FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Equine Vet J / Intra-articular triamcinolone acetonide injection results in...
Equine veterinary journal2023; doi: 10.1111/evj.14003

Intra-articular triamcinolone acetonide injection results in increases in systemic insulin and glucose concentrations in horses without insulin dysregulation.

Abstract: 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 18 mg of TA into one middle carpal joint. Insulin and glucose concentrations were evaluated at baseline and 4, 6, 8, 24, 48, and 72 h following IA corticosteroid injection. Differences from baseline were evaluated using a repeated measures ANOVA with Dunnett's multiple comparison testing or a Friedman test with Dunn's correction (significant at p < 0.05). Results: Mean ± SD blood insulin concentration post IA TA injection was increased at 6 h (15.8 ± 3.1 μIU/mL, p = 0.01), 24 h (23 ± 5.8 μIU/mL, p ≤ 0.001), and 48 h (29 ± 13 μIU/mL, p ≤ 0.01) compared to baseline (10 ± 12.3 μIU/mL), with the peak at 48 h. Median ± 95% CI blood glucose concentration post IA TA injection was increased at 6 h (112.7 ± 20.3 mg/dL, p = 0.006), 8 h (112.9 ± 21.4 mg/dL, p = 0.004), 24 h (122.6 ± 14.6, p ≤ 0.0001), and 48 h (123.5 ± 15.4 mg/dL, p ≤ 0.0001) compared to baseline (89.2 ± 6.6 mg/dL), with the peak at 48 h. Conclusions: Only horses with normal insulin regulation were evaluated. Conclusions: Blood insulin and glucose concentrations modestly increased for 48 h following IA TA.
© 2023 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
Get Full Text
Publication Date: 2023-09-13 PubMed ID: 37705233DOI: 10.1111/evj.14003Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The abstract details a study examining the effects of intra-articular injections of the corticosteroid drug triamcinolone acetonide on blood insulin and glucose levels in healthy horses. The research indicates that these injections can lead to measurable increases in systemic insulin and glucose concentrations for up to 48 hours post-injection.

Objective of the Study

  • The objective of this study was to understand the impact of a single intra-articular dose of triamcinolone acetate (TA) on the blood insulin and glucose concentration in horses. It aimed to fill the knowledge gap generated due to limited evidence on the effects of this common treatment for osteoarthritis in horses.

Research Methods

  • The study used a before-after methodology on ten horses that have normal insulin regulation as measured by an oral sugar test.
  • Each horse received an injection of 18mg of TA into one of their middle carpal joints.
  • With base measurements taken for comparison, the insulin and glucose concentrations of the horses were evaluated at several time points – 4, 6, 8, 24, 48, and 72 hours after the injection.
  • The researchers used repeated measures ANOVA with Dunnett’s multiple comparison testing or a Friedman test with Dunn’s correction to evaluate deviations from the baseline measurements.

Results

  • The study found a significant increase in blood insulin concentration after the IA TA injection. This effect was observed at 6, 24, and 48 hours following the injection, and the peak occurred at 48 hours.
  • Similarly, there was a notable surge in blood glucose concentration at 6, 8, 24, and 48-hour time points when compared to baseline, with the peak at 48 hours.

Conclusions

  • The study concluded that the IA TA injection led to a modest increase in the blood insulin and glucose concentrations which lasted up to 48 hours in horses with normal insulin regulation.
  • This conclusion was drawn keeping in mind the limitation of the study that only included horses with normal insulin regulation. The effect of IA TA injections on horses with insulin dysregulation was not evaluated in this study.

Cite This Article

APA
Boger BL, Manfredi JM, Loucks AR, Salamey MZ, Kapeller LE, Fricano AG, Winkler A, Yob C, Colbath AC. (2023). Intra-articular triamcinolone acetonide injection results in increases in systemic insulin and glucose concentrations in horses without insulin dysregulation. Equine Vet J. https://doi.org/10.1111/evj.14003

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Boger, Brooke L
  • Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA.
Manfredi, Jane M
  • Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA.
Loucks, Abigail R
  • Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
Salamey, Maya Z
  • Department of Animal Science, College of Agriculture and Natural Sciences, Michigan State University, East Lansing, Michigan, USA.
Kapeller, Lydia E
  • Department of Animal Science, College of Agriculture and Natural Sciences, Michigan State University, East Lansing, Michigan, USA.
Fricano, Allie G
  • Department of Animal Science, College of Agriculture and Natural Sciences, Michigan State University, East Lansing, Michigan, USA.
Winkler, Ani
  • Department of Biochemistry and Molecular Biology, College of Agriculture and Natural Sciences, Michigan State University, East Lansing, Michigan, USA.
Yob, Chelsey
  • Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA.
Colbath, Aimee C
  • Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.

