Prednisone Alternatives so That Your Itchy Dog Can Avoid the Serious Side Effects


Dr. Mark is a veterinarian. He has been working with dogs for more than 40 years.

Treating Itchy Dog Skin

Since steroids first hit the market in 1949, many vets have used them as the best alternative treatment for dogs with itchy skin. They have become so popular that some clients expect to come into the vet clinic and get “that allergy shot."

Why do we use them so much? Well, one reason is that they do work. Prednisone and other steroids are a quick solution and often provide almost immediate relief. They are not a cure, however, and there are many problems and side effects associated with them. You may be wondering:

  • What are the problems that can hurt your dog when prednisone is used?
  • Are there alternatives so that you can avoid those side effects?

The Side Effects of Prednisone

  • Many dogs drink more on prednisone. Since prednisone affects your dog's ability to control the water level in his body, he will drink more, and then he will have to urinate more. When a previously house-trained dog has to go in the middle of the night and no one will let her out, accidents do happen.
  • Dogs are hungrier. Prednisone stimulates the appetite and dogs will want to eat all of the time. They do not burn up more calories, however, so weight gain is a problem.
  • Your dog might mope around. One side effect you might notice is that your dog does not want to get up and go for a walk. His back legs might be weak from muscle wastage, or he just may be lacking in energy.
  • Some dogs pant a lot. This is a common complaint for those people that allow their dogs to sleep in their bed.
  • A dog's skin problem can actually grow worse. Dogs might be treated for an itching problem and then start losing hair, develop blackheads, thin skin, or even a large area of hairless and scaly skin known as “calcinosis cutis."

More Side Effects

The dog in the video above has a disease that mimics the side effects of long-term prednisone dosing in the dog.

Other side effects include:

  • Your dog may develop new infections. Since prednisone depresses the immune system, some dogs will come up with an infection in the bladder or the gums.
  • Dogs vomit and may have other GI upsets. This is not as common as the increased thirst and hunger, but when it happens it can be serious.
  • Dogs may also have behavioral problems or uncommon reactions that are not included in this list. If your dog is sick and a steroid injection is suggested before other things have been tried, think about the side effects.
  • Some dogs have even more problems with prednisone: muscle wasting, changes to the muscle of the heart, pancreatitis, and even blood clots and stroke can occur in some cases.

Alternatives to Prednisone

Steroids like prednisone are dispensed for many different problems and at times are the only medication available that will help a dog. If your dog is being treated for a skin problem, though, there are a lot of other things you can do that might help.

  • Improve your dog's diet: Just switching brands is not enough to help your dog avoid steroids and deal with his skin problems. Learn how to feed your dog healthy raw food that contains the essential vitamins, enzymes, essential fatty acids, and other nutrients he needs to improve the quality of his skin.
  • Shampoo: Some skin diseases will respond to frequent shampooing to remove the allergens that cause excessive itching. All dogs will respond to the cool water and a cleaner skin. No matter which product you use, most of them help.
  • Flea control: The most common cause of scratching in dogs is still fleas. Some dogs are so allergic to the saliva of the flea that only one bite will make them chew their skin. Even if no signs of fleas are present, over half the dogs that are presented for skin problems are afflicted with fleas, so all dogs should be protected against fleas before starting a prednisone trial or even one of the alternatives.
  • Natural alternatives: Some herbs and other natural substances can reduce inflammation of the skin, relieve itching, and make your dog comfortable enough to avoid prednisone. Most of them have few side effects and can even help your dog in several ways.
  • Antihistamines: If your dog's allergies are not that severe, sometimes just an antihistamine will take care of his problem. The antihistamine may not be as fast, and it may not clear things up 100%, but your dog's health is a lot less compromised.
  • Prescription allergy suppressants: Some of the drugs that have been developed for use in dogs with allergies may end up being as bad or worse than steroids. Natural alternatives should be tried first, but even if they fail there are new medications that can be tried.

Improving Your Dog's Diet

When presented with a dog suffering from itchy skin, the first thing I recommend is a radical diet change. If you want to try alternatives instead of prednisone, this is a great place to start.

I am not talking about buying a different brand of dog food. The processed dog foods sitting on the shelf of your grocery store may each be different, but one thing is the same: They are all processed and have been sterilized enough to be sitting out on a shelf.

So what does a dog with skin disease need? There are suggestions, but we probably do not know. We know a lot more about skin problems than we did 100 years ago, but does that mean we know everything a dog needs? Foods that announce that they are 100% complete are formulated based on research that was done years previously, and it may be inaccurate. A natural diet made up of the raw components described below provides more than that.

Does a diet change always prevent a dog from needing prednisone?

No, your dog food can have every known essential nutrient required, and in excess, and if he is allergic to some things, he will still have symptoms on an improved diet. So why even bother trying?

