Misconceptions and misuse: assessing horse caregivers’ knowledge, attitudes, and practices regarding dexamethasone use in Ibadan, Nigeria

ABSTRACT

Dexamethasone is a common drug used in equine medicine, but when administered inappropriately, it can lead to serious health complications. There is a dearth of data on horse caregivers’ knowledge, attitudes, and practices regarding dexamethasone use in Nigeria. Understanding current dexamethasone usage patterns is necessary for developing educational interventions which will then improve equine welfare. This study aimed to assess the knowledge, attitudes, and practices (KAP) of horse caregivers regarding dexamethasone use in Ibadan, Nigeria. A cross-sectional study was conducted amongst a total of 100 horse caregivers in Ibadan using a structured questionnaire. Face-to-face interviews were conducted so as to assess KAP regarding dexamethasone use. Descriptive statistics and chi-square tests were conducted with P≤0.05 considered significant. All respondents were male, and 66% of them were aged 20–39 years. Only 46% of them demonstrated satisfactory knowledge, with 76% of them wrongly identifying dexamethasone as a painkiller rather than a steroid (6%). Attitudes (caregivers’ perceptions and willingness to follow veterinary guidance) and practices were satisfactory in 54% of respondents. Facility type significantly influenced attitudes (P=0.036), with commercial stable workers showing poorer attitudes (80% unsatisfactory). Age significantly affected practices (P=0.014), with teenagers demonstrating the worst practices (100% unsatisfactory). Frequency of veterinary consultation significantly affected both attitudes (P=0.025) and practices (P=0.007), with daily interaction showing the best outcomes. Knowledge gaps as well as inappropriate practices regarding dexamethasone use exist among horse caregivers in Ibadan, particularly concerning its classification, mechanism of action, and side effects. We recommend the implementation of educational programmes and encouragement of regular veterinary consultation amongst caregivers.

Dexamethasone is a potent glucocorticoid and is widely used for its anti-inflammatory and immunosuppressive properties in treating conditions such as joint inflammation, recurrent airway obstruction, and allergic reactions [4, 5, 13]. But if misused, it can lead to severe health consequences, including immune suppression, laminitis, and metabolic disorders [7, 8]. In Nigeria, where equine activities are rapidly growing, the knowledge, attitudes, and practices (KAP) of horse caregivers regarding dexamethasone use remain unexplored. Knowledge refers to caregivers’ factual understanding of dexamethasone (e.g., its classification as a steroid, indications, and side effects), while attitudes measure their subjective perceptions (e.g., trust in veterinary advice, comfort with administration, or concerns about risks). Practices refer to the actual behaviors and actions of caregivers in relation to dexamethasone use, such as how frequently they administer it, whether they consult veterinary professionals, how they determine dosages, and whether they monitor side effects or discontinue treatment appropriately. This gap is a thing of concern, as there is a potential for inappropriate administration, which may compromise animal welfare and affect performance [15]. This study focuses on Ibadan, Oyo State, which is one of the major equine hubs in Nigeria, to explore and investigate how caregivers perceive and use dexamethasone, thereby addressing a pressing issue in veterinary and animal husbandry practices. In Nigeria, dexamethasone is often obtained from veterinary pharmacies or unregulated markets without a prescription.

In the literature, the global concerns about the misuse of veterinary medications have been highlighted, especially in places where there are not strong rules or systems in place to control how those medicines are used [2, 10, 12]. Risks associated with corticosteroid misuse are well documented in horses. Such risks include, but are not limited to, incorrect dosing and unapproved applications [5, 15]. This has made continuous education and policy interventions necessary to promote safe use of the drug. This study adds to the ongoing discussion on veterinary pharmacology and animal welfare by showing how important it is to educate caregivers in order to improve the health status of horses.

The use of dexamethasone remains a thing of debate despite the therapeutic benefits. Some practitioners support using it carefully and only under veterinary supervision, especially when treating joint inflammation. But others warn that using it too much can cause degradation of the cartilage in the joints [5, 14]. These disagreements are further complicated by some caregivers knowing more than others, not everyone having access to veterinary services, and cultural or traditional beliefs. For instance, people may suddenly stop treatment or give the wrong dose because they do not fully understand how the medicine works [5].

