Dear Dr., <br />My dog was given a Prednisone shot less than

Dear Dr.,
My dog was given a Prednisone shot less than 2 weeks ago for tendenitis in his arm secondary to a minor fall from the stair.
A few days after the shot, he started behaving very strange.
1. He started driniking a lot of water
3. At night he became very hyper, and kept walking around and around all night
4. Then he started facing corners and just staring!
5. Later he started going under bushes, behind the trash cans, and behind the coach, etc. and then when he got stuck he would start crying
6 He would calm down and all of a sudden he would become hyper and start crying and walking
7. He had a hard time keeping his balance
8. He was leaning on walls when walking.

Long story short, the doctor recommended giving him Benadryl to calm him down. It helped a little bit for a day and the second day he stoped eating and drinking.
When I took him back to the vet, he tested his blood and said that the only thing that was showing was that his thyroid level had dropped to .1 (he said normal is .8 I think) and had a little fever from dehydration.

(My father in law is a Pathologist, he told me that cortisone is a stress hormone and when cortisol level goes up the thyroid level drops.)

My dog was in the hospital last night. I saw him this evening, he was very very very lethargic and I don't think he recognised me.
The docotor has him on thyroid medication, an Antibiotic and a prozac type medication since yesterday.
The doctor says he thinks my dog has had a mini-stroke and since he has been on the medication for 1 day, he still goes through episodes of hyperness but a little less frequently. He said lets wait till Monday and we might have to put him to sleep.

As you can imagine, I am in shock, because my dog was just fine before the shot. I am not blaming the shot, but I would like to know that can Cortisone cause such side effects and how long should I wait to see if these sympotoms will wear off befor I put him to sleep? Or if it is a stroke how long should I wait before I do anything to the dog?

I am sooooooooo confused, please help me.
My dog is a mixed terrior, 14 years old and Male.
He has lost his hearing and the doctor calims he can't see because of cataracts. But frankly I really don't think he is blind, because up to last week he could see.

Thank you for your time.

Sincerely,
Ella

Customer (name blocked for privacy)

Prednisone dose have some of the side effects that you listed. Increased thirst and urination are common, as well as panting, and pacing. I have also seen some dogs get aggressive while on it, and they can have mood changes (act depressed and lethargic). However, the other problems are not commonly seen with prednisone, but more often with brain lesions (strokes, brain tumors).

I would suspect your dog may have had more trauma than a simple tendonitis from falling from the stair. Is it possible that he had some head trauma during this fall also? That might induce a stroke or a bleed in the brain that might take a couple of days to become evident.

You said your dog was fine before the shot, but he really wasn't. He had fallen down the stairs and hurt himself. Do you know why he fell down the stairs? Was his balance already off? It is possible that your dog had some mild issues that were made more evident after the fall. Prednisonse should not cause all these problems, it may be coincidental.

However, if the prednisone did happen to cause some of these changes, 2 weeks is certainly enough time for the shot to wear off. If this was a different formulation of prednisone, it could have been longer acting, in which case, you will need to wait a bit longer to have these effects wear off. I wouldn't think much more time would be needed to see an improvement. If it was a type of stroke or hemorrhage in the brainor brain tumor, there may not be much you can do to help him. It seems your vet is doing everything he can at this point. I would definately give it until Monday, and if he is not better, you can make your decision then.

Here is some info on prednisone: http://www.veterinarypartner.com/Content.plx?P=A&A=622

Let me know if you have further questions.

1 Other Expert Agrees with this!

Reply to Dr. Vicky Lamb's Post: Dear Dr. Lamb,
thank you for your prompt response.
My dog did not fall from the stair. I was going to take him to the groomer, he usaully gets very excited when I want to take him out, so he slipped form the one stair that connects our den to the exit door. He did not have a major fall at all.
Before the shot the only unusal sypmotm that I can think of, was that he would act like he wanted to clear his throat occasionally.
I forgot to mention that he was panting after the shot.
Best case scenario is that it is from the shot.
What is the best treatment in your opinion to counter act the effect of cortisone, considering that he doesn't want to eat and drink on his own.
As I mentioned earlier the doctor has him on thyroid medication, antibiotic and a prozac type medication. Does he need a different type of medication or a different type of psychotic drug?
And in your opinion should I bring him home this weekend to make him feel better psychologically?
Ella

Sorry I misunderstood about his "fall". Hopefully it wasn't severe enough to cause a head trauma.

Yes, best case scenario is that these effects will wear off and he will get back to his normal self. Unfortunately, I've never in my experience seen this type of reaction to prednisone. I would certainly be up front if I did, because you need to know! I am just concerned that your poor guy has some other underlying problem going on in his brain, and the prednisone may have nothing to do with it. I think you should be aware of this possibility (I think you are).

There is really no treatment for the symptoms you are seeing...if they are due to prednisone, then the body needs to break it down. Prednisone is usually cleared from the body within a few days if it is a short acting shot. Do you know the specific name of the drug your vet gave?