We try an improved diet because it will help some dogs. Dogs that have been fed cheap food, or even a good food that is marginally deficient or deficient in ways that we do not even know about, may improve dramatically.

No, we do not know everything yet. What we do know is that your dog's diet should be made up of:

  • About 50% raw meaty bones: Grass-fed beef, chicken carcasses, tails, etc.
  • About 25% soft meat: Beef cheeks, beef hearts, beef tongues, and other cuts of meat available cheap from your butcher.
  • 10% organ meat: To provide the other vitamins and minerals your dog needs, add some kidneys, liver, lungs, and other internal organs.
  • 10% vegetables: As long as you are willing to blend your dog's veggies so that he is able to digest the cellulose, you can supplement with broccoli, green leafy vegetables like spinach, and carrots.
  • About 5% eggs, fruits, and fresh fish: As an added source of calcium, you can give the eggs with the shells, add some fresh fruit like papaya or avocado, and once a week or so give a fresh fish like mackerel or sardines to supplement his omega 3 fatty acids.

These amounts are not exact. You do not need to get out a scale and figure that your dog needs 1 kilo of meaty bones, 100 grams of vegetables, etc. Just make sure that you are feeding your dog a varied diet.

Supplements are not usually necessary for a healthy dog since this diet will provide what a dog needs. With a dog suffering from allergies serious enough to warrant prednisone therapy, however, it is a good idea to give some of the anti-inflammatory natural therapies that I have described elsewhere. (Licorice, coconut oil, sulfur, and omega fatty acids.)

When you are ready to switch your dog's diet, do some research before switching. There are many good sources out there, and the more you learn the better for your dog.

Bathing Your Dog

Is there one kind of shampoo that is always going to help a dog suffering from itchy skin? Unfortunately, there is not. If the itching is caused by dry skin, oatmeal shampoo is most effective. If your dog smells like yeast and has thickened and greasy skin, a benzoyl peroxide shampoo is best. If your dog has a secondary infection, then a shampoo with chlorhexidine will help.

If you are not sure of the source of the allergy, the most important thing is to bathe the dog regularly and remove any potentially irritating substances. I cannot give you a definite interval. Some dogs will develop dry skin if they are bathed too often, some will get greasy and start itching if you do not bathe them often enough. I usually recommend about once a week to start and then increase or decrease the frequency based on how he or she responds.

Try a good cleansing shampoo (labeled for dogs, like benzoyl peroxide) and use it about every week to start. If it works, stick with the same product. If it does not, try another shampoo.

Natural Alternatives

Many natural alternatives are available. None of them are going to work as fast as prednisone, so be prepared to watch for any changes for several weeks:

  • Licorice: This is the alternative that I encourage all clients to try before steroids. It has a glycoside (glycyrrhizin) that works similar to steroids, although not as effectively, but does not have many of the side effects. (If you do try and use this plant, be sure to buy the product that makes licorice tea. You can make about one-half cup with a teaspoon of licorice root powder each morning and then give your dog about 1.5 ml for every 10 pounds of body weight. Some holistic vets do not recommend giving it more than a few weeks because of the potential for potassium loss, but since many allergic dogs will need help for longer than this during the allergy season, it is okay to give it longer. Just make sure you supplement your dog's daily potassium intake, like giving her a banana every day.)
  • Coconut Oil: This natural product improves your dog's skin and may be all that he needs. Coconut oil has some natural antibiotic effects and may reduce a mild skin infection secondary to allergies. It also has a high level of antioxidants that will moisturize your dog's skin, and since the itching may just be to dry patches that you are not able to notice, coconut oil will provide relief.
  • Sulfur: This product is normally just sold as a solution for killing mites, but I recommend it for many dogs with skin disease of unknown origin. For best results mix the sulfur powder with virgin coconut oil (about 1 part sulfur to 2 parts coconut oil) and apply it to any inflamed areas of the skin. If the dog is allergic to mites or is itching secondary to a mild bacterial infection, the sulfur will help. (When using this product, I think it is a good idea to apply it outside and make sure it is all absorbed or removed before coming back inside. If you do not and your house has carpets, he will roll around and stain them.)
  • Fish Oil: This supplement takes some time to work but makes the skin less likely to produce the components of inflammation and itching. Cold water fish oil is best since it contains a high level of omega-3 fatty acids. I am not talking tiny amounts, like those available in dog foods labeled “extra omega acids added.” Your dog needs at least 70mg/kg per day of omega 3 fatty acids, and if he is getting a source of omega-6 acids (like coconut oil) he will need even more. The best way to provide it to him is by giving fish oil in the form of fresh mackerel or sardines, but if you do not have a good source then fish oil capsules can also be given.
  • Yucca: Some holistic vets have tried this herb and found that it is helpful as a prednisone alternative, but there are side effects. It can upset the GI tract of some dogs, and since it has not been used a lot, it may affect many dogs.

