title: Does oral prednisolone treatment increase the incidence of acute laminitis?
abstract: BACKGROUND
  It is accepted among equine practitioners that glucocorticoid treatment is a risk factor for the development of laminitis. However, there is little published evidence of a link between glucocorticoids and laminitis.
  
  
  OBJECTIVE
  To determine whether horses receiving oral prednisolone are at increased risk of laminitis.
  
  
  METHODS
  Retrospective case-control study.
  
  
  METHODS
  Clinical records of horses registered with the ambulatory service at Liphook Equine Hospital between January 2001 and November 2014 were reviewed retrospectively to identify horses that had received treatment with oral prednisolone. For each treated horse, 2 time-matched controls that received veterinary attention but were not treated with prednisolone were selected. Incidence of laminitis was compared between the 2 groups and factors associated with laminitis were assessed using Cox regression analysis.
  
  
  RESULTS
  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. 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.
  
  
  CONCLUSIONS
  Administration of oral prednisolone did not increase the risk of laminitis.
authors.affiliation: Liphook Equine Hospital, Liphook, Hampshire, UK.
authors.forename: V J
authors.initials: VJ
authors.lastname: Jordan
authors.affiliation: The Animal Health Trust, Newmarket, Suffolk, UK.
authors.forename: J L
authors.initials: JL
authors.lastname: Ireland
authors.affiliation: Rainbow Equine Hospital, Rainbow Farm, Old Malton, North Yorkshire, UK.
authors.forename: D I
authors.initials: DI
authors.lastname: Rendle
mesh_terms: D000284:Administration, Oral; D000818:Animals; D016022:Case-Control Studies; D005534:Foot Diseases / Q000139:chemically induced / Q000662:veterinary*; D006724:Hoof and Claw / Q000473:pathology*; D006734:Horse Diseases / Q000139:chemically induced*; D006736:Horses; D015994:Incidence; D007249:Inflammation / Q000139:chemically induced / Q000662:veterinary*; D011239:Prednisolone / Q000009:adverse effects*; D012189:Retrospective Studies
chemical_list: D011239:Prednisolone
keywords: equine metabolic syndrome; glucocorticoids; horse; insulin; pituitary pars intermedia dysfunction