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Menzies-Gow NJ, Knowles EJ. Sodium-glucose transport protein 2 inhibitor use in the management of insulin dysregulation in ponies and horses. J Vet Pharmacol Ther 2024. [PMID: 38984777 DOI: 10.1111/jvp.13470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 05/28/2024] [Accepted: 06/26/2024] [Indexed: 07/11/2024]
Abstract
Laminitis is a common and painful condition of the equine foot and approximately 90% of cases are associated with insulin dysregulation (ID) that is a central feature of the common endocrine disorder equine metabolic syndrome (EMS) and occurs in a subset of animals with pituitary pars intermedia dysfunction. Additional features of EMS include obesity, altered circulating concentrations of adipokines (particularly adiponectin and leptin) and hypertriglyceridaemia. Obesity, ID, hypoadiponectinaemia, hyperleptinaemia and an altered plasma lipid profile are also features of human metabolic syndrome (HMS) alongside hyperglycaemia. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a novel class of oral hypoglycaemic agents used in combination with lifestyle changes in the management of HMS. SGLT2 receptors are responsible for 90% of the renal glucose reabsorption that occurs in the proximal convoluted tubule. Thus, these drugs increase urinary glucose excretion by suppressing glucose reabsorption from the glomerular filtrate resulting in urinary calorie loss with consequent weight loss and improvements in ID, hyperglycemia, hypoadiponectinaemia and hyperleptinaemia. There are no licenced veterinary drugs available for treating ID and preventing insulin-associated laminitis in horses. Thus, the use of SGLT2i for the control of equine hyperinsulinaemia with the goal of improving recovery from associated active laminitis or preventing future laminitis has recently been advocated. There are a small number of published studies reporting the use of the SGLT2i canagliflozin, ertugliflozin and velagliflozin to aid the management of equine ID. However, the doses used are largely extrapolated from human studies with limited consideration of species-specific variations. In addition, there is limited evaluation of the fundamental differences between ID in horses and humans, particularly the fact that most horses with ID remain hyperinsulinaemic but normoglycaemic such that increased urinary loss of glucose may not explain the beneficial effects of these drugs. Further study of the potential deleterious effects of treatment-associated hypertriglyceridaemia is required together with the effect of SGLT2i therapy on circulating concentrations of adipokines in horses.
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Affiliation(s)
- Nicola J Menzies-Gow
- Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, UK
| | - Edward J Knowles
- Department of Clinical Science and Services, Royal Veterinary College, Hertfordshire, UK
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Hallowell KL, Dembek K, Horne CR, Knych HK, Messenger KM, Schnabel LV. Systemic absorption of triamcinolone acetonide is increased from intrasynovial versus extrasynovial sites and induces hyperglycemia, hyperinsulinemia, and suppression of the hypothalamic-pituitary-adrenal axis. Front Vet Sci 2024; 11:1388470. [PMID: 38828366 PMCID: PMC11141165 DOI: 10.3389/fvets.2024.1388470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/01/2024] [Indexed: 06/05/2024] Open
Abstract
Steroid-associated laminitis remains a major concern with use of corticosteroids in horses. Individual case factors such as joint pathology, pre-existing endocrinopathies, or corticosteroid type, dose, and timing influencing steroid-induced laminitis risk have not been investigated. This study aimed to determine if systemic absorption of triamcinolone acetonide (TA) varies between intrasynovial (antebrachiocarpal) and extrasynovial (sacroiliac) injection sites, and to determine the effects of TA absorption on glucose, insulin, cortisol, and adrenocorticotropic hormone (ACTH). Twenty adult horses were randomized into antebrachiocarpal or sacroiliac joint injection groups, and each horse received bilateral injections with a total dose of 18 mg triamcinolone. Blood was collected prior to injection and at 1, 2, 4, 6, 8, 10, 12, 16, 20, 24, 36, 48, 60, and 72 h post-injection. Peak TA absorption occurred at 8 h in both groups, and was significantly higher in the intrasynovial group compared to the extrasynovial group (1.397 ng/mL, 0.672 ng/mL, p < 0.05). Plasma TA levels were significantly higher in the intrasynovial group from 8 to 36 h post-injection (p < 0.05). There was no difference in glucose, insulin, cortisol, or ACTH between groups at any time point. Insulin and glucose were significantly increased from baseline at all timepoints from 10-72 h and 1-72 h post-injection, respectively. Horses with elevated baseline insulin values (>20 μU/mL) from both groups experienced a more marked hyperinsulinemia, reaching a mean peak insulin of 197.5 μU/mL as compared to 90.06 μU/mL in those with normal baseline insulin. Cortisol and ACTH were significantly decreased from baseline at timepoints from 4-72 h post-injection in both groups. This study is the first to evaluate drug absorption from the sacroiliac site and demonstrates that drug absorption varies between intrasynovial and extrasynovial injection sites. TA absorption causes metabolic derangements, most notably a marked hyperinsulinemia that is more severe in horses with elevated baseline insulin values. The influence of baseline endocrinopathies on response to corticosteroid administration as well as the effect of corticosteroid-induced metabolic derangements warrant further investigation as risk factors for corticosteroid-associated laminitis.
