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.
Bronchial collapse during bronchoalveolar lavage in horses is an indicator of lung inflammation. The bronchoalveolar lavage (BAL) procedure can return variable volumes of fluid, possibly depending on the presence of bronchial collapse during fluid aspiration and on the severity of lung inflammation. Objective: We tested the hypothesis that horses with bronchial collapse during BAL are at higher risk of having severe lung inflammation. Methods: Prospective field study. Methods: Bronchial collapse was graded using a new simple scoring method (0, 1 or 2) during a standardised BAL procedure in the field on 131 horses with normal, mild/moderate or severe lower airway inflammation on cytology o...
Breathing pattern and thoracoabdominal asynchrony in horses with chronic obstructive and inflammatory lung disease. The aim of the study was to show that changes in thoracoabdominal asynchrony (TAA) between quiet breathing and CO2-induced hyperpnoea can be used to differentiate between horses with healthy airways and those suffering from inflammatory airway disease (IAD) or recurrent airway obstruction (RAO). The level of TAA was displayed by the Pearson's correlation coefficient (PCC) of thoracic and abdominal signals, generated by respiratory ultrasonic plethysmography (RUP) during quiet breathing and hyperpnoea. Changes in TAA were expressed as the quotient of the PCCs (PCCQ) during normal breathing and ...
Effect of selenium and vitamin C on clinical outcomes, trace element status, and antioxidant enzyme activity in horses with acute and chronic lower airway disease. A randomized clinical trial. Excess production of reactive oxygen species is involved in the pathogenesis of airway disorders in horses. Trace element antioxidants have a beneficial role in oxidant/antioxidant balance. The aim of the present study was to evaluate the effect of a combination of sodium selenite and ascorbic acid on clinical outcome, antioxidant enzymes, and trace elements status in horses with lower airway disease. For this purpose, 40 draft horses with lower airway disease were randomly selected (acute, n = 20; chronic, n = 20). Both acute and chronic cases were randomly allocated into two subgroup...
Retrospective study investigating causes of abnormal respiratory noise in horses following prosthetic laryngoplasty. To investigate causes of respiratory noises in horses following prosthetic laryngoplasty (with or without a ventriculocordectomy) and to examine potential associations between degree of arytenoid abduction and the presence of other upper respiratory tract (URT) abnormalities, including right-sided collapse. Methods: Clinical records and dynamic videoendoscopic recordings were examined from horses presented between 1995 and 2010 for investigation of respiratory noise during exercise, following a prosthetic laryngoplasty (+/- a ventriculocordectomy). Relationships between the degree of left aryt...
Near-fatal misuse of medical tape around an endotracheal tube connector during inhalation anesthesia in a horse. A 7-year-old gelded Irish sports horse weighing 650 kg was anesthetized on 2 consecutive days for lavage of a septic right radio-carpal joint. On both occasions the endotracheal tube connector, which had been bound in medical tape to produce an airtight seal, functioned as a unidirectional valve during mechanical ventilation, retarding expiration, imposing positive end expiratory pressure (PEEP), and probably continuous positive airway pressure (CPAP). The equipment dysfunction was not identified on either occasion despite close inspection prompted by progressive increases in airway pressure a...
Effects of leukotriene C4 on the bioelectric properties and ion transport of equine tracheal epithelium. To determine effects of leukotriene (LT) C(4) on ion transport across equine tracheal epithelium. Sample-Tracheal epithelium from cadavers of 24 horses considered free of respiratory tract disease. Methods: Mucosae were mounted into Ussing chambers, and short-circuit current (I(sc)) was monitored over time. Effects of LTC(4) were examined for various conditions, including addition of amiloride (10μM) to the mucosal bath solution, addition of bumetanide (10μM) to the serosal bath solution, addition of barium (1mM) to the serosal bath solution, and substitution of gluconate for chloride and HE...
Bronchodilator activity of the selective muscarinic antagonist revatropate in horses with heaves. Bronchodilators are frequently used to attenuate airway obstruction in equine heaves (or recurrent airway obstruction). This study evaluated the selective (M(3) and M(1)) muscarinic antagonist revatropate, which offers potential advantages over non-specific antimuscarinic agents such as ipratropium. Protocol 1 assessed the response to inhaled revatropate (1, 2 and 7 mg) using a blinded, negative (inhaled saline) and positive (inhaled ipratropium bromide; 0.3, 0.7 and 2mg) controlled, dose escalation study, with six heaves horses. The lowest doses of revatropate and ipratropium induced a rapid ...
