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Marsella R, White S, Fadok VA, Wilson D, Mueller R, Outerbridge C, Rosenkrantz W. Equine allergic skin diseases: Clinical consensus guidelines of the World Association for Veterinary Dermatology. Vet Dermatol 2023; 34:175-208. [PMID: 37154488 DOI: 10.1111/vde.13168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 02/03/2023] [Accepted: 02/26/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Allergic skin diseases are common in horses worldwide. The most common causes are insect bites and environmental allergens. OBJECTIVES To review the current literature and provide consensus on pathogenesis, diagnosis, treatment and prevention. MATERIALS AND METHODS The 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 RELEVANCE Insect 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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Affiliation(s)
- R Marsella
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - S White
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
| | - V A Fadok
- Zoetis, US PET CARE, Bellaire, Texas, USA
| | - D Wilson
- School of Clinical Veterinary Sciences, University of Bristol, Bristol, UK
| | - R Mueller
- Medizinische Keleintierklinik, Zentrum für klinische Tiermedizin, LMU, Munich, Germany
| | - C Outerbridge
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California, USA
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Hermans H, van den Berg EMH, Slenter IJM, Vendrig DJC, de Nijs‐Tjon LJL, Vernooij JCM, Brommer H, Boevé MH, Gehring R. Penetration of topically administered dexamethasone disodium phosphate and prednisolone acetate into the normal equine ocular fluids. Equine Vet J 2022; 54:965-972. [PMID: 34706129 PMCID: PMC9545554 DOI: 10.1111/evj.13526] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 10/16/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Topical dexamethasone and prednisolone are currently the mainstay treatment for equine ophthalmic inflammatory diseases, such as equine recurrent uveitis. Comparative pharmacokinetic studies in horses are lacking and current guidelines are mainly based on empirical data and extrapolation from other species. OBJECTIVES To investigate the penetration and local concentrations of topically applied dexamethasone and prednisolone in normal equine ocular fluids and serum. STUDY DESIGN Prospective randomised experimental pharmacokinetic study. METHODS Twenty-one Shetland ponies without ophthalmic disease were treated bilaterally topically every 2 hours during 24 hours to obtain steady state drug concentrations. One eye was treated with 0.15 mg of dexamethasone disodium phosphate (0.1%), and the other eye was simultaneously treated with 1.5 mg of prednisolone acetate (1%). Serum samples were taken prior to the induction of general anaesthesia. Aqueous and vitreous humour samples were taken during euthanasia at time points after administration of the last dose (t = 5 min, t = 15 min, t = 30 min, t = 60 min, t = 90 min, t = 120 min, t = 180 min). Each pony was randomly assigned to one time point, and three ponies were sampled per time point. Dexamethasone and prednisolone concentrations were measured by liquid chromatography-mass spectrometry. RESULTS The mean dexamethasone concentration in aqueous humour was 32.4 ng/mL (standard deviation [SD] 10.9) and the mean prednisolone concentration was 321.6 ng/mL (SD 96.0). In the vitreous and in serum samples concentrations of both corticosteroids were below the limit of detection (LOD 2.5 ng/mL). MAIN LIMITATIONS The study group was limited to subjects without evidence of current ophthalmic disease. A limited number of time points were measured. CONCLUSIONS Potentially effective dexamethasone and prednisolone concentrations were measured in the anterior chamber, but vitreal concentrations were negligible. Systemic uptake was low. Therefore, treatment with only topically administered corticosteroids is deemed insufficient in horses in cases of posterior uveitis. Further studies evaluating other routes of administration are warranted.
