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.
Evidence of an association between inflammatory airway disease and EIPH in young Thoroughbreds during training. In an epidemiological study of risk factors for exercise-induced pulmonary haemorrhage (EIPH) in young Thoroughbreds in the UK, in which 148 horses contributed 1614 horse-months of data, there were 64 (4%) episodes of endoscopically visible tracheal bleeding and 824 (51%) episodes of increased quantities of haemosiderophages in tracheal washes. There were increases in prevalence and risk of EIPH by both definitions with age from or = 4 years, season of sampling from winter (Nov-Jan) to autumn (Aug-Oct) and several different measures of airway inflammation, including tracheal mucus, neutrophil...
Airway cooling and mucosal injury during cold weather exercise. In human subjects that exercise strenuously in cold weather, there is evidence that hyperventilation with cold air leads to peripheral airway cooling, desiccation and mucosal injury. Our hypothesis was that hyperventilation with cold air can result in penetration of unconditioned air (air that is not completely warmed and humidified) into the peripheral airways of exercising horses, resulting in peripheral airway mucosal injury. To test this hypothesis, a thermister-tipped catheter was inserted through the midcervical trachea and advanced into a sublobar bronchus in three horses that cantered ...
Effect of chronic airway inflammation and exercise on pulmonary and systemic antioxidant status of healthy and heaves-affected horses. In heaves-affected horses the relation between oxidant status, airway inflammation (AI) and pulmonary function (PF) is unknown. The oxidant status of blood and pulmonary epithelial lining fluid (PELF) of healthy (H, n = 6) and heaves-affected horses in clinical remission (REM, n = 6) and in crisis (CR, n = 7) was assessed at rest, during and after standardised exercise test by measurement of reduced and oxidised glutathione, glutathione redox ratio [GRR%]; uric acid and 8-epi-PGF2alpha. Oxidant status was related to PF parameters (mechanics of breathing and arterial blood gas tension) and Al p...
Effect of commercially available nasal strips on airway resistance in exercising horses. To determine the effect of a commercially available nasal strip on airway mechanics in exercising horses. Methods: 6 horses (5 Standardbreds and 1 Thoroughbred). Methods: Horses exercised on a treadmill at speeds corresponding to 100 and 120% of maximal heart rate with and without application of a commercially available nasal strip. Concurrently, tracheal pressures, airflow, and heart rate were measured. Peak inspiratory and expiratory tracheal pressures, airflow, respiratory frequency, and tidal volume were recorded. Inspiratory and expiratory airway resistances were calculated by dividing pe...
Evaluation of nebulised hay dust suspensions (HDS) for the diagnosis and investigation of heaves. 3: Effect of fractionation of HDS. To investigate the relative importance of inhaled particulates and soluble components in the response to inhaled hay dust suspension (HDS), heaves (previously termed chronic obstructive pulmonary disease; n = 7) and control (n = 6) horses were given inhalation challenges with whole and fractionated HDS. Fractionation was achieved by centrifugation to yield supernatant (SUP) and particulate debris. The particulates were then washed repeatedly in saline to produce a washed particulate (WP) fraction which comprised mainly fungal spores, and a wash fraction (WF) which comprised saline and soluble ...
Evaluation of nebulised hay dust suspensions (HDS) for the diagnosis and investigation of heaves. 2: Effects of inhaled HDS on control and heaves horses. To evaluate inhaled hay dust suspensions (HDS) as a tool for the diagnosis and investigation of heaves, the pulmonary inflammatory and functional consequences of inhalation challenge with 3 different HDS were determined in 6 control and 7 asymptomatic heaves horses. Heaves horses given HDS challenge developed the characteristic features of heaves, including airway neutrophilia, obstructive airway dysfunction and mucus hypersecretion. While HDS challenge induced a mild airway neutrophilia in controls, the no-response threshold for controls was greater than that of heaves horses, and there was n...