Hence, we aimed to assess the knowledge, attitudes, and practices of horse caregivers in Ibadan, Nigeria, regarding dexamethasone use, specifically to find out which common misunderstandings or misconceptions people have, what factors influence how they use the medication, and how demographic factors like education and experience influence the caregivers’ behaviour. The findings will be useful not just for veterinarians but also for stable owners and people who make policies. This research looked at what is happening in Ibadan to better understand how the drug is actually being used for horses there and provide valuable information on equine care in Nigeria.

Materials and Methods

Study area

The study was conducted in Ibadan, Oyo State, Nigeria. Ibadan is a major equine hub where horses are primarily used for sports, pleasure riding, breeding, and companionship [1]. The region has a tropical climate with distinct wet and dry seasons, which may influence equine health management practices. Ibadan was selected due to its high concentration of private stables, commercial stables, equestrian centers, veterinary clinics, and research institutes, providing a diverse sample of horse caregivers. The study focused on caregivers who had direct responsibility for horse health, ensuring that respondents had practical experience in administering medications such as dexamethasone.

Study design

A cross-sectional survey assessed KAP at a single time point, capturing natural practices without intervention.

Study participants, sample size, and sampling

The study participants were horse caregivers, defined as individuals directly involved in the daily care, management, and medical treatment of horses. This included stable workers, grooms, farriers, and horse owners who had hands-on responsibility for equine health. The inclusion criteria required participants to have a minimum of one month of experience in horse care and provide informed consent. Participants were excluded if they were underage, newly employed (less than one month of experience), or unwilling to participate.

A convenience sampling method was used due to logistical constraints, with a target sample size of 100 respondents. The sample was drawn from various facilities, including private stables, commercial stables, equestrian centers, veterinary clinics, and research institutes, ensuring representation across different management systems. Facilities were selected to proportionally represent Ibadan’s equine sector distribution: private stables (76%), commercial stables (10%), equestrian centers (4%), and veterinary clinics (10%). Within facilities, caregivers were randomly sampled proportional to workforce size (e.g., 5 caregivers from large stables housing >15 horses versus 1 caregiver from small stables with ≤5 horses). The sample size was justified based on feasibility, as the study aimed to capture a broad spectrum of experiences rather than achieve statistical power for subgroup analyses.

Questionnaire design and validation

A structured questionnaire was developed to assess three key domains: knowledge, attitudes, and practices related to dexamethasone use. The questionnaire was divided into four sections: (1) demographic characteristics, comprising 9 questions on age, gender, educational background, years of experience, occupation, and stable size; (2) knowledge, with 9 questions evaluating understanding of dexamethasone’s indications, dosage, side effects, and administration routes; (3) attitudes, with 5 questions assessing perceptions of dexamethasone’s safety, efficacy, and necessity in horse care; and (4) practices, with 6 questions exploring frequency, context, and sources of dexamethasone use. Questions were designed to be binary (correct/incorrect) or single-choice to simplify scoring and analysis.

Data collection procedure

Trained field assistants administered the questionnaires through face-to-face interviews to ensure high response rates and minimize literacy-related biases. Interviewers were instructed to read questions verbatim and avoid leading respondents to particular answers. To maintain consistency, all field assistants underwent standardized training on neutral interviewing techniques. Interviews were conducted at stables during early mornings or late afternoons when caregivers were most available, ensuring minimal disruption to their routines.

For non-English speakers, key terms were translated into Hausa using a forward-backward translation method to ensure accuracy. Scientific terms such as “steroid”, “anti-inflammatory”, and “immune suppression” were explained using locally familiar analogies. Data collection was conducted over a defined period to avoid seasonal biases in horse management practices. Each interview lasted approximately 20–30 min, and responses were recorded on paper questionnaires and later digitized for analysis. Data collection spanned three months (September–December) to cover multiple stables and achieve the target sample size.

