Steroids: A Holistic Approach

steroids a holistic approach boulder holistic vet angie krause

If you are like many of my clients, you want to avoid steroids for you pet. As a holistic veterinarian, I also want to avoid steroids for my patients; however, there is a time and a place for the judicious use of steroids in cats and dogs. In this article I am going to outline the benefits and risks of steroids to help you make an informed decision for your pet

First let’s start with the benefits:

Steroids can be a magic bullet for certain inflammatory conditions. When we can help decrease swelling and inflammation, we can help the body heal more quickly. Here are examples of conditions that I treat with steroids.

  • Ear infections – I recommend using topical steroids. However, if the ear canal is too swollen for application of ointment, I will use 1-2 doses of a low dose steroid. It is magic! I also use a steroid combined with an enzyme to to help prevent ear infections in dogs that have had chronic ear infections.

Holistic Health Tip – If your dog or cat suffers from chronic ear infections, they may have a food allergy or sensitivity. Investigate their diet and consider removing grain, corn, soy and gluten. Other common allergens are chicken, beef, and fish.

  • Intervertebral Disc Disease (IVDD) – Many veterinarians use non-steroidal anti-inflammatories (NSAIDs) such as Rimadyl instead of steroids. In my 10 years of practice, I have found that steroids are far superior in controlling symptoms and helping regain mobility.
  • Autoimmune Disease – This is when steroids are non-negotiable. Autoimmune diseases occur when your pet’s immune system attacks the body. These are often life threatening and require steroids and other immunosuppressants for survival. The most common forms of autoimmune disease in dogs are immune mediated thrombocytopenia (IMT), immune mediated hemolytic anemia (IMHA) and lupus. Autoimmune diseases in cats are less common.
  • Inflammatory Bowel Disease (IBD) in cats – This disease often causes vomiting, diarrhea, and weight loss. In less severe cases, we can manage the disease using diet and supplements alone. However, in very severe cases, steroids are needed to manage symptoms. I just recently started my own kitty on steroids. I tried using diet, supplements and herbs with no success. He has lost half of his body weight and would have wasted away without medical intervention.
  • Allergic Reactions – If your pet is having an allergic reaction, steroids and antihistamines may be life saving.

Now let’s talk about the downside of steroids:

It is important to understand that if your pet needs to take a short or even a long course of steroids, the side effects are reversible. This is worth repeating. The side effects of steroids are reversible.

This is why I don’t worry about short courses of small doses and you shouldn’t worry either.

Here are all the reasons why we want to avoid steroids.

  • Your dog might pee in the house – Steroids cause both cats and dogs to drink more and urinate more. It is really important that while on steroids you give your pet access to fresh water at all times. This will help protect their kidneys.
  • Increased appetite – For some animals, steroids can cause a voracious appetite. This is dose dependent and is different for every animal.
  • Behavior changes – Some animals can become cranky, aggressive, or even lethargic on steroids.
  • Stomach/intestinal ulcers – This can be prevented by using antacids to help protect the lining of the stomach and intestines. If your veterinarian prescribes steroids, talk to them about ulcer prevention.
  • Damaging gut flora – Steroids can cause an imbalance in the bacteria in the gut and lead to digestive problems.
  • Long term side effects – This is when things really get ugly. Unless your dog has an autoimmune disease, it’s best to avoid long term steroid use. Thinning of skin, damage to the liver, loss of muscle, loss of hair, immune system suppression, and weakening of ligaments are just a few of the most common side effect of long term steroids. Also, long term use of steroids can cause diabetes mellitus in cats. If caught early this is can be reversible. Some pets require long term use of steroids. Work with your veterinarian to find the lowest dose possible, while still controlling symptoms.

What to do if your pet needs to be on steroids:

If your pet has been on a course of steroids here is a protocol that you can use to help support their body afterwards. I use this protocol for a month after using steroids.

  • Repopulate the gut with healthy bacteria – You can achieve this by using over the counter probiotics or by making fermented foods. If your pet has been on steroids, I recommend using both for maximum effect. Culturelle makes single strain probiotics that are not cultured on dairy. 
  • Provide liver support with milk thistle – Steroids are taxing on the liver. Good news, the liver is a master at rejuvenation! I like to use Hepatosupport by Rx Vitamins for Pets. This is a great supplement to use regularly.
  • Repair the gut with Bone/Meat Broth – The collagen found in broth is an excellent way to help repair the gut after a round of steroids. Broth is also very mineral rich. Click here for my chicken broth recipe for cats and dogs.
  • Support detoxification with regular exercise – Increased blood and lymphatic circulation can help your pet flush out metabolic waste. I recommend daily leash walking for dogs (and cats if you have worked that out). Chances are walking on a leash is not your cat’s cup of tea. Check out these food puzzles to help get your kitty moving.

Here are a few parting tips about steroids:

  • If your pet needs a short dose of steroids, it is not the end of the world.
  • Make sure you never give drugs like Rimadyl while giving steroids.
  • Work with your vet to use the smallest dose of steroid for the shortest amount of time. Sometimes a whisper dose of steroids can be immensely helpful.
  • Remember to follow a course of steroids with the protocol I listed above
  • Never stop steroids without your veterinarian’s instruction.

