Prednisone for Dog Cancer
Updated: June 2nd, 2020
Cortisone drugs have a bad rap.
Pharmaceuticals like prednisone, prednisolone, dexamethasone, budesonide, and triamcinolone are drugs in the cortisone family. And over the years these medications have achieved much attention as bad chemicals.
This is very likely due to what could be described as overuse. These drugs of have historically been prescribed for a wide variety of medical conditions in medicine. Since these meds provide symptomatic relief for many problems, a large number of people–as well as pets–have received them. And the truth is that we have likely used them excessively in our patients in the past.
As time went on, the medical community began to realize that cortisone drugs have side effects that warrant other meds being tried first. In other words, using higher doses of cortisone drugs when milder treatments could have been effective has been shown to be the wrong strategy. We have witnessed this phenomenon in allergies and arthritis in particular.
However, when one is coping with a cancer diagnosis, the realization must be made that cancer is extremely aggressive. In spite of all of our medical advances, it still resists treatment. Thus, in order to get an edge on cancer to promote longevity and life quality, we need to use a broad range of tools to attack this disease.
Cortisone drugs have their place in cancer medicine. The side effects that are seen with cortisone use are rarely life threatening, while systemic cancer is always life threatening. Therefore if the drug can increase a patient’s lifespan and the disease will proceed relentlessly without it, it is sensible wisdom to at least consider its use.
Here are guidelines for the use of the most common drug in this class, prednisone, taken from Plumb’s Veterinary Handbook, the gold standard of veterinary drug texts:
1. Glucocorticoids can mask disease! Try not to use them until you have a diagnosis.
2. Make a specific diagnosis!
3. Determine course from outset
4. Determine endpoint before you starting treating
5. Use the least potent form for the minimal time
6. Know where glucocorticoids inappropriate. (Behrend 2007)
Prednisone and prednisolone are central players in cancer chemotherapy protocols, most commonly for lymphosarcoma. And the good news is that they really make a difference in both life quality and life span. Oncologists are achieving median survival times of 10-14 months using these chemo protocols. This is most definitely worth considering.
The bottom line is that in some cases we have swung too far in being anti-drug. We need a balanced approach to cancer treatment.
We should always consider diet, apoptogens, anti-metastatics, pain control as needed, and efforts to convert our patients to a cancer-fighting brain state. We must consider surgery, radiation, and chemotherapy (all of these are discussed in the Guide).
For more helpful information, get a copy of the Dog Cancer Survival Guide
Don’t forget, when using cortisone drugs, decrease the dose of Apocaps to ¼-1/2 the labeled dose if your dog is receiving cortisone drugs, give with a full meal, and use this combination under veterinary supervision only.
Dr. Demian Dressler is internationally recognized as “the dog cancer vet” because of his innovations in the field of dog cancer management, and the popularity of his blog here at Dog Cancer Blog. The owner of South Shore Veterinary Care, a full-service veterinary hospital in Maui, Hawaii, Dr. Dressler studied Animal Physiology and received a Bachelor of Science degree from the University of California at Davis before earning his Doctorate in Veterinary Medicine from Cornell University. After practicing at Killewald Animal Hospital in Amherst, New York, he returned to his home state, Hawaii, to practice at the East Honolulu Pet Hospital before heading home to Maui to open his own hospital. Dr. Dressler consults both dog lovers and veterinary professionals, and is sought after as a speaker on topics ranging from the links between lifestyle choices and disease, nutrition and cancer, and animal ethics. His television appearances include “Ask the Vet” segments on local news programs. He is the author of The Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog’s Life Quality and Longevity. He is a member of the American Veterinary Medical Association, the Hawaii Veterinary Medical Association, the American Association of Avian Veterinarians, the National Animal Supplement Council and CORE (Comparative Orthopedic Research Evaluation). He is also an advisory board member for Pacific Primate Sanctuary.
my vet said that if they give prednisone to my dog for his bowel inflammation, before the cancer biopsy comes back, that the prednisone will kill him if he has cancer. Why would that be?
We have a 6 year old Rhodesian Ridgeback, Xander. Recently diagnosed with lymphoma. He is on prednisone, 30 ml daily now. We would like to start him on Apoptogens but read that you need to adjust one or the other because of both being blood thinners. He is on the diet suggested in your book as well.
What should the dosage be of prednisone?
