• DVM360_Conference_Charlotte,NC_banner
  • ACVCACVC
  • DVM 360
  • Fetch DVM 360Fetch DVM 360
DVM 360
dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care
dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care
By Role
AssociatesOwnersPractice ManagerStudentsTechnicians
Subscriptions
dvm360 Newsletterdvm360 Magazine
News
All News
Association
Breaking News
Conference Coverage
Education
Equine
FDA
Law & Ethics
Market Trends
Medical
Politics
Products
Recalls
Regulatory
Digital Media
dvm360 LIVE!™
Expert Interviews
The Vet Blast Podcast
Medical World News
Pet Connections
The Dilemma Live
Vet Perspectives™
Weekly Newscast
dvm360 Insights™
Publications
All Publications
dvm360
Firstline
Supplements
Vetted
Clinical
All Clinical
Anesthesia
Animal Welfare
Behavior
Cardiology
CBD in Pets
Dentistry
Dermatology
Diabetes
Emergency & Critical Care
Endocrinology
Equine Medicine
Exotic Animal Medicine
Feline Medicine
Gastroenterology
Imaging
Infectious Diseases
Integrative Medicine
Nutrition
Oncology
Ophthalmology
Orthopedics
Pain Management
Parasitology
Pharmacy
Surgery
Toxicology
Urology & Nephrology
Virtual Care
Business
All Business
Business & Personal Finance
Hospital Design
Personnel Management
Practice Finances
Practice Operations
Wellbeing & Lifestyle
Continuing Education
Conferences
Conference Listing
Conference Proceedings
Resources
CBD in Pets
CE Requirements by State
Contests
Veterinary Heroes
Partners
Spotlight Series
Team Meeting in a Box
Toolkit
Top Recommended Veterinary Products
Vet to Vet
  • Contact Us
  • Fetch DVM360 Conference
  • Terms and Conditions
  • Privacy
  • Do Not Sell My Information
  • About Us

© 2023 MJH Life Sciences and dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care. All rights reserved.

Advertisement
By Role
  • Associates
  • Owners
  • Practice Manager
  • Students
  • Technicians
Subscriptions
  • dvm360 Newsletter
  • dvm360 Magazine
  • Contact Us
  • Fetch DVM360 Conference
  • Terms and Conditions
  • Privacy
  • Do Not Sell My Information
  • About Us
  • MJHLS Brand Logo

© 2023 MJH Life Sciences™ and dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care. All rights reserved.

"I need steroids, STAT!" But do you? Do you?!

January 27, 2016
Daniel Fletcher, PhD, DVM, DACVECC

Are steroids always life-savers? A veterinary criticalist weighs in.

Many veterinarians think that patients should never die without the use of corticosteroids. But is this really true? If all else fails, reach for a corticosteroid? Not always, says emergency and critical care specialist Dr. Daniel Fletcher. Corticosteroids can do wonders in some cases, and he advises that you use the CIA to guide you in when their use is indicated in emergency cases. (Note: This is a mnemonic device, not the actual CIA. No men in black suits here.)

Fletcher says because of the multitude of corticosteroid use recommendations in emergency cases out theresome of which corticosteroids are indeed useful for and some of which they can actually be harmful forhe and a fellow criticalist came up with the CIA for acceptable corticosteroid use:

C is for cancer since some types of cancer that will respond well to corticosteroids.

I is for immune-mediated diseases such as immune-mediated hemolytic anemia, immune-mediated thrombocytopenia and immune-mediated skin disease.

A is for conditions such as atopy, asthma, allergy, anaphylaxis and Addisons disease. It seems like a lot of them seem to fall under the As, says Fletcher.

So when are corticosteroids a no-no? Fletcher says new evidence in the literaturemuch in human literaturesuggests that corticosteroid use is not a good idea in some diseases that veterinarians have classically used them forspinal cord injury, head trauma and shock. I think those are three that a lot of people use steroids for, and I would argue that if you look at the current literature, its not very well supported, he says. The harm: They can cause complications such as infection, immunosuppression and gastric ulceration.

If you're not sure when to reach for a corticosteroid, Fletcher has three questions to ask yourself to help make that determination:

  • Is there a definite benefit associated with it for the disease you are treating?

  • Are there risks associated with it? (There are always risks associated with steroids for any patient you give them to, says Fletcher.)

  • Do the benefits outweigh the risks in those cases?

As for which corticosteroid to use, Fletcher likes injectable dexamethasone sodium phosphate for his emergency cases. "It's important to remember, though, that dexamethasone is a whole lot more potent that prednisone, which is what we're using for chronic therapy," says Fletcher. "So if you're thinking you want 0.5 mg/kg of prednisone, don't pick up the dexamethasone bottle and give 0.5 mg/kg of that. Remember that dexamethasone is about 10 times as potent, so you really want to cut that dose way down."

Hear more in this interview with Dr. Sarah Wooten, our practitioner in the trenches:

Advertisement

 

Related Content:

Expert InterviewsEmergency & Critical Care
Dr Natalie Marks to lecture on diabetes management with Dr Adam Christman
Dr Natalie Marks to lecture on diabetes management with Dr Adam Christman
3 concerns with homemade diets for pets
3 concerns with homemade diets for pets
Top 3 pancreatic diseases in dogs
Top 3 pancreatic diseases in dogs

Advertisement

Latest News

Xylazine moves from the stables to the streets

DEA reports widespread threat of fentanyl mixed with xylazine

3 Must-reads for National Poison Prevention Week

UC Davis study on eye diseases in kittens

View More Latest News
Advertisement