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Dr. Cathy Alinovi

Are low dose steroids safe?

One method of treating an out of balance immune system is to give low-dose steroids. Steroids at the lowest dose to maintain clinical signs is the definition of low dose. Sometimes, this means every other day. Sometimes this means fraction of a tablet. But is this safe?

One method of treating an out of balance immune system is to give low-dose steroids. Steroids at the lowest dose to maintain clinical signs is the definition of low dose. Sometimes, this means every other day. Sometimes this means fraction of a tablet. But is this safe?

Regardless of how it is dosed, repeated use of steroids suppresses the immune system. Properly termed, steroids are called steroidal anti-inflammatory drugs. Meaning steroids take down inflammation. But the steroids don’t take care of why the inflammation is there in the first place. And secondly, steroids have some pretty impressive side effects, made worse with repeated use.

The immune system’s main function is to fight invasion from bacteria, viruses, and other“foreign” substances like allergens. When the immune system is out of balance different things can happen. These things range from allergies, hayfever, inflammatory bowel disease, rodent ulcers in cats, hotspots, and autoimmune diseases like lupus, and pemphigus.

If we suppress the immune system so that the signs of inflammatory bowel disease or rodent ulcers are suppressed, we are also suppressing the rest of the immune system, the helpful part. The helpful part that prevents infections! The helpful part that regulates normal cell life-cycle.

What does that mean in lay terms? The repercussions of long-term use of steroids can include creation of those diseases we are trying to prevent. Other potential side effects include diabetes, pancreatic disorders, and cancer.

By treating symptoms with low-dose steroids, that’s all you’re doing – treating symptoms. This is the mainstay of conventional medicine – treating symptoms. On the other hand, an integrative veterinarian works to get to the bottom line. The integrative veterinarian works to figure out what is the cause of the disease in the first place so as to prevent it from coming back, rather than suppress the disease with harmful medications. See www.AHVMA.org for a list of integrative veterinarians.

Dr. Cathy Alinovi DVM

As a practicing veterinarian, Dr. Cathy treated 80% of what walked in the door — not with expensive prescriptions — but with adequate nutrition. Now retired from private practice, her commitment to pets hasn’t waned and she looks forward to impacting many more pet parents through her books, research, speaking and consulting work.  Learn more at drcathyvet.com

22 Comments

22 Comments

  1. Erzsi Huffman

    April 8, 2016 at 1:52 pm

    But what do you do with a highly allergic dog, when absolutely nothing else seems to work (not even apoquel!). She is miserable, scratching and biting herself raw. Let her be miserable for the rest of her life, or keep her on a low dose pred – every other day – to keep her happy. Yes, side effects might occur, but they might never happen in her entire life. It is a tough decision an owner will have to make, and I would not want my dog to be miserable, if there is a way I can help. If you have any miracle cure, I would love to know about it.

    • Sherrie Ashenbremer

      April 8, 2016 at 3:02 pm

      Erzsi Huffman, I am in the same boat. Steroid shots, Apaquel, other crappy medicines. Seeing a dog dermatologist, different foods, we have tried Stella & Chewy’s Rabbit, Just Food for Dogs, Venison, Just Food for Dogs Kangaroo, Honest Kitchen Fish, Evermore, I just purchased Answer’s Goat Milk and Answer’s food, I am going to give that a try. If any one has a suggestion PLEASE help both of us

      • Debi Cohen

        April 8, 2016 at 6:22 pm

        Sherry, we also have two allergic dogs, young dogs, I am trying everything like you, to help them, I make their food and I also use Ziwi Peak and used to use Great life limited Buffalo dry until I found out from Susan and Dr. Fox’s article that the Tapioca used in the Great life is REALLY bad for dogs, anyway I am trying local raw honey and give them about a half teaspoon of the wildflower honey mixed with the Mesquite honey once a day, hopefully, maybe this will work, it takes up to a year but if it helps, I will be the happiest person, we are also giving our most allergic one this really expensive serum, right, the only thing that showed up in her allergy panel, blood only, was dust mites! so we are giving her that daily, but at 260.00 every 5 or 6 months if it does not “kick in” in a year, we are done, plus our other dog just gets the honey and they both are on 1/2 of a Claritin tablet twice a day, anyway good luck to you because I definitely feel your pain, double!