He stated with 60 ml for7 days
Now 30 ml for14 days
Thank you in advance
Hi Renee! We’re not veterinarians here, and the only one that should be adjusting your dose is your veterinarian — that way they can weigh all the factors. Prednisone in particular is really dangerous to change without supervision, since dogs can go into shock if they are taken off it too quickly. Here’s a great article to read about ALL the factors to consider, and it also includes doses. It also talks about Apocaps, actually: https://www.dogcancerblog.com/articles/full-spectrum-cancer-care/conventional/prednisone-for-dogs/
So take a look at that article 🙂
Meanwhile, the reason the book and the manufacturer recommend doing a half dose of Apocaps when your dog is on a prescription NSAID or prednisone is not because it’s a bloodthinner. It’s because Apocaps can be a mild anti-inflammatory, and when it’s given at the same time as prescription anti-inflammatories (including pred) it’s more likely that your dog will get an upset stomach. Anti-inflammatories can cause upset tummies, and taking two together can increase that risk.
So if your dog is on pred, DO NOT change the dose without checking with your veterinarian first. And if you are adding Apocaps in, just do a half dose until/unless your vet advises otherwise. Here’s a link to the help center on the manufacturer’s website: https://help.functionalnutriments.com/article/40-using-apocaps-cxcxe-with-prednisone-or-other-oral-anti-inflammatory-prescription-medications
If you put a dog on prednisone…can you withdraw it so she isn’t on it long term? We were told once you put a dog on it and it does all it can do…the cancer comes back with a vengeance…making you scared to ever use it.
Hello Trish, thanks for your question. It is possible to take a dog off prednisone MOST of the time, but doing so must be done only under veterinary supervision. Pred is so powerful that the body stops making cortisol and other hormones, because they just aren’t needed when you’re on pred. If you stop cold turkey, the body struggles to start making those again, and if it doesn’t do it quickly enough, it can cause shock and even death. So when vets take dogs off pred they do so very, very slowly, tapering down doses over weeks, usually. Pred can be so helpful for cancer, in some cases, precisely because it works fast and hard. But yes, cancer is a sneaky foe, and it is always trying to figure out how to beat what we do. It’s very clever, and very strong, which is why it often is the ultimate cause of death. The reason to try pred if your vet recommends it is because while it works, it works really, really well. The quality of life is usually very high, even when it’s used for other conditions. But when cancer figures out how to get around it, that quality of life goes down. It’s not that pred’s the problem, it’s cancer that is the problem. It’s tough. There is nothing that stops it from “coming back with a vengeance” if it manages to do so. There are long-term problems with prednisone use (I speak as someone whose dog was on pred for nearly six years at the end of her life, for another health issue), but the quality of life it provides in the meantime might be worth those trade offs. These are just the awful decisions we have to make as dog lovers: what are we willing to live with? What does our dog want, really? You know yourself and your dog best. Ask your vet for best and worst case scenarios for using pred and not using pred, and then take that information inside and sit with it. What kind of life does your dog want? What do you want? In the end, that’s the only thing that makes the decision. And don’t forget, there are literally dozens of other things you can do for your dog other than pred. These have all been shown to really help your dog fight: the dog cancer diet, nutraceuticals, anti-metastatic supplements, and mind-body strategies. Get the book and you’ll see that there is way, way more than pred. https://dogcancerblog.com/book
I do have the book…my dog was given 1 month to live and that was 14 months ago..we started CBD oil and Turkey tail. Then last month was told it had spread all over. Seemed like what we were doing did great for 10 months…because the xrays in Feb showed no spread of cancer then by April it’s all over. So I read researched and did more research….came across the dog cancer survivor book…bought it…changed her diet to the cancer diet…continued our CBD oil but added Canine Transfer factor, Keto “dog cancer diet”, herbs, Frankincense, Benadryl, tramadol, goat milk, Paradigm veggies, krill oil, turmeric and curcumin, prednisone – which was added after resp. Distress one night. I panicked…and the vet started prednisone. I just hope I didn’t rush in. Anyway, being in the medical field..I know you must wean it off…just thought…maybe now that I started it..did that start the clock ticking against her..like it only works for 1 – 3 months??
One other question…being on the transfer factor and prednisone…does that defeat the purpose of increasing immunity since prednisone suppresses it? That’s what has me so worried…I could of gave transfer factor time to work but my fear is the prednisone will cancel the benefits of it. ?? Thanks for your time. I appreciate it.
