Stopped prednisolone suddenly.

Hi Dr. Marie,

My 2.5 year old cat, Pebbles, was diagnosed with pretty severe Gingivitis Stomatitis in 2012. Per my vet's recommendation, I opted to have most of her teeth extracted. Between her 2nd and 3rd oral surgery, my vet prescribed 4 months worth (0.5 mL every 24 hrs) of Prednisolone to Pebbles, but I didn't receive any information about this steroid from the vet(my vet just said, "Here you go, give her this"). A compounding pharmacy made the Prednisolone into a solution, so it didn't come with an informational sheet either. Based on what Pebbles had been put on in the past to help with her gums, I honestly did not think that it was a steroid.

My issue is that between the refills of her prescription (so 3x total), I had waited approx. 2-5 days to get it refilled. I did not realize at all that it was a medication that she had to be weened off of. She exhibited no symptoms of withdrawal and seemed perfectly happy each time. The vet also checked her glucose level 3 months after starting the steroids, and it was normal.

She had her last oral surgery 3 weeks ago and is left with only 2 teeth remaining. She had pre-surgery bloodwork done (not sure what that involves) and all was normal. After the surgery, I accidentally missed one dose of Prednisolone when I had the flu - this was also before I realized that she had to be weened off.

Pebbles is still on the Prednisolone (it's been ~5 months) and I made sure to get her refill this last time right away, since I now understand what can happen if steroids are stopped abruptly. I also have an appointment with the vet to hopefully get her weened off of Prednisolone.

My question is: do you think there will be any lasting effects of me having waited a few days in between refills (3x) and missing that one dose? It was completely unintentional and I feel horrible about it because Pebbles is like a child to me. Please note that it has been at least 1.5 months since the last time she was shortly off the steroids for more than 1 day, and Pebbles seems perfectly fine.

Thanks,
Sarah