Topic:Airway Disease
Airway disease in horses is defined as a respiratory condition marked by inflammation and narrowing of the lower airways, leading to symptoms like coughing, increased mucus production, and reduced performance. This condition, which includes forms such as inflammatory airway disease (IAD) and recurrent airway obstruction (RAO), can significantly impact a horse’s respiratory efficiency and overall health.
This page compiles peer-reviewed research studies and clinical insights that explore the pathophysiology, diagnostic techniques, and effective treatment protocols to manage and improve equine respiratory health.
Changes in airway inflammatory cell populations in standardbred racehorses after interferon-alpha administration. Natural human interferon-alpha (nHuIFN alpha) was administered to actively training Standardbred racehorses with inflammatory airway disease (IAD). Inflammatory airway disease was characterized by poor exercise performance and inflammation and exudate in the upper and lower airway. Placebo, 50, 150, or 450 units(U) of nHuIFN alpha was administered orally for 5 consecutive days to eight horses per treatment group in a double-blind, randomized block design. Response to nHuIFN alpha was monitored by semiquantitative endoscopic examination score and cytologic examination of bronchoalveolar lavage ...
The pathogenesis of chronic obstructive pulmonary disease of horses. Present evidence suggests that chronic obstructive pulmonary disease (COPD) of horses is a delayed hypersensitivity response to inhaled antigens, particularly the thermophilic moulds and actinomycetes that grow in damp hay. Within several hours of exposing COPD-susceptible horses to such hay, neutrophils invade the lung and accumulate in the lumens of airways, particularly bronchioles. The inflammatory response is accompanied by increased levels of histamine in bronchoalveolar lavage fluid, increased plasma levels of the inflammatory mediators thromboxane and 15-hydroxyeicosatetraenoic acid (1...
Measurement of upper airway pressures in exercising horses with dorsal displacement of the soft palate. To determine whether abnormal airway pressures have a role in development of dorsal displacement of the soft palate (DDSP), measurements of tracheal and pharyngeal pressures were correlated with nasopharyngeal morphology in exercising horses. Exercising videoendoscopy and measurement of tracheal and pharyngeal pressures were used in 14 clinically normal horses and 19 horses with intermittent DDSP. The pressure signals were superimposed on the videoendoscope image, and both images were saved simultaneously on a videocassette for slow motion analysis to determine the instant displacement occurre...
Acetylcholine release from airway cholinergic nerves in horses with heaves, an airway obstructive disease. The present study was conducted to determine if acetylcholine (ACh) release from airway cholinergic nerves is increased and if modulation of ACh release by prejunctional receptors is altered in horses with heaves, an obstructive airway disease characterized by airway inflammation and bronchospasm. Trachealis strips and bronchial segments of normal horses and horses affected with heaves were suspended in 2-ml tissue baths. ACh release was induced by electrical field stimulation and the bath ACh content was measured by high performance liquid chromatography (HPLC) with electrochemical detection....
The effects of three models of airway disease on tidal breathing flow-volume loops of thoroughbred horses. The effects of histamine and methacholine aerosols and of a fixed inspiratory resistance on tidal breathing flow-volume loops (TBFVL) were investigated using 18 unsedated, standing, healthy thoroughbred horses. The data were first analysed using traditional flow-volume loop indices and then reduced using standardized factor scoring coefficients obtained in a previous study in this laboratory using similar experimental techniques. On the basis of resting TBFVL analysis, the degree of pulmonary dysfunction caused by inhalation of histamine and methacholine aerosols with concentrations of 10 and ...
Modulation of bronchial smooth muscle function in horses with heaves. Four mechanisms that modulate airway smooth muscle function in normal horses were studied in the bronchi of horses affected by the airway obstructive disease heaves. Results were compared with data from historical controls studied by the same personnel in the same laboratory. Rings from the left cranial lobar bronchus (LB1) and small bronchi (5 mm OD) were suspended in muscle baths, and the isometric tension were measured. The inhibitory nonadrenergic noncholinergic (iNANC) function was studied in LB1. After the LB1 segments were pretreated with atropine and contracted with histamine, electric...
Differential artificial ventilation in anesthetized horses positioned in lateral recumbency. Effects of differential ventilation on gas exchange were studied in 7 isoflurane-anesthetized, laterally recumbent horses, and were compared with effects of conventional ventilation, using similar minute volume. A tracheal tube-in-tube intubation technique allowed each lung to be connected separately to an anesthetic circle system with a ventilator. Two distribution patterns of tidal volume were investigated; half the tidal volume was distributed to each lung and two-thirds the tidal volume was distributed to the dependent lung. Effects of the combination of these patterns with positive end-ex...
