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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.
Randomized study of the effects of testosterone administration on severity of asthma in horses. Low testosterone concentrations are associated with poor lung function in human asthmatics, and androgen administration improves airway obstruction in women with asthma. Objective: Testosterone improves clinical scores, lung function, airway neutrophilia, and airway remodeling in horses with severe asthma. Methods: Ten horses affected by severe asthma from a research herd. Methods: In a randomized, blinded, crossover study, horses received dexamethasone (0.06 mg/kg PO q24h for 10 days) or a single intramuscular injection of testosterone cypionate (0.35 mg/kg), with a 2-week washout period. ...
Population Pharmacokinetics and Detection Times of Betamethasone After Intravenous, Intramuscular, and Intranasal Jet Administration of Betamethasone Sodium Phosphate in Horses. Betamethasone sodium phosphate (BETP) is a glucocorticosteroid used in humans. The primary objective was to estimate irrelevant plasma (IPC) and urine (IUC) concentrations using a pharmacokinetic/pharmacodynamic approach based on systemic clearance estimated from intravenous (IV) pharmacokinetic data. As a secondary objective, detection times (DTs) following IV, intramuscular (IM), and intranasal jet (INJ) administration were estimated for medication control. Plasma and urine concentrations were obtained from a total of 20 horses in Japan and Germany, with some horses contributing to more than...
Perineural dexamethasone does not prolong bupivacaine sensory blockade in equine palmar digital nerve blocks: a randomized crossover trial. To determine whether dexamethasone sodium phosphate (dexamethasone SP) prolongs the sensory blockade produced by perineural bupivacaine during medial and lateral palmar digital nerve blocks in horses. Unassigned: 8 healthy adult horses were enrolled in a blinded, randomized 4 X 4 crossover trial. Each horse received 1 of 4 perineural treatments over the palmar digital nerves of the left forelimb: bupivacaine, bupivacaine + dexamethasone SP, dexamethasone SP alone, or saline. A minimum 7-day washout was used between treatments. Mechanical nociceptive threshold (MNT) was measured at baseline and...
Development and validation of a liquid chromatography-tandem mass spectrometry method for the quantification of twenty-five steroids in equine serum. Steroids are potential biomarkers for monitoring equine pregnancy. However, immunoassays currently used for their quantification suffer from cross-reactivity and limited specificity, thus requiring more accurate methods. This study reports the development and validation of a robust liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for simultaneous quantification of 25 steroids covering the main biosynthetic pathways of progestogens, corticosteroids, androgens, and estrogens. Steroids were extracted by protein precipitation followed by evaporation, derivatization, and reconstitut...
Inhaled Corticosteroids Influence Pulmonary Microbiota in Severe Equine Asthma. The use of inhaled corticosteroids (ICs) could influence the respiratory microbiota. In animals with asthma it is, however, difficult to separate the immunomodulatory effects of ICs from their indirect effects via improvement of ventilation. Our objective was to determine if ICs alter the pulmonary microbiota independently from their effects on lung function, using a blinded, controlled trial in an experimental model of asthma exacerbation in horses. We treated horses with severe asthma with either bronchodilators alone, or in combination with ICs. Twelve horses in exacerbation received long-a...
Serum adipokines are useful for predicting hyperinsulinemia secondary to corticosteroid treatment in horses. To evaluate pretreatment biomarkers for predicting the severity of corticosteroid-induced hyperinsulinemia. Unassigned: Oral glucose tests were performed before (day 1) and after (day 8) a dexamethasone course (0.08 mg/kg, q 48 h) in 24 healthy adult Standardbreds. Associations between day 8 oral glucose test insulin parameters (baseline [T0insulin], maximal [Cmaxinsulin], and area under the curve [AUCinsulin]) and day 1 serum markers (insulin, glucose, adiponectin, leptin, and their ratios) were examined using Spearman correlation, log-linked generalized linear models. Relative risk of exceed...
OPTIMIZING EXTRACTION AND CONCENTRATION METHODS FOR LC-MS/MS ANALYSIS OF VETERINARY PHARMACEUTICALS IN EQUINE-ASSOCIATED ENVIRONMENTAL MATRICES. This study developed a method for the simultaneous quantification of six potentially environmentally toxic veterinary drugs: benzylpenicillin, acepromazine, flunixin, dexamethasone, ketamine and romifidine, in soils, sediments, equine faeces and natural waters. Three methods were compared for their extraction from solid matrices: Ultrasonic extraction (USE), QuEChERS and Accelerated Solvent Extraction (ASE). ASE method was optimized according to temperature and extraction cycles. Quantification was performed by LC-MS/MS. LC and MS parameters were optimized. The method was validated according t...
Ertugliflozin decreases the insulin spike in non-insulin dysregulated standardbred horses following intra-articular triamcinolone administration. Horses with equine metabolic syndrome (EMS) are at an increased risk of laminitis following corticosteroid use. Ertugliflozin reduces hyperinsulinemia in horses with EMS, and therefore may be a management option to reduce the insulin spike seen post corticosteroid use. It was hypothesised that oral ertugliflozin, administered before and after intra-articular (IA) triamcinolone acetonide (TA), will significantly lower the insulin response in comparison to placebo. A randomised, blinded, placebo-controlled, crossover design was performed on eight adult standardbred geldings with no history of la...