Ethical considerations

The study adhered to ethical standards outlined by the Animal Care and Use Research Ethics Committee (ACUREC) of the University of Ibadan (approval number: NHREC/UIACUREC/05/12/2022A). Written informed consent was secured from all participants after explaining the study’s purpose and procedures and the participants’ rights, including confidentiality and the option to withdraw without consequences. Participants were assured that their responses would be anonymised, with no identifiable information stored or published. Questionnaires were coded with unique identifiers, and data were stored securely on password-protected devices accessible only to the research team. Stable owners were informed of the study’s intent, and their permission was obtained before approaching caregivers.

Data analysis

Data were entered into Microsoft Excel and analyzed using IBM SPSS Statistics Version 27. Descriptive statistics (frequencies, percentages) summarized demographic characteristics and KAP levels. Knowledge, attitude, and practice scores were calculated by assigning 1 point for each correct response and 0 points for each incorrect response, yielding maximum scores of 9, 5, and 6, respectively. Cut-off points were set at 50% of the maximum score (4.5 for knowledge, 2.5 for attitudes, and 3 for practices) to classify outcomes as satisfactory (≥ cut-off) or unsatisfactory (< cut-off). χ² tests were used to examine associations between demographic variables (e.g., education, experience) and KAP outcomes. P-values ≤0.05 were considered significant.

Results

Demographic characteristics of respondents

The study involved 100 horse caregivers in Ibadan, Oyo State, Nigeria, with the majority (66%) being young adults aged 20–39 years, followed by middle-aged adults (28%). Notably, all respondents were male, highlighting a gender disparity in horse care roles in the region. Education levels varied among the caregivers, with 64% having secondary education, 16% having tertiary education, and 14% having primary education, while 6% had no formal education. Half of the caregivers had over 10 years of experience, indicating a seasoned workforce. Most worked in private stables (76%), and 86% primarily cared for horses used in sports. Interaction with veterinarians was limited, with 50% consulting vets only during health issues, and 70% received drug-use training on the job (Table 1).

Table 1. Demographic characteristics of respondents (horse caregivers).

Variable	Number of respondents	Percentage (%)
Age (years)
Teenager (13–19)	4	4.0
Young adult (20–39)	66	66.0
Middle-aged adult (40–59)	28	28.0
Old age (60 and above)	2	2.0
Gender
Male	100	100.0
Female	0	0
Education level
No formal education	6	6.0
Primary education	14	14.0
Secondary education	64	64.0
Tertiary education	16	16.0
Years of experience
1–3 years	6	6.0
4–10 years	44	44.0
More than 10 years	50	50.0
Type of facility
Private stable	76	76.0
Commercial stable	10	10.0
Equestrian centre	4	4.0
Veterinary clinic	10	10.0
Number of horses per facility
1–5 horses	42	42.0
6–15 horses	46	46.0
16 or more horses	12	12.0
Primary use of horses
Sport	86	86.0
Pleasure riding	8	8.0
Breeding	2	2.0
Companion	4	4.0
Interaction with a veterinarian
Daily	12	12.0
Weekly	10	10.0
Monthly	18	18.0
Quarterly	8	8.0
Annually	2	2.0
Only when there is a health issue	50	50.0
Structured education on drug use
Yes, as part of formal education	14	14.0
Yes, through professional development course	6	6.0
Yes, through on-the-job training	70	70.0
No, but I have learned from experience	10	10.0

Knowledge about dexamethasone use

While 96% of the caregivers correctly identified dexamethasone as medication, only 6% accurately described it as a steroid, with 76% misclassifying it as a painkiller. Half of the caregivers recognized its anti-inflammatory use, but misconceptions persisted, such as the belief among 12% that it enhances running speed. Notably, 52% were unaware of long-term side effects like immune suppression, and 68% incorrectly viewed dexamethasone as an energy booster (Table 2).

Table 2. Knowledge of horse caregivers towards the use of dexamethasone in horses.

