🐎 Using Prednisolone in Horses with Laminitis and Founder: Safe Dosing in 2025 💊🧠

By Dr Duncan Houston BVSc

Steroids like prednisolone are often essential in treating equine allergies, respiratory inflammation, and immune conditions—but they’ve long been viewed with caution in horses at risk of laminitis or founder. In 2025, new research has helped clarify where and when these drugs can be used safely, especially in horses with equine metabolic syndrome (EMS) or Cushing’s disease (PPID). 🧠🐴

🔍 What Is Prednisolone?

Prednisolone is a corticosteroid commonly prescribed for:

• 🌿 Insect bite hypersensitivity (sweet itch)
• 💨 Equine asthma or inflammatory airway disease
• 🧬 Autoimmune disorders

It’s effective at suppressing the immune system and reducing inflammation—but also known to affect glucose metabolism and potentially increase the risk of laminitis in predisposed horses. 💥

⚠️ Why Laminitis Is a Concern

Laminitis is the inflammation of the sensitive laminae that secure the hoof wall to the coffin bone. In susceptible horses, particularly those with EMS or PPID, even small metabolic changes—like those triggered by steroids—can lead to severe hoof damage. 🦶🔥

🧪 The 13-Year Study on Prednisolone

To address steroid safety concerns, a British study reviewed 416 horses treated with oral prednisolone compared to 814 untreated horses over 13 years. 📊

🔬 Key Findings:

• 📉 Laminitis incidence in prednisolone-treated horses: 2.5%
• 📈 Laminitis incidence in untreated horses: 3.5%
• 💥 Among the horses who developed laminitis on prednisolone, about 50% also had EMS or Cushing’s

Conclusion: Prednisolone did not significantly increase laminitis risk overall, but caution is still warranted in horses with metabolic disorders. 🧠📉

🧬 Why EMS and Cushing’s Increase Risk

Horses with equine metabolic syndrome (EMS) or pituitary pars intermedia dysfunction (PPID/Cushing’s) are:

• ⚖️ Prone to insulin resistance
• 📈 More likely to develop laminitis from small glucose fluctuations
• 🧪 More reactive to steroid-induced metabolic stress

In these horses, the use of any steroid—even for legitimate medical reasons—must be weighed carefully. ⚠️

✅ When It’s Safe to Use Prednisolone

Prednisolone may be safe in horses WITHOUT EMS or PPID when used for:

• 🌿 Severe allergic reactions (hives, sweet itch)
• 💨 Respiratory inflammation (mild to moderate equine asthma)
• 🛡️ Short-term anti-inflammatory support

Use the lowest effective dose for the shortest duration and ensure dietary and metabolic stability before treatment. 📋

🚫 When to Use Extreme Caution

If your horse is:

• 📈 Overweight or cresty-necked
• 💉 Diagnosed with EMS or PPID
• 📉 Has a history of laminitis or founder

…you should avoid corticosteroids unless absolutely necessary. In such cases, discuss non-steroidal alternatives or consider inhaled steroids (with less systemic impact). 🧠⚖️

📋 Safe Use Checklist for Prednisolone in At-Risk Horses

• ✅ Confirm diagnosis of the allergic or respiratory condition
• 🔬 Test for insulin resistance or Cushing’s disease before prescribing
• 🍽️ Feed a low-sugar, low-starch diet during steroid use
• 🚶 Maintain consistent light exercise if possible
• 🧪 Monitor bloodwork and hoof sensitivity weekly during treatment

🧠 Alternatives to Prednisolone

If prednisolone is too risky, consider:

• 💊 Antihistamines for mild allergy management
• 🌬️ Inhaled corticosteroids for equine asthma (e.g., fluticasone)
• 🧴 Topical creams or ointments for local skin reactions
• 🧘 Management-based therapies (fly sheets, turnout changes)

Discuss options with your vet before committing to systemic steroids. 🧠💬

📲 Ask A Vet for Laminitis & Medication Guidance

Managing a horse with allergies, respiratory disease, and metabolic concerns? Visit AskAVet.com or download the Ask A Vet App to consult on prednisolone safety and alternative treatments. 📱🐴

Dr Duncan Houston and the team can help interpret test results, build a risk assessment plan, and provide treatment alternatives. 🧠💬

🏁 Final Thoughts

In 2025, prednisolone remains a valuable tool for treating inflammation and allergy—but not without risk. For horses with EMS or PPID, use it sparingly and under close supervision. With the right diagnosis and management, many horses can be treated safely and effectively. ❤️

Need expert advice on steroids and laminitis risk? Visit AskAVet.com today 🐎💊