A randomized, masked, crossover, clinical trial of the efficacy and safety of nebulized albuterol sulfate and dexamethasone sodium phosphate in asthmatic horses. Nebulization of injectable dexamethasone sodium phosphate (DSP; 0.01 mg/kg) to horses with severe equine asthma (SEA) was previously found to be ineffective. Horses with SEA have marked bronchoconstriction that decreases peripheral lung deposition of nebulized drugs. Administration of a bronchodilator immediately before nebulizing dexamethasone may improve efficacy. Objective: Evaluate the therapeutic effects and optimal dose of nebulized DSP after nebulized albuterol in horses with SEA. Methods: Seven horses with SEA from a research herd. Methods: In this masked randomized crossover trial, h...
An in-hospital clinical trial assessing nebulized lidocaine compared to saline for treatment of asthma in horses. Corticosteroids are the main pharmacologic treatment for equine asthma (EA) but may have adverse effects in metabolically unstable horses. Recent pilot studies support the use of nebulized lidocaine as an alternative treatment option. Objective: Nebulized lidocaine will improve EA-associated clinical variables and airway inflammation. Methods: Twenty client-owned horses diagnosed with EA. Methods: Randomized, blinded, in-hospital study comparing 1 mg/kg preservative-free 4% lidocaine (n = 10) nebulized via Flexineb (twice daily for 7 doses) to 0.9% saline control (n = 10). Clinical examin...
Treatment with ertugliflozin mitigates the hyperinsulinemic response to intra-articular triamcinolone acetonide. Intra-articular (IA) corticosteroids can cause hyperinsulinemia, which can subsequently increase the risk of laminitis, particularly in horses with insulin dysregulation (ID). Sodium glucose cotransporter 2 inhibitors (SGLT2i), a drug class that is being utilised more commonly in horses with insulin dysregulation, could potentially be used to control post-IA corticosteroid hyperinsulinemia. Objective: To determine whether treatment with the SGLT2i drug ertugliflozin decreases hyperinsulinemia following intra-articular corticosteroid administration in metabolically normal horses. Methods: Prosp...
Intra-articular methylprednisolone acetate does not induce hyperinsulinemia or hyperglycemia in metabolically normal horses. The goal of this project was to examine the metabolic effects of IA methylprednisolone acetate (MPA) following injection into multiple low-motion joints. Unassigned: Six 3-year-old geldings without pituitary pars intermedia dysfunction or insulin dysregulation were randomly injected with 20 mg of IA MPA/joint (80 mg total; bilateral distal hock joints) or an equal volume of saline. Serial blood samples were collected for resting ACTH, cortisol, insulin, and glucose, as well as insulin and glucose following repeated low-dose oral sugar tests. Treatments were crossed over after a 6-week washout,...
Characterization of intramuscular Isoflupredone acetate in horses: pharmacokinetics and effects on anti-inflammatory mediators and plasma electrolytes. Corticosteroids, such as isoflupredone, are effective anti-inflammatory medications and as such are commonly used to treat inflammation associated with training and injuries in performance horses. While the pharmacokinetics and pharmacodynamics of isoflupredone acetate (IPA) following intra-articular administration to horses has been well described, studies characterizing intramuscular (IM) administration are lacking. The objective of the current study was to describe the pharmacokinetics and anti-inflammatory effects of IPA following IM administration to horses. Twelve horses received a singl...
Associations between immunological and hormonal parameters during healthy pregnancy in mares. Associations between the immune and endocrine systems during equine pregnancy remain poorly understood. Based on the hypothesis that distinct phases of the equine healthy gestation are characterized by specific associations between circulating immunological and hormonal parameters, contributing to pregnancy maintenance, this investigation aimed to: (i) evaluate how circulating immunological and hormonal parameters change across different phases of pregnancy; (ii) investigate associations between changes in circulating immunological and hormonal parameters; and (iii) propose potential hormonal ...
Ultrasound-guided, minimally invasive, biceps brachii tenotomy in a standing horse. To describe the long-term outcome of a horse that underwent a standing, ultrasound-guided, minimally invasive, biceps brachii tenotomy. Methods: Case report. Methods: A 17-year-old Tennessee Walking Horse gelding. Methods: The horse had a chronic, severe, lameness localized to the left shoulder region. Diagnostic imaging revealed fractures of the intermediate and lesser tubercles of the left humerus, biceps brachii (BB) tendinopathy, and bicipital bursitis. Conservative management was attempted, but lack of improvement prompted surgical intervention. An ultrasound-guided, minimally invasive, B...
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...
Lipid and Corticosteroid Biomarkers Under the Influence of Bisphosphonates. Detecting the use of bisphosphonates (BPs) in equine athletes is of interest to regulators and laboratories due to the threat to welfare issues for the potential to provide analgesic effects and manipulating bone structure. The detection of BPs in biological matrices is challenging due to erratic biological elimination and inconsistent analytical recoveries. Therefore, complementary approaches are needed to provide evidence of their misuse in racehorses. BPs have two sub-classes: nitrogenous and non-nitrogenous. This study investigated plasma elimination following administration of one example...
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...
