Glucocorticoids
Corticosteroids
Also known as: Prednisone · Dexamethasone · Hydrocortisone · Methylprednisolone · Kenalog · Recicort · Glucocorticosteroids · Triamcinolone acetonide
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Anti-inflammatory (Prednisolone equivalent) | 0.5-1.0 mg/kg | PO | q12h to q24h | Taper to lowest effective alternate-day dose | 🌍 EU |
| Immunosuppressive (Prednisolone equivalent) | 2.0-4.0 mg/kg | PO | q24h (divided q12h initially) | Taper slowly over weeks to months | 🌍 EU |
- Anti-inflammatory (Prednisolone equivalent): Doses are highly variable depending on the specific glucocorticoid used.
- Immunosuppressive (Prednisolone equivalent): Monitor closely for severe adverse effects at these doses.
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Anti-inflammatory (Prednisolone equivalent) | 1.0-2.0 mg/kg | PO | q12h to q24h | Taper to lowest effective alternate-day dose | 🌍 EU |
| Immunosuppressive (Prednisolone equivalent) | 2.0-4.0 mg/kg | PO | q12h to q24h | Taper slowly over weeks to months | 🌍 EU |
- Anti-inflammatory (Prednisolone equivalent): Cats require higher doses than dogs and should receive prednisolone, not prednisone.
- Immunosuppressive (Prednisolone equivalent): Monitor for signs of diabetes mellitus.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Glucocorticoids are a broad class of steroid hormones with profound effects on virtually every cell type and system in mammals. In veterinary medicine, they are utilized across four broad dosage ranges and indications:
- Physiologic Replacement: For patients with adrenal insufficiency (e.g., Addison's disease).
- Anti-inflammatory: To manage allergic states, respiratory diseases (asthma), dermatologic conditions, and osteoarthritis.
- Immunosuppressive: For autoimmune disorders such as immune-mediated hemolytic anemia (IMHA), thrombocytopenia, pemphigus, and systemic lupus.
- Antineoplastic: Used as cytotoxic agents in certain neoplasias (e.g., lymphoma).
Clinical Pearl: Cats generally require higher dosages than dogs to achieve the same clinical effect but tend to be more resistant to developing adverse effects. Conversely, dogs are highly sensitive to glucocorticoids and readily develop iatrogenic hyperadrenocorticism (Cushing's syndrome) with chronic use.
Mechanism of action
Glucocorticoids exert their effects primarily by binding to cytosolic glucocorticoid receptors (GR). The receptor-ligand complex translocates to the nucleus, where it binds to glucocorticoid response elements (GREs) on DNA, altering gene transcription (transactivation and transrepression).
- Anti-inflammatory Pathway: They induce the production of lipocortin (annexin-1), which inhibits phospholipase A2. This blocks the release of arachidonic acid from cell membranes → dramatically decreasing the synthesis of both prostaglandins and leukotrienes.
- Immune Suppression: They inhibit macrophage function, decrease circulating T-lymphocytes, suppress inflammatory cytokines (IL-1, IL-6, TNF-alpha), and inhibit the complement cascade.
- Metabolic Effects: Stimulate gluconeogenesis, mobilize amino acids, and redistribute adipose tissue, which can lead to insulin resistance.
Safety & warnings
Contraindications
- Systemic fungal infections (unless used for physiologic replacement)
- Intramuscular administration in patients with idiopathic thrombocytopenia
- Known hypersensitivity to the specific compound
- Chronic use of sustained-release injectables for systemic diseases
- Concurrent use with NSAIDs (relative contraindication due to severe GI ulcer risk)
- Pregnant animals
- Renal disease (systemic use)
- Diabetes mellitus (systemic use)
- Corneal ulcers
- Concurrent use of NSAIDs
- Uncontrolled diabetes mellitus
- Late pregnancy (may induce abortion or parturition)
Adverse effects
- Polyuria (PU), polydipsia (PD), and polyphagia (PP)
- Weight gain and fat redistribution
- Panting (especially in dogs)
- Dull, dry haircoat and alopecia
- Vomiting and diarrhea
- Gastrointestinal ulceration
- Elevated liver enzymes (ALP > ALT) and vacuolar hepatopathy (dogs)
- Pancreatitis
- Insulin resistance leading to or worsening diabetes mellitus
- Muscle wasting and weakness
- Behavioral changes (depression, lethargy, viciousness)
- Iatrogenic hyperadrenocorticism (Cushing's syndrome) with chronic use
- Laminitis (horses)
- Hypothalamic-pituitary axis (HPA) suppression
- Adrenal atrophy
- Weight loss (catabolic effect)
- Cutaneous atrophy
- Diarrhoea
- Increased urine glucose levels
- Decreased serum T3 and T4 values
- Impaired wound healing
- Delayed recovery from infections
- Muscle weakness
- Obesity
- Thromboembolic disease
- Polyuria and polydipsia (PU/PD)
- Muscle atrophy and weakness
- Alopecia and thin skin
- Insulin resistance and secondary diabetes mellitus
- Immunosuppression and increased susceptibility to infections
- Hepatomegaly and elevated liver enzymes (steroid hepatopathy in dogs)
Precautions
Animals receiving systemic glucocorticoids (other than short-term 'burst' therapy) MUST be tapered off the drugs slowly to allow endogenous ACTH and corticosteroid function to return. Abrupt withdrawal can precipitate a life-threatening Addisonian crisis. During periods of stress (e.g., surgery, trauma, severe illness) during the tapering process, additional glucocorticoids should be administered. Use with caution in young, growing animals as it can retard bone growth.