      • Debi Cohen

        April 8, 2016 at 6:35 pm

        Sherry, also use the Canadian freeze-dried food called NRG, I use the one without grain, even tho it does have a small amt of wheat germ in it, I do not like the fact that it comes from Canada, the land of no regs., seems like we are heading in that direction, anyway, I have spoken to a lady that has worked for this company for about 10 years, she told me that they were trying like heck to keep this food from purchasing anything that is a GMO product, so check this food out it is really good, smells good, and the 10 lb. box makes 45 lbs of food, have used it for about 10 years and I have one 70 lb dog that is 14 yrs old, b.t.w., I mix this in with the food that I make them, hope this helps. (our dogs still itch but I think that alot of it is inhalant allergies, and it never hurts to feed them well).

        • Dianne

          April 9, 2016 at 11:12 pm

          As a Canadian,, I must point out that we do indeed have regulations, many of them the same as in the States. But corporations, through the trade deals are finding ways to set the standards lower and lower, even in the states. If you read enough of Susan’s posts, you soon realize that it isn’t the regulations that matter, it is whether or not they are being enforced. Anyway, I wouldn’t worry too much, Canada actually does have food safety regulations very similar to yours. In fact, it is getting to the point that our government is using the same regulations as the FDA and seems to be following their lead. I chuckled, I honestly never expected to hear anyone not wanting food from Canada because we have no regs. 🙂

          • Susan Thixton

            April 10, 2016 at 9:04 am

            Dianne –
            Canada has no pet food regulations – I’ve spoke with Canadian government authorities and with Canadian Veterinary Association President. There is no authority or regulations for pet food manufacturers, no inspections, and no one for Canadian pet food consumers to report a pet food related illness to.

          • Dianne

            April 10, 2016 at 2:17 pm

            Sorry, I was thinking more generally in terms of food safety in general.

    • Dr Cathy

      April 8, 2016 at 3:35 pm

      You are both in a tough place – and I understand as I’ve seen many patients in the same position you are describing. What works for one patient doesn’t work for another. Here are a few things to consider:
      A one month goat’s milk fast like Sherrie is describing has worked for some
      Blood test for hay fever/atopy allergies – the blood test is inaccurate for food allergies – allergy shots only if the test comes back with strong positiives.
      Saliva test for food sensitivity – avoidance is the key for any positives here
      Blood test for SIBO – small intestinal bacterial overgrowth – treated with herbal remedies as appropriate for the patient
      For some animals, natural antihistamines can work
      My point is you love your pet – there are non-conventional methods to get to the cause and make it better for most animals. Hope that helps.

      • orfan

        April 9, 2016 at 12:59 am

        My boy’s not nearly as bad as the above dogs, and we’ve done blood and saliva tests. I pick up the shots for inhaled and atopy allergies tomorrow.

        He’s also on otc antihistamines every day, so I have a question for Dr Cathy – do you have more information, or can you point me to some, concerning natural antihistamines? My goal is to get him off the antihistamines, but noticed a difference when I switched from one to anther. But I’d love to hear more about natural antihistamines, and their use in dogs.

        • Dr Cathy

          April 9, 2016 at 11:08 am

          There are many products, however, I use ones by Biotics – a human supplement company whose products are carried by human chiropractors. Histoplex tends to be more for food allergies; Histoplex AB tends to be more for hay fever type allergies. They don’t have the sleepy/agitation side effects of the OTC antihistamines and don’t steer the patient toward leaky gut,
          Allergy shots only work when your dog has very strong positive reactions to the antigens in the blood test.
          Hoping it all works for you!

    • Lois

      April 8, 2016 at 4:02 pm

      Please see a good integrative/holistic vet that specializes in nutrition. It is amazing what Chinese herbs/acupuncture/chiropractic/diet can do for pets’ immune systems!

    • Dianne

      April 9, 2016 at 11:17 pm

      You might want to consider joining this facebook group for support and suggestions. https://www.facebook.com/groups/dogallergyinternationalgroup/?fref=nf

  2. Lynn

    April 9, 2016 at 3:36 pm

    Had all 3 dogs tested by Dr Dodds and we avoid those foods. I feed raw, make bone broth, process vegetables to give occasionally. They are all healthy, good weight and very energetic. My boy golden has cancer, oncologist gave him 3-6 months to live, that was 2 years ago!

