Steroids: Friends or Foes?

By Joel Kaye, DVM

Angell Animal Medical Center

angell.org/generalmedicine

617-522-7282

What are steroids?

Corticosteroids are a class of hormones that are produced by the Adrenal Gland. They are involved in a variety of activities in the body including: response to stress; immune system function; control of inflammation; nutrient metabolism; and maintenance of sodium, potassium and water balance.

The adrenal gland produces two forms of steroids

• Glucocorticoids: These control carbohydrate, protein, and fatametabolism. They also aid in reducing inflammation. These are catabolic ‑ or break down functions ‑ which differ from anabolic or building steroids that athletes sometimes use.

• Mineralocorticoids: These control electrolyte and total body water levels. An example is aldosterone.

Despite the body’s natural uses for steroids, we rarely use them for these purposes. We mostly use steroids for their anti-inflammatory properties; specifically man made analogues such as prednisone, dexamethasone and methylprednisolone. Depending on dose, steroids can aid in:

1. Controlling inflammation
2. Immune system suppression
3. Cancer chemotherapy
4. Control of central nervous system disorders. Usually after trauma or disc protrusion to relieve swelling
5. Blood calcium reduction

Unfortunately, despite all the good they do, steroids do have side effects. The side effects can be classified into two types:

  Short term side effects: Less than four months

1. Increased Hunger
2. Increased thirst and subsequent urination and urinary accidents
3. Panting (dogs)
4. Decreased energy
5. Hidden infections being unmasked due to lowered immunity
6. In cats predisposed to diabetes, steroids can tip them into clinical disease
7. Animals with preexisting cardiac disease can be pushed into failure due to fluid accumulation

Most of these side effects can be controlled with dose reduction or cessation of medication.

  Long term side effects: Greater than four months

1. Latent urinary infections: It is important to monitor a patient’s urine for infection when on long term steroids. Since steroids suppress inflammation, you will not see the typical symptoms such as straining to urinate, increased frequency or blood in the urine. Left untreated the infection can spread up to the kidneys and beyond.
2. Hair loss, thinning of the skin, black heads on the skin, and poor wound healing
3. Obesity, potbellied appearance, muscle weakness
4. Hard plaques on the skin called calcinosis cutis

All of the above signs are the same as a naturally occurring disease called Cushing’s disease. This is caused by an overproduction of steroid by the adrenal gland either autonomously or secondary to over activity of the pituitary gland in the brain.

It is imperative that if your pet is on long term steroids, they be monitored closely by your veterinarian. The goal of all long term steroid use is to find the lowest dose and least frequency of administration that is effective.

Glucocorticoids can be lifesaving medications and can improve the quality of life of many pets.  By working closely with your veterinarian, you can safely administer this drug and give your pet the quality of life they deserve.

For more information, please contact Angell’s General Medicine Service at 617-522-7282.