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.
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 ...
Effects of cortisol on prostaglandin F2α secretion and expression of genes involved in the arachidonic acid metabolic pathway in equine endometrium – In vitro study. Glucocorticoids (GCs) are known to play an important role in maintaining basal and stress-related homeostasis by interacting with endocrine mediators and prostaglandins (PGs). Although a growing body of evidence shows that GCs exert their regulatory action at a multitude of sites in the reproductive axis through corticosteroid receptors, little is known about the direct role of cortisol, an active form of GCs, in the equine endometrium. Thus, the study aimed to determine the effect of cortisol on PGF synthesis in the endometrial tissue and cells in vitro. In Exp.1, the immunolocalization and ...
Distal Gracilis Tear in an Equestrian. A 61-yr-old female equestrian presented after 2 wks of left medial thigh pain, which developed suddenly while exiting a car. She denied any history of recent trauma or falls. On examination, she was found to have tenderness at the left distal medial thigh with a palpable region of decreased tissue volume at the gracilis myotendinous junction. Point-of-care ultrasound and magnetic resonance imaging confirmed a high-grade partial thickness tear of the left distal gracilis at the myotendinous junction, as well as pes anserine bursal distention. She received physical therapy and underwent a 1-time...
Current joint therapy usage in equine practice: Changes in the last 10 years. Osteoarthritis is a common clinical condition in the performance horse. In the last 10Â years, there has been substantial growth in understanding of the disease and in the development of novel therapies. Objective: To document changes in clinical use of joint therapies over the past 10Â years. We also aimed to understand how newly developed therapies have been added to routine clinical practice. Methods: Survey of veterinary professionals. Methods: We administered an electronic survey to members of the American Association of the Equine Practitioners. Questions from a similar survey in 2009 we...
Glucocorticoid treatment in horses with asthma: A narrative review. Despite substantial research efforts to improve the treatment and outcome of horses with asthma, glucocorticoids (GC) remain the cornerstone of drug treatment of this prevalent disease. The high efficacy of GC to relieve airway obstruction explains their extensive use despite potential deleterious effects. However, much is yet to be uncovered concerning GC use in horses with asthma, including the comparative efficacy of the different drugs, the determination of minimal effective doses and the mechanisms underlying their variable modulation of airway inflammation. The objectives of this structu...
Bronchial angiogenesis in horses with severe asthma and its response to corticosteroids. Severe asthma in horses is characterized by structural changes that thicken the lower airway wall, a change that is only partially reversible by current treatments. Increased vascularization contributes to the thickening of the bronchial wall in humans with asthma and is considered a potential new therapeutic target. Objective: To determine the presence of angiogenesis in the bronchi of severely asthmatic horses, and if present, to evaluate its reversibility by treatment with corticosteroids. Methods: Study 1: Bronchial samples from asthmatic horses in exacerbation (7), in remission (7), and a...
Studies of molecular pathways associated with blood neutrophil corticosteroid insensitivity in equine asthma. Severe equine asthma is characterized by airway hyperresponsiveness, neutrophilic inflammation and structural alterations of the lower airways. In asthmatic horses with neutrophilic inflammation, there is insensitivity to corticosteroids characterized by the persistence of neutrophils within the airways with therapy. We hypothesized that hypoxia or oxidative stress in the microenvironment of the lung contributes to this insensitivity of neutrophils to corticosteroids in asthmatic horses. Blood neutrophils isolated from horses with severe asthma (N = 8) and from healthy controls (N = 8)...
Retrospective analysis of horses with ultrasound evaluation of the sacroiliac region and response to local corticosteroid injection: 42 cases. Local injection of corticosteroids is commonly performed in horses with sacroiliac (SI) region pain and/or dysfunction, ,and ultrasound findings of normal horses and those with SI pain have also been well described. However, no studies have been performed that have evaluated if ultrasound findings, injection technique, or medications injected affect prognosis for return to function. The objectives of the current study are to determine if findings on ultrasound, injection technique, or medications injected are predictive of return to function in horses with SI region pain and/or dysfunction. Me...
[New drugs for horses and production animals in 2020]. In 2020, one novel pharmaceutical agent for horses or food-producing animals was released on the German market, rendering the inhaled glucocorticoid ciclesonide (Aservo EquiHaler) available for horses for the first time. The authorization of one established veterinary active ingredient was extended to an additional species: The anthelmintic fenbendazole (Gallifen) from the benzimidazole group is now also authorized for pheasants. Additionally, 3 veterinary drugs with a new combination of active ingredients (ketoprofen + tilmicosin, ketoprofen + tulathromycin, prednisolone + lidoc...
The Dynamics of Circulating Immune Complexes in Horses with Severe Equine Asthma. Non-invasive diagnostic biomarkers of equine asthma syndrome (EAS) from blood or urine are sought. The aim of this study was to assess the absorbance of circulating immune complexes (CICs) during the exacerbation, remission, and treatment of an asthma episode and assess the potential usefulness of CIC levels in the diagnosis and monitoring of the disease. The control group, asthma group, and treated asthma group each contained six horses. Following an initial examination and group classification, the horses were kept in a dusty environment for seven days and then moved to an asthma-friendly en...
