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Save Sylvester from Steroids! Rescue Rex from Roids!

08/26/2009

It wasn't discussed in any Congressional hearings, but it's a major problem: the overuse of steroids in veterinary medicine. You need to understand this issue so you can protect your pets.

Of course, I'm not really talking about anabolic steroids, as used by athletes. I'm talking about corticosteroids, also called glucocorticoids. These are medications related to cortisol, a hormone normally produced by the body in minute amounts. There are many kinds of corticosteroid medications, from injections to pills to topical creams; you can often recognize them by the letters -one at the end of their name (prednisone, dexamethasone, etc.) or the phrase cort somewhere in the name. 

Corticosteroids exert effects on virtually every system in the body, such as:

-Suppression of the immune system

-Resistance to the action of insulin

-Thinning of the skin and decreased ability to heal

-Increased acid in the stomach and decreased production of the cells lining the stomach and intestines

-Decreased intestinal absorption of calcium and increased absorption of fat

-Increased fat and cholesterol in the blood

-Decreased bone growth and osteoporosis

-Liver damage

-Muscular weakness

-Fluid retention

-Poor hair growth

As you can imagine, the effects of corticosteroids have the potential to be harmful to your pet if these medications are not used wisely.

There are definitely instances where corticosteroid medications are essential and can be life-saving. I don't want to scare you so much that you avoid giving your pet corticosteroids when it's truly necessary. And sometimes, it really, truly is necessary. However, it pains me to say that in veterinary medicine, corticosteroids are often used as a quick fix, catchall treatment for a variety of symptoms. Your dog's vomiting? Give him these steroid pills. Your cat is having labored breathing? I'll give her a steroid injection. Hang on, folks!

Yes, certain very specific diseases require corticosteroids as a component of therapy. But the kind of rampant, casual steroid use on pets that is currently occurring is wrong, and educated pet parents need to understand the proper use of these powerful medications so they can protect their companions.

Here are some rules that can help minimize the risk to your pet:

A diagnosis should be made prior to corticosteroid administration

Giving a pet corticosteroids without a diagnosiss will obstruct identification of the pet's health problem and may even cause it to worsen. Corticosteroids obscure correct diagnosiss by temporarily alleviating symptoms, and can even make diagnosis of some diseases difficult to impossible by affecting the results of medical tests such as blood work and biopsies.

Another concern with using corticosteroids before obtaining a diagnosis is that by suppressing the immune system, corticosteroids can endanger a pet whose symptoms are in fact caused by an infection.

Long-acting corticosteroids should be avoided if possible.

A long-acting injection is commonly used in veterinary medicine, particularly in cats, and can cause severe side effects, including diabetes. These injections have also been associated with a tumor called fibrosarcoma.  These injections should only be used as a last resort in pets who absolutely require corticosteroids and cannot be medicated in any other fashion.

Other therapies should be used first if appropriate

For some health problems, corticosteroids are the mainstay of treatment, and their use cannot be avoided. But for many conditions, other types of treatment can also be effective, and should be tried before leaping to the use of corticosteroids. For example, a dog with allergic skin disease could be treated with a hypoallergenic diet or antihistamines, or could be referred to a dermatologist for allergy testing and specialized treatment.

Often consultation with the relevant type of veterinary specialist can be helpful in developing treatment plans that minimize or eliminate the need for corticosteroids.

The animal should be monitored closely for side effects, and the corticosteroid dose adjusted if necessary

Visible side effects of corticosteroids include thinning of the hair and skin, pot belly, muscle loss, and in dogs, increased thirst and urination, hunger, and panting. If a particular pet's side effects are dramatic or severe, the dose of corticosteroids should be altered accordingly. 

The animal should first be assessed for issues that may increase the risks associated with corticosteroid use

Animals with certain health conditions are more likely to experience serious side effects of corticosteroid treatment. These health conditions include:

-Heart disease. Corticosteroids may exacerbate the risk of congestive heart failure or clot formation.

-Obesity. Corticosteroids may increase the risk of diabetes or ligament rupture.

-Pancreatitis. Corticosteroids may increase the risk of pancreatic inflammation.

-Infections. Corticosteroids suppress the immune system, so infections may worsen.

-Animals on NSAIDs (nonsteroidal anti-inflammatory medications). These drugs can cause gastrointestinal ulceration, as can corticosteroids, so they should never be used together.

-Animals having surgery. Corticosteroids inhibit healing.

Bottom line: If a vet is about to give your pet an injection, or hands you an envelope of pills, stop him or her and ask "Is this a steroid?" If so, slow down the process, ask for an explanation, and think about the rules above. If you're still uncomfortable, it's never wrong to get a second opinion or see a specialist. Never be afraid to stand up for your right to protect your pet.

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