# Predisone, any vets here?



## TxRider (Apr 22, 2009)

I brought home a rescued German shepherd a couple weeks ago, sweet girl and quite smart.

She's evidently had a really rough time with an untreated ear infection though. She's ruined her ears in the past, both have had bad hematomas and are basically cauliflowered and won't stand up like a normal GSD from her scratching them. 

I took her to her first vet visit and he swabbed her ears and said she has a gram negative bacterial infection that is sometimes hard to get rid of.

He gave me zeniquin tablets, and a bottle of TrizEDTA/Bayril ear flush for twice a day, and also predisone tabs.

I looked all this up and the antibiotics and flush seem to be right on target, and a good treatement, even though it took a week before I could get her to let me give her the ear drops, we're on it twice a day now from about 3 days ago.

I saw a marked improvement in her behavior (head shaking etc.) and her sensitivity to her ears in just a couple of days, and I've gotten her to tolerate me manipulating them well now by giving treats after manipulating her ears a few times a day. It's been a week now since the vet visit on the 16th and I'm supposed to go back on Monday the 27th.

But reading about the predisone is scaring me, it has some nasty and permanent side effects with prolonged use. I'm wondering if I should continue using it after two weeks of it. I believe it was for controlling inflammation or possible allergy but I'm thinking something less risky like benadryl might be better if she needs anything for it at all now.

Anyone know what kind of dosage or time span of use brings on the permanent adrenal issues or cushings disease side effects using predisone? I saw some drug info sites that said it can take as little as a week.


----------



## briteday (Feb 10, 2007)

Not a vet, but a medical biochemist. Developing adrenal issues after only a week would be considered a rare side effect. It's like warning you that aspirin can cause stomach bleeding. Yes it happens, but rarely, and we have to disclose the information anyway. 

More commonly seen are weight gain and suppressed immune system. But generally prednisone is prescribed for a very limited period of time and then you need to wean off, not stop abruptly...in most cases. 

Seeing as how the dog already has deformed its ears from previous encounters it sounds like the vet was throwing the whole shabang at it this time, trying to stop anything from letting the train roll too far down the tracks. I'll bet when you go back for the re-check the vet will give you instructions for weaning off the prednisone.


----------



## agility collie mom (Jan 26, 2008)

briteday said:


> Not a vet, but a medical biochemist. Developing adrenal issues after only a week would be considered a rare side effect. It's like warning you that aspirin can cause stomach bleeding. Yes it happens, but rarely, and we have to disclose the information anyway.
> 
> More commonly seen are weight gain and suppressed immune system. But generally prednisone is prescribed for a very limited period of time and then you need to wean off, not stop abruptly...in most cases.
> 
> Seeing as how the dog already has deformed its ears from previous encounters it sounds like the vet was throwing the whole shabang at it this time, trying to stop anything from letting the train roll too far down the tracks. I'll bet when you go back for the re-check the vet will give you instructions for weaning off the prednisone.


I agree with briteday. Your vet gave you the pred to help take down the inflammation and relieve some of the itch. He/she will eventually taper off the dosage as the inflammation recedes. I would not be too concerned of the side effects unless this becomes a lifetime thing.


----------



## TxRider (Apr 22, 2009)

Thanks for the reply, that's comforting knowledge.

From what I've read so far this bacteria type just gets more persistent and more resistant the longer it's treated but not completely eliminated and basically gets almost immortal if that cycle goes on too long and she's obviously had a persistent issue with ear infection.

The vet record from the shelter was just one sparse page of the SPCA vet, and the wrong medication. This was her first vet visit with me. The Vet I chose seems good, he said the ear drops I got at the shelter with her these bacteria would just throw a party in.

He gave me an option of just using the ear drops/flush and checking back, saying the other meds were going to be expensive but would be much more effective. I told him not to worry about cost that I want to make sure its cured and every last little bug is dead. Then it's up to me to make sure it doesn't get a new hold.

I just read about this type of infection to get more knowledgeable since I might have to deal with this for years and saw the permanent effects from predisone and wanted to get some more thoughts on it.

I believe he gave me a 3 week supply of predisone, and yeah it's got her patrolling fo anything to eat, but she's a bit underweight at 65lbs anyway.

The zeniquin has a weaning off schedule on the bottle, the prednisone doesn't.

On the bright side her ears don't seem to be bothering her at all now, and she's gone from yelping before I even touch them to seeming like she actually enjoys a good scratch behind the ears now.


----------



## briteday (Feb 10, 2007)

I'd check the dosing on the bottles with the vet. To my knowledge zeniquin does not have a weaning off period...and prednisone almost always does.