Drug interactions
May cause hypokalemia when administered concomitantly
May lead to profound muscle weakness in myasthenia gravis patients; discontinue 24h prior if possible
Glucocorticoids may reduce salicylate blood levels; increased risk of GI ulceration
Glucocorticoids may inhibit hepatic metabolism of cyclophosphamide
May mutually inhibit hepatic metabolism, increasing blood levels of both drugs
Increased risk for arrhythmias secondary to glucocorticoid-induced hypokalemia
May cause additive hypokalemia
May increase glucocorticoid metabolism
May potentiate the effects of hydrocortisone and possibly other glucocorticoids
Insulin requirements may increase due to glucocorticoid-induced insulin resistance
May decrease glucocorticoid metabolism
May alter steroid metabolism; higher steroid doses may be necessary to treat mitotane-induced adrenal insufficiency
Significantly increased risk of severe gastrointestinal ulceration
May increase the metabolism of glucocorticoids
May increase the metabolism of glucocorticoids
May increase the metabolism of glucocorticoids
Live attenuated vaccines should be avoided due to augmented virus replication; diminished immune response to all vaccines may occur
Hypokalaemia may develop
Decreased metabolism of corticosteroids
Significantly increased risk of severe gastrointestinal ulceration and perforation.
Increased risk of hypokalemia due to additive potassium-wasting effects.
Monitoring
- Weight, appetite, and signs of edema
- Serum and/or urine electrolytes (potassium, calcium, sodium)
- Total plasma proteins and albumin
- Liver enzymes (ALP, ALT, GGT)
- Growth and development in young animals
- ACTH stimulation test (if assessing adrenal recovery or iatrogenic Cushing's)
- Clinical signs of hyperadrenocorticism
- Blood glucose (especially in diabetics)
- Thyroid panel (T3/T4 may decrease)
- Clinical signs of PU/PD and weight gain
- Blood glucose (due to diabetes mellitus risk)
- ACTH stimulation test (to monitor HPA axis suppression)
- Water intake and urine output
- Appetite and body weight
- Blood glucose (especially in cats)
- Liver enzymes (ALP is typically markedly elevated in dogs on steroids)
- Clinical signs of secondary infections (e.g., UTI, pyoderma)
- Gastrointestinal signs (vomiting, melena)
Pharmacokinetics
Half-life
Absorption
Varies significantly by ester formulation. Sodium succinate/phosphate esters are absorbed very rapidly (minutes). Acetate esters are absorbed moderately (days to weeks). Acetonide esters are absorbed poorly (weeks).
Distribution
Widely distributed. Unbound glucocorticoids can enter milk and cross the placenta.
Metabolism
Primarily hepatic metabolism.
Elimination
Metabolites are primarily excreted by the kidneys.
Overdose
Short-term massive overdoses are unlikely to cause acute harmful effects, though one case of acute CNS effects in a dog has been reported (treat supportively). Chronic overdosage leads to serious adverse effects manifesting as iatrogenic hyperadrenocorticism (Cushing's syndrome).
Available products
Formulations
- Oral tablets and liquids
- Injectable solutions (e.g., sodium succinate/phosphate esters for rapid onset)
- Injectable suspensions (e.g., acetate/acetonide esters for sustained release)
- Topical creams, ointments, and sprays
- Ophthalmic drops and ointments
- Injectable: 40 mg/ml suspension for deep i.m., intra-articular or intralesional use
- Topical: Solution containing 1.77 mg/ml with 17.7 mg/ml salicylic acid
- Systemic (Oral/Injectable)
- Local
- Inhaled
- Oral liquids
- Injectable solutions (e.g., sodium phosphate salts)
- Injectable suspensions (e.g., acetate or acetonide salts)
Veterinary
- Kenalog 40 mg/ml injectable suspension
- Recicort 1.77 mg/ml topical solution
- Prednicare (Prednisolone tablets)
- Dexadreson (Dexamethasone injection)
- Moderin (Methylprednisolone tablets)
Human-labeled
- Prednisolone tablets
- Dexamethasone tablets/injection
- Hydrocortisone tablets
Regulatory status
Withdrawal times: cattle meat Varies by specific drug and formulation
Widely approved across member states.
POM-V classification.
No regulatory data for: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Store according to specific product labeling, generally at room temperature away from light and moisture.
Client information
CRITICAL WARNING: Never stop this medication abruptly unless specifically instructed by your veterinarian. Your pet's body stops making its own steroids while on this drug, and sudden withdrawal can cause a life-threatening crisis.
- Expected Changes: It is very common for pets (especially dogs) to drink more water, urinate more frequently, and have a ravenous appetite while on this medication. Ensure they always have access to fresh water and frequent bathroom breaks.
- Panting: Dogs may pant excessively; this is a common side effect.
- Behavior: Some pets may become lethargic, depressed, or unusually irritable.
- When to Call the Vet: Contact your veterinarian if you notice severe vomiting, dark/tarry stools (a sign of stomach ulcers), extreme weakness, or if the increased thirst/urination becomes unmanageable.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.