Tidal breathing flow-volume loops in horses with recurrent airway obstruction (heaves). Tidal breathing flow-volume (TBFV) loops were determined in a group of control horses and in horses affected with recurrent airway obstruction (heaves). The latter group was studied when the condition was in remission and under increasing amounts of airway obstruction as reflected by measurements of change in pleural pressure, pulmonary resistance, and dynamic compliance. The TBFV loops of control horses had biphasic inspiratory and expiratory patterns; peak inspiratory and peak expiratory flows were detected early in inspiration and expiration, respectively. Tidal volume was unaffected by hea...
Effects of centrifugation and specimen preparation technique on bronchoalveolar lavage analysis in horses. Bronchoalveolar lavages (BAL) were performed for 6 healthy horses and 8 horses with lower airway diseases (LAD). Total cell and differential counts were performed before and after centrifugation and resuspension of the BAL cells in a small volume of fluid; there was no difference in the total cell counts, but mast cell percentages were significantly (P < 0.05) lower, after centrifugation, in the LAD group. The two specimen preparation techniques compared were cytocentrifugation and centrifugation on microscope glass covers. For both groups of horses, lymphocyte percentages were significantl...
Tidal breathing flow-volume loop analysis as a test of pulmonary function in exercising horses. The usefulness of tidal breathing flow-volume loops (TBFVL) to evaluate pulmonary function was investigated in 6 Standardbreds during treadmill exercise. Tidal breathing flow-volume loops are a graphic representation of airflow rate vs tidal volume for each individual breath. These TBFVL were obtained from horses exercising at speeds corresponding to 75 and 100% of maximum heart rate. Measurements were recorded in each horse before and after ovalbumin-induced allergic lung disease. Moderate obstructive lung disease, characterized by a significant increase in pulmonary resistance, was observed ...
Prejunctional alpha 2-adrenoceptors inhibit acetylcholine release from cholinergic nerves in equine airways. To determine the presence and function of alpha 2-adrenoceptors on cholinergic nerves innervating horse airway smooth muscle, the effects of some alpha 2-adrenoceptor agents on contractions of and acetylcholine (ACh) release from equine airway smooth muscle preparations were studied. Muscle contractions were elicited by either electrical field stimulation (EFS) or exogenous ACh. ACh release was induced by EFS and measured by high-pressure liquid chromatography and electrochemical detection. The alpha 2-adrenoceptor agonists clonidine (10(-7) to 10(-5) M) and UK-14,304 (10(-8) to 10(-6) M) conc...
The airway response of horses with recurrent airway obstruction (heaves) to aerosol administration of ipratropium bromide. The airway response to aerosol administration of the anticholinergic agent ipratropium bromide was determined in 8 horses with recurrent airway obstruction (heaves). The reversibility of airway obstruction was confirmed by measuring lung function before and during stabling; and by determining the response to atropine administration (0.02 mg/kg bwt intravenously). The dose-response to ipratropium bromide was determined using a Williams square design experiment in which 25, 50 or 75 micrograms ipratropium bromide/ml (4 ml/100 kg bwt) or the same volume of vehicle was administered to each horse b...
In vitro effects of alpha 2-adrenergic receptor stimulation on cholinergic contractions of equine distal airways. In horses with noninduced, reversible airway obstruction (heaves), pulmonary function is improved after sedation with the alpha 2-adrenergic agonist xylazine. The mechanism of this effect is undetermined. Because the predominant excitatory innervation of equine airways is cholinergic, the influence of alpha 2-adrenergic receptor stimulation on the response of isolated distal airways to cholinergic stimulation was determined. Distal bronchial segments from 22 healthy horses were suspended in isolated organ baths where their mechanical responses to various stimuli could be studied. Each tissue w...
Pulmonary edema associated with transient airway obstruction in three horses. Pulmonary edema associated with transient airway obstruction was detected in 3 horses. The cause of obstruction was different in each horse, but after relief of the obstruction, clinical signs and radiographic abnormalities were indicative of pulmonary edema. In 2 of the 3 horses, pink frothy fluid was evident in the airways. The horses were treated with furosemide, nasal insufflation of O2, anti-inflammatory agents, and anti-biotics. Of the 3 horses examined, 1 horse died acutely, 1 horse recovered fully, and 1 developed pleuritis and was subsequently euthanatized.
Distribution of dopamine beta-hydroxylase and neuropeptide Y-immunoreactive nerves in healthy equine lungs. Immunohistochemical methods were used to determine the distribution of pulmonary nerves containing either an enzymatic marker of adrenergic nerves, dopamine beta hydroxylase, or the putative neurotransmitter neuropeptide Y in 7 equids with healthy lungs. Nerves immunoreactive for these substances were found on airway smooth muscle in nearly all the samples of healthy equine lung examined. These nerves were generally more numerous in the larger airways but could be detected even in noncartilaginous bronchioles. Pulmonary and bronchial vessels also contained numerous immunoreactive nerves. On th...