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Affiliation(s)
- Kimberly L. Hallowell
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| | - Katarzyna Dembek
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| | - Caitlyn R. Horne
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| | - Heather K. Knych
- K. L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine, University of California-Davis, Davis, CA, United States
| | - Kristen M. Messenger
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, United States
| | - Lauren V. Schnabel
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, United States
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3
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Boger BL, Manfredi JM, Loucks AR, Salamey MZ, Kapeller LE, Fricano AG, Winkler A, Yob C, Colbath AC. Intra-articular triamcinolone acetonide injection results in increases in systemic insulin and glucose concentrations in horses without insulin dysregulation. Equine Vet J 2024; 56:326-331. [PMID: 37705233 DOI: 10.1111/evj.14003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/25/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Corticosteroids are a commonly used, inexpensive intra-articular treatment for osteoarthritis which may increase the risk for laminitis in horses due, in part, to hyperinsulinaemia. Humans with metabolic syndrome experience increases in insulin and glucose concentrations post-injection, but responses in horses are unknown. OBJECTIVES To determine the effect of a single intra-articular (IA) dose of triamcinolone acetate (TA) on blood insulin and glucose concentrations. STUDY DESIGN Before-after study. METHODS Ten horses with normal insulin regulation as assessed by an oral sugar test received 18 mg of TA into one middle carpal joint. Insulin and glucose concentrations were evaluated at baseline and 4, 6, 8, 24, 48, and 72 h following IA corticosteroid injection. Differences from baseline were evaluated using a repeated measures ANOVA with Dunnett's multiple comparison testing or a Friedman test with Dunn's correction (significant at p < 0.05). RESULTS Mean ± SD blood insulin concentration post IA TA injection was increased at 6 h (15.8 ± 3.1 μIU/mL, p = 0.01), 24 h (23 ± 5.8 μIU/mL, p ≤ 0.001), and 48 h (29 ± 13 μIU/mL, p ≤ 0.01) compared to baseline (10 ± 12.3 μIU/mL), with the peak at 48 h. Median ± 95% CI blood glucose concentration post IA TA injection was increased at 6 h (112.7 ± 20.3 mg/dL, p = 0.006), 8 h (112.9 ± 21.4 mg/dL, p = 0.004), 24 h (122.6 ± 14.6, p ≤ 0.0001), and 48 h (123.5 ± 15.4 mg/dL, p ≤ 0.0001) compared to baseline (89.2 ± 6.6 mg/dL), with the peak at 48 h. MAIN LIMITATIONS Only horses with normal insulin regulation were evaluated. CONCLUSIONS Blood insulin and glucose concentrations modestly increased for 48 h following IA TA.
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Affiliation(s)
- Brooke L Boger
- Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Jane M Manfredi
- Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Abigail R Loucks
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Maya Z Salamey
- Department of Animal Science, College of Agriculture and Natural Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Lydia E Kapeller
- Department of Animal Science, College of Agriculture and Natural Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Allie G Fricano
- Department of Animal Science, College of Agriculture and Natural Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Ani Winkler
- Department of Biochemistry and Molecular Biology, College of Agriculture and Natural Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Chelsey Yob
- Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Aimee C Colbath
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
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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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Tokawa PKA, Baccarin RYA, Zanotto G. Systematic review of the association between intrasynovial corticosteroid use and laminitis—What is the evidence? EQUINE VET EDUC 2023. [DOI: 10.1111/eve.13757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Paula Keiko Anadão Tokawa
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science University of São Paulo São Paulo Brazil
| | - Raquel Yvonne Arantes Baccarin
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science University of São Paulo São Paulo Brazil
| | - Gustavo Zanotto
- Large Animal Clinical Sciences Department, College of Veterinary Medicine and Biomedical Sciences Texas A&M University College Station Texas USA
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Pituitary Pars Intermedia Dysfunction (PPID) in Horses. Vet Sci 2022; 9:vetsci9100556. [PMID: 36288169 PMCID: PMC9611634 DOI: 10.3390/vetsci9100556] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/25/2022] [Accepted: 10/04/2022] [Indexed: 12/12/2022] Open
Abstract
Substantial morbidity results from pituitary pars intermedia dysfunction (PPID) which is often underestimated by owners and veterinarians. Clinical signs, pathophysiology, diagnostic tests, and treatment protocols of this condition are reviewed. The importance of improved recognition of early clinical signs and diagnosis are highlighted, as initiation of treatment will result in improved quality of life. Future research should be targeted at improving the accuracy of the diagnosis of PPID, as basal adrenocorticotropic hormone (ACTH) concentration can lack sensitivity and thyrotropin releasing hormone (TRH) used to assess ACTH response to TRH stimulation is not commercially available as a sterile registered product in many countries. The relationship between PPID and insulin dysregulation and its association with laminitis, as well as additional management practices and long-term responses to treatment with pergolide also require further investigation.
