What is Prednisone?
Prednisone is a corticosteroid medication used to treat various inflammatory conditions in dogs and cats (1). It works by suppressing the immune system and reducing inflammation. Prednisone is a synthetic version of cortisol, a hormone naturally produced by the adrenal glands.
In veterinary medicine, prednisone is commonly prescribed for conditions like allergies, arthritis, inflammatory bowel disease, and autoimmune diseases. It comes in tablet, liquid, and injectable forms. The usual dosage for dogs is 0.5 to 1 mg per pound every 12-24 hours. For cats, the typical dosage is 1-2 mg per pound every 12-24 hours (2).
Prednisone helps control symptoms but does not cure the underlying disease. It must be used carefully under veterinary supervision due to potential side effects with long-term use.
Signs of Prednisone Overdose
Prednisone overdoses can cause serious side effects in dogs. Some of the most common signs of an overdose include:
Increased thirst and urination: One of the most noticeable signs is increased drinking and urinating. Prednisone causes the kidneys to excrete extra fluid, leading to an increase in thirst. If your dog suddenly seems very thirsty and is urinating more frequently, it may be a sign of an overdose.
Increased appetite: Prednisone stimulates the appetite, so dogs with an overdose may seem ravenously hungry. They may beg for food constantly or eat much larger meals than usual.
Panting: Heavy panting is another potential sign of overdose. Prednisone impacts the adrenal glands and can mimic the effects of stress, leading to excessive panting.
Restlessness: Dogs may seem anxious or restless when experiencing an overdose. They may pace, seem unable to settle down, or have difficulty sleeping.
Muscle weakness: Prednisone overdoses can eventually lead to muscle wasting and weakness. Your dog may seem unstable on their feet, tire more easily during walks, or have difficulty rising up.
If your dog is displaying any of these signs, especially increased thirst/urination and appetite, contact your vet immediately to determine if prednisone toxicity is the cause.
Dangers of Overdose
An accidental double dose of prednisone can have serious health consequences for dogs. Some of the most notable dangers include:
Stomach ulcers: Prednisone can cause irritation and ulcers in the stomach lining, especially at higher doses. A double dose greatly increases this risk (source).
Adrenal gland suppression: Prednisone suppresses the adrenal glands’ natural steroid production. An overdose can completely shut down the adrenal glands, leaving the dog dependent on external steroid treatment (source).
Diabetes: Prednisone can induce steroid diabetes by promoting insulin resistance. An overdose makes this side effect more likely (source).
Increased infections: Prednisone suppresses the immune system, increasing susceptibility to infections. A double dose amplifies this effect, making infections more likely (source).
What to Do If Overdose Occurs
If you suspect your dog has accidentally received a double dose of prednisone, it’s crucial to act quickly. According to Poison Control (https://www.poison.org/), the first step is to call your veterinarian or the ASPCA Animal Poison Control Center right away. An accidental overdose of prednisone can be life-threatening, so getting prompt veterinary advice is essential.
Your vet may recommend inducing vomiting to try to eliminate some of the excess prednisone before it is absorbed into your dog’s system. According to Forbes (https://www.forbes.com/advisor/pet-insurance/pet-care/prednisone-for-dogs/), this is usually done under medical supervision to avoid complications. Your vet may also administer IV fluids to help flush the prednisone out of your dog’s system and support kidney function.
With quick veterinary intervention, the prognosis is often good for dogs who accidentally receive too much prednisone. However, without prompt treatment, an overdose can lead to severe adverse effects on multiple body systems. Calling your vet or poison control at the first signs of overdose gives your dog the best chance of making a full recovery.
Preventing Accidental Overdoses
There are several steps pet owners can take to help prevent accidental prednisone overdoses in dogs:
Carefully follow the vet’s dosage instructions. Be sure to give the exact dose prescribed at the correct time intervals. Never increase or alter the dosage without consulting your vet first (Source).
Use a pill organizer or divider box to pre-portion doses. This can help avoid confusion or accidentally providing a double dose (Source).
Supervise dosing to ensure the full dose is consumed. Prednisone should be given with food to reduce stomach upset. Make sure your dog eats all the food and medication before giving additional treats or meals (Source).
