Introduction

• Prescribed for their anti-inflammatory, immunosuppressive, and anti-fibrotic effects.
• Potency, duration of action, and relative mineralocorticoid activity vary with agent and formulation.
• Common side-effects of all glucocorticoids include polyuria/polydipsia (PU/PD), increased appetite, panting, pyoderma, urinary tract infections, insulin resistance, proteinuria Urinalysis: protein Proteinuria , and (probably) pancreatitis Pancreatitis: acute.
• Long-term daily treatment can lead to iatrogenic hyperadrenocorticism Hyperadrenocorticism (thin skin, muscle wasting, pot belly, calcinosis cutis, adrenal suppression).
• Sudden stopping of treatment can unmask adrenal suppression, which can last for weeks to months.
• Glucocorticoids in topical preparations can be systemically absorbed and lead to clinical side-effects, alkaline phosphatase induction, and adrenal suppression.
• Glucocorticoids induce calciuresis and can be used to treat hypercalcemia Hypercalcemia: overview once the underlying cause is determined.
• Glucocorticoids at immunosuppressive (but not anti-inflammatory) dosages can suppress total T4 and free T4, without increasing TSH, and may lead to a false diagnosis of hypothyroidism Hypothyroidism.
• All glucocorticoids can potentially increase the risk of GI ulceration Gastric ulceration from NSAIDs, especially at high dosages.

Route of administration

Examples of use of available agents

Further Reading

Publications

Refereed papers

• Recent references from PubMed and VetMedResource.
• Bizikova P, Linder K E, Paps J et al (2010) Effect of a novel topical diester glucocorticoid spray on immediate- and late-phase cutaneous allergic reactions in Maltese-beagle atopic dogs: a placebo-controlled study. Vet Dermatol 21 (1), 70-79 PubMed.
• Corrigan A M, Behrend E N, Martin L G et al (2010) Effect of glucocorticoid administration on serum aldosterone concentration in clinically normal dogs. Am J Vet Res 71 (6), 649-654 PubMed.
• Gottschalk J, Einspanier A, Ungemach F R et al (2010) Influence of topical dexamethasone applications on insulin, glucose, thyroid hormone and cortisol levels in dogs. Res Vet Sci 90 (3), 491-497 PubMed.
• Olivry T, Foster A P, Mueller R S et al (2010) Interventions for atopic dermatitis in dogs: a systematic review of randomized controlled trials. Vet Dermatol 21 (1), 4-22 PubMed.
• Bonneau S, Skowronski V, Sanquer A et al (2009) Therapeutic efficacy of topical hydrocortisone aceponate in experimental flea-allergy dermatitis in dogs. Aust Vet J 87 (7), 287-291 PubMed.
• Nuttall T, Mueller R, Bensignor E et al (2009) Efficacy of a 0.0584% hydrocortisone aceponate spray in the management of canine atopic dermatitis: a randomised, double blind, placebo-controlled trial. Vet Dermatol 20 (3), 191-198 PubMed.
• Aniya J S, Griffin C E (2008) The effect of otic vehicle and concentration of dexamethasone on liver enzyme activities and adrenal function in small breed healthy dogs. Vet Dermatol 19 (4), 226-231 PubMed.
• Levine J M, Levine G J, Boozer L et al (2008) Adverse effects and outcome associated with dexamethasone administration in dogs with acute thoracolumbar intervertebral disk herniation: 161 cases (2000-2006). J Am Vet Med Assoc 232 (3), 411-417 PubMed.
• Reeder C J, Griffin C E, Polissar N L et al (2008) Comparative adrenocortical suppression in dogs with otitis externa following topical otic administration of four different glucocorticoid-containing medications. Vet Ther 9 (2), 111-121 PubMed.
• Ginel P J, Garrido C, Lucena R (2007) Effects of otic betamethasone on intradermal testing in normal dogs. Vet Dermatol 18 (4), 205-210 PubMed.
• Abraham G, Demiraj F, Ungemach F R (2006) Comparison of the hypothalamic-pituitary-adrenal axis susceptibility upon single-dose i.m. depot versus long-acting i.v. triamcinolone acetonide therapy: a direct pharmacokinetic correlation. J Endocrinol 191 (2), 491-496 PubMed.
• Abraham G, Gottschalk J, Ungemach F R (2005) Evidence for ototopical glucocorticoid-induced decrease in hypothalamic-pituitary-adrenal axis response and liver function. Endocrinology 146 (7), 3163-3171 PubMed.
• Cobb M A, Edwards H J, Jagger T D et al (2005) Topical fusidic acid/betamethasone-containing gel compared to systemic therapy in the treatment of canine acute moist dermatitis. Vet J 169 (2), 276-280 PubMed.
• Ghubash R, Marsella R, Kunkle G (2004) Evaluation of adrenal function in small-breed dogs receiving otic glucocorticoids. Vet Dermatol 15 (6), 363-368 PubMed.
• Deboer D J, Schafer J H, Salsbury C S et al (2002) Multiple-center study of reduced-concentration triamcinolone topical solution for the treatment of dogs with known or suspected allergic pruritus. Am J Vet Res 63 (3), 408-413 PubMed.
• Goodman S, Sprung C L, International Sepsis Forum (2002) The International Sepsis Forums controversies in sepsis: corticosteroids should be used to treat septic shock. Critical Care 6 (5), 381-383 PubMed.
• Daminet S, Paradis M, Refsal R et al (1999) Short term influence of prednisone and phenobarbital on thyroid function in euthyroid dogs. Can Vet J 40 (6), 411-415 PubMed.
• Olby N (1999) Current concepts in the management of acute spinal cord injury. J Vet Intern Med 13 (5), 399-407 PubMed.
• Rohrer C R, Hill R C, Fischer A et al (1999) Gastric hemorrhage in dogs given high doses of methylprednisolone sodium succinate. Am J Vet Res 60 (8), 977-981 PubMed.
• Moore G E, Ferguson D C, Hoenig M (1993) Effects of oral administration of anti-inflammatory doses of prednisone on thyroid hormone response to thyrotropin-releasing hormone and thyrotropin in clinically normal dogs. Am J Vet Res 54 (1), 130-135 PubMed.
• Ridway H B, Moriello K A (1993) Iatrogenic Cushing's syndrome in a dog from owner's topical corticosteroid. Arch Dermatol 129 (3), 379 PubMed.
• Nesbitt G H, Fox P R (1981) Clinical evaluation of Panalog Cream used to treat canine and feline dermatoses. Vet Med Small Anim Clin 76 (4), 535-538 PubMed.

Other sources of information

• Day M (2008) Glucocorticorticosteroids and Antihistamines. In: Maddison J E, Page S W, Church D B Small Animal Clinical Pharmacology. 2nd edn, Philadelphia, Saunders Elsevier, pp 261-269.
• Plumb D C (1999) Veterinary Drug Handbook. 3rd edition.
• Schimmer B P, Parker K L (1996) ACTH; adrenocortical steroids and their synthetic analogs; inhibitors of the synthesis and actions of adrenocortical hormones. In: Hardman J G, Limbard L E, Goodman & Gilmans The Pharmacologic Basis of Therapeutics.9th edition, New York: McGraw Hill, pp 1459-1485.