Cohort study examining long-term respiratory health, career duration and racing performance in racehorses that undergo left-sided prosthetic laryngoplasty and ventriculocordectomy surgery for treatment of left-sided laryngeal hemiplegia. The risk of respiratory conditions, such as inflammatory airway disease (IAD) and exercise-induced pulmonary haemorrhage (EIPH), are thought to be higher in racehorses that undergo prosthetic laryngoplasty with ventriculocordectomy (PLVC) surgery to treat left-sided laryngeal hemiplegia (LLH) than in racehorses with normal laryngeal function. However, this has not been investigated formally owing to the difficulty of obtaining reliable follow-up data. Objective: To determine the incidence of respiratory conditions (IAD and EIPH), duration of racing career, number of starts and number of starts...
Antioxidant trace elements in serum of draft horses with acute and chronic lower airway disease. The aim of the present study was to evaluate the oxidative stress level and antioxidant trace elements status associated with lower airway disease in draft horses. For this purpose, venous blood samples were obtained from draft horses exhibiting signs of lower respiratory tract disorders (n = 83) and from control group (n = 20). Serum trace elements including selenium (Se), copper (Cu), zinc (Zn), manganese (Mn), and iron (Fe) were assayed. Serum malondialdehyde (MDA) and low-density lipoprotein (LDL) levels as well as plasma hydrogen peroxides (H₂O₂) concentration and activity of ...
Corticosteroids and antigen avoidance decrease airway smooth muscle mass in an equine asthma model. Recent studies suggest that airway smooth muscle remodeling is an early event in the course of asthma. Little is known of the effects of long-term antigen avoidance and inhaled corticosteroids on chronically established airway remodeling. We sought to measure the effects of inhaled corticosteroids and antigen avoidance on airway remodeling in the peripheral airways of horses with heaves, a naturally occurring asthma-like disease. Heaves-affected adult horses with ongoing airway inflammation and bronchoconstriction were treated with fluticasone propionate (with and without concurrent antigen av...
Detection of fluticasone propionate in horse plasma and urine following inhaled administration. Fluticasone propionate (FP) is an anti-inflammatory agent with topical and inhaled applications commonly used in the treatment of asthma in steroid-dependent individuals. The drug is used in racehorses to treat Inflammatory Airway Disease; this work was performed in order to advise on its use and detect potential misuse close to racing. Methods were developed for the extraction and analysis of FP from horse plasma and a carboxylic acid metabolite (FP-17βCOOH) from horse urine. The methods utilize ultra high performance liquid chromatography coupled to tandem mass spectrometry (UPLC-MS/MS) in ...
Antimicrobial drug concentrations and sampling techniques in the equine lung. The distribution of antimicrobial drugs in the equine lung is important in designing optimal dosage regimens for the treatment of lower airway infections. Several studies in horses and other species have shown that the pharmacokinetics of a drug in the lung cannot necessarily be predicted by its behaviour in plasma, and influencing factors include the class of drug, the animal species and the chosen sampling technique. This review provides a description of the target site for bacterial lower airway infections and describes the penetration of antibiotics into lung matrices. It also offers an ov...
Effect of prolonged administration of clenbuterol on airway reactivity and sweating in horses with inflammatory airway disease. To determine whether prolonged administration of clenbuterol results in tachyphylaxis, specifically regarding its bronchoprotective properties and effect on sweating in horses. Methods: 8 Thoroughbreds with inflammatory airway disease. Methods: In a crossover design, horses received clenbuterol (0.8 μg/kg, p.o., q 12 h) or placebo for 21 days, with a washout period of ≥ 30 days between the 2 treatments. Airway reactivity was evaluated by use of flowmetric plethysmography and histamine broncho-provocation before (day 0; baseline) and every 7 days after the start of treatment. Sweat function ...
Increased adenosine concentration in bronchoalveolar lavage fluid of horses with lower airway inflammation. Several reports have suggested a role for adenosine in the pathogenesis of chronic airway conditions and this has led to new therapeutic strategies to limit airway inflammation. In this study, detectable levels of adenosine in bronchoalveolar lavage (BAL) samples from 11 horses with non-infectious lower-airway inflammation and 14 healthy controls are reported, with significantly higher values in horses with airway inflammation. Although these increased levels did not correlate with changes in neutrophil percentage in BAL, a positive association between adenosine levels and signs of lower airwa...
Comparison of cytokine mRNA expression in the bronchoalveolar lavage fluid of horses with inflammatory airway disease and bronchoalveolar lavage mastocytosis or neutrophilia using REST software analysis. The pathophysiology of inflammatory airway disease (IAD) is unknown, but in some cases involves the accumulation of mast cells, neutrophils, or both in the bronchoalveolar lavage fluid (BALF). The objective of this study was to characterize cytokine gene expression in the BALF cells of horses with IAD, including a comparison of cytokine gene expression between IAD horses with increased BALF mast cells (IAD-Mast) or neutrophils (IAD-Neutro). Methods: The mRNA expression of IL-4, IFN-γ, IL-17, IL-8, IL-1β, IL-5, IL-6, IL-10, IL-12p35, and eotaxin-2 was studied by quantitative polymerase chain ...
