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Stopped prednisolone suddenly.

Species: Cat
Breed: Domestic Tabby
Age: 2-5 years
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


Online vet, Dr. Marie

Dr. Marie replied:

Hi Sarah.

You can rest assured that you have not caused any lasting problems by stopping the steroid for a few days.

The concern that you were talking about is that the adrenal glands can become dependent on steroids when they're used chronically. If an animal is on a really high dose of steroids and then suddenly the dose is stopped it can cause serious problems with the adrenal glands. This is much more common with dog than with cats. What can happen is something called an acute addisonian crisis.

However, cats are not as sensitive to these effects than dogs are. Also, most likely your cat was not on a high enough dose to cause problems if the medication was stopped.

I have a fair number of cats in my practice who are on a small dose of either prednisone or prednisolone chronically. It is generally very safe. There is no harm in giving it a try to see if she will do okay when off of the medication, but if it is working well to help with her oral problems then don't feel bad about continuing.



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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. AskAVetQuestion.com and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.