Hi Trish, it’s not that prednisone starts a clock ticking. It’s not causing the cancer to get worse. It’s just that the effect can be so powerful while it’s working that people sort of relax. I think your veterinarian was really trying to give you a gentle heads up that once pred is started, it’s pretty powerful, AND when cancer figures out how to beat it, it won’t be effective anymore. Sometimes people become less vigilant, because they think that their dog is fine, so he or she is “beating cancer.” Then later, when it comes back, they are surprised and resent the process. (Which is totally understandable.) For certain YOUR dog is beating cancer. I’m so thrilled to hear about how well your girl is doing for so long now! Yes, pred is immuno-suppressive, but you are definitely in the game of balancing side effects, pros and cons. Thinking you made a mistake is super-common, but the reality is that there is no one right path for cancer. It’s not linear, like a broken leg, or even other chronic diseases, like diabetes of heart disease. Instead, it is always a case of adjust-as-you-go. Ask your veterinarian what they think the pred will do, and for how long, and whether you think it was a mistake, and why or why not. They will be able to help you to understand the mechanics behind their decision, especially since you are in the medical field yourself. Yes, transfer factor and medicinal mushrooms like turkey tail can build immunity, and they might be beneficial even as your dog is on pred. I don’t think this is an either-or situation, but I’m not a veterinarian, so take it back to your vet. They’ll be able to help you detangle all this for your peace of mind.
Thank you..this has really helped me understand.
I live in Rome. Mela, my great 11 year old jack russell mongrel dog, has mast cell cancer, she is on Prednicortone (and Zantadine) at the moment but chemo will probably be added soon. Your book has helped me a lot in understanding and dealing with this challenge. I am very impressed by what I have read of Apocaps. Can you give me more info on why the recommended dose should be decreased? Looking on line the only mention of this is in this blog.
p.s. I have put her on your diet and she loves it!
Thanks for writing. As Dr. D writes in Chapter 12 of the Dog Cancer Survival Guide, the recommended dose should be decreased as doubling up on anti-inflammatories can cause stomach upset (his nutraceutical has an anti-inflammatory effect). So he recommends dropping the dose down to one quarter or one half of the full strength dose. This advice also applies to dogs on NSAIDs and corticosteroids 🙂
I live in Brazil, and I’m looking to understand what could have happened to my wife’s dog.
He had an episode of seizure. The next morning we took him to the vet. They said he had no tumors on his body. Then they did a CT-Scan of his brain. They found a neoplasm and edema, prescribed prednisone and phenobarbital and escheduled surgery to remove the tumor, two weeks later.
The surgeon did the surgery and found no mass. Closed him up and he is now home.
So, could the meds have cured the dog? Is he at serious risk?
Hello. My dog has a tumor on her spleen and was given prednisone and a antibiotic. I ordered a medical mushroom powder with 9 different species plus using the formula of organic maple syrup with organic baking soda without aluminum. I was wondering, will the prednisone limit all of the good I’m trying to do since it suppresses the immune system?
My Dobie was diagnosed with anal gland carcinoma..she is 10 years old, but still very strong, and even playful, but we can tell she is declining. I think she has a lymph now behind her ear…do you think Prednisone will help reduce the symptoms as this goes on?
My Weimaraner has an intramaduliary (sp?) tumor on her c3/c4. It’s on the lining that surrounds her spinal cord. I can’t afford the astronomical cost of surgery. She’s on 10mg prednisone 2-3 times a day. She’s on a diet of chicken, brocoli, Brussels sprouts, cranberries, apples, oats and Shitake mushrooms. No more commercial dog food. Oh and cbd oil. She has lost lots of mobility and stability. The best it seems we can do is make her as comfortable as long as possible. Or is there something else? Higher dose of prednisone? Any help is greatly appreciated.