Dynamic respiratory videoendoscopy in ridden sport horses: effect of head flexion, riding and airway inflammation in 129 cases. Dynamic upper airway obstruction (UAO) is a cause of respiratory noise and sometimes poor performance in sport horses. Riding, head flexion and airway inflammation may impact upper respiratory tract stability during exercise. Objective: To evaluate upper airway mechanical behaviour in ridden sport horses using overground endoscopy and the effect of head flexion, rider intervention and underlying airway inflammation on the pharynx and larynx. Methods: Resting and exercising videoendoscopic recordings during ridden exercise were obtained in 129 sport horses referred mainly for respiratory noise,...
Pulmonary edema at recovery after colic operation with in-situ nasogastric tube in a horse. After an uneventful general anesthesia, in a horse negative pressure pulmonary edema developed due to acute upper airway obstruction during the anesthetic recovery phase after colic surgery. No pathologic alteration of respiration was observed until the horse stood up and began suffocating. The horse had recovered with the nasogastric tube in situ. This, together with the postmortem diagnosis of laryngeal hemiplegia resulted in impairment of airflow through the larynx and development of pulmonary edema. Our objective is to alert clinicians about the possible hazard of recovery with an in-situ ...
Heaves, an asthma-like disease of horses. Animal models have been developed to investigate specific components of asthmatic airway inflammation, hyper-responsiveness or remodelling. However, all of these aspects are rarely observed in the same animal. Heaves is a naturally occurring disease of horses that combines these features. It is characterized by stable dust-induced inflammation, bronchospasm and remodelling. The evaluation of horses during well-controlled natural antigen exposure and avoidance in experimental settings allows the study of disease mechanisms in the asymptomatic and symptomatic stages, an approach rarely feasible ...
Spi2 gene polymorphism is not associated with recurrent airway obstruction and inflammatory airway disease in thoroughbred horses. The aim was to detect the presence of polymorphisms at exons 1, 2, 3 and 4 of the Spi2 gene, and evaluate a possible association between them and recurrent airway obstruction (RAO) or inflammatory airway disease (IAD) in thoroughbred horses, through single-strand conformational-polymorphism (SSCP) screening. Although polymorphism was not detected in exons 1, 2 and 3, three alleles and six genotypes were identified in exon 4. The frequencies of allele A (0.6388) and genotype AA (0.3888) were higher in horses affected by RAO, although no association was found between polymorphism and horses with...
Serum concentration of surfactant protein D in horses with lower airway inflammation. Surfactant protein D (SP-D), mainly synthesised by alveolar type II cells and nonciliated bronchiolar cells, is one important component of innate pulmonary immunity. In man, circulating concentrations of SP-D are routinely used as biomarkers for pulmonary injury. To date, serum SP-D levels have only been investigated in horses in an experimental model of bacterial airway infection. Objective: To compare serum SP-D concentrations at rest and after exercise in horses with and without inflammatory airway disease (IAD). Methods: Venous blood samples were collected from 42 Standardbred racehorses a...
Epiglottic abnormalities in mature nonracehorses: 23 cases (1990-2009). To identify history, clinical signs, endoscopic findings, treatment, and outcome of mature (> 8 years old) nonracehorses with epiglottic abnormalities. Methods: Retrospective case series. Methods: 23 horses with an epiglottic abnormality. Methods: Medical records of horses examined between 1990 and 2009 because of an epiglottic abnormality were reviewed to obtain information on signalment, history, clinical signs, clinical examination findings, upper airway endoscopic findings, diagnosis, surgical procedure, clinical management, postoperative care, and outcome. Results: Mean ± SD age was 16 Â...
Evaluation of a risk-screening questionnaire to detect equine lung inflammation: results of a large field study. The diagnosis of equine recurrent airway obstruction (RAO) and inflammatory airway disease (IAD) is based on clinical signs and increased inflammatory cell percentages in the bronchoalveolar lavage (BAL) fluid. Since a BAL is an invasive procedure, a risk-screening questionnaire (RSQ) would be a valuable screening tool for lung inflammation. Objective: To evaluate the accuracy of a RSQ to detect lower airway inflammation (LAI) in a large population of horses. Methods: A standardised BAL was performed in the field on 167 horses in Alberta, Canada. Horses were separated into 3 categories: 1) BAL...