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Affiliation(s)
- Hanneke Hermans
- Department of Clinical SciencesFaculty of Veterinary MedicineUtrecht UniversityUtrechtThe Netherlands
| | | | - Inge J. M. Slenter
- Department of Clinical SciencesFaculty of Veterinary MedicineUtrecht UniversityUtrechtThe Netherlands
| | - Dax J. C. Vendrig
- Institute for Risk Assessment Sciences (IRAS)Division of Veterinary and Comparative PharmacologyFaculty of Veterinary MedicineUtrecht UniversityUtrechtThe Netherlands
| | - Lilian J. L. de Nijs‐Tjon
- Institute for Risk Assessment Sciences (IRAS)Division of Veterinary and Comparative PharmacologyFaculty of Veterinary MedicineUtrecht UniversityUtrechtThe Netherlands
| | - Johannes C. M. Vernooij
- Department of Population Health SciencesFarm Animal HealthFaculty of Veterinary MedicineUtrecht UniversityUtrechtThe Netherlands
| | - Harold Brommer
- Department of Clinical SciencesFaculty of Veterinary MedicineUtrecht UniversityUtrechtThe Netherlands
| | - Michael H. Boevé
- Department of Clinical SciencesFaculty of Veterinary MedicineUtrecht UniversityUtrechtThe Netherlands
| | - Ronette Gehring
- Institute for Risk Assessment Sciences (IRAS)Division of Veterinary and Comparative PharmacologyFaculty of Veterinary MedicineUtrecht UniversityUtrechtThe Netherlands
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Ramey DW, Knych HK. Oral prednisolone achieves measurable concentrations in equine synovial fluid within 3 hours of administration: Preliminary observations. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - H. K. Knych
- K.L. Maddy Equine Analytical Chemistry Laboratory Davis California USA
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Circulating hypothalamic-pituitary-adrenal axis hormones and insulin concentrations in horses and ponies. J Equine Vet Sci 2021; 111:103810. [DOI: 10.1016/j.jevs.2021.103810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 11/07/2021] [Accepted: 11/08/2021] [Indexed: 11/20/2022]
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Grenager NS. Endocrinopathic Laminitis. Vet Clin North Am Equine Pract 2021; 37:619-638. [PMID: 34674908 DOI: 10.1016/j.cveq.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Endocrinopathic laminitis (EL) primarily occurs because of insulin dysregulation (ID) mediated through downstream effects of insulin on IGF-1R in lamellar tissues. There is likely contributing vascular and metabolic dysfunction within the lamellae, but EL is relatively non-inflammatory. EL is associated with lamellar stretching, proliferation, and failure, ultimately causing failure of the suspensory apparatus of the distal phalanx. Proper education regarding mitigating risk factors makes this a largely preventable cause of laminitis. Annual hoof evaluation plus screening geriatric horses for pituitary pars intermedia dysfunction and ID, and younger horses for ID, can significantly decrease the incidence of this devastating condition.
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Affiliation(s)
- Nora S Grenager
- Steinbeck Peninsula Equine Clinics, 100 Ansel Lane, Menlo Park, CA 94028, USA.
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Orsini JA. The Big Picture in Better Understanding the Equine Foot. Vet Clin North Am Equine Pract 2021; 37:521-528. [PMID: 34674909 DOI: 10.1016/j.cveq.2021.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The multiple topics summarized in this article and discussed in detail in this issue of VCNA are comprehensive and in-depth, exploring concepts and clinical experiences for state-of-the-art care of the equine foot. The research on the equine foot will translate to the clinical setting and with this the compassionate care of the horse.
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Affiliation(s)
- James A Orsini
- Department of Clinical Studies - New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, 382 West Street Road, Kennett Square, PA 19348, USA.
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Mainguy-Seers S, Lavoie JP. Glucocorticoid treatment in horses with asthma: A narrative review. J Vet Intern Med 2021; 35:2045-2057. [PMID: 34085342 PMCID: PMC8295667 DOI: 10.1111/jvim.16189] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 05/13/2021] [Accepted: 05/18/2021] [Indexed: 12/15/2022] Open
Abstract
Despite substantial research efforts to improve the treatment and outcome of horses with asthma, glucocorticoids (GC) remain the cornerstone of drug treatment of this prevalent disease. The high efficacy of GC to relieve airway obstruction explains their extensive use despite potential deleterious effects. However, much is yet to be uncovered concerning GC use in horses with asthma, including the comparative efficacy of the different drugs, the determination of minimal effective doses and the mechanisms underlying their variable modulation of airway inflammation. The objectives of this structured review were to report and compare the plethora of effects of the various GC used in asthmatic horses with a focus on impact on lung function, airway inflammation, and bronchial remodeling. Adverse effects are also briefly described, with an emphasis on those that have been specifically reported in horses with asthma. Ultimately, we aimed to highlight gaps in the literature and to identify future research areas.