I think the medications he is on are fine, do you know the name of the Prozac-like drug? Your vet may have felt this would help with his restlessness, but unless you know the name I can't comment on whether this is necessary or if it may help him.

If he doesn't want to eat and drink on his own, bringing him home may not be best. However, some dogs WILL start eating and drinking once they do get home. If you can commit to forcing food and water if he will not take it on his own, I think the home environment is the best. You can cook him chicken breast, or boil some hamburger with some rice, or any other favorite foods he might like. You will certainly give him more TLC than being at a vet clinic all weekend. If you can't get him to eat and drink though, he might worsen :(

Reply to Dr. Vicky Lamb's Post: Dear Dr. Lamb,
after reading the article about Prednisone you sent me, I realised that the doctor had given him
2 oral medications
1. Dexa .75 mg once a day
2. Deramaxx 25 mg once a day

He used these drugs for 2 days when he started acting weired.
On the second day he had Dexa in the morninga nd Deramaxx after dinner. Later when I was gone that night, because he was acting wiered my parents gave him 1 324 mg aspirin?

Do you think he is having bleeding because of the combination of durgs?
And if he is does he need an xray of some sort tomorrow?
He was also given 325 mg aspirin on the second

Dexa (dexamethasone) is similar to prednisone, and is a steroid. Deramaxx is a non-steroidal anti-inflammatory (NSAID). It is NOT recommended to use the two drugs at the same time, as this creates more side effects. Aspirin is another NSAID, and adding that to the mix can also create more problems. The main side effect we see with NSAIDs is stomach irritation, and when multiple drugs of these types are given together, there is a higher risk of the stomach getting irritated, ulcerated, and perhaps bleeding internally. So, aspirin and Deramaxx should never be given together. In my opinion, I wouldn't have even given him dexa to take with the Deramaxx, I think that is asking for trouble.

So, he was on a lot of medications that can cause loss of appetite. I'm not sure if his neurologic signs are related to these drugs or not. Aspirin can thin the blood, and can create prolonged bleeding, but I'm not sure he got enough to cause any serious problems. I would be more concerned with how his stomach is feeling, secondary to all the medications he was on.

How is he feeling today? If he still has no appetite, personally, I would add something like Pepcid AC and a stomach protector for him to take to see if that would help his appetite. Does you vet think he will be able to come home soon?

Reply to Dr. Vicky Lamb's Post: Hi Dr. Lamb,
I brought my dog home for a few hours tody.
He was extremely weak.
I had to force him to drink a little water.
I made him his favorite sausages, he did respond and started licking, but in my opinion he was too sedated and weak to even eat.
I mangaged to take him on our usual walk, though
he was very weak, and if I didn't guide him with the leash, he had a tendency to go in circles, and he kept walking towards the cars parked by the curbs. He had his good moments too while walking, but again I was thinking he must be so weak from the prozac type medication he had been on for the past 2 days.
I took him back to the vet in the evening and questioned him about the combination of the dexa and the deremax oral pills, he said that one is a pain killer and the other one is an anti-inflamatory, and that humans with arthritis take this combo. I also questioned him whether the dog was so weak from hte prozac type medication that he was so weak, he said he didn't think so because it was a very low dose (3 mg). I asked him what would he do if he was in my shoes, e suggested putting the dog to sleep tomorrow since he had not progressing even though he was on Antibiotics, the thyoid medication and the prozac type medication he called Chloro-something. I am working tomorrow and I told him to wait till Monday and I told him to stop giving the prozac. To see if ther prozac wears off he will he become more alert and eat by himself. Also Monday will be 2 weeks since he got his Dexamethasone shot (I verified the name with him). I hope he will not feel lonely and scared on Sunday in the cage at the vet's. But at least this way I can be sure I waited long enough to let all the medications wear off.
My husband says that he thinks there was already something wrong with the dog and the shot probaly pushed him over the edge quicker!
I feel so guilty for taking him in for his arm pain, and now seeing him crash so rapidly in less than 2 weeks. After the steroid shot he became psychotic and started pacing all night, and after the prozac he even stopped walking!!
If he seems even a little better by Monday then I think I would like to take him in for a second opinion with a different vet, but if he is the same or worse then I think I should just put him to sleep.
Please let me know what you think.
I am definitely going to accept your answer regardless, I just would like to do that once I make a decision with the dog and put a closure to this. I just have so many questions in my head!
Thank you so much for your kindness, I appreciate your support.
Sincerely,
Ella

Hi Ella,

I know this must be very difficult for you. I am very sorry your dog is not doing better. In my opinion, I honestly believe your dog has something more serious going on than just a bad reaction to medication. His neurologic signs (standing in the corner staring, trouble balancing, walking in a circle, leaning on the wall when walking, and even his pacing and panting) all indicate a problem in his brain. None of the medications he was on or was started on should cause these side effects. Maybe some drowsiness or tiredness, or loss of appetite from stomach upset, but not the circling or balance problems.