Flunixin meglumine blocks frusemide-induced bronchodilation in horses with chronic obstructive pulmonary disease. Six horses that developed acute airway obstruction (heaves) when housed in a barn and fed poor-quality hay were studied. Airway obstruction was verified by a maximal change in pleural pressure during tidal breathing (delta Pplmax) of at least 15 cmH2O. Frusemide (1.0 mg/kg bwt) or an equivalent volume of vehicle was then administered intravenously (iv) and lung function was measured 15, 30, 60, 120, 180, 240 and 300 mins after drug administration. The effect of frusemide on lung function was also studied after treatment of horses with the cyclooxygenase inhibitor flunixin meglumine (1.1 mg/kg ...
Effects of xylazine on airway function in ponies with recurrent airway obstruction. The effect of IV administration of the alpha 2-adrenoceptor agonist xylazine hydrochloride (0.5 mg/kg of body weight) was examined in ponies with recurrent obstructive pulmonary disease, commonly called heaves. Six ponies with the disease (principals) were studied during clinical remission and during an acute attack of airway obstruction precipitated by stabling and feeding of dusty hay. Six control ponies were also studied. In principal ponies with airway obstruction, xylazine administration significantly (P < 0.05) decreased pulmonary resistance and increased dynamic compliance, but did n...
Decreased airway mucosal prostaglandin E2 production during airway obstruction in an animal model of asthma. Heaves is a respiratory disorder of horses and ponies characterized by bouts of acute airway obstruction and airway hyperresponsiveness. We measured prostaglandin E2 (PGE2) and 15-hydroxyeicosatetraenoic acid (15-HETE) production in vitro in tracheal epithelium obtained from six affected horses at the time of acute airway obstruction as compared with six matched control horses. Strips of epithelium and subepithelial tissue were prepared and stimulated with A23187, histamine, and bradykinin. The PGE2 and 15-HETE in media from strips was quantitated by radioimmunoassay. 15-HETE above the limits ...
Effect of head and neck position on respiratory mechanics in horses sedated with xylazine. We studied the temporal changes in respiratory mechanics associated with xylazine administration (1.1 mg/kg of body weight, IV) in standing horses (experiment 1), and determined the effects of head and neck position (experiment 2) and atropine administration (experiment 3) on the observed changes. Thoroughbred geldings, 3 to 5 years old (5 in experiment 1, 4 in experiments 2 and 3) were used. Flow rates were obtained from a pneumotachograph and a differential transducer attached to a tight-fitting mask. Electronic integration of the flow signal gave tidal volume. Total pulmonary pressure (PL) ...
Mechanical properties of small airways in excised pony lungs. We evaluated the pressure-flow relationships in collaterally ventilating segments of excised pony lungs by infusing N2, He, Ne, or SF6 at known flows (V) through a catheter wedged in a peripheral airway. Measurements were made at segment- (Ps) to-airway opening (Pao) pressure differentials of 3-15 cmH2O when the lungs were held at transpulmonary pressures of 5, 10, and 15 cmH2O. The data were analyzed both by calculating collateral resistance (Ps-Pao/V) and by constructing Moody-type plots of normalized pressure drop [(Ps-Pao)/(1/2 rho U2, where rho is density and U is velocity)] against Reyno...
Cytologic findings of tracheobronchial aspirates from 66 thoroughbred racehorses. Tracheobronchial aspirates obtained from 66 healthy Thoroughbred racehorses in training at the same track were examined. Twenty-seven percent of the horses had greater than 20% neutrophils in the aspirate. Eosinophils, mast cells, giant cells, and Curschmann's spirals of mucus were observed in 94, 83, 65, and 42% of the horses, respectively. Hemosiderophages were observed in 86% of the horses, half of which had previous confirmation of exercise-induced pulmonary hemorrhage. Although fungal elements were seen in 70% of the horses, bacteria were detected in only 3% of the horses. The authors con...
Treatment of left laryngeal hemiplegia in standardbreds, using a nerve muscle pedicle graft. The efficacy of a nerve muscle pedicle (NMP) graft in restoring upper airway function was evaluated in exercising horses with induced left laryngeal hemiplegia. The NMP graft was created from the first cervical nerve and the omohyoideus muscle and transplanted into the left cricoarytenoideus dorsalis muscle. Seven adult Standardbreds were trained to exercise on a treadmill inclined at 6.38 degrees. With the horses at rest and exercising at 4.2 and 7.0 m/s, the following variables were recorded: peak inspiratory and expiratory transupper airway pressures (defined as the pressure difference betw...
