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Home / Equine Research Bank / Equine Vet J / Intrasynovial triamcinolone treatment is not associated with...
Equine veterinary journal2020; 53(5); 895-901; doi: 10.1111/evj.13361

Intrasynovial triamcinolone treatment is not associated with incidence of acute laminitis.

Abstract: 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. Methods: Retrospective observational cohort study. Methods: Clinical records of horses registered with one large UK equine practice were reviewed retrospectively to identify all horses receiving intrasynovial TA treatment between 1 January 2007 and 31 December 2017. A total of 1510 horses were selected and records investigated for incidence of laminitis over a 4-month period following treatment. For each TA-treated horse, an untreated horse, individually matched by age, sex, date of treatment and client type, was selected from the clinical records. Untreated horses were then investigated for laminitis over the same 4-month period. Data were analysed in a 2 × 2 contingency table using Fisher's exact test. Results: A total of 489 horses were lost to follow-up and 55 horses were excluded, leaving 966 treated and matched, untreated horses. The incidence of laminitis over the 4-month study period in both groups was identical: 3/966 horses (0.31%) (95% C.I. [0.08%, 0.91%]), equivalent to 0.93 cases per 100 horses per year (P > .9). Conclusions: Retrospective study; large proportion (489/1510) of horses lost to follow-up; large proportion of study population were racehorses; selection method resulted in disproportionate selection of horses born before 2013; similar incidence between groups may reflect existing risk-based selection by clinicians. Conclusions: intrasynovial triamcinolone acetonide administration does not increase the risk of laminitis in this study population.
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Publication Date: 2020-11-30 PubMed ID: 33174264DOI: 10.1111/evj.13361Google Scholar: Lookup
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  • Journal Article
  • Observational Study
  • Veterinary

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 research paper studies the risk of developing laminitis in horses treated with intrasynovial triamcinolone acetonide (TA), a type corticosteroid. Findings reveal that there is no increased risk of laminitis in horses treated with this corticosteroid.

Objective of the Research

  • The aim of this study was to determine the risk of acute laminitis in horses following the treatment of intrasynovial triamcinolone acetonide (TA).
  • Previous case reports suggested a link between the use of corticosteroids and the development of laminitis, but no case-control or cohort studies have been published to verify this.

Methods and Approach

  • The researchers conducted a retrospective observational cohort study, analysing clinical records of horses registered with one large UK equine practice over a ten-year period, from 1 January 2007 to 31 December 2017.
  • 1510 horses that received intrasynovial TA treatment were identified and their records investigated for incidence of laminitis over a four-month period after treatment.
  • For each TA-treated horse, a horse not treated with TA and matched on the basis of age, sex, date of treatment and client type, was selected to compare the prevalence of laminitis over the same period.
  • The data was analysed using Fisher’s exact test.

Results and Conclusion

  • Out of the initial group, 489 horses were lost to follow-up and 55 horses were excluded. This resulted in a final tally of 966 treated and matched untreated horses.
  • The rate of laminitis occurrence within the four-month study period was identical for both treated and untreated groups, at 0.31% (or 3 out of 966).
  • The researchers observed that intrasynovial TA treatment does not increase the risk of laminitis in this study population.

Limitations of the Study

  • Almost a third of the initial study population was lost to follow-up, which might affect the reliability of the results.
  • The disproportionately large number of racehorses within the study group may have biased the results.
  • The selection method used resulted in a larger number of horses born before 2013, which could also skew the findings.
  • The similar laminitis incidence in both groups may be due to risk-based selection by clinicians, rather than the lack of an impact of the TA treatment.

Cite This Article

APA
Haseler CJ, Jarvis GE, McGovern KF. (2020). Intrasynovial triamcinolone treatment is not associated with incidence of acute laminitis. Equine Vet J, 53(5), 895-901. https://doi.org/10.1111/evj.13361

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 53
Issue: 5
Pages: 895-901

Researcher Affiliations

Haseler, Callum J
  • Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
  • Westover Veterinary Centre, Hainford, UK.
Jarvis, Gavin E
  • Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK.
McGovern, Kate F
  • Donnington Grove Veterinary Group, Newbury, UK.

MeSH Terms

  • Animals
  • Case-Control Studies
  • Foot Diseases / chemically induced
  • Foot Diseases / drug therapy
  • Foot Diseases / epidemiology
  • Foot Diseases / veterinary
  • Horse Diseases / chemically induced
  • Horse Diseases / drug therapy
  • Horse Diseases / epidemiology
  • Horses
  • Incidence
  • Retrospective Studies
  • Triamcinolone Acetonide / adverse effects

References

This article includes 19 references
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Citations

This article has been cited 2 times.
  1. Page AE, Johnson M, Parker JL, Jacob O, Poston R, Adams AA, Adam EN. The Effects of Intra-Articular Triamcinolone and Autologous Protein Solution on Metabolic Parameters in Horses. Animals (Basel) 2024 Aug 2;14(15).
    doi: 10.3390/ani14152250pubmed: 39123776google scholar: lookup
  2. Hallowell KL, Dembek K, Horne CR, Knych HK, Messenger KM, Schnabel LV. Systemic absorption of triamcinolone acetonide is increased from intrasynovial versus extrasynovial sites and induces hyperglycemia, hyperinsulinemia, and suppression of the hypothalamic-pituitary-adrenal axis. Front Vet Sci 2024;11:1388470.
    doi: 10.3389/fvets.2024.1388470pubmed: 38828366google scholar: lookup
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