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

Abstract

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, corticosteroid therapy prescribed and occurrence of acute laminitis during or within 14 days of cessation of corticosteroid treatment were recorded.For study 1, 205 cases and 205 controls were identified; two animals within each group (1 per cent) developed laminitis. In total, 1565 animals were included in study 2; laminitis period prevalence was 0.6 per cent (95 per cent CI 0.4 per cent to 1.2 per cent), with 10 cases in 1565 treated animals. There were significant associations between laminitis and breed (pony vs horse; p=0.01; univariable analysis only), the presence of a laminitis risk factor (history of laminitis or an underlying endocrinopathy; p<0.001; OR (95 per cent CI) 18.23 (5.05 to 65.87)) and body condition (overweight/obese vs not; p=0.04; OR (95 per cent CI) 4.0 (1.09 to 14.75)).

Intrasynovial triamcinolone treatment is not associated with incidence of acute laminitis

“…Causative mechanisms have been proposed and evidence for these has been reviewed 1‐3 . However, a recent knowledge summary 4 found “no conclusive evidence to support a causal association between therapeutic systemic corticosteroid administration and the development of laminitis in healthy adult horses/ponies” and two recent studies found no association between corticosteroid use and laminitis 5,6 …”

Steroids and laminitis – the value of evidence over anecdote

“…In the retrospective study, 1 per cent of horses in both the glucocorticoid and control groups developed laminitis. In the cohort study, 10 of 1565 glucocorticoid‐treated horses developed laminitis, giving a period prevalence of laminitis of only 0.6 per cent – much lower than published estimates of the laminitis prevalence in the general equine population 3 . The authors identified links between laminitis and being a pony, being overweight, having a history of laminitis and having an endocrinopathy.…”

“…In a paper summarised on p 82 of this issue of Vet Record, Potter and colleagues provide further evidence to help us determine whether there is indeed any link between glucocorticoid administration and laminitis. 3 They performed both a retrospective case-control study of 205 horses and a prospective cohort study of 1565 horses treated with glucocorticoids. These are not perhaps the 'big data' studies that would be desirable to provide a more robust answer to the question of whether glucocorticoids can cause laminitis, but they are another piece of a jigsaw puzzle that appears to be revealing a clear picture.…”

“…In the cohort study, 10 of 1565 glucocorticoid-treated horses developed laminitis, giving a period prevalence of laminitis of only 0.6 per cent -much lower than published estimates of the laminitis prevalence in the general equine population. 3 The authors identiied links between laminitis and being a pony, being overweight, having a history of laminitis and having an endocrinopathy. This is consistent with our current understanding that equine metabolic syndrome and, to a lesser extent, pituitary pars intermedia dysfunction are predisposing factors in the development of most, if not all, cases of pasture-associated laminitis.…”

“…In a paper summarised on p 82 of this issue of Vet Record , Potter and colleagues provide further evidence to help us determine whether there is indeed any link between glucocorticoid administration and laminitis 3 . They performed both a retrospective case‐control study of 205 horses and a prospective cohort study of 1565 horses treated with glucocorticoids.…”