Review of glucocorticoid therapy in horses. Part 2: Clinical use of systemic glucocorticoids in horses

Pereira, Mariano Mora; Groover, Erin S.; Wooldridge, Anne A.; Caldwell, Fred

doi:10.1111/eve.12624

Cited by 6 publications

(9 citation statements)

References 95 publications

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“…oxytetracycline) towards Clostridial spp . Furthermore, the use of bacteriostatic antimicrobials in conjunction with corticosteroids is, in the authors' opinion, counter‐intuitive given the potential immunosuppressive effects of the corticosteroids (Leclere, 2017; Mora Pereira et al., 2018) potentially reducing their efficacy and thus propagating antimicrobial resistance. This particular interaction is not well documented in the literature and further work is needed to confirm or refute this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

Equine limb cellulitis/lymphangitis resulting in distal limb ischaemia and avulsion of the hoof capsule

Duggan

Mair

Fews³

2021

Equine Veterinary Education

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Summary Limb cellulitis/lymphangitis is a well‐recognised syndrome in horses, but there are limited published reports concerning outcomes and complications. This report describes a horse with hindlimb cellulitis/lymphangitis that developed ischaemia of the distal limb resulting in necrosis of the suspensory ligament branches and avulsion of the hoof capsule. A 16‐year‐old Thoroughbred mare was referred for further investigation and treatment of a left hindlimb cellulitis/lymphangitis. The culture of a swab taken from superficial pustules on the leg yielded a moderate growth of coliform bacteria and a profuse growth of Staphylococcus aureus. Treatment included systemic antimicrobials (based on the results of culture and sensitivity), phenylbutazone, dexamethasone, morphine and paracetamol. Following some initial clinical improvement, hyperextension of the metatarsophalangeal joint was noted on Day 5 of hospitalisation. Complete avulsion of the ipsilateral hoof capsule occurred on Day 10, and the horse was immediately euthanised. A limited post‐mortem examination revealed necrosis of the suspensory ligament branches. Fibrin thrombi, interstitial haemorrhage and oedema were identified in the suspensory ligament branches and adjacent subcutaneous tissues, with thrombi in relatively large vessels. The dermal laminae were extensively necrotic, and the majority of the lamellar vasculature contained fibrin thrombi.

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Section: Discussionmentioning

confidence: 99%

Equine limb cellulitis/lymphangitis resulting in distal limb ischaemia and avulsion of the hoof capsule

Duggan

Mair

Fews³

2021

Equine Veterinary Education

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“…There are limited controlled studies evaluating the safety and dosing of glucocorticoids for hypersensitivity disorders in horses. Review articles regarding the function, pharmacodynamics, pharmacokinetics, indications for use and adverse effects associated with glucocorticoids are available 208,209 …”

Section: Atopic Dermatitismentioning

confidence: 99%

“…Review articles regarding the function, pharmacodynamics, pharmacokinetics, indications for use and adverse effects associated with glucocorticoids are available. 208,209 Most veterinarians rely on using two systemic glucocorticoids in practice: prednisolone and dexamethasone. Prednisone is not as effective in the horse as prednisolone, owing to poor absorption, rapid excretion and failure of hepatic conversion of prednisone to prednisolone.…”

Section: Treatmentmentioning

confidence: 99%

Equine allergic skin diseases: Clinical consensus guidelines of the World Association for Veterinary Dermatology