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Boorman S, McMaster MA, Groover E, Caldwell F. Review of glucocorticoid therapy in horses: Intra‐articular corticosteroids. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13719] [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)
- Sophie Boorman
- College of Veterinary Medicine Auburn University Auburn Alabama USA
| | - Mattie A. McMaster
- College of Medical, Veterinary and Life Sciences University of Glasgow Glasgow UK
| | - Erin Groover
- College of Veterinary Medicine Auburn University Auburn Alabama USA
| | - Fred Caldwell
- College of Veterinary Medicine Auburn University Auburn Alabama USA
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Cantatore F, Marcatili M, Withers J. 'First case of Stiff-horse syndrome in United Kingdom'. J Equine Vet Sci 2022; 116:104022. [PMID: 35649492 DOI: 10.1016/j.jevs.2022.104022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/17/2022] [Accepted: 05/21/2022] [Indexed: 11/26/2022]
Abstract
Stiff-person syndrome is a well-recognised disease in humans, whilst cases of stiff-horse syndrome (SHS) have been rarely reported in the veterinary medicine literature. SHS is a progressive immunomediated disorder of the central nervous system leading to a disturbance of gamma amino butyric acid (GABA) transmission at the neuromuscular junction in which antibodies are produced against the enzyme glutamic acid decarboxylase (GAD). A 6 year-old Irish Sport Horse was presented for investigation of involuntary violent contraction of hindlimb and back muscles triggered by stress. The diagnosis of SHS was made after elevated anti-GAD antibodies titres were detected in the horse's serum. Administration of oral corticosteroids (prednisolone 0.75 mg/kg bwt) resulted in resolution of the clinical signs. However, reoccurrence of clinical signs was observed after the dose of corticosteroids was reduced or the treatment discontinued. To the best of the authors' knowledge this is the first reported case of SHS in United Kingdom. Considering the potential implications on the horses' welfare, further investigation on SHS pathogenesis and treatment are warranted.
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Affiliation(s)
- Federica Cantatore
- Pool House Equine Clinic, Fradley, Lichfield, Staffordshire, United Kingdom.
| | - Marco Marcatili
- Pool House Equine Clinic, Fradley, Lichfield, Staffordshire, United Kingdom.
| | - Jonathan Withers
- Pool House Equine Clinic, Fradley, Lichfield, Staffordshire, United Kingdom.
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9
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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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10
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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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11
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Duggan M, Mair T, Fews D. Equine limb cellulitis/lymphangitis resulting in distal limb ischaemia and avulsion of the hoof capsule. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13570] [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)
- M. Duggan
- Bell Equine Veterinary Clinic Maidstone UK
- University College Dublin Dublin Ireland
| | - T. Mair
- Bell Equine Veterinary Clinic Maidstone UK
| | - D. Fews
- Finn Pathologists Harleston UK
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12
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Menzies-Gow NJ, Wakeel F, Little H, Buil J, Rickards K. Cross-sectional study to identify the prevalence of and factors associated with laminitis in UK donkeys. Equine Vet J 2021; 54:757-765. [PMID: 34478179 DOI: 10.1111/evj.13505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 07/21/2021] [Accepted: 08/19/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Laminitis causes lameness in donkeys, but its prevalence and factors associated with disease remain uncertain. OBJECTIVES To determine the prevalence of and identify factors associated with laminitis in donkeys. STUDY DESIGN Retrospective cross-sectional study. METHODS All donkeys at the Donkey Sanctuary, UK, October 2015 to March 2019 were included. For animals that had laminitis during this period, age, sex, weight, body condition score, and the onset date and type of each episode (first or recurrent, acute or chronic) were recorded. Additionally, management data, foot lesion score, endocrine data, other medical conditions, occurrence of foot trimming, surgical procedures, diagnostic imaging, behavioural modification therapy or movement between farms within the month prior were noted. Controls were animals that did not experience laminitis during this period and similar data were recorded. Multivariable logistic regression modelling assessed the differences between the control group and laminitis outcome groups (first, all laminitis, acute and chronic episodes). RESULTS Altogether, 707 animals were included; 364 were control animals; 343 had a first episode of laminitis during the study period, of which 200/343 had no further episodes and 143/343 had recurrent episodes resulting in a total of 512 laminitis episodes and the period prevalence was 48.5% over 42 months. Overall, 180/512 (35%) laminitis episodes were acute and 332/512 (65%) were chronic. Compared with control animals, the laminitic outcome groups were significantly (P < .05) more likely to be younger (first episode), less likely to get extra feed (all four groups) or have an additional medical problem (first episode), and less likely to have undergone dental work, movement, imaging (all four groups) or surgery (first; all laminitis, chronic episodes) in the month preceding the episode. MAIN LIMITATIONS These results may not be applicable to the wider donkey population. CONCLUSIONS Laminitis commonly affects donkeys, but factors associated with donkey laminitis differ from those reported in horses.
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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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14
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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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15
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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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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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