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

Katya Potter,Nicola Menzies‐Gow,Kim Stevens

doi:10.1136/vr.105378

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)).

Highlights

Corticosteroids are used in clinical practice to treat a range of non-infectious inflammatory diseases affecting horses
The occurrence of laminitis in animals treated with corticosteroids was low in both studies (0.6-1.0%) and was similar to the frequency of veterinary-diagnosed laminitis reported in the GB general equine population of 0.5% (Wylie and others 2013a) and that in the untreated population in study one
It would appear that laminitis does not occur more frequently in populations of animals treated with corticosteroids than in the general equine population

Summary

Introduction

Corticosteroids are used in clinical practice to treat a range of non-infectious inflammatory diseases affecting horses Since their introduction to veterinary therapeutics over 40 years ago, they have been associated with a perceived increased risk of acute laminitis (Bailey and Elliott 2007; Cornelisse and Robinson 2004; Cornelisse and Robinson 2013). There are several published case reports involving either single or small number of animals treated with corticosteroids that developed laminitis (Cohen and Carter 1992; Dutton 2007; Frederick and Kehl 2000; Lose 1980; Ryu and others 2004; Vandenabeele and others 2004; Winfield and others 2013). Many of these animals had pre-existing laminitis risk factors. Corticosteroid administration was uncommon in all groups of horses (Coleman and others 2018)

Objectives

Methods

Results

Conclusion