Antihistamines and Prescription Alternatives

The next step to help your dog is not as mild as a diet change or a shampoo. To provide quick relief, however, it is sometimes better to give him an antihistamine. Benadryl (diphenhydramine) is not approved, but it is an antihistamine that has been used for many years and is safe when used in controlled doses. An itching dog can be given about 1 mg per pound. (The pills are small and easy to hide in a piece of cheese or other favorite treat.) Benadryl tends to make dogs a little sleepy, but that is a good thing since he will not be scratching when taking a nap.

Unfortunately, diphenhydramine is only effective when it happens to work. Antihistamines work in a lot less than a third of the cases, so some vets that use them instead of natural substitutes for prednisone will have a series of drugs to try and find out which one might be effective.

If the antihistamine is not enough, you will need to talk to your vet about some of the other potent new drugs available for itching. Some dogs will do better with a cyclosporine pill (Atopica), but it is a potent immunosuppressant and does cause upset stomachs and other problems in some dogs. Others do well on a drug called Apoquel but it too can have a lot of side effects and should be avoided if possible.

The Best Thing for Your Dog

If your dog is scratching, it is a sign that he is in great discomfort. Some people will search for help at the first sign of problems, while others will wait until their dog is chewing all night and has irritated his skin.

Do not wait. Dogs are stoic animals and will not let us know about many of their problems until they are already serious. If your dog has started to chew on his skin, he is already in great discomfort. Learn everything you can about skin diseases in dogs, get him into your local vet for an exam as soon as possible.

References

  • Treatment of canine atopic dermatitis: 2015 updated guidelines from the International Committee on Allergic Diseases of Animals (ICADA), Thierry Olivirry et al, BMC Vet. Res., 2015
  • Double-blinded, placebo-controlled study to evaluate an antipruritic shampoo for dogs with allergic pruritus, Schilling, Journal of Veterinary Research, 2012 Jul 28;171(4):97
  • Biagi, Giacomo & Mordenti, Attilio & Cocchi, Massimo. (2004). The role of dietary omega-3 and omega-6 essential fatty acids in the nutrition of dogs and cats: A review. Progress in Nutrition. 6. 0-0.
  • Rational Uses of Glucocorticoids in Dermatology. Ettinger and Feldman: Textbook of Veterinary Internal Medicine, 6th edition. St. Louis, 2005, Saunders.
  • Dr. Ian Billinghurst. Give Your Dog A Bone. Warrigal Publishing, 1993.
  • Therapeutic use of fish oils in companion animals. Bauer JE. J Am Vet Med Assoc. 2011 Dec 1;239(11):1441-51.

Questions & Answers

Question: Can I give my big dog prednisone for hair mites?

Answer: No. Corticosteroids like prednisone cause immune suppression. If you give a dog with mites prednisone he will get worse.

© 2018 Dr Mark

Dr Mark (author) from The Atlantic Rain Forest, Brazil on June 30, 2020:

Corinne, there is always an alternative.

Your dog will almost certianly be okay after one therapy with this medication but you do not want to make it a habit. If your vet is not willing to look for alternatives you need to think about finding someone else.

The aurizon is another steriod.

The ear cleaner has aspirin, a non-steroidal anti-inflammatory. You may want to look into this option if the ears are not scratched up/dogs/How-to-Clean-Ears-with...

Corinne jane bailey on June 30, 2020:

Hi, I am really concerned

I took my rescue staffie to a new vet because she had terrible ears , scratching , not much and or occasional shaking of head

The vet prescribed virbac epiotic, and aurizon but also prednicare steroid, I am really scared of using this and the vet said there isn't an alternative

My previous rescued staffie passed away at 10 years with many complications including cushions disease, we had used steroids on her when she was younger and I blame the steroids for illness, and maybe she could have lived longer than 10, I have read this steroid or any can causes all sorts of health issues ,please can anyone advise , it just seems to be her ears and they don't seem to be bothering her too much

Desperate for help, too scared to use the steroid but happy to use the ear cleaner and aurizon

Thanks

Gerald Nobles on December 03, 2019:

He's gaining weight and it is not a good thing to do over a long time. He's older pit. He hacks when out. It's just a relief I know.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on March 25, 2019:

Mandy, if you are giving whole cooked vegetables they are passing through without doing any good for your Basset. They have to be finely blended to be digested by a dog.

You can cook the meat but will still need to worry about calcium and other vitamins that are destroyed by cooking. If you cook it the offal is worthless. Cooked bones will not help your dog either.

Mandy on March 24, 2019:

I am very certain that a change in diet is the way to go for our very itchy Basset. BUT I am really not sure that I can cope with the raw food option. Is it still beneficial if you cook the veg and meat? I am trying a 50/50 mix of meat (chicken offal and soft meat) and vegetables, but have no idea if I am on the right track

sprickita from Reno on February 17, 2019:

Some years back I had the pleasure of boarding with a roommate whom adopted a pitbull pup.

