Cortisone (now mainly referred to as cortisol) is the main hormone produced by the adrenal gland, and belongs to a group of hormones called glucocorticoids, which is a class of steroids. Glucocorticoids antagonize or counter the effects of insulin and increase gluconeogenesis--basically they have an overall blood sugar raising effect[1].
All of us produce extra cortisol daily; it's done shortly before we awaken. The body prepares itself to go into "wake mode" and releases cortisol to ready itself for wake up.
In non-diabetics, it happens virtually unnoticed, as the properly working pancreas produces more insulin to handle the cortisol release. Persons without diabetes are unlikely to be checking their blood glucose values on a regular basis, so any temporary increases would not be measured.
But with diabetes, it can become a problem known as Dawn phenomenon; the rise in cortisol levels brings with it a corresponding rise in blood glucose, meaning high morning testing values--even before eating. Everyone with diabetes does not have this occurrence, just as all cats aren't white or all dogs brown.
Cortisol is involved in the response to stress; it increases blood pressure and blood sugar levels and suppresses the immune system. Note that this is why stress is known to raise blood sugar levels and cause hyperglycemia in diabetic pets.
Pets with Cushing's disease are self-administering extra cortisol from the adrenal glands, all the time, leading to hyperglycemia and secondary diabetes.
There is another class of steroids in need of mention here. They are called anabolic steroids, and are related to the male sex hormone, testosterone[2]. Their main uses are for medically supervised weight gain, [3]inappetance, (most commonly Winstrol/Stanozolol),[4], in treatment of some forms of anemia and cancer[5].
Why they are used[]
The glucosteroids are very helpful for a wide number of medical conditions; in some cases they are the only effective way to treat some problems. At times, they are prescribed as appetite stimulants[6].
As with anything else, they can come with a price tag: Short-term use can mean a temporary diabetic condition, which (usually) resolves after stopping steroid use.
Long-term use can cause permanent diabetes. For pets and people who are diabetic, the use of oral or injected steroids brings with it higher blood glucose levels[7].
This is not to say that you should totally rule out any use of steroids with a diabetic pet, but need to be watchful regarding them. Ask if there is an alternative medication for the problem which is non-steroidal.
If you must use steroids, try to use local or inhaled versions, which are less likely to raise blood sugar[8][9]. Using steroids--orally, injected or even topically (applied to the skin as an ointment or cream)--can elevate blood glucose levels. During treatment and for a period after treatment with steroids ends, higher doses of insulin may be necessary[10][11].
Cushing's/Cortisone meds connection[]
Like diabetes, Cushing's can be caused by over-use of Cortisone-type medications[12].
Because the pituitary gland also acts as a sensor, it detects the high levels of cortisol in the body and does not signal the adrenal gland to produce more. The adrenal gland becomes inactive and can atrophy from disuse, much in the way non-used muscles do, losing the ability to function normally.
Exogenous cortisone puts the adrenal gland into a sort-of hibernation. While they are being administered, they furnish the body's cortisol needs in addition to treating the condition they were prescribed for. The adrenal gland needs to be "awakened" from its rest gradually so it can begin full function once again. This is why cortisone and similar drug treatment is slowly and carefully withdrawn. Simply stopping the medication means leaving the body without sufficient cortisone--exogenous or endogenous[13].
