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Q: Canine Prednisone Dosage ( Answered,   0 Comments )
Subject: Canine Prednisone Dosage
Category: Health > Medicine
Asked by: zeusguardian-ga
List Price: $75.00
Posted: 14 Jul 2006 08:05 PDT
Expires: 13 Aug 2006 08:05 PDT
Question ID: 746290
Our 5.5 year old Labrador Retriever has been diagnosed with a large
osteochondroscarcoma in his skull.  The sheer size is putting pressue
on his brain and he's been prescribed high dosages of Prednisone to
reduce the inflammation.  Prednisone is a powerful catabolic steroid
with several well-known nasty side effects.

He weighs 90 lbs and has been taking 60mg of Prednisone daily for five
weeks which is considered a very high dosage.  Aside from Pepcid AC
and Sucralfate which are used to protect the digestive tract from the
Prednisone, no other drugs are being used.

My question(s) are:

1. What dosage levels are considered problematic and/or toxic?
2. What is an acceptable time period at this dosage before serious problem occur?
3. What alternative drugs (other than Piroxicam) might be used to
accomplish the same effect i.e strong anti-inflammatory?  This can
include either prescription steroids or Traditinal Chinese Medicine

Subject: Re: Canine Prednisone Dosage
Answered By: crabcakes-ga on 15 Jul 2006 02:33 PDT
Hello Chris,

First, I?d like to say how sorry I am for your dog and you. 

Wendy Sokol, DVM wrote, on one RXList page:  ?I am a veterinarian in
Atlanta. I just want to assure you that the dosage is correct. Even
with the same drug, dosages in people are very different than dosages
in dogs. The immune dose of prednisone is 1 mg/lb.?

Going by just this comment alone, your dog?s prescribed dose is well
within normal limits.

According to Pet Place, the dosage your vet has prescribed is correct.

?  Doses of prednisone vary widely depending on the reason for prescribing.
?    Anti-inflammatory doses range from 0.1 to 0.3 mg per pound (0.2
to 0.6 mg/kg) up to twice daily.
?    Immunosuppressive doses range from 1 to 3 mg per pound (2 to 6
mg/kg) up to three times daily.
?    Doses for various diseases range between 0.1 to 3 mg per pound
(0.2 to 6 mg/kg).
?    The duration of administration depends on the condition being
treated, response to the medication and the development of any adverse
effects. Be certain to complete the prescription unless specifically
directed by your veterinarian. Even if your pet feels better, the
entire treatment plan should be completed to prevent relapse.?

    Osteochondrosarcoma is a very rare tumor in dogs. ?Chondrosarcoma
(CS) is the second among primary bone tumors in dogs and the third in
cats. Multilobular osteochondrosarcoma (MLO) usually arises from the
skull. It is uncommon in dogs and only few cases of this neoplasm were
described in cats. In osteochondromatosis (multiple cartilaginous
exostosis, MCE) multiple bony exostoses are seen in young dogs usually
on vertebrae, ribs and long bones. Adult cats may be infrequently
affected, mainly in cranial bones. The bony enlargements may cause
musculoskeletal or neurological dysfunction. It is considered to have
viral etiology and not to be a true neoplasm. CS, MLO and MCE usually
appear as rapidly progressing, conspicuous, hard swelling over
affected areas, sometimes painless. All these lesions have aggressive
behavior but not as invasive as osteosarcomas. Chondrosarcoma is
considered to be slowly metastasizing tumor. MLO has the potential to
recur locally following incomplete resection and metastases can occur.
Surgical resection with wide margins is the best treatment and often
results in long-term bone neoplasm control.?

   ?Additionally, the dosage for steroids usually changes with each
animal over time. The animal is usually started at a high or 'loading'
dose for a few days, and is then dropped to a long term maintenance
level. Finally, a reduced dosage is utilized that slowly weans the
animal's body off the medication. During the maintenance stage, it is
preferred to use oral medications and give them only every other day
in the morning. This also reduces the chance of suppressing the
hypophyseal/pituitary gland feedback system on the adrenal glands.
By gradually decreasing the level of steroids at the end of the
treatment, veterinarians greatly reduce or eliminate potential
problems with the adrenal glands being unable to function normally as
described above.?