Sweet little girl ( the pup) indeed, though the poor thing had such problems with here skin. She clearly ichy, irritated & uncomfortable constantly ( when she thought she was being sneaky nawing away at which ever part of her was giving her static at that moment) she left huge bleach spots or whitened out at leaat - large circles of ??? Clean??? Like verywhere she parked herself (comfortably).so...

The owner took her to his local veterinarian and had a 400 algery panel done. The vet recommended different foods , bottled water as opposed to tap etc . Long as story short- thank you this artical has been most helpful, & I will 4 sure pass it on.

Ridgeback story on November 25, 2018:

Hi all, i wanted to share our experience with a vet who prescribed P to my girl, for allergy relieffor longterm at a low dose. Gabby was receiving 5mg every 48 hours for quite some time upon the diagnosis and advice of our vet. I am embarrased to admit that i took his assessment as face value and trusted his expertise without question. Had i undertaken some research in the matter, i would have learned this is not the ideal roite to take, as it is UNSAFE and possibly DANGEROUS. Take it from me, It simply is not worth it. After an acute kidney failure accompanied by a lengthy stint in the emergency hospital, an e coli infection and a mean case of calcinosis cutis, not to mention sleepless nights all within 1 month, I am now a voice of caution to anyone considering the viability of P for their family pets. I have also abandoned the previous vet for an holistic vet for all of her future care. Thanks for reading this, i wish you all the best.

RTalloni on November 12, 2018:

One side effect of steriods often dismissed by docs is damaged eye-sight. Thanks for alternatives for dogs.

Liz Westwood from UK on November 12, 2018:

This is a very useful article. It sounds like steroids for dogs can bring as many side effects as they do with humans.

Miebakagh Fiberesima from Port Harcourt, Rivers State, NIGERIA. on November 12, 2018:

Hi, Dr. Mark, thanks for weighing in and commenting. Good day.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on November 12, 2018:

Hi Miebakagh we do not have that Blue Buffalo brand here so I am not sure it is available where you live either. A lot of other good choices though, and of course the best choice is natural, the way it has always been.

Can you imagine paying 8 billion US$ for a dog food company. They are going to make that profit back, so you know they are going to use as cheap a filler as they can find.

Miebakagh Fiberesima from Port Harcourt, Rivers State, NIGERIA. on November 12, 2018:

Good to note.

Bob Bamberg on November 11, 2018:

Hi, Doc, I'm continuing treatment. Sept. scans weren't what we hoped for but it could be worse. I'm starting to get some side effects now that are mildly bothersome, but I'm going through life pretty much normally. Will see my oncologist this Thursday, so will know more then.

You're right about Blue Buffalo. They had some recalls last year, lost their Whole Dog Journal recommendation last year, and this year got sold to General Mills. Many of the stores that I service report diminishing BB sales, plus some are phasing it out in deference to other high end foods.

Ellison might be interested to know that they also use alfalfa meal (hay) and barley grass as part of their fiber package. A dog with a grass allergy or intolerance may find that problematic. Everyone's watching them so we probably won't see an ingredient compromise, but look for the bags to shrink in size and the price to go up. General Mills paid 8 Billion (with a B) for the company and they have to recover that investment.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on November 11, 2018:

Ellison, be sure to check my profile as there is an article about dry skin that may be helpful.

Blue Buffalo used to have a lot better reputation but I have heard some discouraging things about it lately. My personal preference would be to change, but I realize not everyone is willing or able to make up a diet at home.

Thanks for reading. I hope all goes well with the new canine member of the family!

Dr Mark (author) from The Atlantic Rain Forest, Brazil on November 11, 2018:

Heidi, I wish you all the best of luck with that. It does show promise and so far none of the prednisone side effects have been seen.

I used to see a lot of atopy when I lived in the Chicago suburbs, even more than down here where I live now.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on November 11, 2018:

Bob, it is the same everywhere. The dog has a problem, I suggest a potential solution, but then the problem comes up--it is too much work. Oh well. (I even had a question on one of my raw food articles this week "What is the best dry dog food?" You can be sure I deleted it.

I hope all is going well up there with you. No news is good news?

Bob Bamberg on November 11, 2018:

Interesting article, Doc. I know better than to defend high end commercial dog food here, however I do find it interesting that, while you don't trust the U.S. Government's regulation of dog food, you do site the National Center for Biotechnology Information, which is part of the National Library of Medicine which, in turn, is part of the National Institutes of Health. Are we mellowing?

Very few pet owners around here would take the time to follow a regimen such as you describe, and most vets and professional organization (American Veterinary Medical Ass'n, American Animal Hospital Ass'n, American College of Veterinary Nutrition, etc.) discourage raw diets. I know you take a dim view of them, also.

But for those who would devote the necessary time to formulating the diet you suggest, this is an excellent resource, as your articles always are.

