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Prednisolone is a synthetic corticosteroid with approximately
4 times the anti-inflammatory potency of hydrocortisone. Corticosteroids
have an effect on practically every system of the body. They are important
in normal protein, carbohydrate, and fat metabolism and for their role
in controlling inflammation. They have both strong beneficial effects
and a definite potential to cause negative side effects.
Prednisolone is commonly used in both small and large animal veterinary
medicine. It may be given by injection, orally, opthalmically or topically.
Preparations for topical use may include other active ingredients such
as antibiotics, antifungals, or miticides.
Prednisone is converted by the liver to prednisolone. Animals in hepatic
failure should receive prednisolone instead of prednisone. Systemic prednisolone
is preferred for use in cats over prednisone because there is some question
if cats are able to convert prednisone to prednisolone. Prednisolone should
be used in horses rather than prednisone because horses do not absorb
prednisone.
Prednisolone is used systemically in high doses in
emergencies for anaphylactic reactions, spinal chord trauma, endotoxemic
or septic shock. It is also used in the management and treatment of diseases
of practically every organ system in the dog and cat including; gastro-intestinal,
renal, respiratory, liver, adrenal/endocrine, central nervous system,
hematopoetic, dermatologic, musculoskeletal, some autoimmune diseases,
some reproductive disorders, some toxicoses, and some neoplasic conditions.
Prednisolone is given systemically to decrease inflammatory
and immune responses. It is used in high doses in emergencies for anaphylactic
reactions, spinal chord trauma, or shock. It is used in lower doses to
treat allergic reactions such as Chronic Obstructive Pulmonary Disease,
hives, itching, inflammatory diseases and for the management and treatment
of immune-mediated hemolytic anemia and thrombocytopenia. Other corticosteroids
are preferred for intra-articular use.
• Systemic side effects to corticosteroids are generally dependent on dose and duration of treatment. Adrenocorticosteroids have effects on every body system.
• Polyuria, polydypsia, and muscle wasting can
be seen with prolonged corticosteroid use.
• Chronic or inappropriate use of corticosteroids including prednisolone can cause life threatening hormonal and metabolic changes, specifically iatrogenic Cushing's disease, or Addison's disease.
• Corticosteroids such as prednisolone should not be used in animals with systemic fungal infection.
• Adverse effects due to corticosteroid treatment usually occur with long-term administration of the drug, especially when high doses are used. If possible, the longer acting corticosteroids should be avoided for long-term therapy. Prednisolone is considered a shorter acting corticosteroid. Alternate day therapy with short acting preparations is preferred. Animals who have received long-term therapy should be withdrawn slowly by tapering the dosage and prolonging the interval between doses.
• Corticosteroids suppress immune response. Animals receiving systemic corticosteroids may be more susceptible to bacterial or viral infections. Systemic corticosteroids can mask signs of infection, such as an elevated temperature.
• Corticosteroids can cause or worsen gastric ulcers.
• Corticosteroids should be avoided or used very carefully in young animals both because of immune suppression and the risk of GI ulcers in this population.
• Corticosteroids have been implicated as a cause of laminitis in horses and ponies. Some corticosteroids are thought to be more likely to cause laminitis than others and prednisolone has not historically been considered to be in the higher risk category. Pony breeds and horses with pituitary pars intermedia dysfunction, or metabolic syndrome may be more susceptible to developing laminitis.
• Corticosteroids should be avoided during pregnancy
and lactation unless the benefits outweigh the risks. Large doses in early
pregnancy may be teratogenic. Corticosteroids will cross into maternal
milk.
• When amphotericin B or diuretics such as furosemide are given with corticosteroids, there is an increased risk of electrolyte imbalances due to calcium and potassium losses. If digitalis is also being used in the same animal the risk of digitalis toxicity increases with potassium depletion.
• Corticosteroid use may increase the insulin requirement because they stimulate gluconeogenesis.
• The immune response to vaccination may be reduced when corticosteroids are given at the same time. Animals on immunosuppressive doses of corticosteroids should not be given modified live virus vaccines.
• The risk of GI ulcers may be increased if corticosteroids and other drugs prone to causing ulcers such as NSAIDs are given at the same time.
• Corticosteroids should not be given intravenously with fluids
containing calcium.
• Short-term administration of even large doses is unlikely to cause serious harmful systemic effects due adrenal suppression. Problems associated with long-term administration of prednisolone relate to suppression of normal adrenal function, iatrogenic Cushing's disease and metabolic crisis due to abrupt withdrawal.
Dr.
Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania.
She has a master's degree in animal science from the University of Delaware
and graduated from the University of Pennsylvania School of Veterinary Medicine
in 1982.
She began to develop her interest in client education and medical writing 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
You can purchase books by Dr. Forney at www.exclusivelyequine.com
The information contained on this site
is general in nature and is intended for use as an informational aid. It does
not cover all possible uses, actions, precautions, side effects, or interactions
of the products shown, nor is the information intended as medical advice or
diagnosis for individual health problems or for making an evaluation as to the
risks and benefits of using a particular product. You should consult your doctor
about diagnosis and treatment of any health problems. Information and statements
have not been evaluated by the Food and Drug Administration ("FDA"),
nor has the FDA approved the products to diagnose, cure or prevent disease.
Wedgewood compounded veterinary preparations are not intended for use in food and food-producing animals.
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