Has your pet ever taken steroids? Tell me about it in the comments below. Remember, you are doing a great job and your pet is lucky to have you!

With love,
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20 thoughts on “Steroids: A Holistic Approach”

  1. I have a cat with pemphigus foliaceus since may 2019. Now he is 1, 5 years old. Every day he is comsumtion corticosteroid drug because we can’t found non corticosteroid drug for pet like ciclosporine here. I’m so scarry about his kidney, liver and other organs. Please, what should I do for him? What is natural treatment, or natural immunosupressive for him?

  2. Hi! My five year old yorkie has suffered from stomach problems for a few years now (thought to be colitis) and we are now about to do a biopsy to see if it could be something more (IBD, Lymphangieasia). If it is, our vet says she will likely need to go on steroids indefinitely. This prospect definitely sounds a bit haunting and I was wondering what your thoughts were as to providing a more holistic approach?

    1. Hi Leah,

      I am so sorry that your pup is struggling with stomach issues! And for so long – how stressful for you both.

      Have the biopsy results for your girl come back? I can certainly understand your concern for long term steroid use!

      If you have the opportunity and resource, both a holistic vet and veterinary internal medicine specialist may both be excellent additions to your pup’s team. You can search the Chi Institute website (under “Resources”) and the AHVMA website (under “Find a Vet”) for local holistic vets in your area.

      Will you keep us posted? You are doing an amazing job!

      Warmly,
      Claire

  3. My cat has been on prednisolone for six years now to treat his immune-mediated Cholangitis. At this time he is getting 5mg once a day because the recent attempt to lower it to 2.5 mg resulted in an elevation of his liver enzymes. Overall to date there have been minimal side effects, but the one big concern I see is lethargy. He has very poor energy and sleeps most of the day. Do you have any advice on counteracting his lethargy?

  4. I have a 16 year old tabby named “Woody” who developed some sort of Inflammatory skin condition around the eyes and ears. We tried all kinds of foods ( he needs to be on a uretic formula for a past UT blockage) including Royal Canin multipurpose formula for suspected food allergies. Nothing seemed to help completely, although when I gave him probiotics that helped for a little while, then it started up again. I have to put eyesalve daily ( steroidal) on the affected areas to keep him from digging at his eyes. I keep his nails cut and filed so the damage from scratching is minimal. The problem doesn’t seem to be seasonal because it happens all year round. I’ve tried giving him the freeze dried raw food since it has so many good ingredients that I hope will help his immune system, like organ meat, bone and probiotics. My main concern is him being on the steroid long term. It’s been almost two years on and off and now pretty much all the time.

    1. Hi Linda,

      Thank you for reaching out. You are doing an amazing job and I know this is so stressful!

      It’s so hard to know what is causing the excessive itchiness without seeing your sweet guy. I completely understand your worry with using steroids long-term. Have you been able to have him seen by a veterinary dermatologist? They may be a great asset to you and Woody’s team!

      Will you keep us posted?

      Warmly,
      Claire

  5. Laura B Mastrangelo

    Hello and thanks for all this information. I am fostering a cat that has IBD. We are trying everything. He was doing better although since he didn’t want to eat the vet advised us to give whatever he wanted. We tried a variety of very good food that he wouldn’t eat. Recently he was doing much better with his diarrhea and my vet advised us to give prendisolone 5 mg twice a day. The third day he developed a terrible diarrhea and my vet is on vacation. Is it possible it was too much prednisolone? Can I try to lower the dose and see how he does? Thank you so much.

    1. Hi Laura,

      IBD can be so overwhelming and frustrating!

      Have you read Dr. Angie’s blog discussing her approach to IBD? It’s a long one, so it’s separated into two parts. Here is part 1 and here is part 2. There is so much good information in these that I think may be helpful!

      As far as how much Prednisolone to give, I would keep working with your veterinarian on this. I know that they were on vacation, but have you been able to connect with the clinic to get more information?

      You are doing a great job!

      Warmly,
      Claire

  6. My 2 sister Lhasa’s have been prescribed Temaril P. They are suffering from auto immune problems due to their 1st rabies and unfortunately before I was aware the problem was rabies vaccine, they received a 2nd vaccine a year later. Vaccinois was diagnosed and 1 now has hypothyroidism from this. They have extreme environmental allergies since 4 months after the 1st rabies. March – November is the worse time of the year. Complete hair loss, eye and nose discharge, blackened elephant skin, ear infections, skin yeast and bacterial infections. I hate that I have to use drugs on them at all to help. A drug is what gave them this condition so you can understand why I do not want to use drugs. Apoquel and Cytopoint have been suggested. Apoquel I will not use. Too many dangerous side effects. Cytopoint, too new to know what the long term side effects are. Atopica to me is worse than Apoquel so I do not want to use that either. Is there anything else I can do for them other than Temaril P? Is there any other supplement I can give? They are miserable itching and scratching until they scratch the skin raw and bleeding. They are home-cooked for, no chicken, beef, fish. I stay with pork, turkey, duck or bison, green veg, berries. No grains, use herbs, some TCM from our current vet, omegas, raw goat milk, probiotics; nettles to help with itching but that only does so much. I really don’t want to use the Temaril P due to the steroid but I do not know what else to try and their very few true holistic vets that are true holistics in my area. I have been to 4 out of the 7 holistic vets and called the other 3. They all use Atopica, Apoquel, Cytopoint and other drugs. There are no homeopaths in my area either. Are there an other suggestions I could try?