Efficacy and safety of suprachoroidal triamcinolone injection in horses with poorly responsive equine recurrent uveitis. Equine recurrent uveitis (ERU), a chronic, immune-mediated intraocular inflammatory disease, is a common cause of blindness in horses. The severity and recurrent nature of ERU makes it difficult to treat with current therapeutics leading to a poor visual prognosis. The suprachoroidal space (SCS), a potential space between the choroid and sclera surrounding the ocular posterior segment, offers a promising alternative site for drug application to the eye. Corticosteroid administration within this space is hypothesized to be safe and effective at controlling intraocular inflammation, especially i...
Inhaled ciclesonide is efficacious and well tolerated in the treatment of severe equine asthma in a large prospective European clinical trial. Ciclesonide is a glucocorticoid prodrug, already registered for human use. Due to its mode of action and inhaled route of administration, it was considered an appropriate treatment option for horses with severe equine asthma. Although the efficacy of inhaled ciclesonide has been demonstrated in horses with asthma exacerbations under controlled mouldy hay challenge conditions, it has not yet been reported under field conditions. Objective: To assess the effectiveness and safety of inhaled ciclesonide for the treatment of severe equine asthma. Methods: Prospective, multicentre, placebo-controlle...
Ex vivo effects of corticosteroids on equine deep digital flexor and navicular fibrocartilage explant cell viability. To investigate the effects of triamcinolone acetonide (TA) and methylprednisolone acetate (MPA) on the viability of resident cells within the fibrocartilage on the dorsal surface of the deep digital flexor tendon (FC-DDFT) and fibrocartilage on the flexor surface of the navicular bone (FC-NB) of horses. Methods: 12 to 14 explants of FC-DDFT and of FC-NB from grossly normal forelimbs of 5 cadavers of horses aged 9 to 15 years without evidence of musculoskeletal disease. Methods: Explants were incubated with culture medium (control) or TA-supplemented (0.6 or 6 mg/mL) or MPA-supplemented (0.5 or...
Treatment effects of intra-articular triamcinolone acetonide in an equine model of recurrent joint inflammation. Intra-articular triamcinolone acetonide is a widely used treatment for joint inflammation despite limited scientific evidence of its efficacy. Objective: To investigate if intra-articular triamcinolone acetonide has sustained anti-inflammatory effects using an equine model of repeated joint inflammation. Methods: Randomised controlled experimental study. Methods: For three consecutive cycles 2Â weeks apart, inflammation was induced in both middle carpal joints of eight horses by injecting 0.25Â ng lipopolysaccharide (LPS). After the first LPS injection only, treatment with 12Â mg triamcinolone...
Intrasynovial triamcinolone treatment is not associated with incidence of acute laminitis. Intrasynovial corticosteroid injections are commonly used in the treatment of equine orthopaedic disease, but corticosteroid administration is widely considered a risk factor for the development of laminitis. Despite a list of putative mechanisms and a number of case reports of steroid-induced laminitis, no case-control or cohort studies investigating the association between use of intrasynovial corticosteroids and acute laminitis have been published. Objective: To quantify the risk of laminitis posed by intrasynovial triamcinolone acetonide (TA) administration in a mixed population of horses....
Severe asthma is associated with a remodeling of the pulmonary arteries in horses. Pulmonary hypertension and cor pulmonale are complications of severe equine asthma, as a consequence of pulmonary hypoxic vasoconstriction. However, as pulmonary hypertension is only partially reversible by oxygen administration, other etiological factors are likely involved. In human chronic obstructive pulmonary disease, pulmonary artery remodeling contributes to the development of pulmonary hypertension. In rodent models, pulmonary vascular remodeling is present as a consequence of allergic airway inflammation. The present study investigated the presence of remodeling of the pulmonary arter...
A Survey of Clinical Usage of Non-steroidal Intra-Articular Therapeutics by Equine Practitioners. There are several non-steroidal intra-articular therapeutics (NSIATs) available for use by equine practitioners for the treatment of performance-limiting joint-related pathology. Information is limited on perceived clinical efficacy, recommended treatment protocols, and associated complications. Our objective with this cross-sectional survey was to investigate the current clinical usage of NSIATs by equine practitioners. An electronic cross-sectional convenience survey inquiring about the use of steroidal and NSIATS (platelet-rich plasma, autologous conditioned serum, autologous protein soluti...
Effects of administration of ascorbic acid and low-dose hydrocortisone after infusion of sublethal doses of lipopolysaccharide to horses. Sepsis is associated with ascorbic acid (AA) depletion and critical illness-related corticosteroid insufficiency (CIRCI) in humans. Objective: Intravenous infusion of lipopolysaccharide (LPS) would (a) decrease endogneous AA concentrations, (b) induce CIRCI and (c) administration of a combination of AA and hydrocortisone (HC) would have decreased indices of inflammation compared to either drug alone. Methods: Thirty-two healthy horses. Methods: Randomized placebo-controlled experimental trial. Horses were assigned to 1 of 4 groups (saline, AA and HC, AA only, or HC only). Treatments were admin...