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Affiliation(s)
- Sophie Mainguy-Seers
- Faculty of Veterinary Medicine, Department of Clinical Sciences, Université de Montréal, St-Hyacinthe, Quebec, Canada
| | - Jean-Pierre Lavoie
- Faculty of Veterinary Medicine, Department of Clinical Sciences, Université de Montréal, St-Hyacinthe, Quebec, Canada
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Ehrmann C, Hartung S, Hirz M, Fey K. [Therapy of bullous pemphigoid in a Warmblood gelding]. TIERARZTLICHE PRAXIS. AUSGABE G, GROSSTIERE/NUTZTIERE 2021; 49:139-144. [PMID: 33902144 DOI: 10.1055/a-1395-6307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A 15-year-old Warmblood gelding was presented with multiple large, ulcerative, and crusty dermal lesions that had been existing for 4 years. Histopathology of a skin biopsy revealed cleft formation at the dermal-epidermal junction beneath the basal cells and above the basement membrane leading to the diagnosis of bullous pemphigoid. Immunosuppressive therapy with dexamethasone and azathioprine was initiated and after 14 weeks full remission of the ulcers was achieved. Scar tissue formation was evident in the areas of the formerly affected lesions. Following medication tapering over a period of 5 months, long-term therapy was continued with a maintenance dose of 0.5 mg/kg azathioprine daily. The ulcerative lesions recurred after 63 weeks of disease stabilization. Additionally, adverse drug reactions (acute laminitis and increased susceptibility to infections) were evident and the gelding was euthanized due to animal welfare considerations.
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Affiliation(s)
- Carolin Ehrmann
- Klinik für Pferde, Innere Medizin, Justus-Liebig-Universität Gießen
| | - Svenja Hartung
- Institut für Veterinär-Pathologie, Justus-Liebig-Universität Gießen
| | - Manuela Hirz
- Institut für Veterinär-Pathologie, Justus-Liebig-Universität Gießen
| | - Kerstin Fey
- Klinik für Pferde, Innere Medizin, Justus-Liebig-Universität Gießen
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Hansen S, Laustsen L, Otten ND, Skovgaard K, Bech R, Byrgesen S, Hopster-Iversen C, Fjeldborg J. Evaluation of Treatment With Respiratory Gene Technology and Serum in a Group of Standard Bred Racehorses With Cytological Evidence of Mild Equine Asthma. J Equine Vet Sci 2021; 101:103435. [PMID: 33993937 DOI: 10.1016/j.jevs.2021.103435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 11/20/2022]
Abstract
Alternative treatment options to glucocorticoids for equine asthma is desirable due to withdrawal time. The objective was to evaluate if serum and Respiratory Gene Technology (RGT), a commercial kit to produce autologous conditioned serum, was effective in reducing bronchoalveolar lavage (BAL) neutrophils and mast cells in racehorses with cytological evidence of mild equine asthma . Thirty-six Standardbred trotters in active training were enrolled in this randomized clinical trial; a healthy control group (n=11), a RGT group (n=12) and a serum group (n=13). Endoscopy including tracheal wash (TW) and BAL was performed before (T0), after a 6-week treatment period including 12 intramuscular injections of RGT or serum (T6) and as a follow-up 10 weeks after treatment (T16). A significant decrease in BAL neutrophils for the RGT group was found between T0 and T6 (P = .002, d=-1.51, CI: -2.43;-0.59) and for the serum group between T0-T6 (P = .002, d=-1.36, CI: -2.26;-0.46). Further, a significant decrease in BAL mast cells between T0-T6 for the both the RGT group (P = .019, d=-1.23, CI: -1.22;-0.34) and the serum group (P= .004, d=-0.81, CI: -1.65;0.04), and further between T0-T16 (RGT P= .011, d=-1.55, CI: -2.62;-0.48; serum P= .044, d=-0.65, CI: -1.68;-0.37). No significant difference in TW cytology was found for any of the time-points. Pro- and anti-inflammatory cytokines were regulated according to treatment. The control group showed no cytological differences between any time-point. Study results showed that intramuscular treatment with both RGT and serum was effective associated with reduction of BAL neutrophils and mast cells in horses with cytological evidence of mild equine asthma. Further large-scale studies are necessary.