Heidi Thorne from Chicago Area on November 11, 2018:

Our one dog has skin allergies that flare up seasonally (usually spring and fall). We're trying Cytopoint shots to avoid the steroids. We'll see how that goes. But glad to find some more alternatives to try. Thanks!

Ellison Hartley from Maryland, USA on November 11, 2018:

I just adopted a new little mutt dog, she is perfect besides seeming very itchy, I definitely will try some of your suggestions. Her skin is dry and itchy so I think that maybe coconut oil would be a good start. The food she came with is blue buffalo moist food I need to look into that as well, not sure if that is good quality or not.

Miebakagh Fiberesima from Port Harcourt, Rivers State, NIGERIA. on November 11, 2018:

Hello, Dr.Mark, I am not a dog owner. But as an avid reader, I do read for interest and leisure. I have noted the pieces of information that I can pass to friends who have a dog. Thanks for this informative story, and happy Sunday!


A veterinary guide to treating itchy skin in pets

Itchy skin is one of the most common presenting symptoms at our Indianapolis animal hospital.

Having treated many hundreds of these dogs over the years, we’ve developed an 8 week plan for you and your pet, that has had a very good success rate in managing even chronic cases of itchy skin.

Why Is My Dog Itching?

Most dogs and cats itch for one (or more!) of these six reasons:

  1. Seasonal Allergies – also known as “atopy”
  2. Food Allergies
  3. Dust mite / indoor allergies
  4. Parasites – including fleas, mange mites, or ringworm fungus
  5. Bacterial infection and/or allergic to bacteria
  6. Yeast infection and/or allergic to yeast

An effective diagnostic and treatment plan for itchy skin, therefore, should ideally account for all six of these causes of itch at the same time.

Treating itchy skin in dogs and cats, STEP 1 – rule out food allergies

Cat and dog food allergy is one of those topics that gets a lot of press, but is frequently misunderstood. One of the most frustrating things for me as a veterinarian is to stand in the pet food stores and listen to the employees “educate” well-intentioned pet owners about what diet is best for their food allergic dog or cat. They mean well, but so much of what they are learning about cat and dog food allergy is PR that is handed down from the pet food companies. For example, the most frequent thing I hear is “you need to feed your pet a grain-free diet if it has food allergies”. While some pets are indeed allergic to grain, the vast majority of food allergic pets are primarily allergic to their PROTEIN source, NOT grain.

There is no such thing as a hypoallergenic dog food at the pet store .

Do not let the friendly pet store employee convince you otherwise.

Instead, the only rational way to diagnose a food allergy in a dog, is with an elimination diet trial.

What Is a Food Allergy?

Cat or Dog Food allergy is one type of adverse immunologic reaction to a substance in the diet (the “allergen”). In most cases, a protein, such as chicken, lamb, beef or fish is the culprit, though any carbohydrate, fat or dietary supplement may be an allergen. It is NOT a reaction to a specific brand of food, or a result of switching diets. Most commercial and home-cooked diets, treats, and raw-foods share ingredients that may be allergens, no matter how high quality they are.

The pet may have been fed the offending allergen for over two years before developing signs of a food allergy. Food allergy can occur at any age, in any breed or gender, and patients may react to one or two items or several.

How is Cat or Dog Food Allergy Diagnosed? What types of tests would a vet do to identify and treat a food allergy?

It is important to understand that currently there is no accurate test to determine if a pet has a food allergy. Simply switching from one commercial brand to another is not sufficient, as these diets have many shared ingredients. The only reliable method of diagnosing a food allergy is undergoing an “elimination diet trial.” This means that your pet will be fed a special prescription diet from your veterinarian containing a single new animal or vegetable protein, such as rabbit or beans and a single new carbohydrate, such as yams or green peas. Some of the commercial elimination diets contain common proteins that have been altered (hydrolyzed i.e. made smaller) so the body doesn’t recognize them as allergens. There are blood tests available that claim to be able to determine if your pet has food allergies, and if so, what he or she is allergic to. These tests have MINIMAL if any correlation to true food allergies, so please don’t waste your money or your time.

Regardless of the diet chosen, it needs to be fed absolutely strictly for a period of 8-12 weeks to see improvement. No other treats, supplements or foods can be fed or even mistakenly ingested during this period. There should be absolutely no exposure to other pet’s food or food bowls. During the diet trial skin infections or other sources of itch and discomfort will be addressed by the veterinarian.

Special comments:

Inform friends, neighbors, family members about the diet. If necessary – have “allowable” treats – carrots, broccoli, green beans, asparagus, celery, cucumber – or pieces of their elimination diet for them to feed. Do not allow anyone to give your pet anything not approved by you first.

If you use food to give your pet medications, you will need to find an alternative – marshmallows make great hypoallergenic pill-stuffing treats!

