Intrasynovial triamcinolone treatment is not associated with incidence of acute laminitis.

Authors: Haseler Callum J, Jarvis Gavin E, McGovern Kate F

Journal: Equine veterinary journal

DOI: 10.1111/evj.13361 PubMed: 33174264Log in to save

Summary

# Intrasynovial Triamcinolone and Acute Laminitis Risk: New Evidence from Clinical Practice Intrasynovial corticosteroid injections represent a cornerstone of equine orthopaedic management, yet clinicians have long harboured concerns about laminitis as a potential adverse effect, supported mainly by anecdotal reports rather than robust epidemiological data. Haseler and colleagues conducted a case-control study to quantify the actual risk of acute laminitis following intrasynovial triamcinolone administration, addressing a significant gap in the evidence base. Their findings revealed no significant association between intrasynovial corticosteroid treatment and the development of acute laminitis, contradicting the widely held assumption that these injections substantially elevate laminitis risk. This result has important implications for clinical decision-making: farriers and veterinarians can reassure owners that joint injections themselves are not a primary laminitis trigger, though attention to concurrent systemic risk factors (metabolic disease, infection, dietary factors) remains essential. The evidence suggests that steroid-induced laminitis, while documented in case reports, appears sufficiently rare in standard orthopaedic practice that it should not routinely deter use of intrasynovial corticosteroids in appropriately selected patients.

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Practical Takeaways

•Intrasynovial corticosteroid injections can be used to treat joint disease without fear of precipitating acute laminitis based on current evidence
•The common perception that steroid injections are a major laminitis risk factor is not supported by this study, allowing more confident clinical decision-making regarding their use
•Clinicians should continue to monitor injected horses for laminitis but need not avoid this treatment modality solely based on steroid-related laminitis concerns

Key Findings

•Intrasynovial triamcinolone injection is not associated with increased incidence of acute laminitis
•No case-control or cohort studies had previously investigated the relationship between intrasynovial corticosteroids and laminitis development despite widespread concern

Conditions Studied

acute laminitisequine orthopaedic diseasesynovial joint disease

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