Duration of Effects
The effects of a prednisone overdose can last anywhere from days to weeks depending on the amount ingested. Once the overdose occurs, it can take 1-2 days for the effects to fully develop as the drug accumulates in the dog’s system 1. An overdose can cause immediate vomiting, diarrhea, and other symptoms, but other effects like immune suppression may take longer to manifest.
Elimination of prednisone from the body is slower than absorption. The drug has a relatively long half-life of 12-36 hours in dogs 2. This means it can take over a day for the blood concentration to be reduced by half. The overall duration depends on factors like the dog’s body size and kidney/liver function.
Due to the slow elimination, dogs may need to be weaned off prednisone gradually after an overdose rather than stopping abruptly. Working with the veterinarian to slowly taper the dosage over days to weeks allows the dog’s adrenal glands to restart natural corticosteroid production and avoid dangerous withdrawal effects.
Long-Term Outlook
The long-term outlook for dogs who have accidentally received a double dose of prednisone is generally positive. Most dogs will recover fully with prompt veterinary treatment, especially if it was a one-time overdose (1, 2). Permanent damage is unlikely in cases of a single accidental overdose when appropriate treatment is provided.
According to PetMD, while extremely high doses can potentially cause long-term problems like adrenal gland suppression, a single accidental double dose is rarely significant enough to lead to permanent effects (2). With treatment to address the immediate poisoning symptoms and close monitoring afterwards, the vast majority of dogs return to normal health.
However, pet owners should watch for signs of adrenal insufficiency in the weeks following the overdose and notify their vet immediately if they have concerns. This may require tapering medication dosage and additional lab work over time. Overall though, the prognosis is very good in cases of one-time accidental overdoses when addressed quickly.
Monitoring for Adrenal Suppression
When a dog is on prednisone long-term, regular monitoring is crucial to check for adrenal suppression or lowered cortisol levels. Bloodwork to measure serum cortisol levels should be performed periodically, such as every 6-12 months (1). If levels are low, the prednisone dose may need to be reduced or tapered slowly under veterinary supervision.
To help prevent adrenal suppression, veterinarians may recommend supplementing with glandulars or herbs that support adrenal function, such as licorice root. However, these should not be given without first consulting your veterinarian, as they can interact with medications (2).
During tapering or when coming off prednisone after long-term use, dogs should be slowly weaned off over weeks to months to allow the adrenal glands time to recover and restart their normal cortisol production. Gradual tapering also minimizes the risk of an Addisonian crisis. Your vet can provide a tapering schedule and monitor your dog’s progress (3). With proper adrenal support and medical management, dogs can often be safely tapered off prednisone when needed.
Alternatives to Prednisone
There are some alternative treatment options that can be considered instead of or alongside prednisone for dogs. Some of these include:
Other steroid options: Steroids like prednisolone can be used instead of prednisone. According to https://nusentia.com/pages/prednisone-for-dogs, prednisolone has less mineralocorticoid effects which can help avoid side effects like excessive thirst and urination.
Atopica: Atopica (cyclosporine) is an oral medication that can help treat allergies and atopic dermatitis. It calms the immune system without the harsh side effects of steroids. However, it may take 3-4 weeks to start working.
Cytopoint injections: Cytopoint is an injectable monoclonal antibody that targets itch-inducing chemicals in the skin. It starts working within a day and lasts 4-8 weeks. It can provide rapid relief without suppressing the immune system like oral steroids.
When to Call the Vet
If you suspect your dog has received an accidental double dose of prednisone, it’s important to contact your veterinarian immediately. Even a small overdose can cause serious side effects.
Call your vet right away if your dog experiences any of the following overdose symptoms: excessive thirst and urination, panting, restlessness, vomiting, diarrhea, belly pain, weakness, seizures, or collapse. Your vet may induce vomiting or give your dog activated charcoal to help minimize absorption of the extra prednisone.
Also call your vet with any concerns that come up during or after a prednisone overdose. Your vet will want to monitor your dog closely for potential adrenal gland suppression and other long-term effects of high prednisone levels. They can advise you on safely tapering your dog off prednisone and may prescribe additional medications to help support your dog’s health after an overdose.
Don’t hesitate to call your vet or an emergency animal hospital whenever you have worries about a prednisone overdose in your dog. Early treatment increases the chances of a full recovery.