Watch your pet’s weight. If there is excessive weight loss or gain, you may need to change how much or how often you feed your pet.

SUMMARY: How to perform an 8 week elimination diet trial

  1. Feed only your vet’s prescription hypoallergenic food (we prefer Royal Canin Anallergenic Diet for this purpose) for 8 solid weeks, and nothing else.
  2. At the end of your 8 weeks, change back to your dog’s normal food. If his skin gets itchy again, you’ve officially diagnosed him with food allergies.
  3. If his skin does not get itchy again on his regular food, that means you’ve diagnosed him with seasonal allergies / atopy.

Any deviation from this plan will result in you completely wasting your money on the prescription anallergenic diet, so please follow these directions exactly.

Even just a bite or two of chicken may invalidate the diet trial.

Treating itchy skin in dogs and cats, STEP 2 – eliminate skin parasites

  1. FLEAS: If your dog is suffering from allergies, adding fleas or mange mites to his misery will make him doubly miserable. Save your poor, beloved pooch that agony, and buy some awesome flea stuff from your veterinarian (our current preference is either Vectra 3D if we’re also using ivermectin – see below – or Comfortis if we are not).
  2. MANGE: Your vet may also consider a second prescription drug to treat and prevent mange mites during the diet trial, to make sure no other parasites get involved and complicate the plan (we like oral ivermectin for this). Most veterinarians will perform regular skin scraping tests during the 8 week trial to examine for these mange mites.
  3. RINGWORM: A fungal infection that infests hair follicles, ringworm is usually treated with oral antifungals and topical shampoo. Ringworm is contagious to humans, which is why we rule it out on visit #1.

Treating itchy skin in dogs and cats, STEP 3 – eliminate bacteria and yeast

Most vets will perform an impression smear during each appointment for itchy skin, which involves squishing a clean slide against your dog’s skin, and looking for bacteria and yeast that get stuck to the slide.

We usually treat bacteria and yeast with some combination of oral antibiotics, oral antifungals, and topical antibacterial/antifungal prescription medicated shampoo.

Treating itchy skin in dogs and cats, STEP 4 – antihistamines and prednisone

Prednisone is currently our drug of choice to reduce your dog’s itch while we’re treating the bacteria, yeast, and parasites that may be complicating her itchy skin, and while we’re running the 8 week elimination diet trial test.

Our intention is not for you to keep your dog on prednisone for the rest of her life, but rather to keep her from getting miserable while we’re getting to the bottom of what’s causing her allergies.

Your veterinarian may also recommend human antihistamines to be given at the same time as prednisone to reduce itching.

Treating itchy skin in dogs and cats, STEP 5 – Dust Mites and Inhalant Allergy Testing & Desensitization

Assuming you have successfully completed your 8 week elimination diet trial and either your dog remained itchy throughout the trial, or challenging her with her old diet did not make her itchy, now you’re left with either atopy or dust mite allergy.

Alternatively called Hay Fever or seasonal allergies, atopy has no known cure, but can be managed. Our management vehicle of choice is allergy desensitization.

Along with food allergies, dust mite allergies are the second most common cause of winter allergies and itchy skin seen at our Indianapolis veterinary clinic.

Dust mite allergy FUN FACT #1!

A pet that has scabies (true “mange” mites) will test positive for dust mites.

Dust mite allergy FUN FACT #2!

Dust mites are the leading cause of allergies and asthma in humans, and more dogs and cats are allergic to dust mites than to fleas.

Where do dust mite allergies come from?

Dust mites prefer warm and humid environments, so allergies to dust mites are worst in the fall, when homes are closed up because of cool evenings and increased humidity.

Dust mites prefer mattresses, upholstery, carpeting and fabrics. So while you may find more visible dust in other areas of your home (on bookshelves, inside air ducts for instance) mites actually prefer to hide out in darker and more protected environments. Cleaning out your vents and dusting the shelves probably do very little to reduce dust mites a visibly clean home is not necessarily lower in allergens.

Pet bedding, pet toys, and finished basements are dust mite magnets.

Because true avoidance of dust mites is not practical, most veterinarians direct treatment at minimizing dust mite allergens in the home, and desensitizing the pet to the mite allergen.

