Topic:Corticosteroids
Corticosteroids are a class of steroid hormones that are commonly used in equine medicine for their anti-inflammatory and immunosuppressive properties. These compounds mimic the effects of hormones produced by the adrenal cortex and are administered to manage a variety of conditions, including allergic reactions, joint inflammation, and respiratory disorders in horses. Common corticosteroids used in equine practice include dexamethasone, prednisolone, and triamcinolone. Their application and dosage require careful consideration due to potential side effects, such as laminitis and immune suppression. This page compiles peer-reviewed research studies and scholarly articles that explore the pharmacology, therapeutic applications, and potential risks associated with corticosteroid use in horses.
Evidence Related to the Effects of Intralesional/Intrasynovial Corticosteroids on Tendon/Ligament Homeostasis and Healing. Inflammation plays a role in acute and chronic equine tendon/ligament injury; anti-inflammatories are often indicated. Local corticosteroids provide consistent and profound short-term effects on pain and inflammation across species. However, there is no demonstrated benefit in the long term, and complications can occur. Alternative biologic anti-inflammatory treatments are available and should be used in horses at risk of complications. Nonetheless, corticosteroids remain an affordable and effective anti-inflammatory that, with continued research, may be indicated on a case-by-case basis as pa...
Validation of the Equine Urticaria Activity Score for the assessment of chronic recurrent urticaria in horses. Recurrent urticaria is common in horses. The pathophysiology is poorly understood and treatment options are limited. Often, only glucocorticoids are effective for controlling clinical signs, albeit with potential adverse effects. Studies investigating new treatments need a validated objective scoring system for the grading of skin lesions to assess response. Objective: The aims were to investigate inter- and intraobserver reliability of the Equine Urticaria Activity Score (EqUAS) for the grading of skin lesions in horses with recurrent urticaria, and to examine agreement between experienced an...
Evaluation of an intra-articular carboxymethylcellulose crosslinked hydrogel in horses with osteoarthritis. Numerous treatment strategies have been proposed to manage osteoarthritis (OA) in sport horses. Carboxymethylcellulose (CMC), is used in veterinary medicine for various purposes. Objective: This study aimed to assess the efficacy of a CMC hydrogel in reducing clinical lameness in horses with OA affecting joint. The hypothesis was that intra-articular CMC would produce a sustained reduction in lameness compared to a control treatment. Methods: Thirty client-owned horses diagnosed with OA-related lameness in the metacarpophalangeal joint were enrolled. Horses were randomly assigned to two groups...
Endogenous Nature of Hydrocortisone Acetate in Horse. Hydrocortisone acetate, a synthetic acetate ester of hydrocortisone, was detected in horse blood samples collected from Thoroughbreds. Hydrocortisone acetate is generally considered an indicator for exogenous administration in horses. As hydrocortisone acetate has been previously reported to be endogenous in selected mammals, a proof-of-concept study was performed to evaluate the possible endogenous nature of hydrocortisone acetate in horses by in vitro incubation experiments using homogenized horse brain tissue.
Survey on 9 years of anti-doping controls in horse races in Italy. Doping in racehorses is a threat to horse welfare and the integrity of the sport. Despite its relevance, the literature on the prevalence of anti-doping violations worldwide is limited. Objective: To analyse anti-doping violations in racehorses in Italy. Methods: Retrospective observational study. Methods: Data on horse races, anti-doping testing, and confirmed violations between 2014 and 2022 were collected and analysed. Positivity rates, most common drug classes and parent drugs, and differences between trotting and galloping horses were investigated. Results: During the considered 9-year ti...
Corticosteroid Administration Enhances the Glycemic, Insulinemic, and Incretin Responses to a High-Protein Mixed Meal in Adult Horses. Corticosteroids are used routinely in horses and induce insulin dysregulation (ID). Nutrition is important for ID management and includes low nonstructural carbohydrate (NSC) diets and, often, high-protein ration balancers (RB). Insulin and incretin secretion increase after high-protein meals; corticosteroids may influence these effects. Objective: A high-protein mixed meal will induce hyperinsulinemia and increased concentrations of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) in horses with ID; dexamethasone (DEX) will amplify this effect. Methods: F...
