Clinical Research Abstracts of the British Equine Veterinary Association Congress 2015.
Authors: Hammersley E, Duz M, Marshall J F
Journal: Equine veterinary journal
Summary
# Editorial Summary: Triamcinolone and Laminitis Risk in Equine Practice Concerns about triamcinolone-induced laminitis have long influenced clinical decision-making in equine orthopaedic practice, yet robust evidence quantifying this risk has remained elusive. Hammersley and colleagues conducted a retrospective analysis of 225,777 clinical records from nine North American equine practices, using text-mining software to identify horses treated with triamcinolone (n=27,898) and age-matched controls (n=56,695), tracking laminitis development within 90 days of administration or a comparable timeframe. Remarkably, laminitis occurred in only 0.07% of triamcinolone-treated horses compared with 0.2% in controls, yielding a significantly protective association (odds ratio 0.3, 95% CI 0.18–0.48). These findings substantially challenge the prevailing perception of triamcinolone as a laminitis risk factor, though the authors appropriately flag that investigating the 20 cases that did develop laminitis could reveal specific patient or administration variables warranting clinical caution. For practitioners weighing intra-articular or systemic corticosteroid use against orthopaedic benefit, this evidence provides reassurance that triamcinolone itself does not appear to materially increase laminitis risk at population level, though individualised risk assessment based on concurrent metabolic or mechanical factors remains prudent.
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Practical Takeaways
- •Triamcinolone can be used for orthopaedic conditions without significantly increasing laminitis risk based on current evidence
- •The feared association between triamcinolone and laminitis is not supported by this large retrospective analysis, though individual risk factors in the 20 affected horses warrant investigation
- •Evidence-based treatment guidelines for triamcinolone use in equine practice can be developed with greater confidence in its safety profile
Key Findings
- •Overall laminitis prevalence in the database was 1.1% (2,533 horses)
- •Only 0.07% of triamcinolone-treated horses (20/27,898) developed laminitis within 90 days
- •Laminitis risk was significantly lower in triamcinolone-treated horses compared to controls (OR 0.3, 95% CI 0.18-0.48, P<0.001)
- •Triamcinolone administration does not increase overall risk of laminitis development