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Affiliation(s)
- Sanni Hansen
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Veterinary Clinical Sciences, DK Taastrup.
| | | | - Nina D Otten
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Veterinary and Animal Sciences, DK Frederiksberg C
| | - Kerstin Skovgaard
- Technical University of Denmark, Department of Biotechnology and Biomedicine, DK Kongens Lyngby
| | - Rune Bech
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Veterinary Clinical Sciences, DK Taastrup
| | - Simon Byrgesen
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Veterinary Clinical Sciences, DK Taastrup
| | - Charlotte Hopster-Iversen
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Veterinary Clinical Sciences, DK Taastrup
| | - Julie Fjeldborg
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Veterinary Clinical Sciences, DK Taastrup
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Haseler CJ, Jarvis GE, McGovern KF. Intrasynovial triamcinolone treatment is not associated with incidence of acute laminitis. Equine Vet J 2020; 53:895-901. [PMID: 33174264 DOI: 10.1111/evj.13361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/17/2020] [Accepted: 09/20/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Intrasynovial corticosteroid injections are commonly used in the treatment of equine orthopaedic disease, but corticosteroid administration is widely considered a risk factor for the development of laminitis. Despite a list of putative mechanisms and a number of case reports of steroid-induced laminitis, no case-control or cohort studies investigating the association between use of intrasynovial corticosteroids and acute laminitis have been published. OBJECTIVES To quantify the risk of laminitis posed by intrasynovial triamcinolone acetonide (TA) administration in a mixed population of horses. STUDY DESIGN Retrospective observational cohort study. METHODS Clinical records of horses registered with one large UK equine practice were reviewed retrospectively to identify all horses receiving intrasynovial TA treatment between 1 January 2007 and 31 December 2017. A total of 1510 horses were selected and records investigated for incidence of laminitis over a 4-month period following treatment. For each TA-treated horse, an untreated horse, individually matched by age, sex, date of treatment and client type, was selected from the clinical records. Untreated horses were then investigated for laminitis over the same 4-month period. Data were analysed in a 2 × 2 contingency table using Fisher's exact test. RESULTS A total of 489 horses were lost to follow-up and 55 horses were excluded, leaving 966 treated and matched, untreated horses. The incidence of laminitis over the 4-month study period in both groups was identical: 3/966 horses (0.31%) (95% C.I. [0.08%, 0.91%]), equivalent to 0.93 cases per 100 horses per year (P > .9). MAIN LIMITATIONS Retrospective study; large proportion (489/1510) of horses lost to follow-up; large proportion of study population were racehorses; selection method resulted in disproportionate selection of horses born before 2013; similar incidence between groups may reflect existing risk-based selection by clinicians. CONCLUSIONS intrasynovial triamcinolone acetonide administration does not increase the risk of laminitis in this study population.
