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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.
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...
Towards Non-Targeted Screening of Lipid Biomarkers for Improved Equine Anti-Doping. The current approach to equine anti-doping is focused on the targeted detection of prohibited substances. However, as new substances are rapidly being developed, the need for complimentary methods for monitoring is crucial to ensure the integrity of the racing industry is upheld. Lipidomics is a growing field involved in the characterisation of lipids, their function and metabolism in a biological system. Different lipids have various biological effects throughout the equine system including platelet aggregation and inflammation. A certain class of lipids that are being reviewed are the eicosa...
Concurrent versus delayed exposure to corticosteroids in equine articular tissues cultured with local anesthetic. To determine the effect of concurrent versus delayed treatment with corticosteroid on equine articular tissues also treated with local anesthetic in vitro in the presence of inflammatory mediators. Methods: Controlled laboratory study. Methods: Five geldings, one mare (aged 3-18 years). Methods: From each horse, 24 synovial and 12 osteochondral explants were cultured in a 12-well plate (2 wells/group, 2 synovial and 1 osteochondral explant/well, total 216 explants in the study). Explants were stimulated in culture medium with 10 μg/ml recombinant equine interleukin-1β and 10 μg/ml tumor...
Pharmacokinetics and pharmacodynamics of intra-articular isoflupredone following administration to horses with lipopolysaccharide-induced synovitis. Intra-articular corticosteroids, such as isoflupredone acetate, are commonly used in the treatment of joint inflammation, especially in performance horses. Following administration in a non-inflamed joints blood concentrations of isoflupredone were low and detectable for only a short period of time post-administration compared to synovial fluid concentrations. For some drugs, inflammation can affect pharmacokinetics, therefore, the goal of the current study was to describe the pharmacokinetics of isoflupredone acetate following intra-articular administration using a model of acute synovitis. S...
Residual effects of intra-articular betamethasone and triamcinolone acetonide in an equine acute synovitis model. Intra-articular (IA) corticosteroids are regularly used in equine athletes for the control of joint inflammation. Objective: The goal of this study was to use an acute synovitis inflammation model to determine the residual effects of IA betamethasone and triamcinolone acetonide on various inflammatory parameters and lameness. Methods: Crossover randomised trial. Methods: Five mixed-breed, 2-year-old horses were randomly allocated to an IA treatment of the radiocarpal joint with 9Â mg of either betamethasone or triamcinolone acetonide. Two weeks following treatment, horses were injected with 1Â...
‘First Case of Stiff-Horse Syndrome in United Kingdom’. Stiff-person syndrome is a well-recognised disease in humans, whilst cases of stiff-horse syndrome (SHS) have been rarely reported in the veterinary medicine literature. SHS is a progressive immunomediated disorder of the central nervous system leading to a disturbance of gamma amino butyric acid transmission at the neuromuscular junction in which antibodies are produced against the enzyme glutamic acid decarboxylase. A 6 year-old Irish Sport Horse was presented for investigation of involuntary violent contraction of hindlimb and back muscles triggered by stress. The diagnosis of SHS was made ...
A CONSORT-guided, randomized, double-blind, controlled pilot clinical trial of inhaled lidocaine for the treatment of equine asthma. There are limited options for treatment of the common disease, equine asthma. The aim of this study was to estimate the feasibility and potential efficacy of using nebulized lidocaine for treating equine asthma, while at the same time treating a separate cohort of asthmatic horses with inhaled budesonide. Nineteen horses with a history consistent with equine asthma were recruited from our referral population for a double-blind, randomized, controlled pilot clinical trial using Consolidated Standards of Reporting Trials (CONSORT) guidelines. After screening, 16 horses met the inclusion criteria...
Measurements of hydrocortisone and cortisone for longitudinal profiling of equine plasma by liquid chromatography-tandem mass spectrometry. The conventional detection of exogenous drugs in equine doping samples has been used for confirmation and subsequent prosecution of participants responsible. In recent years, alternative methods using indirect detection have been investigated due to the expanding number of pharmaceutical agents available with the potential of misuse. The monitoring of endogenous biomarkers such as hydrocortisone (HC) has been studied in equine urine with an international threshold of 1 μg/ml established; however, there is no current threshold for equine plasma. The aim of this research was to investigate pl...
