This question was forwarded to me related to the webinar on New Research Insights Into Canine Addison's Disease ...
Should glucocorticoids be tapered off in dogs with Addison's disease prior to surgery and if so, how long in advance considering the pet needs them to survive, and in light of the fact that these drugs also suppress healing?
Glucocorticoids should NOT be tapered off in Addisonian dogs prior to surgery. We do plenty of surgeries in patients that are taking glucocorticoids for a variety of conditions and they do heal and don't get infections, probably because we treat these patients with a higher degree of caution. Long lasting suture material and sterile technique are sufficient.
Remember that Addisonians should be on physiologic doses of glucocorticoids, not anti-inflammatory or immunosuppressive doses, so the risk of surgical complication is only slightly increased in that regard. On the other hand, surgery is a very stressful event and I would tend to actually increase the glucocorticoid dose for several days after surgery, not lower it (that should be decided on a case by case basis).
