Steriod induced laminitis

S

Sandstone1

Well-Known Member
Joined
16 July 2010
Messages
8,969
Visit site
Does anyone have any experience of this please? Is it worse than normal lami and should the vet use this drug on a horse who has already had laminitis?
 
im not quite sure what you are asking and have no experience personally so my post is probably useless but in people steriods are known to raise blood sugars in patients with diabetes so i presume they would raise blood sugars in horses in a similar way thus possibly explaining why they would get laminitis? just guessing though as i might be way off!
 
Horse who have suffered laminitis should not be treated with steriods unless there are no other treatment options.

The veterinary world in devided about whether or not steriod can induce laminitis.. But I am certain, in my own mind (the mind of a farrier) that they can!

Discontinue treatment. Box rest on a thick shavings bed (offers more support than straw)
Feed water and hay and the horse should be given NSAIDs (non-steriodal anti-inflammatories) like Bute or Danilon.

Lou x
 
will my experiance yes steriods can induce laminitis, i had a horse that had steriod injections and my vet would never allow her to have the injections if she was too over weight as the steriods would induce laminitis!
hope that helps a little bit!
 
A horse on our yard was pts earlier in the year with steroid-induced lami. It was scary, came on so quick, the horse had never noticeably suffered from lami but was on the heavy side with a cresty neck so perhaps steroids should have been avoided (it wasn't life or death treatment by any stretch of the imagination). Once the lami started it just got slowly but surely worse & worse over a number of weeks despite everything being done that could be. In the end the hoof walls started to shed & pedal bones were coming through. I would be very, very cautious about administering steroids as anything other than a last resort after watching what happened to this poor horse :(
 
My horse Sunny is just facing this. I posted just a week ago so it might help if you look up my post (vets + NL). This is what the vets explained: the laminae in the hoof are releasing and re-attaching constantly, otherwise the hoof couldn't grow slowly downwards. There are 2 main problems with steroids. The 1st is that the steroid causes an enzyme imbalance so that the releasing of the laminae happens faster than the re-attaching so the laminae start to become loose. The 2nd problem can follow this: crudely speaking the entire weight of the horse is carried by the laminae - the horse is "suspended" inside the hoof - so when they start to become unattached, an overweight horse's weight will more damage than if he was lighter. So yes, giving steroids to a horse can cause laminitis. You can have a starvation blood test done to check whether your horse has insulin resistance or EPMS which adds a further complication - an IR horse would be a higher risk for laminitis. But here's the good(ish) news - most posters replied to me with positive experiences. And my equine vets have been in practice for many years and have had to prescribe steroids many times. And they have never had a case of laminitis.

Mind you, if Sunny already had laminitis the picture would be very different. My belief is that if the treatment is worse than the illness then it's not an option. For Sunny, there are no other options - to be blunt, it is palliative care now. I guess many horses prescribed steroids have no other options. I think you need to talk it over very carefully with your vets. Ask them for complete honesty and no sugar coating. I've been advised that the horse will respond better to steroids if they're given in the morning but I can't remember if that's because the circadian rhythm helps them be more effective or if it makes laminitis less likely because it mimics the body's own natural steroid production. Good luck hun x
 
itsmylife said:
Does anyone have any experience of this please? Is it worse than normal lami and should the vet use this drug on a horse who has already had laminitis?
Click to expand...

Laminitis is laminitis. It is the same condition despite the underlying cause. The laminitis itself can be a hugely varying degrees of severity, but ultimately it is the same condition and is predominantly treated in the same way. (Obviously with the exception of the approach to correct/remove the underlying cause). So no, it's not worse because its steroid induced.

Vets will make a decision on whether to use steroids in each case on the basis of the condition they are treating. If the particular condition in question (e.g. RAO, auto-immune disease) require that drug to make it better, then yes, the vet should use them IMO.

