Steroids and NSAIDs in Cats and Dogs: Uses, Dosage, and Safety Guidelines

Steroids and non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used in veterinary medicine to manage pain, inflammation, and immune-mediated diseases in cats and dogs. While these drugs are effective, their use requires careful consideration of dosages, side effects, and contraindications. This blog provides an in-depth look at these drugs, their mechanisms, indications, dosage guidelines, and safety concerns in companion animals.

1. Introduction to Steroids and NSAIDs in Veterinary Medicine

Steroids (corticosteroids) and NSAIDs are two major classes of anti-inflammatory drugs used in veterinary practice. Both have different mechanisms of action and are used to manage various conditions, ranging from arthritis to autoimmune diseases.

What Are Steroids?

Steroids, specifically corticosteroids, are synthetic versions of hormones produced by the adrenal glands. They help suppress inflammation and modulate immune responses. The two main types of corticosteroids used in veterinary medicine are:

Glucocorticoids (e.g., prednisone, dexamethasone) – used for anti-inflammatory and immunosuppressive effects.
Mineralocorticoids (e.g., fludrocortisone) – primarily used for conditions like Addison’s disease.

What Are NSAIDs?

NSAIDs work by inhibiting cyclooxygenase (COX) enzymes, which play a role in producing inflammatory mediators called prostaglandins. These drugs reduce pain, fever, and inflammation without the immunosuppressive effects of steroids. Commonly used NSAIDs in veterinary medicine include carprofen, meloxicam, and firocoxib.

2. Steroids in Cats and Dogs

Mechanism of Action

Steroids exert their effects by inhibiting phospholipase A2, an enzyme responsible for producing inflammatory mediators like prostaglandins and leukotrienes. This mechanism allows steroids to suppress inflammation at multiple levels.

Indications for Use

Steroids are used in cats and dogs for:

Allergic reactions (e.g., atopic dermatitis)
Autoimmune diseases (e.g., immune-mediated hemolytic anemia, pemphigus)
Inflammatory conditions (e.g., inflammatory bowel disease)
Neoplasia (e.g., lymphoma management)
Shock and trauma (e.g., spinal cord injury)

Commonly Used Steroids and Dosages

Prednisone/Prednisolone

Dogs: 0.5–1 mg/kg/day for anti-inflammatory use; 2–4 mg/kg/day for immunosuppression
Cats: 1–2 mg/kg/day (cats require prednisolone due to poor conversion of prednisone in the liver)

Dexamethasone

Dogs: 0.1–0.3 mg/kg/day for anti-inflammatory effects; up to 1 mg/kg/day for immunosuppression
Cats: 0.1–0.25 mg/kg every 24–48 hours

Methylprednisolone

Dogs: 0.5–1 mg/kg every 24–48 hours
Cats: 1 mg/kg every 48 hours

Triamcinolone

Dogs: 0.1–0.2 mg/kg every 24 hours
Cats: 0.2 mg/kg every 48 hours

Side Effects and Precautions

Long-term steroid use can cause:

Gastrointestinal ulcers
Increased thirst and urination (polyuria/polydipsia)
Immunosuppression, leading to infections
Diabetes mellitus, especially in cats
Cushing’s syndrome (hyperadrenocorticism) in chronic use

To reduce side effects, steroids should be tapered off gradually rather than stopped suddenly.

3. NSAIDs in Cats and Dogs

Mechanism of Action

NSAIDs block COX-1 and COX-2 enzymes, reducing the production of prostaglandins, which are responsible for pain and inflammation. COX-1 is important for gastrointestinal and kidney function, while COX-2 is mainly involved in inflammation. Selective COX-2 inhibitors are preferred to minimize adverse effects.

Indications for Use

NSAIDs are commonly used for:

Osteoarthritis and joint pain
Post-surgical pain management
Acute and chronic inflammation
Soft tissue injuries and musculoskeletal pain

Common NSAIDs and Dosages

Carprofen (Rimadyl, Novox)

Dogs: 2–4 mg/kg/day, divided into one or two doses
Cats: Not commonly recommended due to toxicity risks

Meloxicam (Metacam)

Dogs: 0.1 mg/kg on day 1, followed by 0.05 mg/kg once daily
Cats: 0.1 mg/kg on day 1, followed by 0.05 mg/kg every 24–48 hours (short-term use only)

Firocoxib (Previcox)

Dogs: 5 mg/kg once daily
Cats: Not commonly recommended

Robenacoxib (Onsior)

Dogs: 1–2 mg/kg once daily
Cats: 1 mg/kg once daily for up to 3 days

Deracoxib (Deramaxx)

Dogs: 1–2 mg/kg once daily
Cats: Not recommended

Side Effects and Precautions

While NSAIDs are effective, they can cause:

Gastrointestinal ulcers (vomiting, diarrhea, black stool)
Kidney damage, especially in dehydrated patients
Liver toxicity (idiosyncratic reactions in some breeds)
Delayed wound healing

NSAIDs should never be used concurrently with steroids, as this increases the risk of gastrointestinal bleeding.

4. Comparing Steroids and NSAIDs in Veterinary Practice

5. Best Practices for Using Steroids and NSAIDs in Cats and Dogs

To maximize the benefits and minimize the risks, follow these guidelines:

For Steroids:

Always use the lowest effective dose.
Taper off slowly after long-term use.
Monitor for signs of Cushing’s disease in long-term therapy.
Avoid use in patients with diabetes or existing infections.

For NSAIDs:

Never use NSAIDs and steroids together.
Ensure proper hydration to prevent kidney damage.
Monitor for GI distress (vomiting, diarrhea, loss of appetite).
Use gastroprotectants like sucralfate or omeprazole when necessary.

General Safety Tips:

Always follow veterinary guidance for dosing.
Use regular blood tests to monitor liver and kidney function.
Do not give human NSAIDs (e.g., ibuprofen, aspirin) to pets.
Educate pet owners on potential side effects and when to seek veterinary help.

6. Conclusion

Steroids and NSAIDs are valuable drugs in veterinary medicine, each with unique applications, benefits, and risks. While steroids are potent immunosuppressants and anti-inflammatory agents, NSAIDs are primarily used for pain relief and inflammation control. Proper dosage, careful monitoring, and awareness of potential side effects are crucial for their safe use in cats and dogs.

By following best practices and veterinary recommendations, these drugs can significantly improve the quality of life for pets suffering from chronic pain, inflammatory conditions, and autoimmune diseases. Always consult a veterinarian before using any of these medications to ensure safe and effective treatment.

Veterinary and research