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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.
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 10 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 10 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 2 weeks apart, inflammation was induced in both middle carpal joints of eight horses by injecting 0.25 ng lipopolysaccharide (LPS). After the first LPS injection only, treatment with 12 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...
Management of Subchondral Lucencies of the Medial Aspect of the Equine Antebrachiocarpal Joint. The objective of this study is to describe the management and outcomes of eight horses with subchondral lucencies (SCLs) of the medial aspect of the antebrachiocarpal (ABC) joint. The medical records and radiographs of the carpi of 8 horses with SCLs of the medial aspect of the ABC joint were reviewed. Follow-up clinical information was obtained for 6-60 months (the median duration of 14 months). Treatment was successful if radiographic healing was apparent or lameness was reduced or eliminated. Four horses had SCLs in the distomedial radius (DMR) and four in the proximal aspect of the radio...
In vitro Effects of Methylprednisolone Acetate on Equine Deep Digital Flexor Tendon-Derived Cells. Primary deep digital flexor tendon (DDFT) pathologies and those accompanying degenerative changes of navicular bone fibrocartilage are major causes of lameness associated with navicular disease. Intrasynovial corticosteroids are mainstay in the treatment due to the anti-inflammatory effects, but their effect on DDFT cell biosynthesis are unknown. The objective of this study was to investigate the effects of methylprednisolone acetate (MPA) on cells isolated from the dorsal fibrocartilaginous region of forelimb DDFTs (DDFT-derived cells) of 5 horses (aged 11-17 years). Non-adherent aggregate c...
Serum concentrations, pharmacokinetic/pharmacodynamic modeling, and effects of dexamethasone on inflammatory mediators following intravenous and oral administration to exercised horses. Corticosteroids are potent anti-inflammatory drugs and as such are commonly administered to performance and racehorses. The objectives of the current study were to describe blood and urine concentrations and the pharmacokinetics and effects on cortisol and inflammatory mediator concentrations, following intravenous and oral administration to 12 exercised horses. Horses received an intravenous administration of 40 mg of dexamethasone sodium phosphate and 20 mg of dexamethasone tablets with a 4 week washout in between administrations. Blood and urine samples were collected prior to and for up to...
Case-Control Comparison of Cervical Spine Radiographs From Horses With a Clinical Diagnosis of Cervical Facet Disease With Normal Horses. The accuracy of using radiographs to diagnose cervical facet osteoarthritis (CFA) in horses is undetermined. Further investigation is required to determine the clinical significance of radiographic evidence of CFA, the prevalence of radiographic changes in horses without clinical signs, and the long-term efficacy of intra-articular CFA treatment. The objectives of this study is to compare degenerative changes of the cervical facet joints of the cervical vertebrae on radiographs of horses with clinical signs of CFA with healthy cohort-matched horses, to compare clinical findings between groups,...
Pulmonary response of severely asthmatic horses after intra-articular administration of methylprednisolone. Intra-articular (IA) administration of corticosteroids is performed routinely in equine practice. The lung function of severe asthmatic horses has recently been shown to be improved by IA triamcinolone acetonide (TA). We therefore hypothesised that IA methylprednisolone acetate (MPA), another commonly used corticosteroids, would also decrease the airway obstruction in severe asthmatic horses. Objective: To compare the effects of intra-articular (IA) and intramuscular (IM) methylprednisolone acetate (MPA) administration on lung function and serum cortisol levels in horses with severe asthma. Me...
Rare Generalized Form of Fungal Dermatitis in a Horse: Case Report. A rare case of spp. dermatitis in a horse is presented. After unrelated, previous surgery and antibiotic treatment, a saddle horse showed well-circumscribed areas of non-pruritic alopecia. Suspecting allergic skin disease, the horse was treated with corticosteroids. The skin lesion spread, and a second veterinarian was consulted. At clinical examination, the horse was lethargic, pyretic and hair was shedding/easily epilated over the head, neck, shoulders, and legs and the hind legs were swollen. Blood analysis revealed mild leucocytosis and hyperglobulinemia. Hair, skin scraping, and skin bio...
