Prednisone (predniSONE Intensol) for cats

Prednisone is a corticosteroid widely used in both people and animals. It’s similar to a natural hormone called cortisol, which breaks down bodily substances like fats, sugars, and proteins. Veterinarians use corticosteroids in animals to reduce inflammation (such as in allergic skin disease), control or prevent autoimmune disease flare-ups (like rheumatoid arthritis), treat certain types of cancers, and as hormone replacement therapy for animals who don’t produce enough cortisol. Though commonly used in veterinary practices, prednisone is inactive and must be converted to prednisolone within the body to act on cells. This is a problem for cats. Their livers are less efficient than dogs or humans at converting prednisone to prednisolone, so veterinarians usually don’t use it in cats. They’re more likely to use prednisolone or another corticosteroid. 

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What is prednisone used for in cats?

Prednisone is not considered effective in cats. Unlike humans or dogs, cats do not efficiently absorb prednisone or convert it to its active form, prednisolone. 

Veterinary literature advises veterinarians to use prednisolone in cats instead of prednisone. Its beneficial effects, potential side effects, and dosages are nearly identical to prednisone. At low doses, prednisolone is highly effective at relieving inflammation. It suppresses the immune system response at high doses and can treat problems such as rheumatoid arthritis. 

In cats, prednisolone is used to treat:

• Discomfort, pain, stiffness, and swelling due to inflammation, such as itchy skin or joint pain
• Autoimmune conditions (when the immune system attacks healthy tissues, such as inflammatory bowel disease, lupus, or rheumatoid arthritis)
• Certain types of cancer, such as lymphoma or multiple myeloma
• Adrenal insufficiency is a condition in which the adrenal gland does not produce enough cortisol

Although the use of prednisone is discouraged in cats, the standard guide to veterinary drugs, Plumb’s Veterinary Drug Manual, admits there may be situations where the veterinarian’s only choice is to give oral prednisone. Dose conversions are largely left up to veterinarians.

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Inflammation

One of the most common reasons animals are given prednisone is when the animal experiences discomfort, pain, swelling, or stiffness due to joint pain, allergic reactions, skin problems, or injuries. These problems are very commonly seen in veterinary practices. Low doses of prednisone are enough to resolve these problems in other animals, but cats will be given prednisolone. 

Autoimmune conditions

Autoimmune disorders (or inflammatory disorders) are diseases caused by the immune system. Typically, the immune system targets foreign organisms and other substances. The immune system mistakenly attacks healthy tissues in an animal with an autoimmune disorder. At high doses, prednisolone or prednisone suppresses the immune system response to prevent or control autoimmune flare-ups. 

Cancer

Prednisolone or prednisone can stop the growth of certain cancers involving lymph cells. These include lymphomas, leukemia, and multiple myeloma. In cats, lymphomas can be a complication of infection with feline leukemia virus. It is believed that prednisolone acts on corticosteroid receptors in lymphatic cancer cells that induce those cells to die. In cats, prednisolone is used as an add-on treatment to chemotherapy drugs or as a palliative treatment for advanced cancers. The use of prednisone is discouraged.

Hormone replacement

When cats don’t produce enough corticosteroids naturally, veterinarians call this condition adrenal insufficiency or Addison’s disease. It’s rare, so most cat owners will never see it. If it does happen, the signs will include a lack of appetite, lethargy, vomiting, weight loss, depression, and dehydration. Low doses of prednisolone and other steroids are enough to provide adequate hormone replacement, but prednisone is not advised.

Is prednisone safe for cats?

Prednisone and other corticosteroids are considered safe for cats, provided they’re used at the lowest effective dose for the shortest time possible. 

No drug is 100% safe, particularly corticosteroids. Cats should not take prednisone or prednisolone if they have had an allergic reaction to prednisone/prednisolone or if they have systemic fungal infections. 

Prednisone or prednisolone can worsen some medical conditions, so veterinarians generally avoid the use of prednisone in cats with:

• Congestive heart failure
• Diabetes mellitus
• Chronic kidney disease
• Stomach or intestinal ulcers
• Osteoporosis
• Untreated Cushing’s disease (an overactive adrenal gland that produces too much cortisol)

Giving a pregnant or nursing cat prednisone or prednisolone may be risky for unborn kittens or nursing kittens.

Veterinarians will be cautious about using prednisone or prednisolone in cats with bacterial infections or who are still growing.

Side effects of prednisone in cats

The good news is that cats are less likely to experience side effects of corticosteroids than dogs. The bad news is they require larger doses for the corticosteroids to work. 

The most common side effects of prednisone or prednisolone in cats include:

• Increased thirst
• Increased appetite
• Increased urination
• Behavior changes
• Panting
• Weight gain
• Dull or dry coat
• Vomiting 
• Diarrhea
• Elevated liver enzymes

Serious side effects include:

• Stomach or intestinal ulcers
• Gastrointestinal bleeding
• Gastrointestinal perforation
• High blood sugar or diabetes
• Infections, particularly urinary tract infections
• Muscle wasting
• Severe changes in behavior, such as aggression

It’s important to know that corticosteroids like prednisone and prednisolone have a greater propensity to raise blood sugar in a cat than in other species. This is a serious issue if the cat is diabetic or has other risk factors for developing diabetes mellitus.

