Is Cortisone Safe for Dogs?

Safety is often a relative concept when it comes to medications.

Take a couple of acetaminophens for a headache and you’ll probably be fine; take a couple of them every day for the next decade, and your liver may melt. The same principle holds true for many of the medications we give dogs, and cortisone is a great example.

We’ll explain what cortisone is, what it is used to treat and the typical ramifications of its use below. Just be sure to discuss the matter with your vet before administering this or any other drug to your dog.

Key Takeaways: Is Cortisone Safe for Dogs?

• Cortisone is a naturally occurring hormone in dogs (and other animals). It is typically released in response to stressful stimuli, such as injuries or illness.
• Cortisone is also used administered as a medication to treat various ailments. A few of the most common things cortisone is used to treat include hot spots, arthritis, and autoimmune diseases.
• Over the short-term, cortisone is safe for many dogs. However, when administered over long periods of time, it can lead to health problems, including acne, thyroid dysfunction, and recurrent bladder infections.

What Is Cortisone?

Known to chemists as 17α,21-dihydroxypregn-4-ene-3,11,20-trione (there will be a quiz on that later), cortisone is a hormone known as a corticosteroid, which is produced by your dog’s adrenal glands.  

Essentially, your dog’s body releases cortisone in response to injuries, illnesses, and other threats. Part of the fight-or-flight response, it helps to reduce any pain and itching arising from the problem. It also more-or-less halts the body’s inflammatory response and yanks the reins on the body’s immune system.

You’ll also hear about cortisone being used as a medication, but this is a bit of a misnomer: The term “cortisone,” in this sense, is used more generically, and refers to a variety of different steroid medications, including prednisone, methylprednisone, dexamethasone, hydrocortisone, and betamethasone. The actual cortisone your dog’s body produces is not used as a medication. 

Technical distinctions aside, medications falling under the “cortisone” umbrella are available in oral and injectable forms, as well as a topical cream (which is technically known as hydrocortisone). The vast majority of these medications are only available by prescription (aside from some weak topical versions, which are available over-the-counter).

What Types of Conditions Is Cortisone Used to Treat in Dogs?

Cortisone is primarily used to treat inflammation-related disorders in dogs, although it is also used to provide pain relief or increase mobility in some cases. The most common conditions for which cortisone is prescribed include:

• Hot spots, rashes, itchy skin and similar problems
• Outer ear canal inflammation
• Environmental allergies
• Autoimmune diseases
• Neurological inflammation or injury
• Allergic reactions (such as bee stings)
• Respiratory system inflammation
• Hypoadrenocorticism (Addison’s disease)

Cortisone injections were also historically used to treat joint issues, such as osteoarthritis and hip or elbow dysplasia. However, this type of use isn’t common anymore.  

Cortisone is typically regarded as very effective, especially for treating environmental allergies. It is generally considered safe in the short term, but long-term use can cause serious health problems.

Cortisone Dosage and Administration

Cortisone is generally only available by prescription, so your vet will have to determine a suitable dosage based on the condition being treated, your dog’s size, his medical history and the severity of the symptoms. Your vet will also determine whether it’s better to use a short- or long-acting steroid to address your pet’s specific problem — some only work for a matter of hours, while others continue to work for weeks at a time. 

While both oral and injectable forms are considered safe when used under the supervision of a vet, topical forms do not lead to as much systemic absorption. This means that they’re usually considered even safer.   

Cortisone can cause a number of important side effects (more on these below), so it is typically used for the briefest period possible. Your vet will usually begin by administering relatively high doses of the medication to halt the troubling symptoms quickly, and then he or she will taper the dose down until the minimum effective dose is determined. 

It’s also important to note that oral or injectable steroid medications must be gradually reduced over time. Suddenly stopping steroid medication regimens can cause your dog’s adrenal glands to go into shock. 