Top 10 Ways To Minimize Dust Mites and Indoor Allergies in your home

  1. Keep your pet out of the bedroom. Dust mites love mattresses, pillows, and pet beds, so keeping them in rooms with the least humidity or fabric is best. If that is not possible, wash bed linens at least weekly in hot water, and use allergen-proof covers on your bed and pillows. Special note: no feather pillows! If this is not possible, Use a HEPA vacuum in the room, and run a HEPA air filter near the bed when the room isn’t occupied.
  2. Buy a vapor steam cleaning machine. Vapor contains only 5-6% water, so the vapor doesn’t contribute to a moist environment. Vapor steam deeply penetrates whatever it is cleaning, and it is great for upholstery, couches, carpets, and mattresses.
  3. Replace pet beds and human pillows at least every six months, and cover the ones you have with allergen-proof covers.
  4. Eliminate wall-to-wall carpet, get washable throw rugs instead. (or at least keep the pets off the carpet) Wood, seamless vinyl or linoleum floor coverings are best because they can be cleaned frequently. If this is not possible, steam cleaning a carpet reduces 87% of the dust mites.
  5. Launder or replace stuffed toys weekly. If this is not possible, consider freezing stuffed toys in the freezer (in a tightly closed plastic bag), and shake vigorously outside after removing them from the freezer.
  6. Use air conditioning or central heat, plus dehumidifiers if needed, to keep household humidity low. Change furnace filters frequently.
  7. Keep pets out of closets (dark, humid)
  8. Minimize humidity-increasing houseplants.
  9. Do not confine your dog to the laundry room, bathroom, utility room or basement or other high humidity part of the home.
  10. Choose your furnishings wisely. When possible, choose: Closed bookshelves and curios instead of open shelves Washable curtains instead of blinds and heavy draperies Furniture with simple designs instead of ornately curved pieces Easily cleaned decorations instead of dried flowers or straw Wooden or plastic furniture instead of upholstery.

Veterinary treatment of itchy skin caused by seasonal allergies or dust mites

Primary therapy for dust mite allergies in pets is similar to that of inhalant allergies.

Here is how allergy testing and desensitization works:

  1. First, establish a list of what your pet is allergic to, either using a panel of blood allergens from your veterinarian, or a trip to a local veterinary dermatology specialist.
  2. Second, give your pet ever increasing doses of whatever she is allergic to, either by daily drops under her tongue, or via injections.

Allergy testing and desensitation appears to be helpful in about 80% of patients receiving the treatments, at reducing the length and severity of allergy attacks throughout the pet’s lifetime.

Allergies are never cured, only managed.

If you loved this post, please share it with your friends on Facebook and Twitter, or if you’re not in the Indianapolis and Carmel Indiana area, print out a copy and take it in to your local veterinarian to discuss your options.

If you do live in the Indianapolis / Carmel area, please schedule your first appointment today by calling Leo’s Pet Care today at (317) 721-7387


APOQUEL is safe to use in dogs 12 months of age or older

  • Can be used long-term for maintenance therapy or short-term 4,5
  • Can be used with many other medications 4 :
    • Including nonsteroidal anti-inflammatory drugs (NSAIDs) (such as carprofen), vaccines (such as rabies), and allergen-specific immunotherapy (allergy shots or drops)
    • The use of APOQUEL has not been evaluated in combination with other systemic immunosuppressants, such as corticosteroids and cyclosporine
  • Is not for use in dogs with serious infections, or for use in breeding, pregnant, or lactating dogs

Most common APOQUEL side effects

In a short-term clinical study, the most common side effects were vomiting and diarrhea.


Answer

The less prednisone the better. There is likely no totally safe dose. There has been increased recognition on the long term side effects of prednisone based on clinical studies. Osteoporosis, increased risk of heart disease, increased risk of infections, weight gain are all assocaited with low dose prednisone use. Medications such as methotrexate, Arava, the anti-TNF drugs (Enbrel, Humira, Remicade) are all used to try to reduce prednisone.

Arthritis Center

Founded in 1998, the Arthritis Center at Johns Hopkins is dedicated to providing quality education to patients and healthcare providers alike.


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I had some itching before, but as soon as I went down to 5mg I began itching even worse. A few days later, and still a week later, most of my torso is covered with an awful rash. The itching is unbearable. Yet the Rhumy and MD insist that it is not caused by the Prednisone. I give up on getting any answers or help from these people. anon1001876 July 14, 2019

I have a severe allergy to Prednisone. I suffer from asthma and chronic COPD. The doctors and hospital know not to give me this medication, as last time I ended up in critical care as my throat was closing up and breathing was like I was drowning. I had itching all over especially torso of the body and my head. I got two hours sleep (if that) all night and was very restless, anxious and felt very dizzy. My mental confusion was through the roof. I was climbing the walls and screaming at my friend who was trying to help me. I even took an allergy tablet for allergies and hay fever, but it did nothing to help.

In the ambulance, they gave me a shot of allergy stuff and extra nebulizers. My heart rate also tripled and I had pains in my chest and arm and legs as if I had been working out at the gym all day (if only). My arm collapsed when putting pressure on it bending my hand back. I had no control of the weakness I felt in my muscles.

I have suffered from migraines, but my head was blowing off and no pain relief released it. I had to tie a scarf around the front of my head tightly and put cold compresses around my wrists. I was shaking badly and felt like death. This was after a new doctor who should have checked my records before giving me anything.