Comparison of effects of dexamethasone and the leukotriene D4 receptor antagonist L-708,738 on lung function and airway cytologic findings in horses with recurrent airway obstruction. To evaluate whether the leukotriene (LT) D4 receptor antagonist L-708,738 is therapeutically beneficial in treating horses with recurrent airway obstruction (heaves). Methods: 12 adult horses with heaves and healthy lung lobes from 20 slaughtered horses. Methods: Lung lobes were used for smooth muscle tension and radioligand binding studies. Horses with heaves were given a placebo for 14 days and administered L-708,738 (n = 6; 2.5 mg/kg PO, q 12 h) or dexamethasone (6; 0.04 mg/kg, IV, q 24 h) from days 14 to 28. Pulmonary function was measured weekly for 36 days, and bronchoalveolar cells were...
Efficacy of three corticosteroids for the treatment of heaves. This study used a cross-over design to compare the efficacy of 3 corticosteroids for the relief of airway obstruction and inflammation in 9 heaves-affected horses. The severity of airway obstruction and inflammation was quantified by measurement of lung function and by bronchoalveolar lavage fluid (BALF) cytology, respectively. Airway obstruction was induced by stabling the horses and they remained stabled during the 10 day treatment period. Lung function was measured before treatment (baseline), at Days 3, 7, and 10 of treatment, and after 30 days at pasture. BALF cytology was investigated at...
Neutrophilic airway inflammation in horses with heaves is characterized by a Th2-type cytokine profile. Heaves in horses shares many similarities with human asthma, including lower airway inflammation, reversible airway obstruction, and bronchial hyperresponsiveness. Extrinsic asthma is an allergic response to environmental allergens and a similar immunologic mechanism may be implicated in heaves. It is now recognized that a Th2 subset of CD4+ lymphocytes is associated with allergic diseases such as atopic asthma. The purpose of this study was to determine whether airway inflammation in heaves is associated with a pattern of expression of cytokine suggestive of a Th2 type response. The expressio...
[Bronchoaveolar lavage for the diagnosis of lower airway disorders in horses]. Equine pulmonary disease and especially the terminology of lower airway disease have been subject to discussion. Besides established terms such as 'Chronic Obstructive Pulmonary Disease' (COPD) and Chronic bronchitis, the term 'small airway disease' (SAD) has been introduced, for respiratory disease with inflammation in the lower airways in combination with exercise intolerance. Bronchoalveolar lavage (BAL) enables the practitioner to diagnose SAD in an early stage when there are no other signs such as coughing or exudate in the trachea. The BAL fluid is microscopically examined after centrifu...
Anti-remodelling drugs for the treatment of asthma: requirement for animal models of airway wall remodelling. 1. Airway wall remodelling (AWR), the structural change induced by acute and chronic inflammation in the airways, may be one of the most significant and difficult to reverse components of progressive asthma. 2. The mechanisms underlying the development of AWR are not known. Studies of only the most superficial wall structures of large airways can be conducted in living humans because of the degree of invasiveness required to measure airway structural changes. These studies reveal that currently available agents do not fully prevent or reverse AWR. Thus, animal models of asthma pathology may be...
Stabling is associated with airway inflammation in young Arabian horses. We examined the effect of stabling on upper and lower airway inflammation in 14 yearling Arabian horses that had been at pasture since birth. Horses were divided into 2 groups of 7. One group was stabled for 3 months and the other remained at pasture. The groups were then switched over for another 3 months. The nasopharynx, guttural pouches and trachea were examined endoscopically and bronchoalveolar lavage performed every month. An upper airway inflammation score was devised based on the magnitude of pharyngeal lymphoid hyperplasia and guttural pouch inflammation. During stabling this score r...
Pulmonary and systemic effects of inhaled endotoxin in control and heaves horses. To investigate whether inhaled endotoxin contributes to airway inflammation and dysfunction in stabled horses, control (n = 6) and asymptomatic heaves (previously termed chronic obstructive pulmonary disease)-susceptible (n = 7) horses were given inhalation challenges with 20, 200 and 2,000 microg of soluble Salmonella typhimurium Ra60 lipopolysaccharide (LPS). LPS inhalation induced a dose-dependent neutrophilic airway inflammatory response in both groups. Inhalation with 2,000 microg of LPS also induced detectable lung dysfunction in the heaves group. LPS inhalation did not alter clinical sc...
