When to Say 'No' to Steroids
Wildly overprescribed by veterinarians, steroids can do more harm than good and put your pet at risk for irreversible side effects, even with short-term use. In one study, 90% of dogs showed side effects after only two weeks. Be wary if your vet recommends steroids for any of these conditions.
Analysis by Dr. Karen Shaw Becker
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STORY AT-A-GLANCE
- Catabolic steroids are wildly overprescribed by veterinarians, putting pets at risk of serious — and sometimes irreversible — side effects
- The most common reason veterinarians prescribe steroids, usually prednisone, is to manage an inflammatory response that is typically not life-threatening
- While steroids offer powerful symptom relief, they don't treat the underlying cause of the condition
- By day 14 on steroids, 90% of dogs experience side effects, with increased thirst and increased urination reported most often
- Natural alternatives to steroids exist, but many conventional veterinarians aren't aware of them; an integrative vet can help with symptom relief and addressing the root cause of the issue
Catabolic steroids are wildly overprescribed by veterinarians, putting pets at risk of serious — and sometimes irreversible — side effects. In certain emergency situations, such as traumatic brain injury due to being hit by a car, steroids can quickly control inflammation and save lives.
But often veterinarians use steroids to treat chronic inflammatory conditions like allergies, skin problems or inflammatory bowel disease. In these cases, the steroids may relieve symptoms but they do nothing to address the underlying cause of the disease.
Along with significant side effects like immunosuppression and microbiome disruption, steroids mask symptoms while ignoring the cause of the health problem, allowing it to worsen over time. The end result is likely to be a sicker pet than you had at the start, which is why before starting your pet on steroids, you must weigh the pros and cons carefully, and create a protocol to identify and treat the root cause of the problem while managing your pet, symptomatically.
Be Wary of Giving Your Pets Steroids for an 'Itis' Disorder
Inflammation is a common reason for veterinary visits. Many pets struggle with an "-itis" disorder, such as dermatitis, which is inflammation of the skin, enteritis (inflammation of the small intestine), otitis (inflammation of the ear canals), or perhaps colitis (inflammation of the colon).
Our pets' bodies "talk" to us through symptoms, and inflammation lets us know our pets are having an underlying problem we need to address, not suppress. The problem is most conventionally-trained vets that haven't expanded their medical toolbelts will prescribe a course of catabolic steroids, such as prednisone, to silence their bodies' cry for help, without addressing the root cause. As noted by a 2023 study in BMC Veterinary Research:1
"Corticosteroids are used for many reasons and are commonly used for the treatment of canine dermatitis. While it is estimated 3–15% of dogs have atopic dermatitis, pruritic [itchy] dogs represent up to 30% of dogs presenting to the veterinarian for skin disease.
The anti-inflammatory effects of corticosteroids have led to their use in dogs when underlying allergic dermatitis is suspected, but they often have side effects."
Dermatitis, for instance, can have many causes, ranging from bacterial infection and parasites to immune system disorders, food and environmental allergies and reactions to environmental chemicals. Getting to the underlying cause is essential for healing, but steroids represent a quick-fix solution that stops the symptoms, allowing the root cause to go undiagnosed.
Steroids are also commonly prescribed for autoimmune disease, in order to intentionally suppress the immune system. While this can be useful and even mandatory in some cases, the hope is that with a multi-modal protocol, the animal will be weaned off the drugs eventually and the immune system will reset to a more balanced state.
That being said, steroids are not only powerful at symptom relief but very inexpensive compared to the time and tests required to identify an underlying condition. So sometimes pet parents end up with steroids because they're the cheapest, easiest way to manage symptoms and provide relief to their dog or cat.
In these situations, it's especially important that owners are aware of potential side effects so that if any appear, they can begin tapering their pet off the drug. Also be aware that veterinarians frequently refer to a dose of steroids as an "anti-inflammatory shot," an "allergy shot" or an "injection of cortisone."
Vets may not explain these drugs don't actually treat the cause of problem or even use the term "steroid." If you're a pet parent who has unknowingly given your pet steroids and this isn't what you intended to do, I recommend that you talk to your veterinarian about creating an exit plan for these drugs. It will require a slow weaning process. You may need to add the help of a functional medicine veterinarian or proactive integrative vet, if your vet hasn't sought any additional training in advanced modalities beyond vet school.
After Two Weeks, 90% of Dogs Have Side Effects
When discussing steroid side effects, veterinarians may suggest that they're most likely to occur after long-term treatment. While this is a concern, side effects can occur even after a short course of treatment. In one study of 45 dogs, 74% reported a behavioral change after five days of oral prednisolone and prednisone. Among them, 35% said the changes had "greatly increased."
Behavioral side effects included increased vocalization (or change in behavior), increased thirst, increased urination, increased hunger and rapid panting. Among pet owners, 61% said they noticed they were filling up their pet's water bowel more often while one-third reported cleaning up urinary accidents from pets that didn't typically have accidents in the house.2
Further, by day 14 on steroids, 90% of the dogs experienced side effects, with increased thirst and increased urination reported most often. It's revealing, too, that many pet guardians would choose a safer option if given one. According to the study, "Although most pet owners expressed satisfaction with steroid treatment due to its high efficacy, 70% would select a more costly treatment if that treatment had fewer side effects."3
One of the biggest drawbacks to steroid use is that even maintenance doses can turn your pet's immune system off or cause immunosuppression, when given in perpetuity. The negative consequences of even a mildly suppressed immune system are vast. Your dog or cat may not be able to fight off secondary infections or manage naturally occurring yeast and bacteria on the body. Steroids also disrupt your pet's microbiome.
Other side effects of steroid therapy can include lethargy, gastrointestinal problems, including ulcers, and hair loss. With long term use your pet can also develop a pot belly (which often signals the presence of Cushing's disease), blood clots, and steroid-induced diabetes or pancreatitis.
Natural Steroid Alternatives Are Available
When your dog or cat has a health problem, the goal should be to identify and treat the root cause while relieving symptoms, preferably with nontoxic therapies. An integrative veterinarian can be absolutely invaluable for this.
Natural alternatives to glucocorticoids do exist. Unfortunately, many conventional veterinarians aren't familiar with them because most veterinary schools don't offer integrative medicine courses, so students are taught only about conventional pharmacological drugs.
When I treat inflammatory conditions, I run appropriate diagnostics to determine the underlying cause of the symptoms, while also offering safe solutions to make my patients feel better. For this, I use a variety of effective drug-free remedies with steroidal properties, including plant sterols, the herbs forsythia4 and bupleurum, ginseng, cordyceps and licorice.5
Natural anti-inflammatory protocols can also be instituted during this time, including proteolytic enzymes, curcumin, cat's claw, boswellia, and omega-3 fatty acids (DHA/EPA), for a synergistic effect.
If your veterinarian has prescribed steroids for a chronic condition, or for an extended period of time, a well-trained integrative or functional medicine practitioner can help you to provide nontoxic alternatives to not only relieve symptoms but also reveal the condition's underlying cause.