Effects of nebulized dexamethasone on the respiratory microbiota and mycobiota and relative equine herpesvirus-1, 2, 4, 5 in an equine model of asthma. Prolonged exposure to environmental antigens or allergens elicits an immune response in both healthy horses and those with mild asthma. Corticosteroids often are used to treat lower airway inflammation. Objective: To investigate the changes in equine herpesvirus (EHV)-1,2,4,5 glycoprotein B gene expression and changes in respiratory bacterial and fungal communities after nebulized dexamethasone treatment of horses with asthma. Methods: Horses with naturally occurring mild asthma (n = 16) and healthy control horses (n = 4). Methods: Prospective, randomized, controlled, blinded clinical trial. P...
Hyaluronic acid has chondroprotective and joint-preserving effects on LPS-induced synovitis in horses. The intra-articular use of hyaluronic acid (HA) for the treatment of synovitis and osteoarthritis is still controversial. As a consequence, corticosteroids remain the most frequently employed therapeutic agents, despite their potential systemic and local deleterious effects. This study examined the anti-inflammatory, antioxidant, and chondroprotective activities of low and high molecular weight hyaluronic acid (LMW-HA and HMW-HA) on lipopolysaccharide (LPS)-induced synovitis in horses compared to triamcinolone acetonide (TA). LPS was injected in the metacarpophalangeal joints, which were treat...
The equine asthma model of airway remodeling: from a veterinary to a human perspective. Human asthma is a complex and heterogeneous disorder characterized by chronic inflammation, bronchospasm and airway remodeling. The latter is a major determinant of the structure-function relationship of the respiratory system and likely contributes to the progressive and accelerated decline in lung function observed in patients over time. Corticosteroids are the cornerstone of asthma treatment. While their action on inflammation and lung function is well characterized, their effect on remodeling remains largely unknown. An important hindrance to the study of airway remodeling as a major focu...
Effect of injected dexamethasone on relative cytokine mRNA expression in bronchoalveolar lavage fluid in horses with mild asthma. Mild equine asthma is a common inflammatory airway disease of the horse. The primary treatment of mild equine asthma is corticosteroids. The purpose of this study was to investigate the effects of injected dexamethasone on relative IL-1β, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p35, IL-17, IL-23, IFN-γ, Eotaxin-2 and TNF-α mRNA expression in bronchoalveolar lavage (BAL) fluid in healthy Thoroughbred horses (n = 6), and those with mild equine asthma (n = 7). Results: Horses with mild equine asthma had a significantly greater bronchoalveolar lavage mast cell percentage than healthy horses...
Prevalence of and risk factors for acute laminitis in horses treated with corticosteroids. A retrospective treated versus untreated study (study 1) and multicentre prospective cohort study (study 2) were undertaken to determine the prevalence of, and risk factors associated with, acute laminitis in horses treated with corticosteroids. All old treated with corticosteroids January-December 2014 (study 1) and January 2015-February 2017 (study 2) by two first opinion and referral hospitals in UK were included. Additionally, an untreated animal was identified for each treated animal (study one). Signalment, body condition (study 2 only), relevant medical history, primary condition, corti...
Intra-articular triamcinolone acetonide improves lung function in horses with severe asthma. Locally administered corticosteroids are commonly used to treat joint diseases in sport and racehorses. As they are also the most potent drugs for the treatment of equine asthma, we hypothesised that the intra-articular corticosteroids used to treat joint diseases also improve the lung function in horses with severe asthma, thus potentially delaying the diagnosis of this common lung condition. Objective: To compare the effects of intra-articular (IA) and intramuscular (IM) triamcinolone acetonide (TA) on lung function in horses with severe asthma. Methods: Randomised and controlled experiment ...
Effect of different doses of inhaled ciclesonide on lung function, clinical signs related to airflow limitation and serum cortisol levels in horses with experimentally induced mild to severe airway obstruction. Inhaled corticosteroids are effective for the treatment of equine asthma but they induce cortisol suppression with potential side effects. Objective: To study the efficacy of ciclesonide, an inhaled corticosteroid with an improved safety profile, on lung function, clinical signs related to airway obstruction, and serum cortisol levels in asthmatic horses exposed to a mouldy hay challenge. Methods: Cross-over placebo controlled, blinded, randomised experiment. Methods: Sixteen horses were enrolled in three subsequent dose-titration studies (8 horses/study) to investigate the effects of inhaled ...
