Glucocorticoids and laminitis: a real risk?

Abstract

The relationship between glucocorticoids and laminitis has been a long-standing area of fear, debate and controversy. Evidence continues to emerge that supports clinicians' observations that risk is not uniform across the equine population, and that risk varies between different glucocorticoid preparations, their doses and durations of treatment. In a healthy adult horse, with no previous history of laminitis and without other laminitis risk factors, the risk that therapeutic glucocorticoid use (at commonly used doses) will result in laminitis can be considered negligible or absent. However, in horses with pre-existing laminitis risk factors, in particular those with a previous history of laminitis, a higher degree of risk is likely and should be weighed against the therapeutic benefits of glucocorticoid treatment. Further studies are required to assess the value of screening for insulin dysregulation prior to therapeutic glucocorticoid use, and to understand the relative risks of different glucocorticoid preparations, doses and routes of administration.