Evaluation of the diffusion of corticosteroids between the distal interphalangeal joint and navicular bursa in horses

Frederik E. Pauwels Department of Large Animal Surgery, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

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James Schumacher Department of Large Animal Surgery, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

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Fernando A. Castro Department of Large Animal Surgery, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

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Troy E. Holder Department of Large Animal Surgery, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

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Roger C. Carroll Department of Anesthesia Research, College of Medicine, University of Tennessee, Knoxville, TN 37996.

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Gary A. Sega Department of Anesthesia Research, College of Medicine, University of Tennessee, Knoxville, TN 37996.

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Chris W. Rogers Massey Equine Research, Institute of Veterinary, Animal, and Biomedical Sciences, Massey University, Private Bag 11 222, Palmerston North, New Zealand.

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Abstract

Objective—To determine whether clinically effective concentrations of methylprednisolone or triamcinolone can be achieved in the navicular bursa after injection of methylprednisolone acetate (MPA) or triamcinolone acetonide (TA) into the distal interphalangeal joint (DIPJ) and whether clinically effective concentrations of these drugs can be achieved in the DIPJ after injecting the navicular bursa with the same doses of MPA or TA.

Animals—32 healthy horses.

Procedures—Horses in groups 1 through 4 received 40 mg of MPA in the DIPJ, 10 mg of TA in the DIPJ, 40 mg of MPA in the navicular bursa, and 10 mg of TA in the navicular bursa, respectively. Concentrations of corticosteroids that diffused into the adjacent synovial structure were determined.

Results—For group 1, injection of MPA into the DIPJ yielded a mean ± SD concentration of 0.24 ± 0.072 μg of methylprednisolone/mL in the navicular bursa. For group 2, injection of TA into the DIPJ yielded 0.124 ± 0.075 μg of triamcinolone/mL in the navicular bursa. For group 3, injection of MPA into the navicular bursa yielded 0.05 ± 0.012 μg of methylprednisolone/mL in the DIPJ. For group 4, injection of TA into the navicular bursa yielded 0.091 ± 0.026 μg of triamcinolone/mL in the DIPJ.

Conclusions and Clinical Relevance—A clinically effective concentration of methylprednisolone or triamcinolone diffused between the DIPJ and navicular bursa after intra-articular or intrabursal injection, which would justify injection of the DIPJ with MPA or TA to ameliorate inflammation of the navicular bursa.

Abstract

Objective—To determine whether clinically effective concentrations of methylprednisolone or triamcinolone can be achieved in the navicular bursa after injection of methylprednisolone acetate (MPA) or triamcinolone acetonide (TA) into the distal interphalangeal joint (DIPJ) and whether clinically effective concentrations of these drugs can be achieved in the DIPJ after injecting the navicular bursa with the same doses of MPA or TA.

Animals—32 healthy horses.

Procedures—Horses in groups 1 through 4 received 40 mg of MPA in the DIPJ, 10 mg of TA in the DIPJ, 40 mg of MPA in the navicular bursa, and 10 mg of TA in the navicular bursa, respectively. Concentrations of corticosteroids that diffused into the adjacent synovial structure were determined.

Results—For group 1, injection of MPA into the DIPJ yielded a mean ± SD concentration of 0.24 ± 0.072 μg of methylprednisolone/mL in the navicular bursa. For group 2, injection of TA into the DIPJ yielded 0.124 ± 0.075 μg of triamcinolone/mL in the navicular bursa. For group 3, injection of MPA into the navicular bursa yielded 0.05 ± 0.012 μg of methylprednisolone/mL in the DIPJ. For group 4, injection of TA into the navicular bursa yielded 0.091 ± 0.026 μg of triamcinolone/mL in the DIPJ.

Conclusions and Clinical Relevance—A clinically effective concentration of methylprednisolone or triamcinolone diffused between the DIPJ and navicular bursa after intra-articular or intrabursal injection, which would justify injection of the DIPJ with MPA or TA to ameliorate inflammation of the navicular bursa.

Contributor Notes

Dr. Pauwels' present address is Department of Equine Surgery, Institute of Veterinary, Animal, and Biomedical Sciences, Massey University, Private Bag 11 222, Palmerston North, New Zealand.

Supported by a grant from the Houston Equine Research Foundation.

Presented as an abstract at the 2nd World Veterinary Orthopedic Congress, Keystone, Colo, February 2006.

The authors thank Carolyn Snider for assistance with high-performance liquid chromatography and ELISA testing and Dawnya Breeding for assistance with the animals.

Address correspondence to Dr. Pauwels.
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