----------



## lovemygreys (Jan 20, 2007)

Greyhounds can be very senstive to pred and can actually die from it. We had one practically waste away to nothing in just a couple weeks....so, I am VERY leary of it in greyhounds. HOWEVER....if I had a dog (even a greyhound) who really needed it and it was the only option or the best (by a long shot) treatment, I would give it a try. Our vet knows our concerns about pred and knows we would prefer to avoid it unless it is absolutely necessary.

Bottom line - you should discuss your concerns with your vet. With any medication you should always educate yourself to the side effects (which you did) and discuss concerns with the doctor....You do need to make sure dogs are weaned of pred...it's not something you want to stop cold turkey. She may be on such a small dose though, that you don't need to wean.


----------



## spotted nikes (Feb 7, 2008)

Pred can have some side effects, but don't freak out too much. My mom's Shih Tsu was on it for most of his life, due to very severe allergies. He lived a normal life span for a Shih Tsu.
I had a dog that ended up being on it for the last 3 months of his life due to severe spinal arthritis. He never developed side effects from it.


----------



## TxRider (Apr 22, 2009)

spotted nikes said:


> Pred can have some side effects, but don't freak out too much. My mom's Shih Tsu was on it for most of his life, due to very severe allergies. He lived a normal life span for a Shih Tsu.
> I had a dog that ended up being on it for the last 3 months of his life due to severe spinal arthritis. He never developed side effects from it.


The side effect is once they are on it long enough you can't take them off it, sometimes forever.

From Wiki.. I believe these are effects in humans, but it's the same for any mammal I believe.



> Dependency
> 
> Adrenal suppression will occur if prednisone is taken for longer than 7 days. This will cause the body to lose the ability to synthesize natural corticosteroids, resulting in dependence on prednisone. For this reason, prednisone should not be abruptly stopped if taken for more than seven days, and instead, the dosage should be gradually reduced. This weaning process may be over a few days if the course of prednisone was short, but may take weeks or months if the patient had been on long-term treatment. Abrupt withdrawal may lead to an Addisonian crisis. For those on chronic therapy, alternate-day dosing may preserve adrenal function, thereby reducing side-effects.[4]
> 
> Glucocorticoids act to feedback inhibit both the hypothalamus (decreasing Corticotropin-releasing hormone [CRH]) and corticotrophs in the anterior pituitary gland (decreasing the amount of Adrenocorticotropic hormone [ACTH]). For this reason exogenous glucocorticoid analogues down-regulate the body's ability to naturally produce glucocorticoids. This mechanism leads to dependence in a short time and can be very dangerous if medications are withdrawn too quickly. The body must have time to begin synthesis of CRH and ACTH and for the adrenal glands to begin functioning normally again.


And I got a months supply.

I'll wait and ask the vet about it Monday. Sure is making her act weird though, panting, pacing, won't settle, looking to eat anything. I definitely don't like it and I don't think I would take it myself just for inflammation.

[edit] I just went and looked again and I confused the labels when I posted about weaning off it. It's a 20mg pill for her at 70lbs, he does have me weaning her off it from the initial 2 a day for a week, now one a day for the last couple days and every other day until it's gone next week.


----------



## briteday (Feb 10, 2007)

The adrenal suppression is why you need to wean off prednisone. The amount of adrenal suppression your dog will have after one week 2x/day is minimal. But cold turkey is never a good thing with prednisone anyway. So they always wean, even if the full dose has only been for 3 days.


----------



## vabird (Jun 5, 2007)

Please don't trust wiki for drug info. It is notoriously inaccurate. 

The pacing etc is common on high levels of pred. Your dog may get better after a couple of days on the drug or you might call your vet, describe her symptoms and talk to him about reducing her dose.


----------



## TxRider (Apr 22, 2009)

briteday said:


> The adrenal suppression is why you need to wean off prednisone. The amount of adrenal suppression your dog will have after one week 2x/day is minimal. But cold turkey is never a good thing with prednisone anyway. So they always wean, even if the full dose has only been for 3 days.


Thanks for info, I'm worried a lot less now and I'll discuss with my vet Monday. She'll have been down to 1x a day for almost a week by then and about ready to go on 1x every other day.


----------



## TxRider (Apr 22, 2009)

Update, Hope is on every other day pred now, and still more zenequin.

Her left ear is clean, the right one is still giving up black goop with the 2 a day ear drops, but he said the bacteria are 90% dead and it's looking good, no permanent ear canal damage he can see, just cauliflowered ears that fold over instead of standing up.. Everyone thinks she's hound mix. 

