Steroid Use in Cats: Is it Dangerous?

Nov 11, 2012 by Dr Elyse Kent    37 Comments    Posted under: Tips & Advice

Ms. Worry set up a consultation with me, Dr. Catz, to discuss the use of Prednisolone in her cat, Hershey Squirts.  My manager, Ms. E. Calm held the phone far away from her ear as Ms. Worry screamed that she thought the prescription from Dr. Catz for steroids would shorten Squirts’ life. Ms. Worry said her mother’s face had become permanently bloated and she had terrible mood swings when she was prescribed steroids for her asthma.

What are steroids?

Steroids are natural substances produced by the adrenal glands.

Corticosteroids are the type used for therapy in cats. Anabolic (performance-enhancing) steroids are not used in feline practice.

There are also synthetic steroids that are used to treat a variety of feline diseases.  The most common steroids used in feline medicine are prednisolone, dexamethasone, triamcinolone and budesonide.  Methylprednisolone is a slow release “repositol” steroid that is largely no longer used in cats since the risk is much greater for potential adverse effects than with thee shorter acting oral steroids.  Once given, a long acting injection can’t be reversed.

Steroids have potent anti-inflammatory and anti-allergic effects.

Some of the allergic conditions treated successfully with steroids in cats:

• Allergic reactions to environmental stimuli, either by contact or inhalation
• Flea allergic dermatitis
• Allergic bronchitis
• Allergic reactions to bee stings or spider bites

Inflammation causing acute or chronic pain can be treated with steroids:

• Osteoarthritis
• Trauma, especially to the head
• Disc problems
• Soft tissue injuries like sprains or strains
• Gingivitis

Prednisolone is often used in combination with other drugs for cancer treatment in cats.

Steroids may be used to stop the process of immune-destruction by slightly reducing an overactive immune response.

Some of the diseases in this category are:

• Stomatitis (inflammation in the mouth)
• Pemphigus (skin disease affecting ears, nose and anus)
• Autoimmune hemolytic anemia
• Certain kidney diseases

Corticosteroids are not “strong” medicines and are commonly used very effectively in treating many disorders in feline medicine, ranging from minor to life-threatening problems.

Most of the time, relatively high doses are used initially to achieve an effect, then tapered to the lowest dose and frequency needed to keep clinical signs at bay. Tapering allows the body to adapt to having the steroids removed from the body. Sometimes steroids can be stopped entirely at the end of the taper and other times are they are required long term. Some are started up as needed on a “pulse” or temporary basis when a disease “flares up”

Fortunately, cats are extremely resistant to the side effects of steroids.

The annoying side effects that dogs may experience rarely if ever occur in cats unless a profound overdose of steroids are prescribed.  The common side effects in dogs are increased hunger, thirst and urination, panting, pot-bellied appearance, lethargy,  and thinning of the skin.

Adverse effects of steroids in cats are relatively uncommon and almost always reversible.

The most common potential adverse effect of steroids in cats is diabetes mellitus.  This usually only occurs in cats that are already predisposed to diabetes, especially in those who are obese and/or on high carbohydrate diets. A feline doctor will require a baseline blood glucose level prior to starting corticosteroids and will monitor blood glucose levels periodically as long as the drug is continued.  The interval between glucose tests is dependent on the risks in a given patient as well as the dose required to control disease in that cat. If diabetes does show up secondary to steroid use, it will almost always go away after the drug is tapered and discontinued.   Some steroids have less systemic (whole body) side effects, notably budesonide when compared to the more commonly used prednisolone, and can still be used safely in some patients who have become diabetic while on prednisolone.  Also, steroid inhalers used for allergic bronchitis (Feline Asthma) have fewer systemic effects than oral steroids.

A less common side effect of corticosteroid use is to uncover hidden congestive heart failure (CHF).   If heart disease is undetected (occult), especially if a heart murmur is not heard, fluid can rapidly fill up the lungs causing labored breathing and distress after a steroid injection is given. If the patient is promptly seen by a vet on an emergency basis and CHF is diagnosed by a chest x-ray, oxygen therapy and diuretic injections generally cause the fluid to be urinated out and an echocardiogram can be performed to further define the heart condition.

One additional potential adverse effect is infection due to immunosuppression if high doses of steroids are needed to control an overactive/destructive immune response (diseases described earlier).  Infections may develop due to less than optimal immunity. Frequently these are upper respiratory infections (cold symptoms).  The combination of tapering and discontinuing use of the steroid and adding in antibiotics generally lead to resolution of the infection without complications.

Ms. Calm directed Ms. Worry to read this blog entry prior to her consult with Dr. Catz.  Ms. Worry reluctantly started prednisolone daily for 14 days and Squirt’s diarrhea resolved.  At his two week recheck, Dr. Catz began to taper the dose and frequency of  Squirt’s medication and explained that half the original dose given every 48 to 72 hours is likely to be well tolerated without serious side effects for the rest of Squirt’s life.

Dr Elyse Kent

Dr. Elyse Kent graduated from Michigan State University College of Veterinary Medicine in 1980 and completed an Internship at West Los Angeles Veterinary Medical Group in 1981.

In her early years in practice, Dr. Kent began to see a need for a separate medical facility just for cats, where fear and stress would be reduced for feline patients. In 1985, in a former home in Santa Monica, Dr. Kent opened the only exclusively feline veterinary clinic in Los Angeles, Westside Hospital for Cats (WHFC). Along with other forward-thinking feline practitioners from across North America, Dr. Kent founded the Academy of Feline Medicine in 1991. Through the efforts of these practitioners, feline medicine and surgery became a certifiable species specialty through the American Board of Veterinary Practitioners (ABVP). Dr. Kent became board certified in Feline Practice in the first group to sit for the Feline exam in 1995. She certified for an additional ten (10) years in 2005. There are now 78 feline specialists in the world. Dr. Kent served as the Feline Regent and Officer on the Council of Regents for 9 years. She is currently the immediate Past President of the ABVP, which certifies all species specialists. She also heads up a task force joining certain efforts of the ABVP with The American Animal Hospital Association (AAHA). She currently serves as a Director on the Executive Board of The American Association of Feline Practitioners.

The present day WHFC facility opened in 2000. It was the fulfillment of a vision for a spacious, delightful, state of the art, full service cat medical center that Dr. Kent had dreamed of and planned for over many years.

Westside Hospital for Cats
2317 Cotner Ave.
Los Angeles, CA 90064

Phone: 310-479-2428

Website: http://www.westsidehospitalforcats.com/
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