BUT

I believe in this situation, owners should have the drugs effects (good and bad) fully explained, including any of the possible side-effects.

Laminitis secondary to steroid administration has been well researched and is always overly publicised in the media IMO. There is not really a great debate as to whether it can occur, I think vets a mostly agreed it is a risk. BUT the more debated point is about the type of steroid given and the critical thing, what doses could induce laminitis.

kez1001 said:
...u are asking and have no experience personally so my post is probably useless but in people steroids are known to raise blood sugars in patients with diabetes so i presume they would raise blood sugars in horses in a similar way thus possibly explaining why they would get laminitis?...
Click to expand...

The link between Cushings and laminitis is well known, as we attribute that in the main to an increase in the level of circulating endogenous steroids (i.e. those that the body produces itself). Exogenous steroids (i.e. those we administer) are slightly different in their make up. These as a rule, do not work in quite the same way. Here lies the confusion and subsequent grey area. As such, I think we have still been unable to induce clinical laminitis during research by using exogenous steroids...but there are cases in practice where the drug administration has been deemed to be the inciting cause.

Box_Of_Frogs said:
But here's the good(ish) news - most posters replied to me with positive experiences. And my equine vets have been in practice for many years and have had to prescribe steroids many times. And they have never had a case of laminitis.
Click to expand...

Box of frogs, I read your post with interest and I'm not sure I agree with all the details but the science is almost irrelevant here and gets very confusing IMO. But I would concur with the above quote.

I personally have used steroids in practice when necessary and fortunately without complication. I know of cases that are put under scrutiny have the steroids administered have been blamed for subsequent laminitis.

I try to stick by these rules when prescribing steroids - does the condition I am treating required them to improve? If so, then move on to....which steroid am I giving and at what dose? I, and I'm sure most would go for the minimum dose required to be effective. Have I discussed the risks in full? If all of these questions are answered appropriately then I would use steroids, regardless of previous laminitic history.

In my experience, I have seen laminitis following an over dose of one particular type of steroid used. I have not seen it following the steroid I use for RAO, auto-immune disease, skin problems, etc. That's not to say it can't happen, I just happen to think it's very rare where common sense is employed but the vets and owners.

For example, I advise that cases given steroids have their weight watched and I'm more aware of other factors predisposing towards laminitis. I think of all the causal factors as a sliding risk scale...

If the horse is obese, on lush grass all day and night, has little work, has had laminitis previously and now steroids are indicated, I would deem that to be a high risk case. If I had to use them I would, but I'd address all the other factors at the same time as far as possible...i.e. diet, remove from that grazing, start gradual increase of exercise is the condition permits etc.

If a slim, thoroughbred, in medium work, with a good body condition score and no previous history of laminitis needs them, then discussions take place as above but this horse in my mind is probably lower risk.

In any case, if you are unfortunate enough to see a laminitis case subsequent to steroids. STOP steroid treatment immediately, having contacted the vet. And start all the usual treatments for laminitis, ddep bed, box rest, NSAIDs, poss ACP etc etc.

It's rare, it could happen, be careful and if worried discuss with your vet before starting treatment. I believe in careful hands, you are unlikely to have a problem.

I was unfortunate enough to deal with a sinking laminitic once who had a concurrent auto-immune disease that was potentially fatal. We had no choice but to give this active laminitis case steroids. The auto-immune disease got better, the laminitis also got better and did not get worse at all while of the steroids. We remained terrified throughout treatment to be fair, but I'm glad I tried it as she's now in full work again with no lameness. That happens once in a lifetime and we monitored her like a hawk. I wouldn't do it if I didn't have to, but it can be done successfully, and I'd do it again if I had to!

Hope that allays some fears.:o
Imogen
 
Thanks, Only asking as someone I know has a horse that has had laminitis in the past but may be having a steriod injection for hind leg lameness. I would be worried by this myself, but I think they are going ahead with it.
 
You must log in or register to reply here.
Top