Cortisone Usages by Frank Utchen, DVM

Dr. Utchen, the vet said she wanted to give my dog a shot of steroids. Is this the same thing athlete’s abuse? 

Answer:
No, due to an unfortunate similarity in terms, the performance-enhancing drugs that athletes abuse, and the type of steroids doctors and veterinarians commonly prescribe, sound the same, but are actually very different drugs with entirely different effects.  

Performance-enhancing steroids are correctly referred to as “Anabolic Steroids”, meaning they cause the body to build more tissue through metabolism. These unfortunately have numerous side effects, including “steroid rage”, acne, hair loss, high blood pressure, strokes, increased risk of ligament and tendon injuries, and a risk of liver damage, to name a few.

The type of steroids that your veterinarian is suggesting is most likely correctly called “Corticosteroids” or sometimes simply “Cortisone.” This type of steroid has an entirely different set of effects—some good and some bad.  

The most common uses for corticosteroids are to suppress allergies and to reduce inflammation.  

Used judiciously, for short periods, this is a very good medicine, and usually the only unwanted side effects are an increase in urine production and generally and increase in water intake and in appetite. 

Used indiscriminately or for extended periods of time (weeks or months) this medication can have its own set of significant unwanted side effects. These include increased body fat, muscle weakness, delayed healing of injuries, suppression of the immune system, and possible stomach ulceration, to name a few. 

Because corticosteroids work so well for allergies and for various inflammatory conditions (muscles, joints, etc.) there is a temptation to continue administering it whenever a similar problem occurs. This is not wise. As spring time comes into bloom, dogs and cats experience the same kinds of allergies people do, and cortisone can work wonders to shut down the extreme itching that can result. However, a short course of cortisone is generally all that is recommended, and better treatments for allergies in pets involve using antihistamines (safer, but not as effective as cortisone), a combination of a small amount of cortisone with an antihistamine (as effective as a full dose of cortisone, but more costly), or a drug called cyclosporine (equally effective as cortisone, but much more expensive). Dogs and cats can even be tested to find out what they are allergic to and then can receive true allergy shots like people do.  

There are some diseases for which the only treatment is cortisone administered in high doses. These are serious, potentially life-threatening diseases, and the choice to use cortisone in these cases is made out of necessity, where its use is best viewed as the lesser of two evils. 

I discuss these various aspects of “Steroid” use (cortisone, that is) with my clients any time we are faced with a situation where its application would be of potential benefit to a pet, so that a pet owner can make an informed decision. I would encourage you to discuss this with your veterinarian also.