Cortisone Use in Horses by a Vet – 2025 Guide on Laminitis Risk & Safe Dosages 🐎💉

By Dr Duncan Houston, BVSc

Introduction

In equine medicine, corticosteroids—commonly referred to as cortisone—remain an essential tool for managing inflammation, especially in joint therapies for performance horses. But a lingering concern among owners and some veterinarians persists: can cortisone cause laminitis or founder? Let’s explore the science and guidelines as they stand in 2025.

What Is Cortisone Used For in Horses? 🐴💊

• Primarily used for arthritis and joint inflammation
• Also used for allergic skin conditions
• Most joint injections include a form of cortisone, especially in performance horses

Understanding Laminitis Risk 🌡️

• Laminitis (or founder) is inflammation of the sensitive laminae in the hoof
• It causes pain, instability, and in severe cases, rotation of the coffin bone
• There is no confirmed direct link between cortisone and laminitis in healthy horses

Is There Scientific Evidence of a Risk? 📚

Studies have not demonstrated a consistent, causative link between cortisone and laminitis when administered properly. However:

• Some horses with laminitis histories had prior cortisone use
• High doses or frequent injections may increase risk in sensitive horses
• Pre-existing metabolic conditions (e.g., equine metabolic syndrome) elevate the risk significantly

Forms of Cortisone Commonly Used 🧪

Triamcinolone Acetonide (Vetalog)

• Favored for high-motion joints like hocks and stifles
• Potent anti-inflammatory effect with relatively low joint damage

Methylprednisolone Acetate (Depo-Medrol)

• Common in low-motion joints like the hock or coffin joint
• May cause more cartilage irritation than triamcinolone

Betamethasone

• Used in a variety of joints; less commonly than the two above

Safe Dosage Guidelines (2025) 📏

Horses at Higher Risk for Cortisone-Induced Laminitis 🚨

• Obese horses or those with cresty necks
• Horses diagnosed with equine metabolic syndrome or insulin resistance
• Ponies and warmbloods—often more sensitive to metabolic shifts
• Horses with a history of laminitis

Signs to Watch for Post-Injection 🔍

• Increased hoof warmth or pulse
• Reluctance to move or shifting weight frequently
• Stiffness or mild lameness in multiple limbs

Safe Use Tips for 2025 📋

1. Monitor Dosage Closely

• Track the total corticosteroid dose per visit
• Avoid exceeding 80 mg triamcinolone

2. Space Out Injections

• Don’t repeat injections too frequently
• Allow time for joints and systems to respond and clear the drug

3. Screen for Metabolic Risk

• Run bloodwork and insulin levels before using corticosteroids in at-risk horses

4. Maintain a Trim Body Condition

• Obesity is a major risk factor for laminitis of any cause

FAQs About Cortisone and Laminitis 🧠

Q: How common is laminitis from cortisone?

A: Very rare. The vast majority of horses tolerate joint injections safely when dosed appropriately.

Q: Can I use cortisone in a horse with a history of founder?

A: Only under veterinary supervision—alternate therapies may be safer depending on the case.

Q: Is there a limit to how many joints can be injected?

A: Technically no official limit, but most vets aim to keep total dose under safe thresholds.

Conclusion

Cortisone remains a cornerstone of equine lameness therapy, particularly in performance horses with joint issues. While the risk of laminitis is small, it increases with high dosages, sensitive horses, or metabolic conditions. In 2025, proper dosage tracking, breed awareness, and individualized care help ensure cortisone injections are both safe and effective.

Need help assessing your horse’s laminitis risk before a cortisone injection? Visit AskAVet.com or download our app 📱 to consult directly with Dr Duncan Houston. 🩺🐴