Meta-Analysis and Mechanism-Based Modeling of Synovial and Plasma Pharmacokinetics and Adrenal Suppression Following Intra-Articular Injection of Methylprednisolone Acetate in Horses. This study assesses the pharmacokinetics (PK) of published methylprednisolone (MPL) data in horses following intra-articular (IA) administration of MPL acetate (MPA) and the associated adrenal suppression. The concentrations of MPL/MPA in synovial fluid, blood, and urine, as well as hydrocortisone (HC) in plasma, were digitized from multiple sources in the literature. A minimal physiologically based pharmacokinetic model and a linked indirect response model with a circadian rhythm baseline were applied. Concentrations of MPA in joints followed a triexponential decay, converting to MPL. The cle...
Use of inhaled ciclesonide for treatment of moderate asthma in Thoroughbred racehorses. Mild-moderate asthma is common in horses. Inhaled ciclesonide has been approved only for treatment of severe asthma in horses. Objective: We hypothesized that a 10-day treatment course of inhaled ciclesonide (Aservo EquiHaler) would improve clinical signs, endoscopic tracheal mucus scores, and bronchoalveolar lavage fluid (BALF) cytology in racehorses with moderate asthma. Methods: Racehorses with moderate asthma housed at the Emerald Downs Racetrack in Auburn, WA. Methods: Prospective, randomized, double-blinded, placebo-controlled clinical study. Horses received inhaled ciclesonide (n = ...
The Combined Use of Triamcinolone and Platelet-Rich Plasma in Equine Metacarpophalangeal Joint Osteoarthritis Treatments: An In Vivo and In Vitro Study. Intra-articular corticosteroids, such as triamcinolone acetonide (TA), help reduce pain related to osteoarthritis (OA), but they may impair cartilage metabolism. In contrast, platelet-rich plasma (PRP) therapy, a regenerative therapy, has shown potential to promote healing and regeneration of articular cartilage. This study investigates the effects of combining PRP with TA to treat osteoarthritis in racehorses. The study proposes that PRP injection following TA treatment could reduce side effects and improve treatment outcomes. Firstly, in the in vitro study, chondrocytes were exposed to diffe...
Detection of Over 110 Anabolic-Androgenic Steroids, Corticosteroids and/or Their Esters in Horse Hair Using Ultra-High-Performance Liquid Chromatography-High-Resolution Mass Spectrometry and Gas Chromatography-Tandem Mass Spectrometry After Solid-Supported Liquid Extraction. Anabolic-androgenic steroids (AAS) are banned substances in both human and equine sports. They are often administered intramuscularly to horses in esterified forms for the purpose of extending their duration of action. As such, the detection of intact esters of endogenous steroids in hair is particularly advantageous, as it can provide unequivocal proof of their external origin. Compared with urine and blood matrices, hair in general allows a longer detection window as long as the administered drug can be incorporated into hair and has not degraded. This can be useful in doping control of equi...
Clinical efficacy of inhaled corticosteroids in equine asthma: A meta-analysis and number needed to treat. Equine asthma, a prevalent chronic inflammatory condition affecting the equine population, significantly compromises the performance and quality of life in affected horses. Inhaled corticosteroids (ICS) are often the first-line pharmacological intervention due to their potent anti-inflammatory properties. This meta-analysis investigates the clinical efficacy of ICS in treating equine asthma, emphasizing the number needed to treat (NNT) and the likelihood of achieving a clinical response. A comprehensive literature search identified relevant studies comparing ICS with placebo (PCB) controlled t...
