Q about Prednisone for Addisons

[jenny finnell]

My dog Yanka was diagnosed with Addisons April 20th. She is one year old and weighs 14 lbs. She was in the doggie ER for a few days with an Addisonian crisis. She was started on 2.5 mg of Prednisone and the Zycortal injection. She went in yesterday to our normal vet, for bloodwork and her 2nd injection. Her bloodwork came back fine. The vet wants to gradually reduce her Prednisone dosage. I was told to start giving her the 2.5 mg every other day. But everything I've read, says they should be on it daily. Any input?

[Catherine]

Jo Tucker should be able to help you more with that. She should be along soon. Meanwhile you can use the search facility on the main page which may give more information.

[Jo CIMDA]

Hi Jenny and welcome

A daily dose of prednisolone is the recommended way to provide a replacement dose of glucocorticoid.  It is usual, when starting treatment for Addison's disease,  for the dose to be on the higher side as this will address the stress that the dog is experiencing at this time of diagnosis, but as the DOCP starts to become effective, and the dose of replacement mineralocorticoid hormone is satisfactory, as long as the clinical signs and the blood results are within normal limits, then the daily dose of prednisolone can be reduced to the lowest replacement dose.  See this reference:

https://todaysveterinarypractice.com/endocrinology/diagnosis-and-management-of-hypoadrenocorticism-in-dogs/

For glucocorticoid replacement, oral prednisone at a starting dose of 0.5 to 1.0 mg/kg/day is usually recommended. This dose should be gradually lowered (over several weeks) to an optimal dose that controls signs of hypoadrenocorticism and avoids side effects (e.g., polyuria, polydipsia, polyphagia, panting). Larger dogs seem to be more sensitive to the side effects of glucocorticoids. Although published maintenance doses are usually 0.1 to 0.22 mg/kg/day,4 we have managed a number of patients with lower doses (as low as 0.03 mg/kg/day). Dosage adjustments should be based on clinical signs only; for dogs with confirmed naturally occurring hypoadrenocorticism, an ACTH stimulation test should not be repeated for monitoring purposes.


I have never known an Addisonian dog to be put on every other day dosing of prednisolone in order to provide sufficient replacement glucocorticoid hormone. The general opinion is that this will not be sufficient because prednisolone has a biological 'half life' of 12-36 hours, so a daily dose is required.

Personally, I would always carry a little extra prednisolone when out on walks etc., because if Yanka becomes stressed for whatever reason (her body is unable to produce the required increase in glucocorticoid to combat the stress) then you will have the extra prednisolone to hand. This extra dose doesn't need to be continued after the event is over, it will do no harm, and it will support her through the stressful event, so you can resume with usual daily dose of prednisolone the following day.

It can take a few months to establish the right dose of DOCP, but when that is achieved Yanka should be able to live a normal, happy life.  I have known dogs to live until they are 16 years of age with well controlled Addison's disease.

I hope this is useful.

Best wishes
Jo