Spectrum analysis of respiratory sounds in exercising horses with experimentally induced laryngeal hemiplegia or dorsal displacement of the soft palate. To record respiratory sounds in exercising horses and determine whether spectrum analysis could be use to identify sounds specific for laryngeal hemiplegia (LH) and dorsal displacement of the soft palate (DDSP). Methods: 5 Standardbred horses. Methods: Respiratory sounds were recorded and pharyngeal pressure and stride frequency were measured while horses exercised at speeds corresponding to maximum heart rate, before and after induction of LH and DDSP. Results: When airway function was normal, expiratory sounds predominated and lasted throughout exhalation. After induction of LH, expiratory s...
Effect of a tongue-tie on upper airway mechanics during exercise following sternothyrohyoid myectomy in clinically normal horses. To determine the effect of a tongue-tie on upper airway mechanics in clinically normal horses exercising on a treadmill following sternothyrohyoid myectomy. Methods: 6 Standardbreds. Methods: Upper airway mechanics were measured with horses exercising on a treadmill at 5, 8, and 10 m/s 4 weeks after a sternothyrohyoid myectomy was performed. Pharyngeal and tracheal inspiratory and expiratory pressures were measured by use of transnasal pharyngeal and tracheal catheters connected to differential pressure transducers. Horses were fitted with a facemask and airflow was measured by use of a pneumo...
Statistical shape analysis of volumetric capnograms: evaluation of a new approach for the assessment of pulmonary function in horses with chronic obstructive pulmonary disease. The shape of the volumetric capnogram is modified by airway obstruction, and the evaluation of this deformation could allow an indirect measurement of bronchial patency. The study included 35 horses; five horses without evidence of pulmonary disease (group I) and 30 horses suffering from different degrees of chronic obstructive pulmonary disease (COPD) (groups II-IV). Data of recorded CO2 and volume curves were off-line plotted and statistically analysed using regression analysis. Analyses were performed separately for fractions 25-95% (VTE25-95), 25-50% (VTE25-50) and 50-95% (VTE50-95) of exp...
Comparative responses of bronchial rings to mediators of airway hyperreactivity in healthy horses and those affected with summer pasture-associated obstructive pulmonary disease. To compare responses of bronchial rings obtained from healthy horses and horses affected with summer pasture-associated obstructive pulmonary disease (SPAOPD) to selected mediators of airway hyperreactivity in vitro. Methods: Bronchial rings from 6 healthy horses and 6 horses affected with SPAOPD. Methods: Bronchial rings obtained from each group of horses were mounted in organ baths and attached to force transducers interfaced with a polygraph. After applying 2g of tension, each ring was allowed to equilibrate for 45 minutes in Tyrode's solution at 37 C. Cumulative concentration-response rela...
Endoscopic electrosurgical excision of laryngeal granulation tissue in a standing pregnant mare. An 11-year-old, eight-months pregnant mare suddenly developed severe respiratory distress. Endoscopic examination identified intralaryngeal granulation tissue obstructing the airway. In order to avoid general anaesthesia and the problems associated with a permanent tracheostomy, the mass was resected electrosurgically while the mare was standing. Patency was restored to the airway and the mare foaled without complication.
Relationship between clinical signs and lung function in horses with recurrent airway obstruction (heaves) during a bronchodilator trial. During a trial to determine the dose response to the beta2-adrenergic agonist pirbuterol, we judged the severity of airway obstruction by use of a clinical scoring system and compared this to objective data obtained by quantitative measures of lung function. Six horses affected by recurrent airway obstruction were used in this trial. Four hundred and sixty-eight measurements of lung function and clinical scores were obtained from 13 measurement periods when horses received each of 6 doses of pirbuterol. Scores of 1-4 were assigned to degree of nasal flaring and abdominal effort and summed for ...