Comparative results of 3 treatments for medial femoral condyle subchondral cystic lesions in Thoroughbred racehorses. To compare 3 different methods for treatment of medial femoral condyle (MFC) subchondral cystic lesions in Thoroughbred horses <24 months old based on the criterion of ability to race post-treatment. Methods: Retrospective cohort study. Methods: Thoroughbreds (n = 107, age < 24 months) diagnosed with MFC subchondral cystic lesions. Methods: Medical records between January 2004 and December 2017 were reviewed. Three treatment methods were used in these horses during that time frame: arthroscopic debridement, intralesional autologous mesenchymal stem cell (MSC) injection, and int...
Effects of azithromycin on bronchial remodeling in the natural model of severe neutrophilic asthma in horses. Steroid resistance in asthma has been associated with neutrophilic inflammation and severe manifestations of the disease. Macrolide add-on therapy can improve the quality of life and the exacerbation rate in refractory cases, possibly with greater effectiveness in neutrophilic phenotypes. The mechanisms leading to these beneficial effects are incompletely understood and whether macrolides potentiate the modulation of bronchial remodeling induced by inhaled corticosteroids (ICS) is unknown. The objective of this study was to determine if adding azithromycin to ICS leads to further improvement o...
Penetration of topically administered dexamethasone disodium phosphate and prednisolone acetate into the normal equine ocular fluids. Topical dexamethasone and prednisolone are currently the mainstay treatment for equine ophthalmic inflammatory diseases, such as equine recurrent uveitis. Comparative pharmacokinetic studies in horses are lacking and current guidelines are mainly based on empirical data and extrapolation from other species. Objective: To investigate the penetration and local concentrations of topically applied dexamethasone and prednisolone in normal equine ocular fluids and serum. Methods: Prospective randomised experimental pharmacokinetic study. Methods: Twenty-one Shetland ponies without ophthalmic disease...
LC-HRMS/MS study of the prodrug ciclesonide and its active metabolite desisobutyryl-ciclesonide in plasma after an inhalative administration to horses for doping control purposes. Ciclesonide (CIC) is the first inhaled highly potent corticosteroid that does not cause any cortisol suppression. It has been developed for the treatment of asthma in human and more recently in equine. CIC is the active compound of Aservo® EquiHaler® (Boehringer Ingelheim Vetmedica GmbH), the pre-filled inhaler generating a medicated mist based on Soft Mist™ technology. This prodrug is rapidly converted to desisobutyryl-ciclesonide (des-CIC), the main pharmacologically active compound. Due to its anti-inflammatory properties, CIC is prohibited for use in horse competitions. To set up an ap...
Diagnostic imaging features, cytological examination, and treatment of lymphocytic tenosynovitis of the common digital extensor tendon sheath in an eventing horse. In horses, the structures at the dorsal aspect of the carpus, including the digital extensor tendons, their related tendon sheaths, and bones, are vulnerable to injury because of their superficial location. Injuries to these structures may result in lameness of the affected limb(s) and reduce a horse's athletic performance. A 13-year-old eventing horse that routinely underwent regular exercise exhibited dorsolateral distension of the right carpus. An effusion insensitive to compression was observed in the affected area. No lameness was detected, and the horse exhibited a negative response to t...
Retrospective investigation of automated hematology analyzer-determined indicators of neutrophil activation in blood samples from horses with asthma. To investigate indicators of neutrophil activation in the blood of healthy and asthma-affected horses and assess associations between corticosteroid treatment and these variables. Methods: 48 horses (14 with severe equine asthma [SEA], 21 with mild to moderate equine asthma [MEA], and 13 healthy controls). Methods: In a 3-part retrospective study, hematology analyzer data for horses included in previous studies were reviewed. Neutrophil size, neutrophil light absorbance (NLA), and myeloperoxidase (MPO) index were recorded. Data for each variable were compared among groups for the entire study ...