Because adverse effects are possible, owners should watch for signs of these effects and call the veterinarian when they see symptoms such as:

• Blood in the stools
• Black and tarry stools
• Bloody vomit
• Loss of appetite
• Weight loss
• Excessive thirst
• Excessive urination
• Lethargy
• Depression
• Weakness
• Fever
• Pain when urinating

Interactions of prednisone with other pet meds

Prednisone and prednisolone are powerful drugs that affect nearly every system in the body. There are a variety of drug interactions to be concerned about:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) increase the risk of gastrointestinal problems such as ulcers and bleeding. Veterinarians will try to avoid combining prednisone or prednisolone with NSAIDs.
• Prednisone and prednisolone increase blood sugar, an effect that’s more extreme in cats. Cats on insulin may require higher doses of insulin.
• Diuretics increase the risk of low potassium in cats taking prednisone or prednisolone.
• Live vaccines should be avoided because prednisone and prednisolone weaken the immune system.
• Some drugs speed up the body’s metabolism of prednisone, making it less effective.

Prednisone can affect the results of many important tests such as allergy, cholesterol, blood sugar, potassium levels, and thyroid hormone tests. 

Prednisone dosage for cats

Because cats aren’t typically given prednisone, there are no standard prednisone dosages for cats. Instead, veterinarians use prednisolone, the active form of prednisone. According to Plumb’s Veterinary Drug Manual, veterinarians should increase the dose if the only option is oral prednisone. However, there are no published guidelines.

Dosages of prednisolone are higher for cats than dogs because cats are more resistant to the effects of corticosteroids.

For prednisolone, Plumb’s Veterinary Drug Manual suggests the following dosages for cats:

• Recommended prednisolone dosage in cats for inflammation: 1-2 mg/kg taken as a single or divided dose daily
• Recommended prednisolone dosage in cats for autoimmune disorders: 2-8 mg/kg per day

Dosages for cancer or hormone replacement are individualized.

Corticosteroids suppress the ability of a cat’s adrenal glands to make cortisol, the natural form of prednisolone. If prednisone or prednisolone is stopped too suddenly, the cat will not have enough corticosteroid hormones, a potentially catastrophic condition. When it’s time to stop prednisone or prednisolone, the veterinarian will prescribe a steadily decreasing dose. Tapering may last for several weeks.

Can cats overdose on prednisone?

Cats can be overdosed on prednisone or prednisolone. As with any medication, call the veterinarian or an animal poison control helpline if an overdose is suspected.

The most likely reason for an overdose is that the veterinarian set the dose too high. This is called medication-induced Cushing’s disease, but it requires a few weeks of overdosing before problems become evident. Call the veterinarian if you notice signs such as weight gain, pot belly, hair loss, thin skin, or weakness.

Can I give my cat prednisone every day?

Veterinarians will likely not prescribe prednisone. If prednisone or prednisolone is prescribed, you will give the cat one or two doses daily for a few days or weeks. Prednisone/prednisolone is not intended for long-term use. 

How to give your cat prednisone

Prednisone can only be given by mouth, but prednisolone can be given by mouth or injection. Before administering prednisone or prednisolone to a cat, ensure you fully understand the veterinarian’s instructions. 

• Follow the veterinarian’s dosage instructions carefully.
• Give this medicine with food.
• Give it at the same time each day. 
• Do not skip doses. 
• If a dose is missed, give it as soon as it’s remembered. If it’s almost time for the next dose, skip the missed dose. Never give the cat an extra dose to compensate for a missed dose.
• Do not stop giving the cat this medicine until told to do so by the veterinarian, especially if the cat has been on long-term treatment. Sudden discontinuation can cause serious problems. 
• The veterinarian will prescribe a tapering dose when it’s time to quit. Be aware that tapering may take several weeks to complete.
• Store this medicine at room temperature.
• Store any compounded version of this medicine following the directions on the label.

Prednisone alternatives for cats

There may be reasons that prednisone or prednisolone are not the best choice for a cat. Fortunately, veterinarians have other choices depending on the condition being treated:

• Other corticosteroids, including topical steroids
• NSAIDs to manage pain or reduce swelling
• Other pain medications
• Antihistamines for allergic reactions or itching
• Other types of immunosuppressive drugs, such as cyclosporine for inflammatory conditions
• Chemotherapy for cancer

Alternative or complementary treatments for some of the conditions treated by prednisone include:

• Omega-3 fatty acid supplements and glucosamine-chondroitin for joint pain
• Mild exercise
• Probiotics for inflammatory bowel disease

Summary

Veterinarians rarely give prednisone to cats because it’s not as effective as prednisolone, the active form of prednisone. Although prednisolone is very effective, cat owners should be aware that it is intended only for short-term treatment because of potential side effects, overdose, and problems caused by discontinuing the drug. Cat owners should be familiar with signs that the drug is causing problems and call the veterinarian if the cat starts showing these symptoms.