Canis ISSN: 2398-2942

Therapeutics: glucocorticoids

Synonym(s): steroids; steroidal anti-inflammatories; corticosteroids; glucocorticosteroids

Contributor(s): Jonathon Elliot, Linda Horspool, Lauren Trepanier

Introduction

  • Prescribed for their anti-inflammatory, immunosuppressive, and anti-fibrotic effects.
  • Potency, duration of action, and relative mineralocorticoid activity vary with agent and formulation.
  • Common side-effects of all glucocorticoids include polyuria/polydipsia (PU/PD), increased appetite, panting, pyoderma, urinary tract infections, insulin resistance, proteinuria Urinalysis: protein Proteinuria , and (probably) pancreatitis Pancreatitis: acute.
  • Long-term daily treatment can lead to iatrogenic hyperadrenocorticism Hyperadrenocorticism (thin skin, muscle wasting, pot belly, calcinosis cutis, adrenal suppression).
  • Sudden stopping of treatment can unmask adrenal suppression, which can last for weeks to months.
  • Glucocorticoids in topical preparations can be systemically absorbed and lead to clinical side-effects, alkaline phosphatase induction, and adrenal suppression.
  • Glucocorticoids induce calciuresis and can be used to treat hypercalcemia Hypercalcemia: overview once the underlying cause is determined.
  • Glucocorticoids at immunosuppressive (but not anti-inflammatory) dosages can suppress total T4 and free T4, without increasing TSH, and may lead to a false diagnosis of hypothyroidism Hypothyroidism.
  • All glucocorticoids can potentially increase the risk of GI ulceration Gastric ulceration from NSAIDs, especially at high dosages.

Route of administration

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Examples of use of available agents

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Bizikova P, Linder K E, Paps J et al (2010) Effect of a novel topical diester glucocorticoid spray on immediate- and late-phase cutaneous allergic reactions in Maltese-beagle atopic dogs: a placebo-controlled study. Vet Dermatol 21 (1), 70-79 PubMed.
  • Corrigan A M, Behrend E N, Martin L G et al (2010) Effect of glucocorticoid administration on serum aldosterone concentration in clinically normal dogs. Am J Vet Res 71 (6), 649-654 PubMed.
  • Gottschalk J, Einspanier A, Ungemach F R et al (2010) Influence of topical dexamethasone applications on insulin, glucose, thyroid hormone and cortisol levels in dogs. Res Vet Sci 90 (3), 491-497 PubMed.
  • Olivry T, Foster A P, Mueller R S et al (2010) Interventions for atopic dermatitis in dogs: a systematic review of randomized controlled trials. Vet Dermatol 21 (1), 4-22 PubMed.
  • Bonneau S, Skowronski V, Sanquer A et al (2009) Therapeutic efficacy of topical hydrocortisone aceponate in experimental flea-allergy dermatitis in dogs. Aust Vet J 87 (7), 287-291 PubMed.
  • Nuttall T, Mueller R, Bensignor E et al (2009) Efficacy of a 0.0584% hydrocortisone aceponate spray in the management of canine atopic dermatitis: a randomised, double blind, placebo-controlled trial. Vet Dermatol 20 (3), 191-198 PubMed.
  • Aniya J S, Griffin C E (2008) The effect of otic vehicle and concentration of dexamethasone on liver enzyme activities and adrenal function in small breed healthy dogs. Vet Dermatol 19 (4), 226-231 PubMed.
  • Levine J M, Levine G J, Boozer L et al (2008) Adverse effects and outcome associated with dexamethasone administration in dogs with acute thoracolumbar intervertebral disk herniation: 161 cases (2000-2006). J Am Vet Med Assoc 232 (3), 411-417 PubMed.
  • Reeder C J, Griffin C E, Polissar N L et al (2008) Comparative adrenocortical suppression in dogs with otitis externa following topical otic administration of four different glucocorticoid-containing medications. Vet Ther (2), 111-121 PubMed.
  • Ginel P J, Garrido C, Lucena R (2007) Effects of otic betamethasone on intradermal testing in normal dogs. Vet Dermatol 18 (4), 205-210 PubMed.
  • Abraham G, Demiraj F, Ungemach F R (2006) Comparison of the hypothalamic-pituitary-adrenal axis susceptibility upon single-dose i.m. depot versus long-acting i.v. triamcinolone acetonide therapy: a direct pharmacokinetic correlation. J Endocrinol 191 (2), 491-496 PubMed.
  • Abraham G, Gottschalk J, Ungemach F R (2005) Evidence for ototopical glucocorticoid-induced decrease in hypothalamic-pituitary-adrenal axis response and liver function. Endocrinology 146 (7), 3163-3171 PubMed.
  • Cobb M A, Edwards H J, Jagger T D et al (2005) Topical fusidic acid/betamethasone-containing gel compared to systemic therapy in the treatment of canine acute moist dermatitis. Vet J 169 (2), 276-280 PubMed.
  • Ghubash R, Marsella R, Kunkle G (2004) Evaluation of adrenal function in small-breed dogs receiving otic glucocorticoids. Vet Dermatol 15 (6), 363-368 PubMed.
  • Deboer D J, Schafer J H, Salsbury C S et al (2002) Multiple-center study of reduced-concentration triamcinolone topical solution for the treatment of dogs with known or suspected allergic pruritus. Am J Vet Res 63 (3), 408-413 PubMed.
  • Goodman S, Sprung C L, International Sepsis Forum (2002) The International Sepsis Forums controversies in sepsis: corticosteroids should be used to treat septic shock. Critical Care (5), 381-383 PubMed.
  • Daminet S, Paradis M, Refsal R et al (1999) Short term influence of prednisone and phenobarbital on thyroid function in euthyroid dogs. Can Vet J 40 (6), 411-415 PubMed.
  • Olby N (1999) Current concepts in the management of acute spinal cord injury. J Vet Intern Med 13 (5), 399-407 PubMed.
  • Rohrer C R, Hill R C, Fischer A et al (1999) Gastric hemorrhage in dogs given high doses of methylprednisolone sodium succinate. Am J Vet Res 60 (8), 977-981 PubMed.
  • Moore G E, Ferguson D C, Hoenig M (1993) Effects of oral administration of anti-inflammatory doses of prednisone on thyroid hormone response to thyrotropin-releasing hormone and thyrotropin in clinically normal dogs. Am J Vet Res 54 (1), 130-135 PubMed.
  • Ridway H B, Moriello K A (1993) Iatrogenic Cushing's syndrome in a dog from owner's topical corticosteroid. Arch Dermatol 129 (3), 379 PubMed.
  • Nesbitt G H, Fox P R (1981) Clinical evaluation of Panalog Cream used to treat canine and feline dermatoses. Vet Med Small Anim Clin 76 (4), 535-538 PubMed.

Other sources of information

  • Day M (2008) Glucocorticorticosteroids and Antihistamines. In: Maddison J E, Page S W, Church D B Small Animal Clinical Pharmacology. 2nd edn, Philadelphia, Saunders Elsevier, pp 261-269.
  • Plumb D C (1999) Veterinary Drug Handbook. 3rd edition.
  • Schimmer B P, Parker K L (1996) ACTH; adrenocortical steroids and their synthetic analogs; inhibitors of the synthesis and actions of adrenocortical hormones. In: Hardman J G, Limbard L E, Goodman & Gilmans The Pharmacologic Basis of Therapeutics.9th edition, New York: McGraw Hill, pp 1459-1485.


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