Cortisone Side Effects in Dogs

Despite its efficacy and value in treating several medical problems, cortisone can cause a litany of side effects. Some of the most common side effects occur relatively quickly, while others only appear after long-term use.

Some of the most common short-term side effects include:

• Poor resistance to bacterial, fungal, and viral infections
• Increased thirst and water consumption
• Frequent urination
• Increased appetite and food consumption
• Reduced energy level
• Weight gain
• Panting
• Nausea
• Vomiting

Dogs who are treated with cortisone for lengthy periods of time (months rather than weeks) may suffer from the following long-term side effects:

• Recurrent or treatment-resistant bladder infections
• Thinning of the bones, ligaments, and skin
• Blackheads
• Predisposition to diabetes mellitus
• Demodectic mange (which is typically rare in adult dogs)
• Muscle weakness
• The development of a pot belly
• The development of skin plaques
• Fatty liver
• Thyroid dysfunction
• Cushing’s disease

Bladder and urinary tract infections are so common among dogs receiving long-term cortisone treatment that many vets begin testing urine samples routinely, even if no symptoms are noticed or reported (cortisone will often eliminate the pain and discomfort that accompanies bladder infections).

Regular blood tests are also important for catching infections in other parts of your dog’s body.

Contraindications for Cortisone

Not all dogs can safely tolerate cortisone, which is part of the reason the medication is only available by prescription.

For example, dogs with the following conditions should usually avoid taking cortisol:

• Poor liver function
• Liver disease
• Weakened or compromised immune systems
• Diabetes mellitus
• Cardiac problems
• Systemic infections
• High blood pressure

Additionally, some vets hesitate to prescribe cortisone for pregnant or lactating dogs, or puppies less than 6 months of age.

Alternatives to Cortisone For Dogs

Because cortisone is often problematic when used over the long-term, your vet may recommend trying a few other medications and treatment strategies if your dog’s problem continues after several weeks or months.

However, the alternatives will vary depending on the type of condition your dog has.

 Dogs Suffering from Osteoarthritis or Dysplasia

Hip dysplasia, elbow dysplasia, and osteoarthritis are often treatable with several cortisone-free strategies. Omega-3 supplements often reduce dog inflammation (particularly when administered in very high doses), and glucosamine and chondroitin can also help reduce joint inflammation and support the creation of cartilage, which will help cushion the bones and reduce friction.

NSAIDs and other pain medications may also provide relief to dogs with joint problems, as can weight loss and physical therapy. Surgical options are also effective in many cases, and they usually completely eliminate the symptoms associated with dysplasia.

 Dogs Suffering from Allergies or Skin Conditions

Cortisone is usually very effective for treating skin conditions and allergies, so it is one of the first tools out of the box for vets trying to treat afflicted dogs.

However, because many dogs require long-term (potentially life-long) treatments for environmental allergies, alternative approaches often prove necessary.

Omega-3 fatty acid supplementation can be effective for skin conditions too, as their inflammation-stopping capabilities are somewhat similar to those achieved by cortisone. Antihistamines are also effective in many cases, although second-generation antihistamines (such as Allegra) are often more effective than first-generation options, such as Benadryl or Zyrtec. Apoquel may be another option to discuss with your vet.

If your dog is suffering from environmental allergies, you should always take steps to eliminate the primary cause. For example, if your dog is allergic to oak tree pollen, you may need to limit his time outdoors while the oak trees are blooming. You’ll probably want to bathe him a little more frequently during this time and vacuum your house a few times too.

De-sensitization therapy may also prove helpful for some dogs. This treatment strategy relies on exposing your dog to minute quantities of the offending allergen, in hopes of getting his immune system to recognize that the substance isn’t dangerous.

This will hopefully get your dog’s immune system to chill out a little, which will put an end to dry skin, itching and similar problems.

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Has your pup ever needed cortisone to feel better? What condition did he have that necessitated it? Did it work as well as you’d have liked? Let us know all about your experiences in the comments below.