Urinary incontinence and sabulous cystitis in mares: report of five cases. This report describes five cases of urinary incontinence in Quarter Horse mares associated with the development of sabulous cystitis. The animals in this study had a history of persistent urinary incontinence for eight months, with clinical signs of continuous dribbling urine during rest and movement. The initial treatment with antibiotics and anti-inflammatory drugs was ineffective. Clinical examination revealed severe scalding in the perineal region and on the medial aspect of the hind limbs, along with neurological signs such as ataxia, hind limb paresis, and diminished perineal reflexes. T...
Treatment of a urethral stricture by image-guided placement of a custom-made absorbable stent in a standing, sedated horse. A 10-year-old Irish Sport Horse gelding developed complications from a general anesthesia resulting in sling support and recurrent urinary catheterization. The horse subsequently presented signs of dysuria and pollakiuria, was diagnosed with sabulous cystitis, and developed a urethral stricture from the repeated catheterizations, which was confirmed on urethroscopy. Clinical signs persisted despite conservative management with topical corticosteroids and urethral bougienage with balloon dilators. An image-guided approach was used to treat the stricture with a custom-made polydioxanone stent pl...
A SIRT1-independent mechanism mediates protection against steroid-induced senescence by resveralogues in equine tenocytes. Tendinopathy is a common age-related disease which causes significant morbidity for both human athletes and performance horses. In the latter, the superficial digital flexor tendon is an excellent model for human tendinopathies because it is a functional homologue of the human Achilles tendon and a primary site of injuries with strong similarities to the human disease. Corticosteroids have been previously used clinically to treat tendinopathic inflammation, but they upregulate the p53-p21 axis with concomitant reductions in cell proliferation and collagen synthesis in human tenocytes. This phe...
The Effects of Intra-Articular Triamcinolone and Autologous Protein Solution on Metabolic Parameters in Horses. Intra-articular corticosteroids are a popular treatment choice for joint-associated pain and inflammation in horses despite recent work on the metabolic effects of these drugs. The goal of this project was to compare metabolic effects between intra-articular (IA) triamcinolone acetonide (TA) and an autologous protein solution (APS). Five mixed-breed geldings (4-9 years) were utilized for this project. Three identical and consecutive 28-day treatment blocks were used, with metacarpophalangeal IA treatments consisting of equal volumes of saline, a commercially available APS, or 9 mg of TA. Regul...
Pharmacologic Interventions to Immunologic and Immune-Mediated Conditions in Horses. Immunomodulators can stimulate, suppress, or regulate one or many aspects of the immune response. Use of a variety of immunostimulants, immunosuppressors, and anti-inflammatory drugs are described in horses, but the evidence supporting their efficacy is variable. Corticosteroids and nonsteroidal anti-inflammatory drugs are the best characterized immunomodulators in horses, but further study is needed to fully define their ideal dosing protocols and indications and to characterize the efficacy of other immunomodulators in equine medicine.
Clinical Approach to Immune-Mediated Hemolytic Anemia and Thrombocytopenia. Primary immune mediated hemolytic anemia (IMHA) and thrombocytopenia (IMTP) are rare in horses with the conditions more commonly occurring secondary to underlying disease. Several case reports have suggested a link between neoplasia and immune-mediated destruction of platelets and red blood cells. Diagnostic investigations should therefore focus on identifying possible underlying causes such as infections and neoplasia. Immunosuppressive therapy with corticosteroids and azathioprine is the mainstay of treatment but should be used cautiously in cases where underlying infection has not been excl...
Findings and Prognosis in 149 Horses with Histological Changes Compatible with Inflammatory Bowel Disease. Inflammatory bowel disease (IBD) is a chronic disease characterized by different cell infiltrates in the intestine. The aims of this study were to report the clinical and clinicopathological findings in horses with histological changes compatible with IBD in the duodenum. Further, the clinical progression of IBD and survival were investigated. Patient records were reviewed for horses in which histological evidence of IBD was found in duodenal biopsies collected during endoscopy. The histological changes were classified as mild, moderate or severe and the predominant infiltrating cell type was ...
