Glucocorticoids and laminitis in the horse.

The study focuses on the relationship between the administration of glucocorticoids (GCs) and the development of laminitis, a painful condition affecting horses’ hooves, with the findings suggesting a potential risk. Nevertheless, the causal link is not definitively established, and various theories exist for the possible mechanisms involved. The study emphasizes that veterinarians should exercise caution when administering GCs to horses, particularly those who have previously suffered from laminitis, due to the unpredictability of individual susceptibility.

Link between Glucocorticoids and Laminitis

• The study observes that horses given glucocorticoids (GCs) or those with syndromes showing an excess of GCs tend to have an increased risk of developing laminitis, a condition causing inflammation in the hooves.
• Despite this observation, there is significant controversy regarding whether the surplus GCs are directly responsible for causing laminitis. The study suggests that if GCs do cause laminitis, the disease’s progression may be different from that seen in cases initiated by gastrointestinal illnesses or endotoxemia.
• While no satisfactory explanation currently accounts for how laminitis could be a direct result of GC action, numerous theoretical mechanisms have been proposed.

Caution in Administration of Glucocorticoids

• The research advises veterinarians to exercise care when using GCs in adult horses due to the unpredictability of GCs effect on individual horses’ susceptibility to laminitis.
• Extra caution is highlighted for horses that have previously suffered from laminitis when administered systemic GCs, backing up the suggestion with close monitoring for additional laminitis symptoms.
• Differing GC types, such as dexamethasone and triamcinalone, were noted to potentially induce a high risk of laminitis than others like prednisone and prednisolone.

Suggestions for Reducing Risk of Laminitis

• The study suggests local administration of GCs, wherever possible, to reduce the risk of laminitis, with inhalation as the preferred method for horses suffering from chronic obstructive pulmonary disease (COPD).
• Further examination into GCs’ effect on the hoof lamellar interface was deemed necessary due to hypothesized structural modifications in the horse’s hoof that resemble laminitis’ signs resulting from excess GCs. These changes are not directly associated with pain or inflammation, but may make the horse more susceptible to bona fide laminitis under other conditions.