Dexamethasone for Dogs

Dosage

Dexamethasone is most commonly administered to dogs as an oral tablet, injection, or topical ointment. It is available only by prescription.

Dexamethasone can be administered as a 2 mg/ml injectable solution. The FDA's Code of Federal Regulations (CFR) states vets can administer dexamethasone intravenously or intramuscularly to dogs at a dosage of 0.25 to 1 mgThis dosage can be repeated for 3 to 5 days.

Vets can also administer 4.0 mg/ml of dexamethasone sodium phosphate, which equals 3 mg of dexamethasone. The intravenous dosage of dexamethasone sodium phosphate for dogs is 0.25 to 1 mg. This dosage can be repeated for 3 to 5 days.

According to the FDA, dexamethasone can be dispensed orally to dogs in pill form at a dosage of 0.25 to 1.25 mg daily for up to 7 days.

Dexamethasone chewable tablets can be added to food at a dosage of 0.25 to 1.25 milligrams. It can be given to dogs as a single dose or divided between two meals. These tablets can be administered to your dog for up to 7 days. Once a dog responds to the medication, the dosage should be reduced by 0.125 mg daily until a maintenance dose is reached.

Dexamethasone can be applied as a topical solution combined with neomycin and thiabendazole. The solution consists of 40 mg of thiabendazole, 3.2 mg of neomycin, and 1 mg of dexamethasone.

When treating dermatoses everywhere but the ear, you should apply 2 to 4 drops per square inch twice daily. When treating an outer ear infection, apply between 5 and 15 drops in the ear twice daily. Treatment shouldn't exceed 7 days.

Dexamethasone can be used as an anti-inflammatory agent, a supportive therapy for posterior paresis, a supportive treatment before and after surgery, or for unspecified dermatosis. Dexamethasone sodium phosphate is used primarily as a glucocorticoid or anti-inflammatory agent. 

Cost

The cost of dexamethasone depends on the form. Generic tablets cost as little as 30¢ per tablet. You can buy a generic 100 ml bottle of 2mg/ml dexamethasone for as little as $22. A 3.5 g tubes of generic dexamethasone ointment cost between $10 and $15.

Efficacy

According to the National Institutes of Health, studies of dexamethasone injections in lab animals found it’s 20 times more effective at controlling inflammation than prednisone and nearly 80 times more effective than hydrocortisone.

Side effects

Contact your veterinarian if you notice any of the following side effects: 

• Changes in hair appearance
• Loss of hair coat
• Increase in body fat
• Swelling of the abdomen
• Panting
• Lethargy
• Muscle weakness
• Stomach ulcers
• Excessive thirst or urination
• Opportunistic infections (bacterial, viral, and fungal)
• Pancreatitis
• Seizures 
• Slow wound healing
• Excessive hunger
• Plaque deposits on the skin
• Thinning skin

This medicine can also potentially cause abnormal blood work, steroid hepatopathy, pancreatitis or swelling of the brain.

Considerations

Canines undergoing long-term corticosteroid treatment should have frequent check-ups to monitor their weight and bloodwork since these medications can worsen pre-existing conditions. Prolonged use of dexamethasone for dogs can cause electrolyte imbalances and abnormally high protein and blood glucose levels. Over time, a dog’s blood panels may reveal higher-than-normal liver enzyme levels and lead to steroid hepatopathy, a typically reversible condition caused by steroidal effects on the liver.

Dexamethasone isn’t recommended for puppies and adolescent dogs since it can adversely affect bone and cartilage development. This medication may also exacerbate medical conditions such as kidney disease, stomach ulcers, Cushing’s syndrome, heart disease, and bacteria or fungal infections. 

Studies show that long-term treatment in dogs increases canines’ susceptibility to urinary tract infections. It’s estimated that 30% of dogs who take this drug for more than 90 days are diagnosed with a UTI. Most pet owners don’t even realize their dog is ill when taking dexamethasone because it masks the inflammation, pain, and other symptoms associated with UTIs. Most vets recommend that dogs on this medication for more than 3 months undergo regular urinalysis to make sure they remain healthy.

Drug interactions

Dexamethasone may interact with the following drugs: 

• NSAIDs (including aspirin, ibuprofen, and indomethacin)
• Certain diuretics 
• Fluoroquinolone antibiotics
• Vaccines
• Insulin
• Fentanyl
• Barbituates
• Bupropion
• Amphotericin B
• Diflucan
• Carprofen
• Meloxicam
• “-azole” antifungals
• Rifampin
• Chemotherapy drugs
• Macrolide antibiotics
• Ephedrine
• Valium
• Biltricide
• Anticholinesterases
• Certain immunosuppressants

Allergic reactions and sensitivity

Allergies would be rare. Signs of an immediate allergic reaction to this medicine would include:

• Coughing
• Sneezing 
• Trouble breathing
• Scratching
• Hives
• Swelling of the face, tongue, or throat 

Frequently asked questions

Can you give dexamethasone to dogs who are pregnant?

This medicine is not intended for use in pregnant dogs. Dexamethasone is known to cause miscarriage, fetal death, preterm labor, and palette deformities in offspring. 

My dog is panting a lot since starting dexamethasone. Is this normal? 

Yes, panting is one of the most common side effects of this medication. 

My dog seems hungrier than usual when they take dexamethasone. Should I be feeding them more?

No. Dexamethasone can cause weight gain in canines due to its effects on appetite. Feed your pet their usual amount, and if they still seem hungry, consider dividing their meals into smaller portions and feeding throughout the day. 

How long does it take dexamethasone to start working for dogs?

Dexamethasone is a rapid-onset steroid and typically starts working within 1 to 2 hours.

How should I store dexamethasone for dogs?

Keep both tablets and liquid forms between 68° - 77°F, away from UV light. Topic solutions should be stored between 59° - 77°F. Dispose of any remaining oral solution after 30 days of opening. Do not refrigerate or freeze dexamethasone liquid suspensions.