   ?Corticosteroids, when used judiciously, are an important
therapeutic modality....perhaps a veterinary medicine.
However, overuse or misuse particularly in dogs*, can result in
long-term undesirable effects, not the least of which is a shortening
of lifespan. To minimize risk and maximize benefits, it is extremely
important that when treating your pet with these drugs, you follow
your veterinarian's directions regarding dose, frequency ( which may
vary over days, weeks, months) and duration (length of treatment)
EXACTLY as prescribed. The following is a brief, somewhat simpleminded
overview of this subject, with particular emphasis on those factors
bearing directly on the efficacy and safety factors which you, as a
responsible pet owner, are entitled to appreciate.?
?Immune Suppression/Neoplasia
?	immune-system mediated diseases (various skin disorders, muscle and
joint disorders, blood and marrow disorders)
?	neoplasia (part of chemotherapy protocol for specific forms of cancer)

   One study showed dogs reacted well to long term prednisone therapy:
"The 5 dogs with secondary hypoadrenocorticism received only
glucocorticoid replacement therapy (prednisone) at initial and final
daily dosages of 0.41 mg/kg and 0.25 mg/kg, respectively, during a
median treatment period of 4.4 years. More than 80% of the dogs were
considered to have a good to excellent response to therapy. The median
survival time of all 205 dogs was 4.7 years. There were no differences
in response to treatment or survival between dogs treated with
fludrocortisone and those receiving DOCP, or between dogs with primary
hypoadrenocorticism and those with secondary hypoadrenocorticism.

   ?Glucocorticoids: The previously mentioned cortisol belongs to the
glucocorticoid group. The members of this group get their name because
they affect glucose metabolism and are produced by the cortex section
of the adrenal glands. The glucocorticoids are the predominant
steroids used in veterinary medicine. These naturally occurring
steroids cause proteins (e.g., muscles) and lipids (e.g., body fats)
to be chemically broken down and converted into glucose. This is why
the glucocorticoids are also referred to as the "catabolic" steroids.
Catabolism means to break down large molecules into smaller ones.
Additionally, the glucocorticoids also cause carbohydrates stored in
the form of glycogen to be converted back to glucose and deposited
into the circulating blood. There it is available to all the body's
tissues. To break down the proteins or fats of the body may seem
harmful to the animal, but remember that glucose is the main energy
source for all of the body's activities. The vast majority of the
glucose that the body utilizes comes directly from the diet or stored
glycogen, but in emergency situations it can be derived from its own
protein and lipids. It is generally thought that the glucocorticoids
only cause this to occur to a significant degree during periods of
exceptional need.

Glucocorticoids also suppress inflammatory processes within the body.
A bruise, bee sting, bacterial infection, or arthritis are just a few
examples of inflammation within a pet's body. Inflammation is
specifically defined as an area of the body characterized by redness,
swelling, heat, and pain, often with impaired function. The warmth and
redness seen in these affected tissues comes from an increase in the
number and size of blood vessels within the area. The swelling (edema)
is caused by free fluid within the tissues and also the engorged blood
vessels. All of these changes are brought on by physical trauma and/or
irritants within the tissues. The pain is caused by the swelling, by
harmful substances putting pressure on, or by stimulating the local
nerve fibers. The loss of function can be caused by pain or the simple
inability of the body to move or act correctly.?

?Cancer treatment: Some forms of cancer such as lymphosarcoma and mast
cell tumors respond to high doses of glucocorticoids, or
glucocorticoids combined with other medications.?
Please refer to the link below for complete information.

Side effects of prednisone:
?Increased water consumption and increased urination: are two of the
most common side effects of glucocorticoid usage. Although it can be
quite disconcerting to the owner of a pet that lives predominately in
the home, it is not by itself a serious problem. Glucocorticoids
increase the activity of the glomeruli, which are the filtration units
of the kidneys. This causes the animal to excrete higher levels of

Changes in attitude and appetite

Abortion: If given to an animal during pregnancy, glucocorticoids can
cause an abortion.

Immune suppression: During use, and for a period thereafter, higher
doses of glucocorticoids will suppress the immune system to some
degree and therefore make the animal more susceptible to viral,
bacterial, or fungal diseases.

Changes in protein metabolism: Glucocorticoids will alter the animal's
metabolism of protein and can easily lead to muscular weakness or

Pancreatitis: There may be a relationship between the use of
glucocorticoids and the development of pancreatitis, however, it has
not been proven.