Grant Funding

  • AA-22-0064 / Michigan Alliance for Animal Agriculture

References

This article includes 22 references
  1. Zanotto GM, Frisbie DD. Current joint therapy usage in equine practice: changes in the last 10 years. Equine Vet J 2022;54(4):750-756.
  2. Haseler CJ, Jarvis GE, McGovern KF. Intrasynovial triamcinolone treatment is not associated with incidence of acute laminitis. Equine Vet J 2021;53(5):895-901.
  3. De Laat MA, van Eps AW, McGowan CM, Sillence MN, Pollitt CC. Equine laminitis: comparative histopathology 48 hours after experimental induction with insulin or alimentary oligofructose in Standardbred horses. J Comp Pathol 2011;145(4):399-409.
  4. de Laat MA, McGowan CM, Sillence MN, Pollitt CC. Equine laminitis: induced by 48 h hyperinsulinaemia in Standardbred horses. Equine Vet J 2010;42(2):129-135.
  5. Coleman MC, Belknap JK, Eades SC, Galantino-Homer HL, Hunt RJ, Geor RJ. Case-control study of risk factors for pasture-and endocrinopathy-associated laminitis in North American horses. J Am Vet Med Assoc 2018;253(4):470-478.
  6. Potter K, Stevens K, Menzies-Gow N. Prevalence of and risk factors for acute laminitis in horses treated with corticosteroids. Vet Rec 2019;185(3):82.
  7. Stout A, Friedly J, Standaert CJ. Systemic absorption and side effects of locally injected glucocorticoids. PM and R 2019;11(4):409-419.
  8. Box JR, Karikoski NP, Tanskanen HE, Raekallio MR. The effects of an alpha-2-adrenoceptor agonist, antagonist, and their combination on the blood insulin, glucose, and glucagon concentrations in insulin sensitive and dysregulated horses. Vet J 2021;269:105610.
  9. Schuver A, Frank N, Chameroy KA, Elliott SB. Assessment of insulin and glucose dynamics by using an oral sugar test in horses. J Equine Vet 2014;34(4):465-470.
  10. Berryhill EH, Magdesian KG, Tadros EM, Edman JE. Effects of age on serum glucose and insulin concentrations and glucose/insulin ratios in neonatal foals and their dams during the first 2 weeks postpartum. Vet J 2019;246:1-6.
  11. Frank N, Bailey S, Bertin FR, Burns T, de Laat M, Durham A. Recommendations for the diagnosis and management of equine metabolic syndrome (EMS) [Internet]. Medford, MA: Tufts; 2022 [cited 2023 May 20].
  12. Kim WH, Sim WS, Shin BS, Lee CJ, Jin HS, Lee JY. Prospective evaluation effects of two different doses of epidural steroid on blood glucose levels and pain control in patients with diabetes mellitus. Pain Physician 2013;16(6):557-568.
  13. Neeley WE. Simple automated determination of serum or plasma glucose by a hexokinase-glucose-6-phosphate dehydrogenase method. Clin Chem 1972;18:509-515.
  14. Macon EL, Harris P, Bailey S, Caldwell Barker A, Adams A. Identifying possible thresholds for nonstructural carbohydrates in the insulin dysregulated horse. Equine Vet J 2022;1-9. Online ahead of print.
    doi: 10.1111/evj.13910google scholar: lookup
  15. Warnken T, Reiche D, Huber K, Feige K. Comparison of endocrine and metabolic responses to oral glucose test and combined glucose-insulin tests in horses. Equine Med 2018;34(4):316-326.
  16. Hammersley E, Duz M, Marshall JF. Triamcinolone administration does not increase overall risk of developing laminitis. Equine Vet J 2015;47(S48):24.
  17. McGowan C, Cooper D, Ireland J. No evidence that therapeutic systemic corticosteroid administration is associated with laminitis in adult horses without underlying endocrine or severe systemic disease. Vet Evid Online 2016;1(1):1-17.
  18. McCluskey MJ, Kavenagh PB. Clinical use of triamcinolone acetonide in the horse (205 cases) and the incidence of glucocorticoid-induced laminitis associated with its use. Equine Vet Educ 2004;16(2):86-89.
  19. Genovese R. The use of corticosteroids in racetrack practice. Symposium on effective use of corticosteroids in veterinary practice. Princeton, NJ: Veterinary Learning Systems; 1983. p. 56-65.
  20. French K, Pollitt CC, Pass MA. Pharmacokinetics and metabolic effects of triamcinolone acetonide and their possible relationships to glucocorticoid-induced laminitis in horses. J Vet Pharmacol Ther 2008;23(5):287-292.
  21. Aleem AW, Usman AMS, Nicholson T, Getz CL, Namdari S, Beredjiklian PK. Blood glucose levels in diabetic patients following corticosteroid injections into the subacromial space of the shoulder. Arch Bone Jt Surg 2017;5(5):315-321.
  22. Hood DM, Stephens KA, Amoss MS. The effect of chronic exogenous steroid on the carbohydrate model of laminitis. Proceedings of the endotoxemia-laminitis symposium american association of equine practitioners newsletter. Lexington, KY: American Association of Equine Practitioners; 1982. p. 2.

Citations

This article has been cited 0 times.
Subscribe to our newsletter
Join 99,359 horse owners like you who receive our email updates on horse health and nutrition.