Variable	Number of respondents	Percentage (%)
What is dexamethasone?
A type of feed	4	4.0
Medication (correct)	96	96.0
Best description of dexamethasone
Antibiotic	8	8.0
Painkiller	76	76.0
Steroid (correct)	6	6.0
Antibiotic and painkiller	8	8.0
Painkiller and steroid	2	2.0
Common use of dexamethasone
To make horses run faster	12	12.0
To reduce inflammation (correct)	50	50.0
To make horses run faster and reduce inflammation	24	24.0
To make horses run faster and improve appetite	4	4.0
To reduce inflammation and improve appetite	4	4.0
To make horses run faster, reduce inflammation, and increase appetite	6	6.0
Administration of dexamethasone
Injection (correct)	100	100.0
How often dexamethasone can be used
Daily for extended periods	24	24.0
Weekly for maintenance	6	6.0
Short-term use as needed (correct)	70	70.0
Potential side effects of long-term use
Increased appetite	16	16.0
Weakened immune system (correct)	24	24.0
Improved coat condition	6	6.0
I don’t know	52	52.0
No side effect	2	2.0
Can dexamethasone treat lameness?
Yes, always	56	56.0
Yes, in cases (correct)	44	44.0
Does dexamethasone help with weight gain?
Yes, directly	14	14.0
No, it causes weight loss	4	4.0
It may directly through increased appetite	40	40.0
I don’t know	18	18.0
No (correct)	24	24.0
Does dexamethasone give horses more energy?
Yes, it is an energy booster	68	68.0
No, it does not affect energy level (correct)	2	2.0
It may seem to, by reducing pain and inflammation	26	26.0
I don’t know	4	4.0

Attitudes toward dexamethasone use

Attitudes were polarized: 42% of the caregivers deemed veterinary consultation unimportant, while 56% were very concerned about side effects. The majority (66%) felt very comfortable administering dexamethasone, and 80% expressed willingness to learn more. However, 46% incorrectly believed it was always suitable for lameness (Table 3).

Table 3. Attitude of horse caregivers.

Variable	Number of respondents	Percentage (%)
Importance of consulting a vet
Very important (correct)	28	28.0
Somewhat important	30	30.0
Not important	42	42.0
Concerns about dexamethasone side effects
Very concerned (correct)	56	56.0
Somewhat concerned	14	14.0
Not concerned	14	14.0
I don’t know	16	16.0
Comfort with administering dexamethasone
Very comfortable	66	66.0
Somewhat comfortable	30	30.0
Not comfortable (correct)	2	2.0
I don’t know	2	2.0
Willingness to learn more about dexamethasone use
Very willing (correct)	80	80.0
Somewhat willing	8	8.0
Not willing	12	12.0
Is dexamethasone best for lameness?
Yes, always	46	46.0
Sometimes (correct)	44	44.0
No, never	10	10.0

Practices in dexamethasone administration

Practices revealed risky behaviors: 42% of the caregivers always used dexamethasone without professional advice, and 58% stopped treatment abruptly after improvement instead of tapering doses. Only 54% monitored side effects, while 60% preferred dexamethasone as a first-line treatment for lameness. Dose determination was often based on horse weight (58%), but 14% of the caregivers used uniform doses for all horses (Table 4).

Table 4. Practice of horse caregivers.

Variable	Number of respondents	Percentage (%)
Use of dexamethasone on horses without professional advice
Always	42	42.0
Sometimes	26	26.0
Rarely	18	18.0
Never (correct)	14	14.0
Monitoring of side effects after administration of dexamethasone
Regularly (correct)	54	54.0
Occasionally	12	12.0
Never	30	30.0
I don’t administer it	4	4.0
What to do after horses show improvement with dexamethasone use
Continue the treatment indefinitely	2	2.0
Stop immediately	58	58.0
Gradually reduce the dose (correct)	24	24.0
I don’t know	4	4.0
Stops after the condition gets better	12	12.0
Consulting professionals on dexamethasone use
Always (correct)	18	18.0
Sometimes	42	42.0
Never	38	38.0
I don’t use dexamethasone	2	2.0
First choice in treating lameness
Dexamethasone	60	60.0
Non-steroidal anti-inflammatory drugs	4	4.0
Rest and cold therapy (correct)	36	36.0
Determining dexamethasone dose
Based on the horse weight	58	58.0
Use the same dose for all horses	14	14.0
Follow instructions from a professional (correct)	14	14.0
I don’t administer dexamethasone	4	4.0
Based on the severity of the condition	10	10.0

Overall knowledge, attitude, and practices scores

The overall KAP assessment showed that 46% of the caregivers had satisfactory knowledge, while 54% had satisfactory attitudes and practices (Table 5).

