During the 2025 American Association of Equine Practitioners Convention, Erin Contino, DVM, MS, DACVSMR, Associate Professor of Equine Sports Medicine at Colorado State University, provided insights into the latest information regarding intra-articular therapies, including corticosteroids. She described two studies assessing the effects of intra-articular triamcinolone (TA) on normal horses and how that could potentially impact horses with metabolic issues.
IA TA Increases Insulin and Glucose Concentrations in Healthy Horses
In this study, 10 horses without insulin dysregulation had a joint injected with 18 mg TA. The research team monitored them for 72 hours and reported elevated insulin levels at 6, 24, and 48 hours with a peak of 29 uIU/ml at 48 hours. They concluded that TA does affect systemic levels of insulin concentration in normal horses.1
The Effects of IA TA and APS on Horses’ Metabolic Parameters
In another study, researchers compared the effects of 9 mg intra-articular triamcinolone and autologous protein solution (APS) on the metabolic parameters of normal horses. In TA-treated horses, insulin concentrations increased by 36 hours and remained so for about five days. Insulin did not increase in APS-treated horses. The TA group also showed significant decreases in ACTH at four hours, which lasted for four days.
Take-Home Message
A 9 mg dose of triamcinolone increased insulin levels in normal horses. While the effects on horses with insulin dysregulation still needs to be investigated, TA might not be safe for use in any horse with metabolic dysfunction. Because a horse’s phenotype (e.g., cresty neck or high body condition score) is not always predictive of laminitis risk, practitioners should perform insulin testing prior to treating a horse’s joints with triamcinolone.
Sports medicine coverage from the 2025 AAEP Convention is brought to you by Dechra.
References
- Boger BL, et al. Intra-articular triamcinolone acetonide injection results in increases in systemic insulin and glucose concentrations in horses without insulin dysregulation. Equine Vet J. 2024 Mar;56(2):326-331. doi: 10.1111/evj.14003.
- Page AE, Johnson M, Parker JL, Jacob O, Poston R, Adams AA, Adam EN. The Effects of Intra-Articular Triamcinolone and Autologous Protein Solution on Metabolic Parameters in Horses. Animals (Basel). 2024 Aug 2;14(15):2250. doi: 10.3390/ani14152250.
Related Reading
- Improving Equine Rehab Outcomes Through Better Owner Adherence
- How Endocrine Disorders Impact Equine Athletes
- Recent Research Compares Metabolic Effects of Pro-Stride® APS and Triamcinolone Acetonide
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