can Prednisone cause hair loss??

Question
My male ferret was diagnosed with EGE (Eosiniphilic Gastroenteritis) at a young age.  We are managing the symptoms with a low dose of Prednisolone and special food, but he continues to have occasional flare-ups.  He is almost always ithcy and has been missing most of his hair from the shoulders down since shortly after he began the meds over a year ago (though it does grow back in patches from time to time).  I asked his vet if he could have adrenal disease; she said it's possible, but does not recommend surgery at this point.

My question is do you know if Prednisolone can cause hair loss in a ferret, or is this likely a symptom of his EGE, or perhaps adrenal disease? Just curious.

Answer
What an excellent question.  I just took Endocrinology and learned all about the effects of long term steroid use in the body and can go back into my notes to make sure I get everything right.  

Yes, Prednisolone can cause hair loss if it is administered over a long period of time.  This, along with other symptoms, is called "Iatrogenic Hyperadrenocorticism".  It has pretty much the same symptoms of Adrenal Disease since both cause an increase in steroids in the body but for different reasons.  This will make it very difficult to tell if the ferret has Adrenal Disease, Iatrogenic Hyperadrenocorticism, or if he is just itching all of his fur off from the allergies.  It also can be a combination of two or all three.  

Long term prednisolone use is not good for the body.  It can cause all sorts of detrimental effects.  But, despite all of the drawbacks, your ferret's quality of life is important.  Steroids might be the only way to make him comfortable and the benefits may outweigh the risks.  

Some of the effects of long term steroid use to keep in mind are:

Muscle wasting
Loss of bone density (osteopenia)
Degeneration of connective tissue
Dermatologic changes (hair loss, increased bacterial infections, etc)
Drinking more/urinating more
Increased appetite
Liver enlargement
Hypertension
Insulin resistance (diabetes)
Increased cholesterol in the blood
Urinary Tract Infections

There is really no way to test for Adrenal Disease since the blood test that is available is not very accurate.  The only other option is an abdominal ultrasound, may or may not yield results.  Usually with Iatrogenic Hyperadrenocorticism, the adrenal glands get shrived up from disuse (since they body is getting enough steroids from the Prednisolone) and with Adrenal Disease one or both of the glands is enlarged.  This difference could help you determine if the hair loss is due to the oral steroids or not.  

Surgery based on clinical signs is the normal diagnosis and treatment, but since your ferret's hair loss can be due to the steroid medications, Adrenal disease or his allergies; it is difficult to say which is the case.  If you really want to know, try the ultrasound and see if the glands are "shrived", normal or enlarged. The only other option is to try a Lupron injection which is used to manage adrenal disease.  This is often given to ferrets who cannot have adrenal surgery.  It will not stop the progression of the disease but only help mask the symptoms.  If the fur grows back, you are probably dealing with an adrenal hyperplasia.  

Just as a side note:  Never suddenly discontinue Prednisolone or any other steroid.  Since the adrenal glands are "shrived" from disuse the body cannot suddenly start producing the natural steroids it needs.  You need to gradually ween him off of the steroids for a few weeks to let his adrenal glands kick back into action or you might end up with an Addisonian Crisis due to shock.  This is good to know, so always keep it in mind.

I hope this information helps and does not further confuse you.  If you need any clarification, please do not hesitate to ask.  I am sorry I could not help more.

-Cindy P.