Increased apoptosis of CD4 and CD8 T lymphocytes in the airways of horses with recurrent airway obstruction. Recurrent airway obstruction (RAO, also known as equine heaves) is an inflammatory condition similar to human asthma caused by exposure of susceptible horses to poorly ventilated stable environments. The disease is characterized by neutrophilic airway inflammation, mucus hypersecretion and reversible bronchoconstriction. This inflammatory process is mediated by several factors, including antibodies, cytokines, resident cells of the airway and inflammatory cellular components that arrive in the respiratory tract. An increasing body of evidence has lent support to the concept that a dysregulatio...
Descriptive results from a longitudinal study of airway inflammation in British National Hunt racehorses. Rates of airway inflammation in young racehorses decrease with time but it is not clear whether this is associated with increasing age or time exposed to the training environment. The structure of the British National Hunt (NH) population allowed closer examination of this relationship. Objective: To compare rates of inflammatory airway disease diagnosed by tracheal sampling (trIAD), and its components, in NH racehorses by age and training history and with published rates in young racehorses. Methods: A prospective, longitudinal study was conducted on 5 NH yards over 2 years. Period sample pre...
Enhanced IL-6 transcriptional response to adenosine receptor ligands in horses with lower airway inflammation. Accumulation of extracellular adenosine has been closely associated with human asthmatic responses. However, the relevance of adenosine signalling in equine airways has not previously been investigated. Objective: To determine the expression of adenosine receptors (AR) in bronchoalveolar lavage (BAL) cells and assess the reactivity of these cells to AR ligands ex vivo, employing IL-6 as readout of adenosinergic inflammatory signalling. Methods: Eight horses with varying degrees of lower airway inflammation and 10 healthy controls were analysed. Expression of AR-subtypes in each BAL sample was ...
Comparative efficacy of inhaled albuterol between two hand-held delivery devices in horses with recurrent airway obstruction. Studies investigating the clinical efficacy of albuterol administered with the same propellant and commercially available delivery devices in horses with recurrent airway obstruction (RAO) are not currently available. Objective: To determine the efficacy of aerosolised albuterol administered to horses with RAO by means of 2 commercially available, hand-held delivery devices. Methods: Ten horses with RAO were kept in a dusty environment and fed mouldy hay to induce airway obstruction. Lung mechanics were measured before and after the procedure. ΔP(max) was measured 5 min after administration o...
Evaluation of suitable reference genes for gene expression studies in bronchoalveolar lavage cells from horses with inflammatory airway disease. The stability of reference genes has a tremendous effect on the results of relative quantification of genes expression by quantitative polymerase chain reaction. Equine Inflammatory Airway Disease (IAD) is a common condition often treated with corticosteroids. The diagnosis of IAD is based on clinical signs and bronchoalveolar lavage (BAL) fluid cytology. The aim of this study was to identify reference genes with the most stable mRNA expression in the BAL cells of horses with IAD irrespective of corticosteroids treatment. Results: The expression stability of seven candidate reference genes (B2...
Effect of antigenic exposure on airway smooth muscle remodeling in an equine model of chronic asthma. Recent studies suggest that airway smooth muscle remodeling is an early event in asthma, but whether it remains a dynamic process late in the course of the disease is unknown. Moreover, little is known about the effects of an antigenic exposure on chronically established smooth muscle remodeling. We measured the effects of antigenic exposure on airway smooth muscle in the central and peripheral airways of horses with heaves, a naturally occurring airway disease that shares similarities with chronic asthma. Heaves-affected horses (n = 6) and age-matched control horses (n = 5) were kept on pastu...
Pulmonary function measurements immediately after exercise are correlated with neutrophil percentage in tracheal aspirates in horses with poor racing performance. Inflammatory airway disease (IAD) is common in racehorses, and is a cause of wastage in the industry. IAD has been diagnosed by measurement of percent neutrophils (N%) in tracheal aspirates (TA). The aim of this study was to investigate whether spirometric indices of pulmonary function were correlated with N% in TAs. Limits to breathing were measured by analyses of relationships between relative times and relative respiratory gas flows during inspiration and expiration in individual breaths recorded after exercise. Horses with higher N% had significantly lower relative gas flows at the same re...
Immunohistochemical identification of collagen in the equine lung. Recurrent airway obstruction (RAO) in the horse is a disease characterized by reversible bronchoconstriction and by mucus and neutrophil accumulation in the airways. It has been hypothesized that in horses with RAO, remodeling changes occur that are similar to those described in humans with asthma. Although collagen fibrils are present surrounding normal airways, they are a prominent feature of airway remodeling in human asthma with evidence of enhanced collagen III and I fibril deposition. An immunolabeling method was developed to identify collagen I and III in equine lung and to describe the...