Table 5. Overall assessment of knowledge, attitudes, and practices of horse caregivers.

Variables	Satisfactory	Unsatisfactory
Knowledge	46 (46)	54 (54)
Attitudes	54 (54)	46 (46)
Practices	54 (54)	46 (46)

n (%).

Demographic factors influencing knowledge, attitude, and practice levels

Demographic factors had a limited statistical impact on knowledge (P>0.05). However, tertiary-educated caregivers had the lowest rate of unsatisfactory knowledge (12.5%), while those with no formal education scored worst (66.7%). Private stable workers (57.9%) and sport-horse caregivers (60.5%) also had higher knowledge gaps, though these trends were not statistically significant (P>0.05). Even with daily vet contact, 66.7% of the caregivers had poor knowledge, suggesting vets may not explain drug properties adequately (Table 6).

Table 6. Demographic characteristics as factors influencing the knowledge levels.

Variable	Unsatisfactory knowledge (%)	χ2	P-value
Age (years)
Teenager (13–19)	4 (100)	2.972	0.396
Young adult (20–39)	36 (54.5)
Middle-aged adult (40–59)	14 (50)
Old age (60 and above)	0 (0)
Gender
Male	54 (54)	-	-
Education
No formal education	4 (66.7)	6.699	0.082
Primary education	8 (57.1)
Secondary education	40 (62.5)
Tertiary education	2 (12.5)
Experience
1–3 years	2 (33.3)	1.701	0.427
4–10 years	28 (63.6)
More than 10 years	24 (48)
Type of facility
Private stable	44 (57.9)	6.267	0.099
Commercial stable	8 (80)
Equestrian centre	0 (0)
Veterinary clinic	2 (20)
Number of horses
1–5 horses	18 (42.9)	2.253	0.324
6–15 horses	30 (65.2)
16 or more horses	6 (50)
Primary use of horses
Sport	52 (60.5)	5.600	0.133
Pleasure riding	2 (25)
Breeding	0 (0)
Companion	0 (0)
Interaction with vet
Daily	8 (66.7)	5.542	0.353
Weekly	2 (20)
Monthly	12 (66.7)
Quarterly	2 (25)
Annually	2 (100)
Only when there is a health issue	28 (56)
Structured education on drug use
Yes, as part of formal education	4 (28.6)	2.918	0.404
Yes, through professional development course	2 (33.3)
Yes, through on-the-job training	42 (60)
No, but I have learned from experience	6 (60)

χ²: chi square, *: significant (P<0.05).

Attitudes were significantly influenced by facility type (P=0.036), with commercial stable workers showing the worst attitudes (80% unsatisfactory). Daily vet interaction correlated with better attitudes (0% unsatisfactory), while caregivers who consulted vets only during emergencies had poorer attitudes (68% unsatisfactory, P=0.025) (Table 7).

Table 7. Demographic characteristics as factors influencing the attitude levels.