Systemic absorption of triamcinolone acetonide is increased from intrasynovial versus extrasynovial sites and induces hyperglycemia, hyperinsulinemia, and suppression of the hypothalamic-pituitary-adrenal axis. Steroid-associated laminitis remains a major concern with use of corticosteroids in horses. Individual case factors such as joint pathology, pre-existing endocrinopathies, or corticosteroid type, dose, and timing influencing steroid-induced laminitis risk have not been investigated. This study aimed to determine if systemic absorption of triamcinolone acetonide (TA) varies between intrasynovial (antebrachiocarpal) and extrasynovial (sacroiliac) injection sites, and to determine the effects of TA absorption on glucose, insulin, cortisol, and adrenocorticotropic hormone (ACTH). Twenty adult hors...
Treatment Comparison for Medial Femoral Condyle Subchondral Cystic Lesions and Prognosis in Yearling Thoroughbred Racehorse Prospects. Subchondral cystic lesions (SCL) in the medial femoral condyle are a usual finding in Thoroughbred survey and auction repository radiographs. Several treatments with different outcomes have been studied over the years to improve soundness and racing prognosis. Our objective was to report the racing prognosis in Thoroughbred yearlings intended for racing that were diagnosed with SCL in the medial femoral condyle and were treated using four current and different techniques: intralesional injection of corticosteroids, SCL debridement through the joint with a drill bit, translesional cortical scre...
Diamond burr debridement of calcific band keratopathy in 24 eyes of 22 horses. To evaluate the safety and effectiveness of diamond burr debridement (DBD) for the treatment of calcific band keratopathy (CBK) in horses. Methods: Medical records from horses with CBK were reviewed over a period of 4 years. Diagnosis of CBK was based on slit-lamp examination findings, and DBD was performed on standing sedated horses. Follow-up was obtained by clinical reevaluation of the treated eyes or a telephone survey with the referring veterinarian. Results: Twenty-two horses of different ages (median: 11 years; range: 5-23) representing 24 CBK-affected eyes (14 left eyes and 10 righ...
Osteoarthritis of the coxofemoral joint in 24 horses: Evaluation of radiography, ultrasonography, intra-articular anaesthesia, treatment and outcome. Few case reports describe equine coxofemoral joint osteoarthritis (CFJOA). Objective: To evaluate diagnostic findings and outcome of horses with CFJOA and to provide a score facilitating radiographic assessment. Methods: Retrospective case series. Methods: History, clinical signs, ultrasonographic, radiographic and intra-articular anaesthesia findings, treatments, outcome, and necropsy results of horses with CFJOA presented between 2002 and 2023 were collated. Radiographic findings were categorised to develop a radiographic score which was applied by two masked examiners. Intra- and inter-obse...
Intra-articular triamcinolone acetonide injection results in increases in systemic insulin and glucose concentrations in horses without insulin dysregulation. Corticosteroids are a commonly used, inexpensive intra-articular treatment for osteoarthritis which may increase the risk for laminitis in horses due, in part, to hyperinsulinaemia. Humans with metabolic syndrome experience increases in insulin and glucose concentrations post-injection, but responses in horses are unknown. Objective: To determine the effect of a single intra-articular (IA) dose of triamcinolone acetate (TA) on blood insulin and glucose concentrations. Methods: Before-after study. Methods: Ten horses with normal insulin regulation as assessed by an oral sugar test received 18â€...
Allogeneic chondrogenic-induced mesenchymal stem cells for the treatment of tarsometatarsal lameness in horses. To assess the efficacy of commercial intra-articular blood-derived allogeneic-induced mesenchymal stem cells (CIMSCs) to treat tarsometatarsal lameness in horses. Methods: This was a retrospective cohort study. Methods: Records from 167 adult light breed horses with bilateral tarsometatarsal lameness. Methods: Horses with tarsometatarsal lameness were retrospectively selected from medical records. Diagnosis followed subjective graded lameness assessment before and after intra-articular analgesia, with graded radiographic tarsal examination. Horses were excluded if they were diagnosed or treate...