It is a very serious offense as on my allergy list red flagged not to have this drug. He gave it to me as a suppository for inflammation in my pelvis. I am livid and going to take this further. I was going to the hospital, but knew I would be left sitting in a chair with no breathing nebulizers, which I have at home so I had a double dose at home. I was very lucky, but the doctor will not be, as leaving that practice as this sort of mistake can cost lives.

I am still dizzy, shaky and breathing still wheezy. I had another double dose on my breathing machine and calming it now hopefully. It has been 20 hours since taking it. It has a half life, I believe, from the research I've done, so it may be 72 hours before it is out my system at the dose given in one go. I can never take these! I was very lucky it was a lower dose and still some got in the bloodstream. That's how bad my allergy is. It's poison stuff, and can be lethal. anon978877 November 21, 2014

I was given injections in my knees. My blood pressure spiked and my face looks like I have a severe sunburn. I have also not felt well. I have had some nausea. anon948146 April 29, 2014

All of this makes sense now but I'm still not sure. I was prescribed prednisone for bronchitis and asthma for 12 days. And suddenly on the tenth day, I have a rash all over my body and it itches like crazy. anon939901 March 16, 2014

I had an allergic reaction to prednisone as well. I ended up in the hospital with severe swelling to my cheeks, nose, forehead and eyes. There were red welts that burned like a sunburn. anon349900 September 30, 2013

I have been on steroids for a severe allergic reaction, but I'm getting tightness in my chest and my rash is getting worse. Is that a side effect of the steroids or the original allergic reaction? anon342626 July 22, 2013

I too believe I'm allergic to prednisone. I was given it to help with asthma due to a cold and within two days, I had a rash and hives all over. I went to the emergency room, where they said that they treat hives with prednisone and increased the dosage. I also was told to take Benadryl at the same time. I am still breaking out in hives as soon as the Benadryl wears off.

This is nuts. I am going to attempt to cut out prednisone. I will take one less pill each day and hope for the best. The back of my throat swelled a bit and the mucus is so thick. I hope this works. I can't take much more. anon328600 April 4, 2013

I am so glad that I found this site. I took prednisone for just five days and I have a terrible rash. I knew that it was some sort of side effect but didn't realize how serious it could be. Thank you for sharing. anon324786 yesterday

Even though I've had steroid shots in the past, last year I took oral prednisone and had a reaction. Now, I have another doctor who wants to give me a steroid shot for my shoulder, but will not until he finds out if I have an allergy or not.

My allergist wants to test me, but the only lab he knew of that tested for prednisone allergy doesn't do it anymore. He's checking his contacts but I'm checking on my own. Does anyone out there know of a lab that still does tests for a prednisone allergy? lighth0se33 August 17, 2012

My brother has a prednisone allergy, so he had to find an alternative treatment for his inflammation. The doctor he goes to believes in using natural herbs and spices as alternatives, so he recommended turmeric.

This spice can act as an anti-inflammatory. It makes your body produce more corticosteroids, so it can have an effect similar to that of prednisone.

My brother took turmeric pills so that he could get the correct dosage. Just sprinkling it on food wouldn't have been enough. Oceana August 16, 2012

I find it strange that anyone is allergic to prednisone, because it is often prescribed to treat severe allergies. You wouldn't think that the treatment could also be the problem!

My vet prescribes prednisone for dog allergies. Once, my Doberman got stung by a bee, and her face and throat swelled so much that she was having trouble breathing. The doctor gave her a shot of prednisone and a dose pack to take home.

I'm really glad that she didn't have an allergy to prednisone, because with her throat already swelled like that, it would have killed her. At the time, I didn't know there was even a chance that she could have a prednisone allergy, and I'm glad that I was unaware of this fact. DylanB August 16, 2012

@cloudel – Yes, the side effects of prednisone aren't very pleasant. My dad actually had a prednisone allergy, and he became pretty sick while on it.

He started having intestinal cramps that were pretty severe. He had diarrhea that went on and on, and he felt queasy on top of it all.

So, he cannot take prednisone anymore. His doctor has written on his file that he is allergic to it, and he reminds the doctor every time that he visits that he can't take it.

I guess that the allergy doesn't run in the family, though, because I can take it without having these issues. Even so, I don't like taking it, because it makes my abdomen swell so much that I look pregnant, and the swelling doesn't fully go away for months! cloudel August 15, 2012

I experienced some of the side effects of prednisone that were mentioned on the label, but I don't think I had an actual allergy to it. I had some nausea and sleeplessness, as well as increased energy, but I didn't break out in a rash or have any trouble breathing.

Even though I didn't have any severe reactions to it, I did find the side effects troubling. I would become nauseated if I went for more than two hours without a snack, and this mean I had to get up at night and eat a cracker or something.

I only got an hour or two of sleep while I was on it. Somehow, though, I had enough energy to redecorate the house and clean it from top to bottom. I felt invincible, until I crashed five days later.


Watch the video: The Best PREDNISONE Alternative


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