Marsella

White

Fadok

et al. 2023

Veterinary Dermatology

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BackgroundAllergic skin diseases are common in horses worldwide. The most common causes are insect bites and environmental allergens.ObjectivesTo review the current literature and provide consensus on pathogenesis, diagnosis, treatment and prevention.Materials and MethodsThe authors reviewed the literature up to November 2022. Results were presented at North America Veterinary Dermatology Forum (2021) and European Veterinary Dermatology Congress (2021). The report was available to member organisations of the World Association for Veterinary Dermatology for feedback.Conclusions and Clinical RelevanceInsect bite hypersensitivity (IBH) is the best characterised allergic skin disease. An immunoglobulin (Ig)E response against Culicoides salivary antigens is widely documented. Genetics and environmental factors play important roles. Tests with high sensitivity and specificity are lacking, and diagnosis of IBH is based on clinical signs, seasonality and response to insect control. Eosinophils, interleukin (IL)‐5 and IL‐31 are explored as therapeutic targets. Presently, the most effective treatment is insect avoidance. Existing evidence does not support allergen‐specific immunotherapy (ASIT) using commercially available extracts of Culicoides. Hypersensitivity to environmental allergens (atopic dermatitis) is the next most common allergy. A role for IgE is supported by serological investigation, skin test studies and positive response to ASIT. Prospective, controlled, randomised studies are limited, and treatment relies largely on glucocorticoids, antihistamines and ASIT based on retrospective studies. Foods are known triggers for urticaria, yet their role in pruritic dermatitis is unknown. Recurrent urticaria is common in horses, yet our understanding is limited and focussed on IgE and T‐helper 2 cell response. Prospective, controlled studies on treatments for urticaria are lacking. Glucocorticoids and antihistamines are primary reported treatments.

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“…Corticosteroids inhibit the inflammatory response which is a key factor preventing the development of irreversible fibrotic damage of the lung (Pereira et al, 2016) but they can be potentially associated with multiple side effects such as worsening of viral infection, hypothalamic-pituitary-adrenal axis suppression, hyperglycaemia, polyuria and polydipsia and increased susceptibility to infections and laminitis (Leclere, 2017). This report describes the clinical presentation, diagnostic evaluation, and follow-up of a horse diagnosed with EMPF associated with EHV-5 infection and treated with systemic corticosteroids, which developed unexpected complications, including bacterial dermatitis, liver damage and acute pleural effusion.…”

Section: Introductionmentioning

confidence: 99%

Equine multinodular pulmonary fibrosis and presumed corticosteroid‐induced side effects in a horse

Lauteri

Tortereau

Peyrecave

et al. 2023

Equine Veterinary Education

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Summary Equine multinodular pulmonary fibrosis (EMPF) associated with herpesvirus‐5 infection (EHV‐5), is a severe, fibrosing interstitial lung disease of horses. Most common reported clinical signs are pyrexia, weight loss, depression, respiratory distress with tachypnoea and cough. Multiple tissue tropism of the EHV‐5 has been suggested. Treatment with valacyclovir and corticosteroids has been reported to be successful in a few cases, but the disease is usually associated with a poor prognosis because of progressive impairment of respiratory function. Corticosteroid administration can carry potential side effects, such as hypothalamic–pituitary–adrenal axis suppression, laminitis and increased susceptibility to infections. This report described a case of an 11‐year‐old gelding diagnosed with EMPF. The horse was treated with valacyclovir and corticosteroids and, after a transient initial improvement, showed a rapid deterioration of clinical signs and multiple complications, including severe bacterial dermatitis, liver damage and pleural effusion of unknown origin. A polymerase chain reaction (PCR) assay of liver biopsy sample was positive for EHV‐5, confirming the virus' multiple tissue tropism. A role of corticosteroids in exacerbating the disease progression and the increasing susceptibility to infections was strongly suspected.

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Review of glucocorticoid therapy in horses. Part 2: Clinical use of systemic glucocorticoids in horses

Cited by 6 publications

References 95 publications

Equine limb cellulitis/lymphangitis resulting in distal limb ischaemia and avulsion of the hoof capsule

Equine limb cellulitis/lymphangitis resulting in distal limb ischaemia and avulsion of the hoof capsule

Equine allergic skin diseases: Clinical consensus guidelines of the World Association for Veterinary Dermatology

Equine multinodular pulmonary fibrosis and presumed corticosteroid‐induced side effects in a horse

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