Our dog Sheba was diagnosed with oral melanoma back in September of 2015. They decided because of how aggressive it was to not do surgery on her nor put her through the costly radiation and vaccine only to extend her like maybe 1-2 years because she is a very elderly dog anyway and we agreed to not put her through that since it would require removal of most of her jaw and not give much quality of life and I’d rather her have quality than quantity so anyway because she was bleeding from her tumor and it smelled like a dead rotten animal from her breath, they decided to initially give antibiotics and prednisone and to slowly decrease the pred from 20 to 10 to 5mg. The vet said he didn’t think she needed the antibiotic, but it couldn’t hurt and her breath was smelly because the tissue along the tumor was necrotic (tissue death) due to the tumor cutting off the blood supply so it all made sense. Within 2 days of starting pred, both of the symptoms cleared up and she went from looking like on death’s door step to having pep in her step and being close to back to normal. Even the cheek swelling had went down a great deal so I praised the treatment and still do even though now it is starting to look like it isn’t working anymore. A bit of a backstory on that: As soon as we started to decrease her down to 10mg of pred, the bleeding returned, but her breath was still fairly good and tolerable, but we went down to 5 as instructed and it was like it was not doing her any good at all cause all symptoms returned full swing so we increased back to the 10mg and stayed there. The bit of bleeding was manageable just so long as she still seemed to be mostly like her old self otherwise and her breath was tolerable. Well at the beginning of this year in January 2016 the bleeding picked up and her breath began smelling horrid again to the point I was having to keep her outside when weather permitted because a whiff of her breath caused me to gag and be nauseated and we could smell it from another room. It was that strong, so we call the vet back and he decided to give another round of antibiotics and put her back on 20mg of the pred, but has instructed to decrease her like before. Well my dilemma is that initially when we started this treatment it seemed to perk her back up as before except her breath problem didn’t fully disappear and neither did the bleeding, but made it tolerable, but now we are a week in and it seems like the treatment is slowly, but surely not working for her anymore even still being on 20mg of the pred. She was just standing next to me a few minutes ago and I noticed a medium sized blood patch in the floor and when she came up to me and I petted her I noticed her breath smells pretty bad again. Still not smelling it from another room over, but it is going back that direction so now I am not quite sure what to do at this point especially when it comes to decreasing again. Before we got her down to 10mg, but now the 20mg isn’t doing the job so if we decrease as directed then I feel it is going to put her in a worse boat with the symptoms. I have came to the conclusion that either cancer has gotten to a point where the prednisone isn’t going to work for it anymore or she has gotten used to it so we need to move to a higher dose. I realize there are bad long term side effects to using prednisone for extended amounts of time, but at the same time I feel the cancer is worse and that is going to get her eventually anyway so I don’t see the harm in upping the pred dose if it will keep her comfortable. Don’t get me wrong, I would not do this without first consulting the vet, but they seem pretty headstrong about not even wanting her to stay on the 10mg let alone the 20mg for no longer than a week so I’m fairly certain they aren’t going to up her dose any and I’ll probably be told it’s probably getting to be about that time to consider euthanizing her, however that is hard for me to do when otherwise she still has that pep and energy, still eats, drinks, plays occasionally, loves on us, wags her tail and all, but I am pretty sure that would change if we took her down or off the pred and then we would have to go that route. The pred is still helping as far as those things go, but the blood and breath it isn’t so much anymore. I’m not sure what to think or do at this point other than to just keep her at 20mg and wait and see and when I see the other stuff declining then I need to make a decision. I am telling my story because I can’t find any other regarding canine oral melanoma and the use of prednisone specifically online. I can’t be the only one, but noone else has written about their story where they had a dog with this same cancer and they got prescribed pred to manage the symptoms nor does any vet website or blog specifically address this and this one didn’t. It addressed using pred with a different cancer so I thought I would put this out there. Despite the pred seeming to be losing it’s umph in my dog, I praise it because the vet gave her approximately 6 months at best to live with no other treatment and if not for the pred I really believe she would have passed away shortly after the diagnosis the way it was looking, but I believe pred extended her life just by making her feel so much better and managing the imflammation which of course causes pain. We are nearing that 6 month mark and if she holds steady then I can easily see her living another 2 months at least if not even making it to the beginning of Summer, but that’s if the pred don’t stop working all together. We will see, but in the meantime we are cherishing every moment we can with her knowing she is on borrowed time and don’t really want to think about putting her down even though I am sure it is going to happen sometime in the first half of this year. If she does make it past that I’ll call it a miracle and celebrate with her. I just wanted others to know if your dog is too old to risk surgery or is not a good candidate for one and/or you can’t afford the radiation and vaccine then ask your vet about managing it with prednisone because while it has worked it has done wonders for our sweet dog. It doesn’t cure the cancer or combat it, but it makes living with it a whole lot more comfortable!