  7. Christina Bourne

    My 14 yo male cat has suffered from IBS for 7 years. It has been up and down on steroids and off steroids. He developed what the vet said was asthma during this time. 2 late spring/early summers in a row he has a huge flair up and he was given a rabies shot both summers. Last year he had a kidney infection and supposedly pneumonia, spent a week in the hospital and came home on Science Diet ID canned, Cerenia and Famotidine plus fluids. During that time he had very inflamed lymph nodes. We opted for not biopsying because it would have been inconclusive die to heavy steroid use. He did fabulous during the winter month and gained up to 12 lbs from 10 lbs. Spring came, he started going outside. He began coughing, 1 ear developed the blue/black bumps, inside but he was still doing fine with digestion and weight. I took him back to internal medicine for routine checkup and ultrasound showed a mass in his stomach, possible mass on pancreas, and very large lymph node. Given his history with IBS, coughing and ear bumps I know he is in a huge flare again. I told her I was declining biopsies just because if it is lymphoma there is no cure and very expensive. I spent 8,000 last hear on him. I am just wondering if its possible that all of the “masses”could be inflamation since I see it in his ears and hear his coughs. None of us could believe he had this ultrasound result not seeing any digestive signs. I wonder if it would be worth trying to change him to rabbit or venison since ID is chicken and pork and adding supplements like probiotics, L-lysine. Anybody got any suggestions. His specialist wants to keep his food the same although it is probably causing him to react and be inflamed.

    1. Dr. Angie Krause, DVM

      Hi Christina,

      I am so sorry to hear that your boy has been going through such a hard time recently. I know this probably feels so overwhelming.

      It’s so hard to know what the masses may be without biopsy.

      Have you read Dr. Angie’s blog discussing IBD in kitties? Here is Part 1, and here is Part 2. It has a wealth of information, that may also be helpful!

      I hope this helps. Big hugs to you and your kitty!

      Warmly,
      Claire

    1. Dr. Angie Krause, DVM

      Hi Amanda,

      Steroids can be absolutely life saving for cats with immune mediated disease. My own kitty is on steroids everyday. I like to use supplements that will help support the gut lining. Probiotics are a great place to start. I really like this new Thorne probiotic. Other gut supporting herbal blends like Nutrigest can also be helpful. Feeding a low carbohydrate diet is imperative.

      Keep us updated on your sweet kitty!

      Dr. Angie

      1. Thank you! We are not sure yet if Hank’s condition is auto immune but that is the current ‘most likely’ thinking.

        First we are dealing with a secondary infection of his nail beds (several toes) and then we will dig deeper to find out the root cause. Speaking of which, I assume probiotics are definitely necessary after antibiotics, anything else? Milk thistle? Anything for kidney support?

  8. Becky McEnerney

    My cat never had symptoms of IBD and it was found on an ultrasound because she has lung issues. Endoscopy was performed as well as biopsies where it was determined she did in fact have IBD. Long story short, shortly after starting predniselone, enduring ravenous appetite and hanging over the water bowl for hours, a bladder infection ensued. Had to be on antibiotics for 21 days, with massive diarrhea the entire time. I requested to change her to budesonide as my other 2 IBS kitties tolerated it well. The ravenous hunger and thirst subsided. Yeah!! Now 2 months later she is having another UTI so I am going to request to take her off all steroids. She is again having massive diarrhea with the antibiotics, is not eating, and has started vomiting. This seems to be a case of the cure killing my poor baby. I am going to see if I can manage this holistically with the ZD wet and hydrolyzed dry. I give her B12 shots, holistic vitamins, Omegas, clay, probiotics, and psyllium seed. I will add more supplements after reading your article and do everything in my power to keep or get her healthy again. Ruthie is a vey finicky eater and although I tried going raw with my other IBD kitties, they couldn’t tolerate it and even with minute amounts, it would be vomited. Thanks for all the great information. Becky, Kingston, WA

    1. Dr. Angie Krause, DVM

      Hi Becky!

      This is an excellent point! If the CBD product you are using reports the amount of CBD in percentage, you must first convert the percentage of CBD into milligrams of CBD. Percentage of concentration is equal to grams/100 mls. For example if you had a 20% solution, you would have 20 grams of CBD per 100 mls. This would need to be converted to milligrams per milliliter. There are 1000 mg in 1 gram. Brings me back to college chemistry!

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