Common Glucosteroids[]
Many people are familiar with the use of cortisone for medical conditions such as allergies/asthma, arthritis, and poison ivy. Glucocorticoid hormones (glucosteroids) are given in drug form for their anti-inflammatory properties. Some medications that are glucosteroids are:
Common Glucosteroids | |
---|---|
Prednisone[15] and Prednisolone[16] | |
Dexamethasone (Azium)[17][18] | |
Trimacinolone (Vetalog) (Panalog) (Animax)[19][20][21] | |
Methylprednisolone (Medrol)[22][23] |
Steroids are dispensed in many different ways-they can be given as oral or injected medications, rubbed on the skin (topical), for eye (opthalmic) and ear (otic) use as ointments or drops, and inhaled. Here are some common ones and their patient information sheets:
Topical (skin)-common brand names:[]
Topical (skin) Steroids | |
---|---|
Hydrocortisone Cream/Gel | |
Genesis[24] Genesis Topical Spray[25] | |
Panalog[26]---ointment and cream--with antibiotics | |
Animax[27][28] | |
Corti-Care Spray[29] Corti-Care Lotion[30] Corti-Care Shampoo[31] | |
Dermigard Hydrocortisone Spray[32] Dermigard Medicated Shampoo[33] | |
Cortispray[34] | |
GentaVed Topical Spray[35] | |
ResiCORT Leave-On Lotion[36] | |
Zymox Topical Wipes with Hydrocortisone[37] Zymox Topical Spray with Hydrocortisone[38] Zymox Topical Cream with Hydrocortisone[39] | |
Fuciderm gel-UK[40] |
Opthalmic (eyes) with antibiotics-common brand names:[]
Opthalmic (eyes) Steroids With Antibiotics | |
---|---|
Neobacimyx-H[42] | |
Gentocin Durafilm[43] | |
Vetropolycin HC bacitracin, neomycin, polymixin & hydrocortisone acetate[44] | |
BNP with Hydrocortisone bacitracin, neomycin,polymixin & hydrocortisone acetate[45] | |
Cortisporin[46] | |
NeoDecadron[47] | |
Trioptic S[48] | |
Neo-Predef[49] | |
Neo-Poly-Dex[50][51] |
Opthalmic (eyes)--common brand names:[]
Opthalmic (eyes) Steroids | |
---|---|
Decadron (Dexamethasone)[52] | |
Pred Forte (Prednisolone)[53] | |
Econopred Plus (Prednisolone)[54] | |
Inflamase Forte (Prednisolone)[55] |
Otic (ears)-with antibiotic(s)-common brand names:[]
Otic (ears) Steroids with Antibiotics | |
---|---|
Otomax[56] | |
Tresaderm/Mintezol (can also be used topically)[57][58][59] | |
Zymox with Hydrocortisone[60] | |
DVMax[61] | |
GentaVed Otic[62] | |
Aurizon-UK[63] | |
Canaural-UK[64] | |
Surolan-UK[65] | |
Cortisporin Otic[66] |
Otic (ears)-common brand names:[]
Otic (ears) Steroids | |
---|---|
Synotic Otic Solution[67] |
Inhalers--common brand name:[]
Inhalers With Steroids | |
---|---|
Amazacort (Triamcinolone)[68] |
Oral & Injectable--generic and brand names:[]
Oral and Injectable Steroids | |
---|---|
Prednisolone: | Solu-Delta-Cortef[69] Prednistab[70] PLT Tablets-UK[71] Prednicare Tablets-UK[72] Temaril-P[73] |
Dexamethasone:[74][75] | Azium[76] Decadron[77] Dexaject[78] Dexadreson-UK[79] Dexafort-UK[80] Opticorten-UK[81] Voren 14-UK[82] Voren Suspension-UK[83] |