Variable	Unsatisfactory attitude (%)	χ2	P-value
Age (years)
Teenager (13–19)	2 (50)	1.002	0.801
Young adult (20–39)	32 (48.5)
Middle-aged adult (40–59)	12 (42.9)
Old age (60 and above)	0 (0)
Gender
Male	46 (46)	-	-
Education
No formal education	4 (66.7)	2.296	0.513
Primary education	8 (57.1)
Secondary education	30 (46.9)
Tertiary education	4 (25)
Years of experience
1–3 years	2 (33.3)	0.786	0.675
4–10 years	18 (40.9)
More than 10 years	26 (52)
Type of facility
Private stable	38 (50)	8.535	0.036*
Commercial stable	8 (80)
Equestrian centre	0 (0)
Veterinary clinic	0 (0)
Number of horses
1–5 horses	18 (42.9)	3.887	0.143
6–15 horses	18 (39.1)
16 or more horses	10 (83.3)
Primary use of horses
Sport	44 (51.2)	4.734	0.192
Pleasure riding	0 (0)
Breeding	0 (0)
Companion	2 (50)
Interaction with vet
Daily	0 (0)	12.802	0.025*
Weekly	2 (20)
Monthly	6 (33.3)
Quarterly	4 (50)
Annually	0 (0)
Only when there is a health issue	34 (68)
Structured education on drug use
Yes, as part of formal education	2 (14.3)	4.068	0.254
Yes, through professional development course	2 (33.3)
Yes, through on-the-job training	38 (54.3)
No, but I have learned from experience	4 (40)

χ²: chi square, *: significant (P<0.05).

Unsatisfactory practices were linked to age (P=0.014), with teenagers showing the worst practices (100% unsatisfactory) and middle-aged adults the best (14.3% unsatisfactory). Daily veterinary interaction reduced unsatisfactory practices (16.7%) compared with emergency-only consults (72%; χ²=16.067, P=0.007) (Table 8).

Table 8. Demographic characteristics as factors influencing the practice levels.

Variable	Unsatisfactory practices (%)	χ2	P-value
Age (years)
Teenager (13–19)	4 (100)	10.649	0.014*
Young adult (20–39)	38 (57.6)
Middle-aged adult (40–59)	4 (14.3)
Old age (60 and above)	0 (0)
Gender
Male	46 (46)	-	-
Education
No formal education	6 (100)	5.357	0.147
Primary education	8 (57.1)
Secondary education	28 (43.8)
Tertiary education	4 (25)
Years of experience
1–3 years	4 (66.7)	3.304	0.192
4–10 years	14 (31.8)
More than 10 years	28 (56)
Type of facility
Private stable	42 (55.3)	7.348	0.062
Commercial stable	4 (40)
Equestrian centre	0 (0)
Veterinary clinic	0 (0)
Number of horses
1–5 horses	20 (47.6)	1.491	0.475
6–15 horses	18 (39.1)
16 or more horses	8 (66.7)
Primary use of horses
Sport	46 (53.5)	6.934	0.074
Pleasure riding	0 (0)
Breeding	0 (0)
Companion	0 (0)
Interaction with vet
Daily	2 (16.7)	16.067	0.007*
Weekly	0 (0)
Monthly	4 (22.2)
Quarterly	4 (50)
Annually	0 (0)
Only when there is a health issue	36 (72)
Structured education on drug use
Yes, as part of formal education	2 (14.3)	4.068	0.254
Yes, through professional development course	2 (33.3)
Yes, through on-the-job training	38 (54.3)
No, but I have learned from experience	4 (40)

χ²: chi square, *: significant (P<0.05).

Discussion

This pilot study highlights dexamethasone KAP gaps in Ibadan. Larger, nationally representative samples are needed to generalize findings; we aim to expand this work to other major equine hubs in Nigeria, such as Lagos and Abuja. Our study assessed the knowledge, attitudes, and practices of horse caregivers in Ibadan, Nigeria, regarding dexamethasone use. The results showed that gaps exist in knowledge, with only 6% of the caregivers accurately identifying dexamethasone as a steroid, while 76% wrongly classified it as a painkiller. Attitudes were mixed, with 42% of the caregivers disregarding veterinary consultation and 56% expressing concern about side effects. Risky practices were prevalent, including abrupt discontinuation of treatment (58%) and unsupervised administration (42%). Only 46% of the caregivers demonstrated satisfactory knowledge, whereas 54% had satisfactory attitudes and practices.

