No Evidence That Therapeutic Systemic Corticosteroid Administration is Associated With Laminitis in Adult Horses Without Underlying Endocrine or Severe Systemic Disease.

Abstract

Clinical bottom line
 
 There is currently no conclusive evidence to support a causal association between therapeutic systemic corticosteroid administration and the development of laminitis in healthy adult horses/ponies.
 There is weak evidence of an association between administration of multiple doses of systemic corticosteroid and the onset of laminitis in adult horses/ponies with underlying endocrine disorders or severe systemic disease.

Prevalence of and risk factors for acute laminitis in horses treated with corticosteroids

“…25 If a horse developed laminitis ater 14 days, it was not included in the study as the time frame is too long to suggest a direct causal association. 4 The main limitation of this study was the lack of an untreated control population in study two. While comparisons can be made with other studies with similar populations of horses and study one, ideally, the study would have included a time-matched cohort of animals that was not treated with corticosteroids for a more appropriate comparison.…”

“…Since their introduction to veterinary therapeutics over 40 years ago, they have been associated with a perceived increased risk of acute laminitis. [1][2][3] However, there is little scientific evidence to support this association in healthy animals, 4 and direct causation has not been established. 5 There are several published case reports involving either single or small number of animals treated with corticosteroids that developed laminitis.…”

What is the risk that corticosteroid treatment will cause laminitis?

“…Previous appraisals concluded that there was little or no evidence to indicate a significant risk of laminitis in a healthy adult horse or pony due to corticosteroid treatment but that there was weak evidence for increased risk in animals with pre‐existing risk factors (Menzies‐Gow ; McGowan et al . ). Recent UK evidence supports this conclusion assuming the healthy horse has no history of previous laminitis.…”

“…Many of the papers included in the recent appraisals (Menzies‐Gow ; McGowan et al . ) were retrieved and are not re‐appraised in this summary. The highest quality evidence retrieved was considered to be level 3 and 4 evidence.…”

“…The topic has been thoroughly appraised in two recent publications (Menzies‐Gow ; McGowan et al . ). Studies published since these reviews may provide further information.…”