Prednisone: |
Meticorten Sterapred[84] Deltasone[85] |
Methylprednisolone: |
Depo-Medrol[86][87] Medrol[88][89] Medrone V-UK[90] Solu-Medrone V-UK[91] Depo-Medrone V-UK[92] |
Triamcinolone: |
Cortalone[93] Vetalog[94][95] Triamtabs[96] |
Desoxycorticosterone |
Pericorten-V[97][98] |
Anabolic Steroids[]
Anabolic Steroid name | Effects |
---|---|
Winstrol, Stanozolol[99][100] | insulin dose may need adjustment |
Anadrol-50, Anapolon-50, Oxymethalone[101][102] |
insulin dose may need adjustment |
Durabolin,Deca-Durabolin, Durabolin-50, Hybolin Decanoate, Hybolin Improved, Durabolin-50, Kabolin, Nandrolone[103] |
insulin dose may need adjustment |
Oxandrin, Oxandrolone[104] | insulin dose may need adjustment |
Further Reading[]
- Wiki cases-Steroid-induced Feline Diabetes cases
- Steroids and Cats
- Hemodynamic Effects of Methylprednisolone Acetate Administration in Cats-American Journal of Veterinary Research 2006
- Good article-Steroid Use-Veterinary Partner
- Use of Corticosteroids in Veterinary Dematology
- The Veterinary Use of Steroids-Drs. Foster & Smith-Pet Education Library
- LA Care Health Plan Formulary
This 5 page list shows many steroid-containing brand names of human drugs, according to what they are used for. - Prednisone/Prednisolone-Petplace.com
- Dexamethasone-Petplace.com
References[]
- ↑ Merck Veterinary Manual-Glucocorticoids
- ↑ Mayo Clinic-Anabolic Steroids
- ↑ Mayo Clinic-Anabolic Steroids
- ↑ Merck Veterinary Manual-Drugs Affecting Appetite
- ↑ Mayo Clinic-Anabolic Steroids
- ↑ Merck Veterinary Manual-Glucosteroids Stimulate Appetite
- ↑ Childrenwithdiabetes.com-Ask the D Team-2006
- ↑ [1]
- ↑ [2]
- ↑ Steroid Treatment and Insulin Needs
- ↑ PetPlace.com-Insulin-Precautions & Side Effects
- ↑ Veterinary Partner-What Exactly is Cushing's Syndrome?
- ↑ Veterinary Partner-What Exactly is Cushing's Syndrome?
- ↑ Drugs.com-Corticosteroids
- ↑ Medi-Vet.com-Prednisone Tablets
- ↑ Medi-Vet.com-Prednisolone Tablets
- ↑ 1-800PetMeds.com-Dexamethasone--Azium
- ↑ Medi-Vet.com-Generic Dexamethasone Injection
- ↑ 1-800PedMeds.com-Animax--Different Brand Name for Panalog-type Product
- ↑ 1-800PetMeds.com-Panalog Cream
- ↑ Vetalog/Panalog-Petplace.com
- ↑ 1-800PetMeds.com-Methylprednisolone--Medrol
- ↑ Medi-Vet.com-Methylprednisolone Tablets
- ↑ Topical Corticosteroids Patient Information Sheet-Drs. Foster & Smith
- ↑ MediVet.com-Genesis Topical Spray
- ↑ Fort Dodge Reintroduces Panalog
- ↑ 1-800PedMeds.com-Animax--Different Brand Name for Panalog-type Product
- ↑ 1-800PetMeds.com-Panalog Cream
- ↑ 1-800PetMeds.com-Corti-Care Spray
- ↑ 1-800PetMeds.com-Corti-Care Lotion
- ↑ 1-800PetMeds.com-Corti-Care Shampoo
- ↑ 1-800PetMeds.com-Dermigard Hydrocortisone Spray
- ↑ 1-800PetMeds.com-Dermigard Medicated Shampoo
- ↑ Medi-Vet.com-Cortispray
- ↑ Medi-Vet.com-GentaVed Topical Spray
- ↑ Medi-Vet.com-Resi-CORT Leave-On Lotion