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Affiliation(s)
- Callum J Haseler
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.,Westover Veterinary Centre, Hainford, UK
| | - Gavin E Jarvis
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
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11
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Knowles EJ. What is the risk that corticosteroid treatment will cause laminitis? EQUINE VET EDUC 2019. [DOI: 10.1111/eve.12901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- E. J. Knowles
- Bell Equine Veterinary Clinic, Kent and The Royal Veterinary College Hatfield UK
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12
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Potter K, Stevens K, Menzies-Gow N. Prevalence of and risk factors for acute laminitis in horses treated with corticosteroids. Vet Rec 2019; 185:82. [DOI: 10.1136/vr.105378] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 04/15/2019] [Accepted: 05/15/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Katya Potter
- Department of Clinical Sciences and Services; Royal Veterinary College; North Mymms Hertfordshire UK
| | - Kim Stevens
- Department of Pathobiology and Population Sciences; Royal Veterinary College; North Mymms Hertfordshire UK
| | - Nicola Menzies-Gow
- Department of Clinical Sciences and Services; Royal Veterinary College; North Mymms Hertfordshire UK
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13
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Rendle D. Steroids and laminitis - the value of evidence over anecdote. Vet Rec 2019; 185:79-81. [DOI: 10.1136/vr.l4730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- David Rendle
- Rainbow Equine Hospital; Malton North Yorkshire UK
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14
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Pollard D, Wylie CE, Verheyen KLP, Newton JR. Identification of modifiable factors associated with owner-reported equine laminitis in Britain using a web-based cohort study approach. BMC Vet Res 2019; 15:59. [PMID: 30755193 PMCID: PMC6373032 DOI: 10.1186/s12917-019-1798-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 01/25/2019] [Indexed: 12/27/2022] Open
Abstract
Background Equine laminitis is a complex disease that manifests as pain and lameness in the feet, often with debilitating consequences. There is a paucity of data that accounts for the multifactorial nature of laminitis and considers time-varying covariates that may be associated with disease development; particularly those that are modifiable and present potential interventions. A previous case-control study identified a number of novel, modifiable factors associated with laminitis which warranted further investigation and corroboration. The aim of this study was to identify factors associated with equine laminitis in horses/ponies in Great Britain (GB) using a prospective, web-based cohort study design, with particular interest in evaluating modifiable factors previously identified in the case-control study. Results Self-selected horse/pony owners in GB submitted initial baseline and follow-up health and management questionnaires for 1070 horses/ponies between August 2014 and December 2016. The enrolled horses/ponies contributed 1068 horse-years at risk with a median of 38 days between questionnaire submissions. Owners reported 123 owner-recognised and/or veterinary-diagnosed episodes of active laminitis using a previously-validated laminitis reporting form. Multivariable Cox regression modelling identified 16 risk/protective factors associated with laminitis development. In keeping with the previous case-control study, a prior history of laminitis (particularly non-veterinary-diagnosed episodes), soreness after shoeing/trimming and weight gain were associated with higher rates of laminitis. There is now strong evidence that these risk factors should be used to guide future recommendations in disease prevention. Factors with some prior evidence of association included breed, steroidal anti-inflammatory administration, transport and worming. The modifiable factors amongst these should be the focus of future laminitis studies. The remainder of the identified factors relating to health, turnout and grazing management and feeding are novel, and require further investigation to explore their relationship with laminitis and their applicability as potential interventions. Conclusions This study has demonstrated a temporal relationship between a number of horse- and management-level factors and laminitis, identifying potential interventions and important risk groups for which these interventions would be of particular importance. These results serve as a sound evidence-base towards the development of strategic recommendations for the horse/pony-owning population to reduce the rate of laminitis in GB. Electronic supplementary material The online version of this article (10.1186/s12917-019-1798-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- D Pollard
- Epidemiology Department, Centre for Preventive Medicine, Animal Health Trust, Newmarket, Suffolk, UK. .,Veterinary Epidemiology, Economics and Public Health Group, Pathobiology and Population Sciences, Royal Veterinary College, North Mymms, Hertfordshire, UK.
