The Effects of Intra-Articular Triamcinolone and Autologous Protein Solution on Metabolic Parameters in Horses.
Authors: Page Allen E, Johnson Mackenzie, Parker Jordan L, Jacob Olivia, Poston Rachel, Adams Amanda A, Adam Emma N
Journal: Animals : an open access journal from MDPI
Summary
# Editorial Summary Intra-articular triamcinolone acetonide (TA) remains widely used in equine practice for managing joint inflammation and pain, yet its systemic metabolic effects warrant closer scrutiny, particularly when metabolic screening is clinically indicated. Researchers administered either saline, autologous protein solution (APS), or 9 mg TA into the metacarpophalangeal joints of five geldings across three consecutive 28-day blocks, measuring plasma and serum hormones (ACTH, cortisol, baseline and stimulated via thyrotropin-releasing hormone challenge), glucose, insulin, and thyroid function at multiple timepoints over 96 hours. TA induced significant suppression of baseline ACTH and cortisol between 2 and 96 hours post-injection, whilst also triggering hyperglycaemia (12–48 hours) and hyperinsulinaemia (at 32 hours); notably, both the TRH challenge and oral sugar test showed significant treatment effects at 48 hours post-injection, whereas APS produced no measurable metabolic disturbance and thyroid hormones remained unaffected by either treatment. For practitioners integrating metabolic testing into diagnostic protocols—whether assessing insulin dysregulation or investigating Cushing's disease—a minimum washout period of 2 to 7 days should separate TA injection from oral sugar testing or TRH stimulation to avoid treatment-induced false positives. These findings distinguish TA's metabolic footprint from emerging biologics like APS, reinforcing the importance of coordinating intra-articular treatments with the timing of any metabolic investigations.
Read the full abstract on PubMed
Practical Takeaways
- •Wait at least 2-7 days after intra-articular triamcinolone injection before performing oral sugar tests or TRH stimulation tests for metabolic screening, as the drug significantly alters baseline ACTH, cortisol, and glucose metabolism
- •Triamcinolone acetonide causes acute metabolic changes including elevated insulin and glucose; this should be considered when treating horses with concurrent metabolic concerns or insulin dysregulation
- •Autologous protein solution may be a metabolically safer alternative for intra-articular joint treatment in horses where metabolic stability is a clinical concern
Key Findings
- •Intra-articular triamcinolone acetonide (9 mg) caused significant suppression of ACTH and cortisol for 2-96 hours post-injection
- •Triamcinolone induced hyperglycemia (12-48 h) and hyperinsulinemia (32 h post-treatment)
- •Triamcinolone significantly affected thyrotropin-releasing hormone and oral sugar test responses at 48 hours post-injection
- •Autologous protein solution produced no significant metabolic effects on any measured parameters