Another two weeks and hopefully she'll have clean ears, for the first time in who knows how long.


----------



## TxRider (Apr 22, 2009)

Ugh, first day on pred 20mg every other day. Went ok I guess, but this morning after a day without it she's pretty listless and was yakking up on the rug. Gave her pred for today and hope she feels better.


----------



## sw_df27 (Feb 22, 2008)

Alexis my 5yr old has to go in for pred shot a few times a yr followed by pills afterward she's had to do it almost her whole life and haven't had any problems yet she has severe allergies and it's the only thing that works!


----------



## TxRider (Apr 22, 2009)

Well she's definitely getting her ups and downs with the pred and antibiotics having opposing side effects, but getting better.

In three weeks she's gone from yelping before anyone even touched her ears, and literally going into panic flight mode when the eardrops come into view, to liking me scratching and rubbing her ears, and tolerating eardrops..

I started getting some soft toilet paper and wrapping my finger with it and wiping out as much of the black snotty stuff coming out of her ear as I can about 5 mins after she shakes the drops out. 

She's at the point now that I put a TP wrapped finger by her ear about 5 mins after the ear drops and she crams my finger down her ear herself.. I thought she was going to push my finger all the way in her lower ear canal this morning. It must feel really really good to her. 

Hopefully I can get her off the meds pretty soon and get her back to her self without the freaky behavioral drug side effects.


----------



## briteday (Feb 10, 2007)

A while back one of the more senoir members around here posted a recipe for an ear wash, some sort of blue wash with genetian violet I think. You may get something if you do a search at the top of the page. It was something to use as a preventative that seemed to work quite well for everyone that tried it.


----------



## TxRider (Apr 22, 2009)

briteday said:


> A while back one of the more senoir members around here posted a recipe for an ear wash, some sort of blue wash with genetian violet I think. You may get something if you do a search at the top of the page. It was something to use as a preventative that seemed to work quite well for everyone that tried it.


Yeah I think I'll want something for a preventative. The vet told me 50/50 vinegar and water, twice a month. That sounds a little harsh to me.


----------



## TxRider (Apr 22, 2009)

Woohoo!!

Hope got her ears sampled and slides done and they are now 100% clean of nasty gram negative rod bacteria... 

Probably first time in years. And she finally gained some weight.

Vet says a 50/50 vinegar/water ear wash twice a week, and we'll check again in a few weeks when she goes back for more vaccinations. Nice to only have $75 vet visit too.

She seems to be doing ok on the every other day prednisone now, no barfing or anything since the first day without it.

She's starting to act more like she did the first week I had her. She gets to stay with me at the office all day today and meet all the computer geeks. 

I make computer games and simulations for a living, pretty informal office...


----------



## TxRider (Apr 22, 2009)

After a few days off the prednisone and zenequin Hope is starting to show her real personality.. It's been strange as the first week I had her she was stressed out about a new home and had painful ears, and the last 4 weeks on drugs each with it's own behavioral side effects... I couldn't always determine what was normal and what was drug effects.

Vet appt today went great, she's gained 4-5lbs in 6 weeks, up to 69lbs, ears clean, vet said they look excellent, and she's getting a lot more playful and energetic now that the drugs are gone. She actually romped around in regular doggy play mode with me for the first time yesterday running all over the yard jumping around obviously feeling good. Now I can really get to know her and learn to read her better.

I didn't expect $900 worth of vet bills in the 6 weeks after the $175 I paid to the shelter for adoption fee, but ya gotta do what ya gotta do.

No more vet bills till October now! Woohoo!

I also think I found out why I like the vet I chose so much. Hope looks just like a shepherd with floppy ears he had back when he was going through vet school. He said he was his buddy all through school and lived to be 19, and even went and got a picture to show me. He did look a lot like her to be sure.


----------



## ValtheAussie (Apr 19, 2009)

I've never known Prednisone to NOT need a taper when discontinuing. For the sake of the dog, make sure you touch bases with the vet who prescribed the medication.

Your dog is depending on you.


----------



## TxRider (Apr 22, 2009)

ValtheAussie said:


> I've never known Prednisone to NOT need a taper when discontinuing. For the sake of the dog, make sure you touch bases with the vet who prescribed the medication.
> 
> Your dog is depending on you.


Yeah the taper was just one 20mg every other day for two weeks

I saved the last pill just in case I saw problems I figured I could give her half of it and call the vet. She's looking fine though.


----------