A retrospective study of bronchoalveolar lavage cytology in horses with clinical findings of small airway disease. A retrospective of 69 bronchoalveolar lavages (BAL) on horses was done to investigate the relationship between bronchoalveolar cell types and clinical signs in horses with small airway disease. Horses were grouped according to clinical findings. The groups were as follows: I. cough only (n = 14), II. cough with mucopurulent secretions in the trachea (n = 14), III. cough, mucopurulent secretions in the trachea and abnormal lung sounds (n = 24) and IV., all of the above plus dyspnea at rest (n = 17). An asymptomatic group was formed from horses in the same population to serve as control (n = 8)....
Histamine inhalation challenge in normal horses and in horses with small airway disease. A histamine inhalation challenge (HIC) procedure was developed to assess hyperreactive states in horses. Following clinical evaluation, percutaneous lung biopsies were performed on nine light breed mares aged 6 to 15 years. Five horses, with normal small airways, were classified as group A and four subjects with small airway disease (SAD) lesions formed group B. Pulmonary mechanics parameters were monitored following an aerosol of 0.9% saline and every 5 min for up to 30 min after HIC with 0.5% w/v of histamine diphosphate, administered through a face mask for 2.5 min. Tidal volume (VT) and ai...
Use of a protected catheter brush for culture of the lower respiratory tract in horses with small airway disease. A protected catheter brush introduced by fiberoptic bronchoscopy was used to sample the tracheai and bronchial mucosa in 28 horses with small airway disease. Tracheal and bronchial brushings were examined for the presence of fungi, aerobic and anaerobic bacteria, and a cytoiogical evaluation was also done on fluid collected by the bronchoalveolar lavage (BAL) technique. Microorganisms (bacteria and fungi) were isolated more often in tracheal brushings (53.6%) than in bronchial brushings (10.7%). Anaerobic bacteria were not isolated. Results of this study indicate that fiberoptic bronchoscopy u...
Effects of furosemide on ponies with recurrent airway obstruction. The effect of aerosol and intravenous administrations of furosemide was examined in ponies with recurrent obstructive pulmonary disease, commonly called 'heaves'. This recurrent airway disease bears many similarities to human asthma. Six ponies with the disease (principal animals) were studied during clinical remission and during an acute attack of airway obstruction precipitated by stabling and feeding dusty hay. Six control animals were also studied. Furosemide (1.0 mg/kg) or vehicle was administered by aerosol in the first study, and intravenously in a second study. In principal ponies with...
Bilateral arytenoid cartilage paralysis after inhalation anesthesia in a horse. An 8-year-old Quarter Horse gelding was anesthetized for surgical exploration and debridement of a chronic draining wound in the intermandibular space. Anesthesia was without complication other than persistently low PaO2. Severe airway obstruction was evident immediately after extubation, requiring tracheostomy. Endoscopic diagnosis was bilateral arytenoid paralysis, which gradually resolved over the next 7 days. Compression, trauma, or tension of the recurrent laryngeal nerves are the postulated causes of idiopathic laryngeal hemiplegia in horses. The extremely extended position of the head a...
Upper airway function during maximal exercise in horses with obstructive upper airway lesions. Effect of surgical treatment. Upper airway pressure was measured during maximal exercise in 10 Thoroughbred racehorses with naturally occurring upper airway obstruction. Left laryngeal hemiplegia and arytenoid chondropathy resulted in substantial increases (30-40 cm H2O) in inspiratory upper airway pressure (Pl), whereas complicated aryepiglottic entrapment and subepiglottic cysts produced only modest increases (15 cm H2O) in Pl. Uncomplicated aryepiglottic entrapment and grade IV pharyngeal lymphoid hyperplasia produced only slight increases (3-5 cm H2O). In general, surgical procedures restored airway pressures to within...
Use of videoendoscopy during exercise for determination of appropriate surgical treatment of laryngeal hemiplegia in a colt. Videoendoscopy of the larynx during treadmill exercise was used to determine the surgical treatment of upper airway obstruction in a Standardbred colt. Surgical correction of right-sided laryngeal hemiplegia, first by laryngoplasty, then subtotal arytenoidectomy, was ineffective. Videoendoscopy indicated, and upper airway flow mechanics confirmed, that the laryngeal opening was adequate at rest, but obstruction occurred during exercise. On the basis of the appearance of the larynx during high airflow rates on slow-motion playback of the videorecording, total arytenoidectomy was performed, whic...