When I talk about steroid therapy, I'm not talking about the illicit use of anabolic steroids like testosterone by athletes. I'm referring to catabolic steroids that are, in my opinion, wildly overprescribed by conventional veterinarians. Steroids are incredibly powerful drugs that can have very serious side effects most pet parents aren't aware of.
Two Types of Naturally Occurring Steroids
There are two primary types of naturally occurring steroids secreted by your pet's adrenal glands. The first are called mineralocorticoids, which are produced in the outside layer of the adrenal glands and secrete the hormone aldosterone, which is used by the body to regulate electrolytes.
The second type of naturally occurring steroids produced by the adrenal glands are called glucocorticoids, or cortisol. These are very important hormones that influence your dog or cat's metabolism and immune system function.
Synthetic versions of these glucocorticoids are the drugs most often overprescribed by veterinarians, either for oral use in pill or tablet form or by injection. There are a number of these drugs available and they usually end in "-one," such as prednisone, prednisolone, dexamethasone, and betamethasone.
Why Steroids Are Prescribed So Often in Veterinary Medicine
Pets prescribed steroids usually have one of three health-related problems, the most common of which is inflammation of any kind (more about this shortly). The least common reason your pet might end up on glucocorticoids is to treat an emergency.
If your dog is hit by a car, for example, and suffers acute brain swelling as a result, the emergency clinic veterinarian will use steroids to very quickly control the inflammation caused by the traumatic brain injury. In these situations, we're very thankful for the existence of steroids because they literally save lives.
Another very common reason steroids are used in veterinary medicine is to intentionally suppress the immune system in an animal with autoimmune disease. Autoimmune disease, also called immune-mediated disease, involves a confused immune system that attacks rather than defends the body.
In these situations, steroids are used to intentionally turn the immune system off to achieve symptom relief, and sometimes, to save the animal's life. The hope is that when we wean the patient off steroids, the immune system resets to a balanced state.
However, the most common reason, hands down, for putting a pet on steroids is neither of the above potentially life-threatening situations. The most common reason veterinarians prescribe steroids, usually prednisone, is to manage an inflammatory response that is typically not life-threatening.
Inflammation is a common reason for veterinary visits. If your dog or cat is dealing with an "-itis" disorder such as dermatitis, which is inflammation of the skin, or enteritis (inflammation of the small intestine), otitis (inflammation of the ear canals), or perhaps colitis (inflammation of the colon), most conventional vets will prescribe a course of steroids.
We aren't really taught in veterinary school how to diagnose the root causes of inflammation, so most conventional veterinarians prescribe steroid therapy for symptomatic treatment.
Pets with any of the conditions that come under the umbrella of inflammatory bowel disease also often end up on steroids, as do pets with skin conditions, allergies, inflamed gums or eyes, asthma and upper respiratory symptoms. Even some types of cancer – lymphoma and mast cell cancer, for instance – create massive inflammation and veterinarians routinely prescribe steroids for these diseases.
Steroids are among the most potent and effective drugs available to manage symptoms stemming from an inflammatory condition. I was told in veterinary school 25 plus years ago that "no animal should die without trying steroids first." Many veterinarians live by that mantra throughout their careers.
In fact, the first veterinarian I worked for in Chicago kept small packets of steroids and antibiotics — prednisone and amoxicillin — 20 pills each, in his exam rooms because he prescribed them so routinely.
Steroid Therapy Downsides
The downsides of synthetic steroid hormones like prednisone and others is they have a very long list of side effects, some of which can, over time, create a host of serious health problems that pet parents aren't informed about. One of the biggest drawbacks to steroid use is that over time, even maintenance doses can turn the immune system off or cause immunosuppression.
The negative consequences of a suppressed immune system are vast. Your dog or cat can have a very hard time fighting secondary infections, including being able to manage naturally occurring yeast and bacteria on the body. Other side effects of steroid therapy can include increased hunger and thirst; increased urination; lethargy; gastrointestinal (GI) problems, including ulcers; and hair loss.
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.
Steroids Treat Only Symptoms — Not the Underlying Cause of Symptoms
For me, the most significant issue with overuse of steroids is that the underlying condition causing the symptoms is often never identified. It's important to remember that inflammation is symptom of a deeper issue that needs to be addressed. When steroids are used to treat a symptom like inflammation, but no effort is made to identify the underlying cause of the inflammation, it will get worse over time.
In addition, steroid therapy can at some point become ineffective at treating symptoms. This typically doesn't mean the drug isn't working anymore, but that the animal's body has adapted to it while the underlying condition has grown progressively worse to the point that the steroids are no longer effective.
In veterinary school, students are trained to prescribe steroids when patients present with inflammatory conditions. We're trained to focus on alleviating symptoms rather than finding and treating the underlying cause. So, if you're tempted to blame your veterinarian for prescribing steroids, it's important to realize that's exactly what he or she was trained to do.
Conventional medicine for both people and animals is about treating symptoms rather than the cause of the symptoms. And believe it or not, it's not uncommon for pet parents to be unaware the drug their dog or cat is receiving is a steroid.
Veterinarians frequently refer to a dose of steroids as an "anti-inflammatory shot," or an "allergy shot," or an "injection of cortisone."
If you don't realize your pet is taking steroids, or you're not knowledgeable about what they can do to the body, you can end up surprised and heartbroken to learn of the side effects that result from steroid therapy. So, the ball is in your court as your pet's advocate to always ask your veterinarian for the specific name of the drug he or she is prescribing, and the known side effects.
Steroids are very inexpensive when 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.
However, if you're a pet parent who has unknowingly given your pet steroids and this isn't what you intended to do, I do recommend that you talk to your veterinarian about creating an exit plan for these drugs. It will require a slow weaning process to avoid an adrenal crisis, especially if your dog or cat has been on them for a while. You can't just stop cold turkey.
Instead of Giving Your Pet Steroids, Consider an Alternative Approach
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. This is when finding an integrative veterinarian — either in person or via phone consultation — can be absolutely invaluable.
Natural alternatives to glucocorticoids do exist, but unfortunately, only certain integrative and functional medicine veterinarians who have continued their education past veterinary school are familiar with them. Most veterinary schools don't offer integrative medicine courses, so students are taught only about conventional pharmacological drugs.
Until veterinary schools offer integrative medicine courses, their students will graduate without a full toolbox of nontoxic therapies — such as, for example, plant-based cortisol — to offer their patients.
When I treat inflammatory conditions, in addition to running diagnostics to determine the underlying cause, I also want to make my patients feel better. So, I may use a variety of effective drug-free remedies such as plant sterols, proteolytic enzyme therapy, homeopathics, Chinese herbs and other herbal compounds, and/or acupuncture to manage symptoms.
In closing, it's important to ensure that your dog or cat isn't receiving steroid treatment for an extended period of time, or just because your veterinarian doesn't really know what's going on.
If your pet is taking steroids but isn't improving, I strongly recommend getting a second opinion from a well-trained integrative or functional medicine practitioner who can provide nontoxic alternatives to alleviate your pet's symptoms and begin the process of uncovering what is causing those symptoms in the first place.