| | - C E Wylie
- Rossdales Equine Hospital, Exning, Newmarket, UK.,University of Sydney, School of Medical Sciences, Camperdown, Sydney, Australia
| | - K L P Verheyen
- Veterinary Epidemiology, Economics and Public Health Group, Pathobiology and Population Sciences, Royal Veterinary College, North Mymms, Hertfordshire, UK
| | - J R Newton
- Epidemiology Department, Centre for Preventive Medicine, Animal Health Trust, Newmarket, Suffolk, UK
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Laat MA. Science in brief: Progress in endocrinopathic laminitis research: Have we got a foothold? Equine Vet J 2019; 51:141-142. [DOI: 10.1111/evj.13056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 11/22/2018] [Indexed: 12/21/2022]
Affiliation(s)
- M. A. Laat
- Science and Engineering Faculty Queensland University of Technology Brisbane Australia
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Huhmann R, Mueller RS. A cream containing omega‐3‐fatty acids, humectants and emollients as an aid in the treatment of equineCulicoideshypersensitivity. Vet Dermatol 2019; 30:155-e46. [DOI: 10.1111/vde.12728] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Rebecca Huhmann
- Tierarztpraxis am Schlagbaum Am Schlagbaum 2a 59192 Bergkamen Germany
| | - Ralf S. Mueller
- Centre for Clinical Veterinary Medicine LMU Munich Veterinaerstraße 13 80539 Muenchen Germany
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Loeffler A, Herrick D, Allen S, Littlewood JD. Long-term management of horses with atopic dermatitis in southeastern England: a retrospective questionnaire study of owners' perceptions. Vet Dermatol 2018; 29:526-e176. [PMID: 30175879 DOI: 10.1111/vde.12685] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Allergic pruritus and urticaria in the horse are challenging for veterinarians and owners; little is known about their long-term management. OBJECTIVES To summarize intradermal allergen test results (IDT), and to assess owners' perceptions of skin disease and the effects of medical treatment and management changes in their atopic horses over time. ANIMALS Eighty two horses with atopic dermatitis in southeastern England between 2006 and 2011. METHODS AND MATERIALS The IDT results were reviewed retrospectively. Owners completed telephone questionnaires on skin changes, medication, effect of allergen-specific immunotherapy (ASIT) and management. RESULTS Sixty one owners (74.4%) could be contacted, an average of 5.9 years (range 28-88 months) after IDT; of those, three could not be enrolled. Of the 58 remaining horses, eleven (19%) were deceased at the time of owner interview, including four (6.9%) euthanized due to uncontrollable skin disease. The remaining 47 owners reported that the signs of skin disease had not been seen for at least two years in 18 horses (38.3%), including two that only flared with known triggers. Twenty nine horses (61.7%) still required medication to control skin disease although 25 (53.2%) required less since testing. Owners reported benefit from ASIT in nine of 14 horses (64.3%) from glucocorticoids in 33 of 35 (94.3%) and from antihistamines in 17 of 28 (60.7%). Specific management changes were implemented for 22 horses and reported as beneficial in nine of 22 (40.9%). CONCLUSIONS Equine atopic dermatitis may not always be chronic, but severe cases appear difficult to control. IDT may help to formulate ASIT and can help to guide management changes.