  3. Casey

    April 9, 2016 at 5:05 pm

    I also recommend Nutriscan by Hemopet as a means of identifying food allergies. We feed prey model raw and still had issues with itching and yeasty ears in my GSD. We had run one of these tests a couple of years earlier and knew to avoid certain items. When the itching began increasing (despite the dog eating pastured beef and other high quality foods), the test came back with all 24 items on it being reactive. We reran the test with the same result.

    The suspicion is leaky gut syndrome. This dog has NO digestive symptoms, but something is definitely affecting his immune system. We’re now on novel meats (not easy, but doable) and plain goat yogurt, Bacillus Coagulans probiotic, and looking to add in transfer factor and goat colostrum.

    The vet says that if we don’t get it sorted, this dog will end up being allergic to everything we put into him and I’ll have to hunt unicorns to feed him.

    But the point is, if you have a very itchy dog, think about treating for leaky gut. It’s helping us.

  4. Liz gill

    April 11, 2016 at 5:29 am

    My dog is autoimmune thyroiditis. Have had the nutriscan done by Dr Dodds. My dogs body seems to be rejecting all foods eventually. She suffers from diarrhoea and sickness. The vets thinks she may have IBD and want to take a sample of her intestine. They want to give her steroids if it’s positive. Will this help. I have tried kefir,changing to a new protine. Are you saying steroids will not help? I really don’t know what to do, my dog is really suffering and is even pooing blood.

    • Dr Cathy

      April 11, 2016 at 11:31 am

      Your dog has an autoimmune disease – in some cases, steroids are appropriate. Autoimmune diseases are hard to treat, sadly. I have had a few autoimmune thyroiditis cases – some of them decompensate quickly – which is quite heart-breaking. Some can be managed for a long-time. I’ve treated the second group fairly successfully with nutritional supplements. I think the difference is how early you catch the disease. Your dog unfortunately sounds like things are advancing. If steroids help, then that is a wonderful thing. I’d caution about taking an intestinal sample surgically in a dog with an unbalanced immune system who is pooping blood. Many diagnoses of IBD are based on everything else being negative. However, have you had the blood test done at Texas A&M to test for exocrine pancreatitic insufficiency, bacterial overgrowth and cobalamin/folate imbalances?

  5. Barby

    April 20, 2016 at 12:55 pm

    This is also an amazing group. https://www.facebook.com/groups/K9Kitchen/ The woman who runs it is a fabulous nutritionist who has helped many dogs, and really and truly looks at every dog as an individual case. No cookie cutter diets for her clients.

  6. Bonnie

    December 30, 2016 at 11:50 am

    Any info on EPI in cats. I have a starving kitty. I thought it might be from cancer from a rabies vaccine…but I am thinking it is EPI because of her poo. Yes poo. Vet gave me persoildone (spelled wrong) but from what I have read it masked the symptoms instead of issues.

    • Liz Chalfant

      October 5, 2017 at 2:35 pm

      Bonnie, please join FB group: Raw Feeding for IBD Cats, or visit http://www.rawfeedingforibdcats.org. No need to be planning to or currently feeding raw. Excellent, intelligent, caring moderators and group. Several members are involved in research using “poo pills”- capsules with feces from cats with healthy guts. I can almost guarantee you will learn and will receive helpful advice for you and your poor kitty. Best of luck to you. I am sorry this posting is so far past yours. 🙂

      • Bonnie

        October 23, 2017 at 1:43 pm

        Liz, I lost my kitty about 4 months ago. I had her on the enzymes until she died. They were not going to save her life however they made her last few months not as miserable as they could have been.

        • Liz Chalfant

          October 23, 2017 at 6:26 pm

          Hi Bonnie, I am so sorry to hear that you lost your sweet kitty. You are very kind to respond to my post. It is so hard to lose our wonderful, sweet pets. I hope you have many fond memories that are helping to diffuse the sadness of your loss. I know you were a loving caregiver to your kitty. 🙂

  7. Mark Napier

    September 28, 2020 at 10:57 am

    What I want to see is a list of dog food that uses steroids.

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