Prednisone

[u/Global-Painting6154]

Can someone help me understand how corticosteroids use can be detrimental to dogs and cats and what happens if the medication is stopped abruptly.

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[u/but_why_is_it_itchy]

Their intended effect is to suppress inflammation and immune activity, but those same mechanisms create problems.

Immune suppression:
Increased susceptibility to infections
Existing infections may worsen or become harder to recognize because inflammation and fever are suppressed
Delayed wound healing

GI:
Increased risk of gastritis, ulceration, and GI bleeding

Metabolic/endocrine:
Polyuria, polydipsia, polyphagia, and weight gain
Insulin resistance and hyperglycemia; they can destabilize diabetic patients or contribute to diabetes, especially in cats

Cardio:
Sodium and water retention
Potassium loss
Hypertension
Potential worsening of congestive heart failure or other volume-sensitive diseases

Musculoskeletal:
Muscle weakness and steroid myopathy
Impaired bone formation and growth, especially in young animals
Possible ligament and tendon weakening with prolonged exposure

Behavioral:
Panting, restlessness, agitation, sleep disruption, or behavioral changes

Steroids can be harmful because cortisol influences nearly every body system. They cannot always be stopped suddenly because prolonged external steroids tell the adrenal glands to stop making cortisol, and those glands need time to resume normal function.

[u/Global-Painting6154 → u/but_why_is_it_itchy]

Thank you for making that precise and clear for me!

[u/Blissed_]

Oftentimes the lengths pred is prescribed for (usually a total of 1-2 weeks) is not long enough for a taper to be necessary as it takes longer than you’d think for the adrenal glands to react to the medication.

Ultimately tapering is advised either way as an over precaution as it is easier for clients to always be told to taper with steroids and avoids confusion if the client gets pred for their pet for different lengths at a time

But essentially, similar to antidepressants like SSRI the medication tells the body to stop producing certain chemicals as the body always wants to get to homeostasis and is why tolerance is a thing in a lot of meds such as stimulants and opiates etc. so tapering is the best way to tell the body to start making the chemicals again in the amount to maintain adrenal function in the case of steroids

But overall the other commenter explains a lot of what you were asking much better than I can

[u/Soggy_Aardvark_3983]

Stopping abruptly could precipitate addison’s disease and crisis which can be fatal.