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
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
- 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.
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.
March 27, 2023
My little dog peekapoo has severe itching problems. I have tried everything. He gets a shot from the vet (steroid) but I do not want him to get that all the time. Long term will effect him. I have changed his food thinking it may be that but its not. He bites and scratches his back end and feet all the time . I was wondering if anyone had any other solutions I could try. thanks in advance.
March 27, 2023
Hey there, Melissa. We’re sorry to hear about your dog’s itchiness!
Fleas are another common cause of itching, but I’m guessing you’ve already ruled that out. Have you spoken to your vet about environmental allergies? Those are much more common than food allergies.
May 20, 2020
Our 7-month-old German Shepherd is having a terrible time with grass pollen. We’ve tried regular doses of Benadryl. He’s also getting a skin-conditioning supplement. and medicated oatmeal baths once a week. Either way, he’s chewing holes in his pelt, chewing sores on himself, scratching sores on himself, rubbing his eyes raw…I mean the poor puppy looks so bad we call him Scarface.
His eyes don’t seem to be bothering him as bad, and I see the swelling is starting to go down. It could be the allergen is no longer bothering him, but all the scratching and sores have started a different vicious cycle of itchiness.
So, our vet is going to give him a Cortisol shot Friday. Our goal is to just get him to stop scratching for a while so the sores and rest of his skin can heal. I think once we break the cycle, he’ll get much better.
April 11, 2020
I cannot identify my dogs newly developed allergy. She is ten years old. Her symptoms became noticeable when she was just nine yrs. old. I’ve used Apoquel, I’m only on a second script and it’s not as effective as I imagined. I also used to pet sit a small dog (mine is 50 pounds) who was on a high dose of Apoquel daily and it did not work for her either. I don’t like the idea of any steroid and avoid using it for my asthma. I could try Allergra, she does take omega supplements daily in a fairly high daily dosage. I’m at a loss. I was hoping one injection of Cortisone would keep her inflammation down for at least six months meaning she may need one twice a year. It seemed to help my cat for six months. I’m not completely comfortable with this choice though.
April 11, 2020
That sounds frustrating for you and your pooch, Helen!
Have you spoken with your vet about possible alternatives?
November 7, 2018
My golden retriever had two hot spots treated by cleaning, a cortisone shot and oral antibiotic. For one week she has been drinking twice as much water as normal and peeing in house which she has never done. Will contact vet for advice but is this result of the one time cortisone shot or antibiotics?
November 8, 2018
Definitely check with your vet, but frequent urination (including accidents) is a pretty common side effect of cortisone. It’s probably no cause for worry.
Let us know what your vet says!
July 21, 2018
My jack Russell is age 14 he has been on Bravecto, Benadryl, Baytril,Apoquel,Ketoconazole and an ophthalmic ointment for his eyes. Nothing has worked and he continues to itch, chew and smells from yeast infection I believe. I’ve bathed him with oatmeal, medicated shampoos, iodine in bath water etc. I’m at my wits end and don’t know what to do for him. Any ideas ?
July 18, 2018
Just experienced a continuous 40 day exceptionally sunny period ( Ireland) Celcius 30. Lots of dry grass where my Lakeland Terrier likes to frolic. Now he’s scratching all over
And even pulling tufts of his hair out with his teeth. He now has a sore wound on his hind leg and on his undercarriage between
Base of penis and testicles. Applying Vet prescribed ‘Isaderm’ to these sore wounds, seems to be giving positive results.
Continuous full stretching ( jerking ) of one or the other of his back legs while sleeping.. Been reluctant to allow Vet to prescribe Cortisone. However having read your article we have just now made another appointment with our Vet. To discuss this form of treatment.