- ↑ Medi-Vet.com-Resi-CORT Zymox Topical Wipes with Hydrocortisone
- ↑ Zymox Topical Spray with Hydrocortisone
- ↑ Medi-Vet.com-Zymox Topical Cream with Hydrocortisone
- ↑ NOAH Compendium-UK-Fuciderm gel
- ↑ Steroid/Antibiotic Eye Medications Petplace.com
- ↑ Neobacimyx-H
- ↑ Antibiotic & Corticosteroid Opthalmic Patient Information Sheet-Drs. Foster & Smith
- ↑ Vetropolycin HC-Photo of Package Label
- ↑ 1-800PetMeds.com-BNP With Hydrocortisone
- ↑ Cortisporin-Petplace.com
- ↑ -Petplace.com
- ↑ Trioptic S-Petplace.com
- ↑ Neo-Predef-Petplace.com
- ↑ Neo-Poly-Dex-Drs. Foster & Smith
- ↑ Medication Sheet--note there's no information re: diabetes and corticosteroids
- ↑ 1-800PetMeds.com--Decadron--Dexamethasone
- ↑ 1-800PetMeds.com-Pred Forte
- ↑ Corticosteroid Opthalmic Patient Information Sheet-Drs. Foster & Smith
- ↑ 1-800PetMeds.com-Inflamase Forte
- ↑ Otomax-Photo of Tube
- ↑ 1-800PetMeds.com-Tresaderm
- ↑ Medi-Vet.com-Tresaderm
- ↑ Tresaderm/Mintezol-Petplace.com
- ↑ 1-800PetMeds.com-Zymox With Hydrocortisone
- ↑ Medi-Vet DVMax
- ↑ Medi-Vet GentaVed Otic
- ↑ NOAH Compendium-UK-Aurizon
- ↑ NOAH Compendium-UK-Canaural
- ↑ NOAH Compendium-UK-Surolan
- ↑ Cortisporin Otic-Drugs.com
- ↑ Medi-Vet.com-Synotic Otic Solution
- ↑ Corticosteroid Inhaler Patient Information Sheet-Drs. Foster & Smith
- ↑ Solu-Delta-Cortef-Photo of Vial Label
- ↑ 1-800PetMeds.com-Prednistab--Prednisolone
- ↑ NOAH Compendium-UK-PLT Tablets
- ↑ NOAH Compendium-UK-Prednicare Tablets
- ↑ Temaril-P Drugs.com
- ↑ Dexamethasone Sodium Phosphate--Generic Label Photo
- ↑ Dexamethasone Tablets--Generic Package Label
- ↑ 1-800PetMeds.com--Azium--Dexamethasone
- ↑ 1-800PetMeds.com--Decadron--Dexamethasone
- ↑ Dexaject--Photo of Vial Label
- ↑ NOAH Compendium-UK-Dexadreson
- ↑ NOAH Compendium-UK-Dexafort
- ↑ NOAH Compendium-UK-Opticorten
- ↑ NOAH Compendium-UK_voren 14
- ↑ NOAH Compendium-UK-Voren Suspension
- ↑ 1-800PetMeds.com-Sterapred--Prednisone
- ↑ 1-800PedMeds.com--Deltasone--Prednisone
- ↑ Depo-Medrol--Photo of Vial Label
- ↑ Medi-Vet.com-Depo-Medrol
- ↑ Medi-Vet.com-Medrol Tablets
- ↑ Methylprednisolone/Medrol/Depo-Medrol-Petplace.com
- ↑ NOAH Compendium-UK-Medrone V
- ↑ NOAH Compendium-UK-Solu-Medrone V
- ↑ NOAH Compendium-UK-Depo-Medrone V
- ↑ 1-800PedMeds.com--Cortalone
- ↑ Oral & Injected Corticosteroid Patient Information Sheet-Drs. Foster & Smith
- ↑ Vetalog Tablets--Labeling
- ↑ Triamtabs--Triamcinolone
- ↑ Desoxycorticosterone/Pericorten-V-Petplace.com
- ↑ About Pericorten-V-Novartis Animal Health
- ↑ Merck Veterinary Manual-Drugs Affecting Appetite
- ↑ Rx List-Winstrol/Stanozolol
- ↑ Rx List-Androl-50/Oxymethalone
- ↑ Drugs.com-Anabolic Steroids-Anapolon-50
- ↑ Drugs.com-Durabolin/Deca-Durabolin/Durabolin-50/Nandrolone, etc.
- ↑ Drugs.com-Oxandrin/Oxandrolone
Case studies:[]
See steroid-induced cases of diabetes here.
Steroid-Induced Diabetes--Feline--Fuzzer: Caution: Graphic