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Affiliation(s)
- Anette Loeffler
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hertfordshire, AL9 7TA, UK
| | - Desiree Herrick
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hertfordshire, AL9 7TA, UK
| | - Serena Allen
- Department of Clinical Science and Services, Royal Veterinary College, North Mymms, Hertfordshire, AL9 7TA, UK
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Calzetta L, Rogliani P, Page C, Roncada P, Pistocchini E, Soggiu A, Piras C, Urbani A, Matera MG. Clinical effect of corticosteroids in asthma-affected horses: A quantitative synthesis. Equine Vet J 2018; 50:594-601. [PMID: 29393535 DOI: 10.1111/evj.12815] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 01/10/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND There are limited findings from low-powered studies based on few number of subjects with equine asthma. Furthermore, no studies have been performed to assess a meaningful clinically detectable impact of corticosteroids in equine asthma. OBJECTIVES To assess and compare the clinical effect of inhaled and systemic corticosteroids in equine asthma and identify a quantitative clinical score suitable to assess the Minimal Important Difference (MID), expressed as the Minimally Clinically Detectable Difference (MCDD). STUDY DESIGN Pair-wise and network meta-analysis. METHODS Literature searches for studies on corticosteroid therapy in equine asthma were performed. The risk of publication bias was assessed by Funnel plots and Egger's test. The effect on changes in clinical scores vs. control was analysed via random-effects models and Bayesian networks. RESULTS Corticosteroids significantly improved the clinical condition (Standardised Mean Difference: -1.52, 95% CrI -2.07 to -0.98; P<0.001 vs. control). No difference was detected between inhaled and systemic corticosteroids with regard to the changes in clinical scores (Relative Effect: 0.08, 95% CrI -1.45 to 1.32; P = 0.8). An Improved clinically Detectable Equine Asthma Scoring System (IDEASS) indicated that corticosteroids improved the clinical condition of asthmatic horses by 30% compared with controls (IDEASS value: -2.36, 95% CI -3.39 to -1.33; P<0.001). A one-point change in IDEASS represented the MCDD in equine asthma. MAIN LIMITATIONS Moderate quality of evidence for systemic corticosteroids. CONCLUSIONS Inhaled corticosteroids are effective in improving the clinical condition of horses with equine asthma and prevent exacerbations. Systemic corticosteroids should be used only in selected cases with symptomatic airway hyperresponsiveness during exacerbation. IDEASS requires further validation but may represent a suitable approach to rank the level of asthma severity and assess the clinical effect of pharmacotherapy in horses with equine asthma.
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Affiliation(s)
- L Calzetta
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - P Rogliani
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - C Page
- The Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, London, UK
| | - P Roncada
- Istituto Sperimentale Italiano "Lazzaro Spallanzani", Milan, Italy
| | | | - A Soggiu
- Dipartimento di Medicina Veterinaria, University of Milan, Milan, Italy
| | - C Piras
- Dipartimento di Medicina Veterinaria, University of Milan, Milan, Italy
| | - A Urbani
- Istituto di Biochimica e Biochimica Clinica, Università Cattolica, Rome, Italy
| | - M G Matera
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
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Leclere M. Corticosteroids and Immune Suppressive Therapies in Horses. Vet Clin North Am Equine Pract 2017; 33:17-27. [PMID: 28325178 DOI: 10.1016/j.cveq.2016.11.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Immune suppressive therapies target exaggerated and deleterious responses of the immune system. Triggered by exogenous or endogenous factors, these improper responses can lead to immune or inflammatory manifestations, such as urticaria, equine asthma, or autoimmune and immune-mediated diseases. Glucocorticoids are the most commonly used immune suppressive drugs and the only ones supported by robust evidence of clinical efficacy in equine medicine. In some conditions, combining glucocorticoids with other pharmacologic and nonpharmacologic treatments, such as azathioprine, antihistamine, bronchodilators, environmental management, or desensitization, can help to decrease dosages and associated side effects.
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Affiliation(s)
- Mathilde Leclere
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, 3200 Sicotte, St-Hyacinthe, Quebec J2S 7C6, Canada.
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Mora Pereira M, Groover E, Wooldridge A, Caldwell F. Review of glucocorticoid therapy in horses. Part 2: Clinical use of systemic glucocorticoids in horses. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12624] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- M. Mora Pereira
- J. T. Vaughan Large Animal Teaching Hospital; Auburn University; Alabama USA
| | - E. Groover
- J. T. Vaughan Large Animal Teaching Hospital; Auburn University; Alabama USA
| | - A. Wooldridge
- J. T. Vaughan Large Animal Teaching Hospital; Auburn University; Alabama USA
| | - F. Caldwell
- J. T. Vaughan Large Animal Teaching Hospital; Auburn University; Alabama USA
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Wright S. Highlights of recent clinically relevant papers. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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