have both a very good vet and derm, and it sounds like the first place to start is maybe looking at a lower dosage, so I will make contact and ask about that. Both dogs here are on Phenergan 25mg 3 x daily. Asher had to be taken off his immunotherapy, as he was too sensitive (in fact that was when we first started seeing the reactions we are dealing with now). We've had problems getting the Pred into his system quickly, as he also has a lot of GI issues with the allergies and absorption is 100% we don't think. Atopica was thought to be not the best option in our case, as its not a constant problem, rather one that suddenly flares and then goes, and Atopica is designed for regular use, rather than as a drug that is administered as needed.

My understanding is that when using pred for the first time, side effects are often greater, (and your 25mg dose is relatively high so I'm not surprised hearing those side effects), but after a couple of days and probably also over long term, they seem to fade off a bit.

In our case we've been using it as needed since before Xmas, and the symptoms have actually gotten worse... we also see side effects for a few days after - 5 days or a week even if he's had a couple of doses, not just a couple of days after. This is part of why its concerning me... its not something that seems to clear his system quickly. The symptoms we have seem to be a magnification of some of the symptoms we get from the allergy reaction, like the lethargy / depression / thirst. He is also a very foody dog naturally, but not to the point of the hysteria over food we see after Pred.

As he is sensitive with chemicals, we do have to be careful of the potential for developing more sensitivities in this area as well, so I'll be discussing this with her as well. Our derm has had a couple of dogs that were severely allergic to Pred, and I have a good friend with a dog who is, so that has been in my mind with his reactions to it as well.

LOL I would give you my human experiences but nonoe with a doggy - I take pred myself frown.gif Yukky medicine lol

I've read a fair bit on it to do with humans... some people's experiences are not nice at all!

I'm glad to hear that its working well for you guys, and I totally agree on quality being so important... So we'll chat to our Derm about dosage and see how we go from there.

[Rappie]

Skin allergies are frustrating no doubt. Sometimes we need to use prednisolone to manage them - sometimes because nothing else helps, sometimes it's financial, sometimes it for a 'rescue'.

I think it has it's place if used with due care and with respect. I aim for the lowest possible dosage that will keep a dog comfortable, and I usually only start at 0.5mg/kg and do a short reducing dose schedule over 5-7 days. I do have the occasional dog that is on it long term and in some cases we have got 20kg dogs down to 5mg every 2 or 3 days. I see far too many dogs that have just been stuck on pred at high doses and have never been investigated - tend to find a lot of underlying demodex cases that way!

Before looking at long term pred, I would throw everything else I could at the allergies - every little improvement helps, so that means antihistamines, shampoo and conditioners, skin support diets, omega oil supplementation, derm referrals, immunotherapy, cyclosporin if possible etc. I don't think we should forget that steroids are VERY good at what they do, but they are frequently misused and get a bad rap for that. I'm not suggesting that every 'skin' dog go on steroids, but sometimes it really does come down to a quality of life issue.

Edited January 8, 2010 by Rappie

[zayda_asher]

I think it has it's place if used with due care and with respect.

I agree. This dog is a well managed dog with a long term care plan (he was six in Oct and diagnosed at 1.5yrs, receives regular vet care and 6 monthly revisits to his derm with regular email contact in between). Maintenance plan includes: weekly baths, daily antihistamines, fatty acid supps and herbal / other supplementation to help with skin and gut condition and to prevent bacterial infection. Asher was on ASIT, but had to be taken off, as he was too sensitive and we were having reactions from it. This is the first time in those 6 yrs that we have had to use Pred (starting just before Xmas). Atopica was not deemed suitable in our case.

I aim for the lowest possible dosage that will keep a dog comfortable, and I usually only start at 0.5mg/kg and do a short reducing dose schedule over 5-7 days.

I'm not using it as most "long term" users would: he's not on a regular dose every day or every other day. He only gets a dose of Pred when his reaction is so strong that an extra antihistamine is ineffective. So in the last three weeks he's had 4 individual administrations of a single dose. So he's not just been whacked on some ludicrous high dosage for everyday use, although it does appear that we may still find a lower dosage effective, and I will talk to my vet and derm about this.

Before looking at long term pred, I would throw everything else I could at the allergies - every little improvement helps, so that means antihistamines, shampoo and conditioners, skin support diets, omega oil supplementation, derm referrals, immunotherapy, cyclosporin if possible etc. I don't think we should forget that steroids are VERY good at what they do, but they are frequently misused and get a bad rap for that. I'm not suggesting that every 'skin' dog go on steroids, but sometimes it really does come down to a quality of life issue.

Pred is "the kitchen sink" for us... We've found that upping his antihistamines and utilising Olive Leaf extract has great reduced his reactions both in frequency and how chronic they are. Unfortunately sometimes he is still getting the odd chronic reaction and nothing else I have seems to help.

I do try to save steroids as the "big guns" you pull out only when you really need to, and I have been lucky that my dogs have responded to other therapies. That is how I've been using it here, and I totally agree that it comes to a point where quality of life needs considering first. However, the current way it is working for Asher the "cure" is almost as bad as the illness in side effects that effect quality of life... So I'll have a chat with our derm about lowering the dosage and take it from there... hopefully that will help us find a median point

Thanks.

[zayda_asher]

Maintenance plan includes: weekly baths, daily antihistamines, fatty acid supps and herbal / other supplementation to help with skin and gut condition and to prevent bacterial infection. Asher was on ASIT, but had to be taken off, as he was too sensitive and we were having reactions from it. This is the first time in those 6 yrs that we have had to use Pred (starting just before Xmas). Atopica was not deemed suitable in our case.

