Research Explores Safer Steroid Use in Horses

By Blake Jackson

Joint injections containing corticosteroids like triamcinolone acetonide are widely used by veterinarians to relieve joint pain and inflammation in horses.

Although administered directly into a joint, these medications can affect the body more broadly, sometimes causing temporary increases in blood glucose and insulin levels. Because elevated insulin is closely linked to laminitis, a painful and potentially devastating hoof condition researchers are exploring ways to reduce that risk.

Scientists at the Martin-Gatton College of Agriculture, Food and Environment, working through the Maxwell H. Gluck Equine Research Center, investigated whether ertugliflozin could help control insulin spikes following joint injections.

Ertugliflozin belongs to a class of medications known as SGLT2 inhibitors, commonly prescribed to people with Type II diabetes to lower blood sugar by promoting glucose excretion through urine.

“Corticosteroids injections are an important option for managing joint pain and inflammation, but we also have to realize that they may have effects beyond the joint,” said Allen Page, DVM, assistant professor of equine health and inflammation.

“Treatment of only a single joint can affect blood sugar and insulin concentrations, and that’s where laminitis risk becomes part of the conversation.”

The study involved eight healthy geldings that received corticosteroid injections alone during one phase and, in another phase, were given ertugliflozin for a week before and after the injections. Horses treated with ertugliflozin experienced smaller increases in blood sugar and insulin, and no adverse effects were observed.

“Our results suggest ertugliflozin can blunt the temporary glucose and insulin changes we see after a joint injection with triamcinolone,” Page said. “This study was in healthy horses, but it gives us a starting point to explore whether this approach could help horses that are at higher risk for laminitis.”

“Going into this study, we were not sure what we were going to find,” Page said. “It’s clear that we need to expand this research into horses with elevated insulin and see if ertugliflozin may decrease the risk for laminitis in this important portion of the equine population.”

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