Most clinicians in private practice are regularly faced with challenging dermatologic cases, and a common question arises: How much prednisone is too much? No one can definitively answer this question, as different dogs respond in different ways. Some patients are unaffected by long-term prednisone administration, while others immediately demonstrate polyphagia, polydipsia and polyuria, or incontinence. Still others show signs of iatrogenic Cushing's disease—muscle wasting, a pot-bellied appearance, and muscle weakness—early on in therapy. The best approach is to try the safest treatment first, monitor the patient's response carefully, and adjust the therapeutic protocol if side effects become problematic or the condition does not respond.
Stanley’s allergy tests identified a list of food, insect, and inhalant al lergens, including chicken, carrots, rice, grains, fleas and flea saliva, cats and cat dander, mold, grasses, and trees. Schaff eliminated what allergens she could and used topical medications and the corticosteroid Prednisone to treat Stanley’s remaining symptoms. The topicals did not work, and the pharmaceuticals gave the dog polyuria/polydipsia (PU/ PD), a condition causing excessive thirst and passage of large volumes of urine. Added to his misery of itchy raw spots, weepy lesions, and a stinky, gooey coat, poor Stanley was now having frequent and unavoid able accidents.