The above list of potential side effects may frighten the average pet
owner. They are, however, the exception. The vast majority of all
cases in which steroids are used correctly provide great benefit to
the pet without any serious side effects occurring. When serious
problems do occur, it is usually in cases in which steroids were
administered over very long periods of time or at excessive doses.
Large single doses or short-term use at normal levels rarely, if ever,
causes a serious problem unless there is some pre-existing condition
such as diabetes, pregnancy, or heart disease.?

?Prednisone and prednisolone are both three to four times stronger in
their anti-inflammatory effects as cortisol. They have been used for
decades and their action is often easier to predict than some of the
stronger preparations. Methylprednisolone and triamcinolone are newer
synthetics with about five to seven times the strength of cortisol in
their glucocorticoid effects. Dexamethasone and betamethasone are the
powerhouses of steroids. They are thirty to thirty-five times more
powerful than cortisol in their effect on inflammation.?

   ?You should keep your veterinarian informed as to your dog's health
and activity level. The prednisolone dosage may have to be lowered if
you notice lethargy, weakness, frequent infections, runny eyes,
elevated heart rate, excessive weight gain or other abnormal symptoms.
Any pet on a steriod should be closely moniorted by the veterinarian
with regular visits, and good communication from owner to doctor
between visits. Keep in mind, your veterinarian assumes all is going
well if you don't call.?

   ?Prednisone and other corticosteroids may cause other side effects, as well. 
Hairloss, dullness or thinning of the haircoat is occasionally seen in cats. 
Thinning of the skin and increased susceptibility to skin infections may 
occur. Panting is commonly seen in dogs as a side effect of corticosteroid 
use and is seen less frequently in cats, as well. We have had a couple of 
feline patients who developed diarrhea as a side effect of prednisone usage. 
Ulcers are reported to occur sometimes after corticosteroid usage but I 
don't recall seeing this problem in any of our patients. 
Generalized immune suppression can occur, particularly at higher 
corticosteroid doses or with frequent administration of corticosteroids. 
This is the side effect that we worry the most about in cats, as there is 
some evidence that corticosteroids can make it possible for dormant feline 
leukemia virus or herpes virus infections to reappear. It is a good idea to 
watch carefully for signs of illness when it is necessary to use 
corticosteroids in a cat and to report any signs of illness to your vet as 
soon as possible.?

   ?Prednisone is known to produce a "steroid psychosis" in some
people. To the best of my knowledge, no one really knows for sure if
this occurs in dogs, but I believe that it does. I have seen two or
three dogs with really strange behavior when they were on prednisone
that cleared up consistently when they were not on prednisone.?

   ?It is best, whenever possible, to use prednisone on an every other
day basis when it must be used long term. There are situations,
including some of the spinal diseases, in which this isn't possible if
a beneficial effect is to be maintained. In these cases it is
sometimes really hard to figure out how to handle the negative side
effects. At least for the ulcers some protection can be gained by
using cimetidine (Tagamet tm), famotidine (Pepcid AC tm) or other
gastrointestinal protectant medications.?

   ?It usually takes very long term use of prednisone or other corticosteroid 
medications before side effects that might lead to kidney damage occur. If 
prednisone is helpful for your rottweiler's problem it is probably best to 
go ahead and use it as your vet advises.?

?Your dog's body can not really tell the difference between types of
cortisones and if a sufficient quantity of cortisone is in the body,
the endocrine system suppresses cortisone production by the adrenal
glands. The amount of cortisone administered orally as prednisone is
almost always well in excess of what the dog's body would produce
naturally. So giving it daily suppresses the adrenal glands. Over
time, this suppression causes the gland to have a difficult time
making cortisone when a sudden demand is placed on it. This is a
problem when cortisone is withdrawn rapidly and can even result in the
death of the dog. If the cortisone is never withdrawn this effect is
not as worrisome but it is very important to keep it in mind.

High levels of cortisone in the body produce several other problems
over time. Skin damage can occur, resulting in skin sores known as
calcinosis cutis, thinning of the skin and hairloss. Suppression of
the immune system occurs, making bacterial infections more likely.
Increased drinking and urination can become a problem. Muscular
weakness can occur. Pancreatitis is more common in dogs on long term
cortisone therapy. These side effects are minimized but not completely
eliminated by every other day use of prednisone. In any situation in
which long term use of prednisone is anticipated, these things must be
considered as possible side effects. These effects are probably more
important than the adrenal suppression in most patients.

