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 VetMed Resource and PubMed.
  • Bizikova P, Linder K E, Paps J, Olivry T (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, 70-79 PubMed.
  • Corrigan A M, Behrend E N, Martin L G, Kemppainen R J (2010) Effect of glucocorticoid administation on serum aldosterone concentration in clinically normal dogs. Am J Vet Res 71, 649-654.
  • Gottschalk J, Einspanier A, Ungemach F R, Abraham G (2010)Influence of topical dexamethasone applications on insulin, glucose, thyroid hormone and cortisol levels in dogs. Res Vet SciJul26[Epub ahead of print].
  • Olivry T, Foster A P, Mueller R S, McEwan N A, Chesney C, Williams H C (2010)Interventions for atopic dermatitis in dogs: a systematic review of randomized controlled trials. Vet Dermatol21, 4-22PubMed.
  • Bonneau S, Skowronski V, Sanquer A, Maynard L, Eun H M (2009)Therapeutic efficacy of topical hydrocortisone aceponate in experimental flea-allergy dermatitis in dogs. Aust Vet J87, 287-291PubMed.
  • Nuttall T, Mueller R, Bensignor E, Verde M, Noli C, Schmidt V, Rème C (2009)Efficacy of a 0.0584% hydrocortisone aceponate spray in the management of canine atopic dermatitis: a randomised, double blind, placebo-controlled trial. Vet Dermatol20, 191-198PubMed.
  • 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 Dermatol19, 226-231PubMed.
  • Levine J M, Levine G J, Boozer L, Schatzberg S J, Platt S R, Kent M, Kerwin S C, Fosgate G T (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 Assoc232, 411-417PubMed.
  • Reeder C J, Griffin C E, Polissar N L, Neradilek B, Armstrong R D (2008)Comparative adrenocortical suppression in dogs with otitis externa following topical otic administration of four different glucocorticoid-containing medications. Vet Ther9, 111-121.
  • Ginel P J, Garrido C, Lucena R (2007)Effects of otic betamethasone on intradermal testing in normal dogs. Vet Dermatol18, 205-210.
  • 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 Endocrinol191, 491-496. Abraham G, Gottschalk J, Ungemach F R (2005)Evidence for ototopical glucocorticoid-induced decrease in hypothalamic-pituitary-adrenal axis response and liver function. Endocrinology146,3163-3171.
  • Cobb M A, Edwards H J, Jagger T D, Marshall J, Bowker K E (2005)Topical fusidic acid/betamethasone-containing gel compared to systemic therapy in the treatment of canine acute moist dermatitis. Vet J169, 276-280.
  • Ghubash R, Marsella R, Kunkle G (2004)Evaluation of adrenal function in small-breed dogs receiving otic glucocorticoids. Vet Dermatol15, 363-368.
  • Deboer D J, Schafer J H, Salsbury C S, Blum J R, Beale K M, Vitale C B, Muse R, Moriello K A, Garfield R A, Keefe T J, McArthur T R (2002)Multiple-center study of reduced-concentration triamcinolone topical solution for the treatment of dogs with known or suspected allergic pruritus. Am J Vet Res63, 408-413.
  • Goodman S, Sprung C L (2002)The International Sepsis Forums controversies in sepsis: corticosteroids should be used to treat septic shock. Critical Care6,381-383.
  • Daminet S, Paradis M, Refsal R, Price C (1999)Short term influence of prednisone and phenobarbital on thyroid function in euthyroid dogs. Can Vet J40(6), 411-415.
  • Olby N (1999)Current concepts in the management of acute spinal cord injury. J Vet Intern Med13(5), 399-407.
  • 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 Res60(8), 977-981.
  • Moore G E, Ferguson D C, Hoenig M (1993)Effects of oral administration of anti-inflammatory doses of prednisone on thyroid hormone response to TRH and TSH in clinically normal dogs. Am J Vet Res54(1), 130-135.
  • Ridway H B, Moriello K A (1993)Iatrogenic Cushing's syndrome in a dog from owner's topical corticosteroid. Arch Dermatol129, 379.
  • Nesbitt G H, Fox P R (1981)Clinical evaluation of Panalog Cream used to treat canine and feline dermatoses. Vet Med Small Anim Clin76, 535-538.

 

 

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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