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Marked muscle fiber atrophy can result from chronic corticosteroid use (selective atrophy of type 2 fibers, steroid myopathy) Profound muscle weakness resulting from corticosteroids may worsen existing weakness Other side effects of corticosteroid use including hypercorticism Very Minimum Diagnostics Suggested for Neuromuscular Disorders Careful physical and neurological examination localizing the clinical problem to the muscle, nerve, or neuromuscular junction Careful history regarding diet, previous drug therapy, travel, and known similar problems in other related animals CBC and serum chemistry panel including creatine kinase (CK) and electrolytes Evaluation of thyroid status (remember that neuromuscular manifestations of hypothyroidism may be the first clinical sign of hypothyroidism!) Acetylcholine receptor antibody titer (acquired myasthenia gravis is a great mimic and can have many clinical presentations) Plasma lactate concentration (an increasing number of neuromuscular diseases are being recognized associated with lactic acidemia) What Can I Do If An Owner Will Only Allow the Very Minimum Diagnostics

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Management strategies include starting at the lowest prescribed dose and escalating slowly, taking drops in the morning when the stomach is empty (counterintuitively, an empty stomach often produces less nausea than taking drops after eating), and keeping bland foods available for your first meal after the fasting window

it seems to be particularly beneficial when on a Cagrilintide protocol

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