Environment and prednisone interactions in the treatment of recurrent airway obstruction (heaves). Recurrent airway obstruction (RAO) or heaves is a manifestation of a hypersensitivity to dust, moulds, and spores in the environment of a susceptible horse. Although in the majority of RAO-affected horses, clinical remission can be achieved by keeping horses at pasture to reduce their allergen exposure, this often is not practicable. For this reason, we investigated if changing the environment of a single stall in a 4 stall stable was sufficient to improve lung function and reduce inflammation in RAO-affected horses. In addition, we determined if addition of oral prednisone provided additional...
Tracheobronchial mucus viscoelasticity during environmental challenge in horses with recurrent airway obstruction. The goal of this study was to compare the rheological properties of mucus from horses with recurrent airway obstruction (RAO) to that from healthy controls during environmental challenge by stabling in stalls with straw as bedding and hay as feed. We determined viscoelasticity (log G* dyn/cm2, at 10 radian/s) and calculated mucociliary clearability index (MCI) and cough clearability index (CCI), which are derivative parameters of G* and the ratio of viscosity and elasticity measured at 1 and 100 radian/s, respectively. We also investigated the solids content of mucus, and cytology of bronchoal...
An in vitro comparison of cordopexy, cordopexy and laryngoplasty, and laryngoplasty for treatment of equine laryngeal hemiplegia. To examine the effect of cordopexy, laryngoplasty, and cordopexy combined with a modified laryngoplasty on airway mechanics. Methods: Experimental airway mechanics were determined by subjecting equine cadaveric larynges to airflows similar to inspiratory airflow of exercising horses. Methods: Twenty equine larynges. Methods: Using cadaveric larynges, we developed and tested a new technique of arytenoid cartilage abduction. All larynges had the right arytenoid cartilage abducted to mimic the degree of arytenoid abduction that occurs at maximal exertion in live horses. Three surgical techniques ...
Causes of poor performance of horses during training, racing, or showing: 348 cases (1992-1996). To determine results for horses undergoing a high-speed treadmill examination, including videoendoscopy of the pharynx and larynx before and during exercise, echocardiography before and after exercise, and electrocardiography before, during, and after exercise, because of poor performance. Methods: Retrospective study. Methods: 348 horses. Results: A definitive diagnosis was obtained for 256 (73.5%) horses. One hundred forty-eight horses had dynamic obstruction of the airway during exercise, 33 had clinically important cardiac arrhythmias alone, 22 had a combination of dynamic airway obstructi...
Equine respiratory pharmacology. Differentiation of diseases of the equine respiratory tract is based on history, clinical signs, auscultation, endoscopy, imaging, and sampling of airway exudate. Upper respiratory therapies include surgical correction of airway obstructions; flushing of localized abscesses (strangles), guttural pouch disease, or sinusitis; and oral or parenteral antibiotic and anti-inflammatory therapy if deemed necessary. Pneumonia usually is treated with antimicrobials, anti-inflammatories, and bronchodilators. Pleural drainage is indicated if significant pleural effusion is present. The most commonly used ...
Airway responses to histamine aerosol in clinically normal foods. To describe the spectrum of nonspecific airway reactivity in a group of clinically normal foals. Methods: 12 clinically normal mixed-breed foals, 48 to 92 days old, without history of clinical lung disease. Methods: Nonspecific airway reactivity was determined by measuring the extent of changes in dynamic compliance during nebulization of incrementally increasing concentrations of histamine aerosol. Degree of airway reactivity was expressed as the dose of histamine that evoked a decrease in dynamic compliance (Cdyn) to 65% of the after saline nebulization value (PC65Cdyn) or increase in pulmon...
Pre- and postjunctional effects of inflammatory mediators in horse airways. In addition to their direct contractile effects, histamine (Hist), serotonin [5-hydroxytryptamine (5-HT)], and leukotriene (LT) D(4), in low concentrations, dramatically augment electrical field stimulation (EFS)-induced smooth muscle contractions in equine airways. To determine the mechanism of their action, we studied, in trachealis strips, the effect of these mediators on both cholinergically induced tension and the release of ACh from cholinergic nerves. All three mediators synergistically augmented the contraction of the trachealis that was due to release of endogenous ACh, i.e., EFS-indu...