Despite all of this, I will use prednisone on a daily basis when it is
the best medication for older dogs with arthritis, especially when
they are at or near the point where the owners would consider
euthanasia without the benefits of the medication. My reasoning in
this instance is that side effects may take a long time to develop
into a problem and any time past the time euthanasia is being
considered is better than none. Now that carprofen (Rimadyl Rx) is
available there is an alternative to prednisone for some patients and
we are making this decision a little less often than in the past.

Ultimately, you have to decide what is best in this situation since
you are in the best position to judge the importance of using the
medication every day. Your vet is correct that alternate day dosing is
best in most circumstances but there are times when it is appropriate
to make exceptions.?

   ?Treatment for primary bone tumors of the long bones is divided
into "palliative" and "curative-intent". Palliative treatment is
intended to provide pain control and improve quality of life but not
necessarily prolong life. In contrast, the aim of curative-intent
treatment is to provide a good quality of life while controlling the
local tumor and minimizing the risk of metastasis in an effort to cure
the tumor. However, it must be stressed a true cure (long term
survival without regrowth or spread of the tumor) for long bone
osteosarcoma is achieved in less than 25% of dogs.

Palliative treatment options include pain-killing drugs, radiation
therapy, and surgery. Many drugs have pain-killing (or analgesic)
properties but the degree of analgesia provided by these drugs can
vary. Non-steroidal anti-inflammatory drugs (deracoxib, carprofen,
meloxicam, and others) are usually effective initially, although
stronger analgesic drugs (such as codeine, morphine, or fentanyl
patches) or drug combinations may be required as the tumor progresses.
Radiation therapy can be used to reduce pain and inflammation alone or
in combination with other pain-killing drugs. The bone tumor is
irradiated using various protocols; the most common are either once
weekly radiation for 3 to 4 weeks or once monthly radiation. Lastly,
the affected limb can be amputated if the bone tumor is very painful
or fractured.?

I am not a vet, nor would I recommend online treatment if I were, but
is it possible that your vet is providing your pet with palliative
care? Meaning, the goal would be to provide your pet with as
comfortable a life as possible, for as long as he has,. If so, long
term effects of prednisone would not be of a great concern.

   It does not appear that NSAIDS such as Deracoxib  or Meloxicam
would reduce swelling as effectively as

  Has your vet ruled out surgery for your pet? ?Of the 12 treated
dogs, 7 (58%) had local recurrence, with median time to recurrence of
14 months. Seven dogs (58%) developed metastatic disease after
treatment, with median time to metastasis of 14 months. The median
disease-free interval was 12 months, and the median survival time was
21 months. Excision with histologically complete surgical margins
appeared to offer good opportunity for long-term tumor control. The
role of adjuvant chemotherapy and radiotherapy in the management of
MLO remains unclear.?

   I was unable to find any Chinese herbal ?remedies? for your pet.
Since these herbal remedies are not tested for humans, it is unlikely
they have been tested for canine use. I would be extremely hesitant to
use herbal remedies in a dog. Some plants that are not toxic to humans
may be so to animals. If you feel strongly about using any alternative
therapy, I would seek out a vet that is familiar with botanicals in

  When the time comes to stop using prednisone, ask your vet how to
taper the drug off slowly. Do not abruptly stop prednisone. Prednisone
will also increase your dog?s thirst, so be sure to provide plenty of
fresh water for him. Your dog should also be monitored regularly with
blood tests to check for liver and kidney function, along with a CBC.

Additional Useful Links

I hope this has helped you out. If not, please request an Answer
Clarification, and allow me to respond, before you rate. I will be
happy to clarify further, before you rate. From one dog lover to
another, please give your dog a belly-scratch for me!

Sincerely, Crabcakes

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Canine cranial osteochondrosarcoma
prednisone + canine + dosage + osteochondrosarcoma
prednisone + veterinary dosages
osteochondrosarcoma + Chinese herbal medicine
canine cranial osteochondrosarcoma + alternative therapies
long term prednisone therapy + dogs
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