Of course we also have a host of things like Resichlor and lamisil we use to help fight minor flare ups when they happen, so that we can nail them before they turn chronic and need ABs...

Here's a pic of the boy:

[stormie]

Wow Zayder, for such an allergic boy, he looks great! Well done and looks like all your time, effort and money is worth it.

[*Avanti*]

Skin allergies are frustrating no doubt. Sometimes we need to use prednisolone to manage them - sometimes because nothing else helps, sometimes it's financial, sometimes it for a 'rescue'.

I think it has it's place if used with due care and with respect. I aim for the lowest possible dosage that will keep a dog comfortable, and I usually only start at 0.5mg/kg and do a short reducing dose schedule over 5-7 days. I do have the occasional dog that is on it long term and in some cases we have got 20kg dogs down to 5mg every 2 or 3 days. ......................................................

I'm not suggesting that every 'skin' dog go on steroids, but sometimes it really does come down to a quality of life issue.

Both of my dogs (Labradors) have what seems to be a contact allergy to the Kikuyu grass in our back yard (still being investigated). One gets it worse than the other and she ended up on long-term prednisolone, only .25mg a day, and with that she still had slight signs of the allergy but nothing nearly as bad as it had been. I had a constantly crying and scratching dog before this so I resorted to it for the 'quality of life' issue.

Many other things had been tried but nothing worked as well as the pred. It felt to me a bit like being caught between the devil and the deep blue sea as on the pred. she was becoming overweight and had become like a junkie to food, even raiding the house when and if she could. She had other symptoms from it too, it seemed to effect her breathing.

I do not want to scare people but this is what happened to her; After two years on this low dose she came down with pancreatitis and nearly died. I no longer give her the pred., she is on a special diet for the rest of her life, still not 100% in her health. As for the grass I have been forced to fence them off from it. It is far from ideal but now their territory is an area of concrete and an area of pebbled garden. We have a huge lawn and they cannot run on it . She is seeing a dermatoligist but it is a slow process for us as we are still getting over the hospital bills from the pancreatitis. One can only do the best they can with what they have.

ETA PS Zayda, what a handsome boy!

Edited January 10, 2010 by WhiteEagle

[*Avanti*]

Whoops, double post!

Edited January 10, 2010 by WhiteEagle

[zayda_asher]

Thanks for posting White Eagle... sorry you are having such a rough ride... Kikuyu is a very common allergen... something you may consider is swapping your grass... We have Sir Walter, it works well for a lot of people as its a sterile male plant, so no pollen. Some dogs do still get a contact reaction from it, so maybe if you know someone with it you can let the dogs romp on their lawn and see how they go? Good luck!

[zayda_asher]

Wow Zayder, for such an allergic boy, he looks great! Well done and looks like all your time, effort and money is worth it.

Thanks mate!! We do work really hard to keep them in good condition, but its more than worth it as you would know! Zayda is 8 next week, and I'm really proud of both of them...

[zayda_asher]

ETA PS Zayda, what a handsome boy!

Thanks!

[zayda_asher]

Thanks for posting White Eagle... sorry you are having such a rough ride... Kikuyu is a very common allergen... something you may consider is swapping your grass... We have Sir Walter, it works well for a lot of people as its a sterile male plant, so no pollen. Some dogs do still get a contact reaction from it, so maybe if you know someone with it you can let the dogs romp on their lawn and see how they go? Good luck!

Did I read right that you are working with a dermatologist? Have you done intradermal testing? I would think immunotherapy, antihistamines and atopic may be options for you as well (unless of course you've tried without success etc.).

[*Avanti*]

Did I read right that you are working with a dermatologist? Have you done intradermal testing? I would think immunotherapy, antihistamines and atopic may be options for you as well (unless of course you've tried without success etc.).

Those things are still on the cards, I'm intersted to try the immunotherapy. Antihistamines don't seem to help at all in her case.

At the moment I am trying to build her strength up a little. She is underweight now and seems generally a bit frail and has been since the pancreatitis. She also is due to have a broken molar extracted and I am dreading having to have her put under an anesthetic atm.

Grass change is not feasible, we might move in the longer term instead.

Anyway enough about us, love the other pics too, and the smiles!

.

Edited January 10, 2010 by WhiteEagle

[zayda_asher]

Did I read right that you are working with a dermatologist? Have you done intradermal testing? I would think immunotherapy, antihistamines and atopic may be options for you as well (unless of course you've tried without success etc.).

Those things are still on the cards, I'm intersted to try the immunotherapy. Antihistamines don't seem to help at all in her case.

The immunotherapy is Zayda's saviour... works really well for her and she is a terrible mess when off it. It worked well for Asher, until he sensitised to it and couldn't tolerate it any more. So in my experience it is definitely worth a try, hopefully you get a "Zayda like" result and it helps your girl out.

Pity the antihistmines didn't do much, some dogs just really don't get benefit from them. First Time Puppy Owner had that experience with her dog, but found the atopica worked very well in their case... so it might be worth dropping her a PM to chat about the atopica as another potential treatment.

At the moment I am trying to build her strength up a little. She is underweight now and seems generally a bit frail and has been since the pancreatitis. She also is due to have a broken molar extracted and I am dreading having to have her put under an anesthetic atm.

Grass change is not feasible, we might move in the longer term instead.

Good luck with it all... sounds like the poor girl is in the wars... I hope it all goes well. Zayda had a molar removed last year and it was a pretty big op... we had her given fluids thought the procedure, which definitely helps.

We're prepping to buy sometime this year / next year and things like grass and no carpets are all on the list of things to look for to maximise a nice, clean environment for all us allergy sufferers! Its a good opportunity really!

love the other pics too, and the smiles!

Thanks again! :D