It might be a good idea to get a second opinion on monday, unless he is worse, and then I think you might want to put him down. This might make making a decision a little easier for you. Bring copies of all blood tests, xrays, and all the names and doses of all your medications to the new vet. They can examine him, and hopefully give you their opinion of the situation. I have given you mine, but keep in mind that I have not ever physically looked at or examined your dog, and so don't have all the info I need to make a firm recommendation to you.

Also, I do not agree with your vet using Dexa and Deramaxx together. It is very much frowned upon, and not considered standard veterinary practice. It may very well be used in that way with people, but it is not in veterinary medicine. This is just an FYI, I don't think these medications are part of your dog's bigger problem. But, take a look at this site, and read down to the section on interaction with other drugs. http://www.marvistavet.com/html/body_dexamethasone.html It may not be an issue in the short term for your dog, but in any case, I would choose one drug or the other, and not both. If a dog develops stomach ulcers while on these medications together, it would be your vet's fault.

You've done everything you can, and if Monday he is not improving or worse, I think it would be the right decision to put him down. Otherwise, I agree with you and would look for a second opinion like you had said.

Please let me know on Monday what you decide to do. You can wait until after that to accept if you like, so this question stays open and we can continue to correspond. I will keep you in my prayers over the weekend.

Reply to Dr. Vicky Lamb's Post: Hi Dr. Lamb,
Thank you for putting my mind at ease.
I called the vet on Saturday to see how my dogie was doing since he was off prozac.
He said he is a little more alret and walks around in his cage. I dind't want him to be in a cage all weekend by himself, considering that the vet was only going to visit the dog twice. So Long story short, my husband brought him home today since I was at work. He has been feeding him baby food and pedialite. I honestly am coming to the conclusion that there really is something wrong with his brain.
1. He still sleeps a lot
2. He still wants to go underneath things and hide.
3. and he is definitely having a hard time walking and keeping his balance, thoug sometimes he still has his better moments.
4. My husband said he sorta barked today.
5. He still doesn't eat or drink volunteraly.
6. Tonight he keeps waking up and crying every 2 hours and walking around and he keeps wanting to put his nose into something or under something. I keep petting him which calms him down and he goes back to sleep.
I really can see that he is not getting any better, if anything he is getting worse.
I don't want to see him so sad and sick.
I think I need to put him to sleep ASAP.
I wish he would go to sleep on his own.
Tomorrow is Sunday, and the vet is off.
He will be back on Monday.
I am not sure if I should wait even untlil Monday.
But I don't know what is the best method of putting him to sleep on a Sunday which is a holiday.
Can you give me some suggestions?
My mom recommended giving the dog 100 mg of Co-Q 10, to liven him up, what do you think?
Thanks.
Ella

Ella,

You will be the best judge of whether or not it is time to put him to sleep. If you do not feel his quality of life is good, and he is not eating well or enjoying his time, then it may be time. I've found every person and every dog is different in how things go at the end. My personal feelings are that I do not want to let an animal suffer for my own personal reasons (meaning-- just keeping them around because I can't say goodbye). I'd rather put them down before they deteriorate significantly. I've found some people don't do this though, so you have to decide what is right for you.

If you feel you want to put him down, and he cannot wait until monday, then the only option is to find an emergency clinic that is open to have them put him to sleep. If he can hang on until Monday, it may be nicer to have this done by your regular vet, but of course, if he is suffering, we will want to do what is best for him.

I am glad he got to come home to be with you, though. You can certainly give him the Co-Q10, it will not hurt him. In dogs we mainly use this with heart problems, so I don't know if it will help him much.

Let me know how things are going and what you decide.

Hi Ella,

How is he doing today? Has he made any progress, or no?

Reply to Dr. Vicky Lamb's Post: Dear Dr. Lamb,
Thank you for all your expert opinions.
You made my decison making a lot easier.
I put my dogie to sleep on Sunday with a doctor that my neighbor recommended.
He rushed me, but later apologised to my husband and told him that he was nervous too because it was his first time putting a dog to sleep!
I guess it was better this way, I will keep my good memories from his original vet.
I bought this metal fan flower from the nursery that day and put it in my garden where I last had my dog.
It spins with the wind and comforts my soul.
The funny thing is we have wild rabbits in our garden and the past two mornings I see the rabbit sitting right underneath the flower and eating grass. Do you believe in dogie reincarnation or in Doggie heaven?!!!!..........
Thank you for all your comforting thoughts.
Please keep doing what you are doing.
Sincerely,
Ella

Dear Ella,

I'm glad I was able to help a little during this rough time. It is never easy at the end of a friend's life. You have been in my thoughts these past days.

I am very sorry for your loss.

I don't know if you've ever read this story....but it might help

http://www.petloss.com/poems/maingrp/rainbowb.htm

Take care,

Vicky

Behavioral side effects of Prednisone shot

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