Treatments and Prognosis for Subchondral Cystic Lesions in the Distal Extremities in Thoroughbred Prospect Racehorses. Subchondral cystic lesions (SCLs) in equines and their treatments have been mainly studied in the medial femoral condyle of the femur. SCLs in the distal extremities affecting the fetlock or interphalangeal joints are frequent, but treatment or prognosis studies in horses are currently sparse. Our objective was to compare four treatments for SCLs in the distal extremities (intralesional injection of corticosteroids, transcortical drilling, cortical screw placement, and absorbable hydroxyapatite implant placement) and report the racing prognoses for affected thoroughbred yearlings. Data from 11...
Insect Bite Hypersensitivity in Horses: Causes, Diagnosis, Scoring and New Therapies. Insect Bite Hypersensitivity (IBH, Queensland itch, sweet itch, equine summer eczema) is the most common pruritic disease of horses. It is most often caused by sensitivity to the saliva of spp. of biting midges; however, it can also be caused by hypersensitivity to other insect species. The prevalence of IBH in horses is reported to be as high as 60% in some parts of the world. Due to the severe pruritus and effects of secondary self-trauma, IBH has animal welfare concerns, and there is currently no cure. Management of this condition is life-long, time consuming and costly. New grading system...
Arthroscopically guided lag screw fixation of subchondral bone cysts in the medial femoral condyle in Thoroughbred racehorses: description of technique and comparative results. To describe an arthroscopically guided technique for lag screw placement across subchondral bone cyst (SBC)Â in the medial femoral condyle (MFC) and to compare postoperative racing performance with corticosteroid injection and cyst debridement. Methods: Retrospective cohort study. Methods: One hundred twenty-three horses with 134 MFC SBCs undergoing treatment at a single referral hospital in the UK between January, 2009, and December, 2020. Methods: Sex, age, limb affected, radiographic cyst dimensions, preoperative and postoperative lameness, surgical technique (lag screw placement, cyst debr...
Equine allergic skin diseases: Clinical consensus guidelines of the World Association for Veterinary Dermatology. Allergic skin diseases are common in horses worldwide. The most common causes are insect bites and environmental allergens. Objective: To review the current literature and provide consensus on pathogenesis, diagnosis, treatment and prevention. Methods: The authors reviewed the literature up to November 2022. Results were presented at North America Veterinary Dermatology Forum (2021) and European Veterinary Dermatology Congress (2021). The report was available to member organisations of the World Association for Veterinary Dermatology for feedback. Conclusions: Insect bite hypersensitivity (IBH...
Interleukin-1β and methylprednisolone acetate demonstrate differential effects on equine deep digital flexor tendon and navicular bone fibrocartilage cells in vitro. To investigate the effects of interleukin-1β (IL-1β) and methylprednisolone acetate (MPA) on equine intrabursal deep digital flexor tendon (DDFT) and navicular bone fibrocartilage (NBF) cells in vitro. Methods: Third passage DDFT and NBF cells from 5 healthy donor horses ages 11-17 years euthanized for reasons unrelated to musculoskeletal conditions. Methods: Aggregate cultures were incubated with culture medium alone (control), 10 ng/mL IL-1β, 10 ng/mL IL-1β + 0.05 mg/mL MPA, or 10 ng/mL IL-1β + 0.5 mg/mL MPA for 24 hours. Extracellular matrix (ECM) gene expressions were assessed via rea...
A one-health perspective: use of hemoderivative regenerative therapies in canine and equine patients. Regenerative medicine therapies have become significant tools for treatment of joint, soft tissue, and a variety of other conditions in animals and humans. Regenerative medicine aims to restore form and function of injured tissues using the body's own resources such as cells, fluids (ie, plasma and serum), and their resulting anti-inflammatory and prohealing cytokines. Platelet-rich plasma and other hemoderivatives have application for joint disorders such as osteoarthritis, cartilage injury, synovitis, and soft tissue injuries. These therapies achieve anti-inflammatory and healing effects wit...