Prednisone Dose Reduction

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Dogs being treated for AIHA will eventually need Prednisone dose reduction. The body perceives Prednisone as similar to cortisol, a hormone produced by the adrenal glands. Used at high immunosuppressive doses for more than a few weeks this drug will cause the adrenal glands to decrease cortisol production and eventually become inactive. Gradual reduction of the prednisone dosage will give the adrenal glands time to begin producing cortisol again.

The guidelines for this reduction can vary from one veterinary clinic to another. However, this drug is widely used in veterinary treatments and reduction protocols are similar.

Prednisone Reduction Guidelines

Dogs that are being treated for AIHA, IMHA, ITP and non-regenerative anemia should have conservative reductions when possible unless required for special medical reasons.
Reductions generally should not begin until the hematocrit – PCV is stable and close to the minimum 38%.
When another immunosuppressive drug like Atopica has been added and has become effective.
Precede each reduction with a CBC.
Decreases should be approximately 25-33% of the current dose and are generally not done more than every 2-3 weeks.
In between reductions an owner can request a simple spun PCV to see if the PCV is holding steady.
Be prepared to raise the dosage if there is a decrease in the PCV.

What side effects can there be when decreasing prednisone? Prednisone affects nearly every organ and system in the body. By removing it slowly the adrenal glands are encouraged to return to normal function and supply the normal amounts of cortisol. However, there may be times when they are having difficulty with that. Cortisol is an important hormone and is especially needed by the body to respond to stress. What signs would you see?