The high recognition rate suggests dexamethasone’s prominence in equine care, likely due to its efficacy in treating inflammation-related conditions like lameness. However, prevalent misconceptions, particularly the misclassification of dexamethasone as a painkiller, indicate a fundamental misunderstanding of its pharmacological properties, which could lead to misuse. This limited understanding aligns with risky practices such as abrupt cessation, which risks adrenal suppression, as sudden withdrawal disrupts cortisol production [5]. The polarised attitudes among the caregivers—some dismissing veterinary advice while others showing excessive caution—reflect inconsistent perceptions of the drug’s risks and benefits. These unsafe practices align with global concerns about corticosteroid misuse [5, 15] and may exacerbate adverse effects like immune suppression and laminitis, compromising equine welfare. While openness to learning is a promising sign suggesting that educational interventions could correct misconceptions, the resistance to veterinary consultation is concerning. The fact that 50% of caregivers only interact with veterinarians in emergencies points to systemic barriers like limited access to professionals, driving self-administration. The influence of education and facility type underscores the role of structured environments in fostering responsible drug use, highlighting a critical need for improved education on dexamethasone use among horse caregivers.

The high level of comfort reported by the Nigerian equine caregivers in administering dexamethasone (66%) contrasts with studies in other regions where caregivers often exhibit hesitancy due to concerns about side effects, such as adrenal suppression or cartilage degradation [3, 5]. Ekstrand’s [5] work highlights the delicate balance between therapeutic efficacy and potential harm, noting that dexamethasone suppresses lameness at doses lower than approved. Still, prolonged use or high doses may detrimentally affect joint health. This discrepancy in caregiver attitudes may reflect cultural or experiential differences, wherein Nigerian practitioners prioritise immediate symptom relief over long-term risks, a practice also observed in equine sports medicine [6].

The misconception that dexamethasone enhances performance was shared by 12% of the caregivers. This misconception mirrors global issues in equine sports, where corticosteroids are misused to mask pain or prolong athletic performance [5, 11]. Such misuse parallels the broader ethical and welfare concerns that Ekstrand [5] raised, emphasising the need for stringent anti-doping controls to protect animal welfare and sports integrity. This study underscores the critical role of education, as caregivers with tertiary education demonstrated better pharmacological knowledge.

The lack of veterinary supervision reported in this study increases the chances of misuse. This same issue was seen in the study of Lehnus et al. [9], where poor supervision led to people misusing prescription drugs. Ekstrand [5] also supports this point, explaining that administering dexamethasone intra-articular without veterinary guidance can cause it to affect the body in unpredictable ways and lead to side effects.

The high level of comfort with unsupervised administration—paired with misconceptions about performance enhancement—suggests a disconnect between caregivers’ perceptions and evidence-based veterinary guidelines. Such practices may inadvertently perpetuate misuse, risking adverse effects like adrenal suppression or joint deterioration, as documented in pharmacological studies [5]. The lack of veterinary oversight further exacerbates these risks, highlighting systemic challenges in access to professional guidance. These findings signal an urgent need for interventions to align caregiver practices with therapeutic standards, particularly in regions with limited regulatory enforcement. The findings also underscore the role of demographic factors. For example, caregivers with tertiary education exhibited better knowledge, suggesting that literacy plays a role in understanding pharmacological concepts. Conversely, poor practices among teenagers and those with limited vet interaction emphasise the need for mentorship and oversight.

The study’s limitations include the following: it relies on convenience sampling and a sample size of 100, which restricts generalizability beyond Ibadan; self-reported data may introduce recall bias; and the 50% cut-off for ‘satisfactory’ is lenient (future studies should use a stricter benchmark).

This study reveals significant gaps in horse caregivers’ understanding and use of dexamethasone in Ibadan, Nigeria. Only 46% of them demonstrated satisfactory knowledge, with most misclassifying it as a painkiller rather than a corticosteroid. Concerning practices included administration without veterinary consultation (42%) and abrupt treatment discontinuation (58%). Age and frequency of veterinary interaction significantly influenced practices, while facility type affected attitudes toward proper use. These findings show the urgent need for structured educational interventions, regular veterinary consultation, and formal training programs to improve medication stewardship and horse health outcomes. Future studies should expand geographically to include other Nigerian equine hubs.