That's the unpleasant thing about steroids -- the side effects generally occur over time.
As someone who has been on long term low dose steroids for a form of muscular arthritis, I totally agree that it is the miracle drug, kind of/at first! (and was hailed as this when first discovered in the 40s (or so ?) -- but then eventually they discovered the huge range of side effects.
For many conditions it is the only thing that can bring relief from pain. It is actually the diagnostic tool for my kind of arthritis -- if steroids eliminate pain generally within a few hours of taking it, when nothing else has worked, then they know you have this condition.
It is amazing --you take it and in 24 hours or so, go back to a state you have long forgotten -- what it is like to be say 20 with no pain at all, no little creaks and discomforts and dings that we all get to some extent as we get older, sustain some injuries, etc. I had utterly forgotten what that was like.
It really made me think about that quote that youth is wasted on the young. :lol: I marvelled at just feeling fully fit with not one little bit of soreness from anything -- the stiff wrists from a career of typing, the family bad knees, the point where my neck hurts when I turn it from an impact in a softball game 20 years ago, little bits of shoulder soreness from decades of swimming & water polo etc. Gone, gone gone!
If there were no side effects, everyone would be taking prednisone after about 45! :lol: Also useful to know I think that two people --or dogs -- can have exactly opposite symptoms, yet both due to steroids.
I am lucky that my kind of arthritis starts people on a generally low dose of preds, with slow reductions over 1-2 years in most cases, then full remission of the condition. I'm also lucky that I had no serious side effects at those low-ish starting doses and still don't. I am almost off the preds, and down to a very low daily dose (dropping to just 1.5 mg daily next week, then will hopefully be off entirely by start if new year, but has taken 18 months to get to this dose from 15mg).
However doctors are now recognising that steroids even at low doses can bring side effects over time too, as an accumulated dose.
So I really do understand the pros and cons of this drug and also the often misguided knee-jerk opposition to it but also the fact that initial wonder response can make it easy to forget the longer term possible implications of some mild to serious problems. That's why I would always argue that people should try every other possibility before opting for long term steroids for SM, but also that they are not necessarily something to avoid either if they are the only thing bringing relief. In my case, steroids have made it possible for me to move over the past 18 months. They also greatly lowered the risk of the onset of a more serious form of arthritis and of heart disease and stroke. But at all times I have been anxious to get off them asap!
Most of the knee-jerk response BTW is for short term use for significant pain -- where people or a pet may start on a high dose and swiftly taper dosage over a week or 2. This is not the kind of usage that generally brings on problems! I's long term use even on low doses, and for long term dose you always want the lowest possible dose.
I never thought I'd have a lot of personal knowledge and experience of prednisone and never wanted it but there you go -- like others here who take gabapentin or Lyrica, it does give us cavalier owners some insight into what our dogs with SM go through.