Does oral prednisolone treatment increase the incidence of acute laminitis?

Many equine practitioners believe that it does; however, there is little published evidence that links glucocorticoids and laminitis. In a retrospective case-control study, researchers from the United Kingdom determined that administration of oral prednisolone did not increase the risk of laminitis.

The researchers reviewed clinical records of horses registered with the ambulatory service at Liphook Equine Hospital from January 2001 and November 2014 to identify horses that had received treatment with oral prednisolone. For each horse, two time-matched controls that received veterinary attention, but were not treated with prednisolone, were selected. The researchers compared the incidence of laminitis between the two groups, and factors associated with laminitis were assessed using Cox regression analysis.

“Of the 416 horses treated with prednisolone, 16 (3.8%) were diagnosed with laminitis subsequent to the initiation of prednisolone treatment with an overall incidence of 2.60 (95% CI 1.49–4.22) cases per 100 horse-years at risk,” the researchers wrote. “A total of 7 horses (1.7%) developed laminitis during the course of their treatment and 3 (0.7%) of the horses treated with prednisolone were ultimately subjected to euthanasia as a result of laminitis. A total of 46 (5.7%), of the 814 time-matched control horses were diagnosed with laminitis during the study period with an overall incidence of 3.46 (95% CI 2.54–4.62) cases per 100 horse-years at risk.

“Of these, 12 (1.5%) were subjected to euthanasia as a result of laminitis. There were no significant differences in the overall laminitis incidence rate (P = 0.8), incidence rate during prednisolone treatment (P = 0.09), or probability of laminitis (P = 0.3) between the 2 groups. Mean survival time was greater in the prednisolone than the control group. Equine metabolic syndrome and increasing age were associated with increased risk of laminitis.”

Jordan, V. J., Ireland, J. L. and Rendle, D. I. (2017), Does oral prednisolone treatment increase the incidence of acute laminitis?. Equine Vet J, 49: 19–25. doi:10.1111/evj.12565