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Topic:Lung Health

Lung health in horses encompasses the study of respiratory system function, disease, and maintenance in equine species. The equine respiratory system is vital for oxygen exchange and plays a significant role in overall health and athletic performance. Conditions affecting lung health include inflammatory airway disease (IAD), recurrent airway obstruction (RAO), and exercise-induced pulmonary hemorrhage (EIPH). These conditions can impact a horse's respiratory efficiency and performance capabilities. Research in this area often focuses on understanding the pathophysiology, diagnosis, and management of respiratory diseases, as well as the impact of environmental factors on lung function. This page compiles peer-reviewed research studies and scholarly articles that explore the mechanisms, diagnostic approaches, and therapeutic strategies related to lung health in horses.
MicroRNA-221 is overexpressed in the equine asthmatic airway smooth muscle and modulates smooth muscle cell proliferation.
American journal of physiology. Lung cellular and molecular physiology    August 7, 2019   Volume 317, Issue 6 L748-L757 doi: 10.1152/ajplung.00221.2018
Issouf M, Vargas A, Boivin R, Lavoie JP.Airway wall remodeling, including hyperplasia and hypertrophy of smooth muscle (ASM) cells leading to an increased smooth muscle mass, is considered central to asthma. However, molecular pathways responsible for ASM remodeling remain poorly understood. MicroRNAs (miRNAs) have emerged as key regulators of inflammatory and repair processes affecting the lungs and can downregulate protein expression by inhibiting target mRNA translation. We therefore hypothesized that miRNAs are involved in ASM remodeling in asthma by modulating ASM proliferation. We have analyzed the expression of miRNAs in bron...
Effects of general anaesthesia in dorsal recumbency with and without vatinoxan on bronchoalveolar lavage cytology of healthy horses.
Veterinary journal (London, England : 1997)    August 5, 2019   Volume 251 105352 doi: 10.1016/j.tvjl.2019.105352
Rossi H, Raekallio M, Määttä M, Tapio H, Hanifeh M, Junnila J, Rajamäki MM, Mykkänen A.Pneumonia is one of the potential complications of general anaesthesia in horses. Anaesthesia is known to increase neutrophils in bronchoalveolar lavage fluid (BALF) of horses after lateral recumbency, but studies after dorsal recumbency are lacking. Our primary aim was to determine when lung inflammation reaches its maximum and how rapidly BALF cytology returns to baseline after anaesthesia in dorsal recumbency. A secondary aim was to investigate the possible effect of vatinoxan, a novel drug, on the BALF cytology results. Six healthy experimental horses were enrolled in this observational cr...
Randomised study of the immunomodulatory effects of azithromycin in severely asthmatic horses.
The Veterinary record    August 3, 2019   Volume 185, Issue 5 143 doi: 10.1136/vr.105260
Mainguy-Seers S, Vargas A, Labrecque O, Bédard C, Hélie P, Lavoie JP.Neutrophilic inflammation is believed to contribute to the airway obstruction and remodelling in equine asthma. Azithromycin, an antibiotic with immunomodulatory properties, reduces pulmonary neutrophilia and hyper-responsiveness in human asthmatics and decreases airway remodelling in rodent models of asthma. It was therefore hypothesised that azithromycin would improve lung function, mucus accumulation and central airway remodelling by decreasing luminal neutrophilia in severe equine asthma. The effects of a 10-day treatment with either azithromycin or ceftiofur, an antimicrobial without immu...
The relationship between bronchoalveolar lavage fluid cytology and airway hyper-reactivity in a population of Australian horses presented for poor performance.
Australian veterinary journal    July 8, 2019   Volume 97, Issue 9 343-350 doi: 10.1111/avj.12861
Secombe CJ, van Eps AW, Bruce M, Lester GD.To investigate the relationship between bronchoalveolar lavage fluid cytology, particularly mast cells, and airway hyper-reactivity in athletic horses presented for poor performance that included a respiratory tract evaluation in two disparate locations in Australia. Methods: Multi-centre, retrospective and prospective cross-sectional study METHODS: Eighty four adult horses underwent both pulmonary function testing and histamine bronchoprovocation with a commercial flowmetric plethysmography system. A bronchoalveolar lavage was performed four to twelve hours later. Bronchoalveolar lavage fluid...
Clinical efficacy of bronchodilators in equine asthma: Looking for minimal important difference.
Equine veterinary journal    July 1, 2019   Volume 52, Issue 2 305-313 doi: 10.1111/evj.13137
Airway obstruction is the main trait of severe equine asthma that affects respiratory function and elicits detrimental effects on clinical presentation. Only few and underpowered clinical studies have investigated the impact of improvement in lung function induced by bronchodilators on the clinical signs of asthma-affected horses. Objective: To identify the minimal important difference (MID) in lung function elicited by bronchodilator leading to a meaningful improvement in clinical signs. Methods: Pairwise meta-analysis and meta-regression analysis. Methods: Literature searches were performed ...
Effects of positive end-expiratory pressure alone or an open-lung approach on recruited lung volumes and respiratory mechanics of mechanically ventilated horses.
Veterinary anaesthesia and analgesia    June 26, 2019   Volume 46, Issue 6 780-788 doi: 10.1016/j.vaa.2019.04.016
To evaluate the effects of positive end-expiratory pressure (PEEP) alone and PEEP preceded by lung recruitment manoeuvre (LRM) on lung volumes and respiratory system mechanics in healthy horses undergoing general anaesthesia. Methods: Controlled, prospective clinical study. Methods: A group of 15 horses undergoing arthroscopy. Methods: Following anaesthetic induction, initial ventilatory settings were: tidal volume 15 mL kg, inspiratory:expiratory ratio 1:2, respiratory rate to maintain end-tidal CO between 5.3-6.6 kPa (40-50 mmHg). The following settings were implemented sequentially: zero PE...
Two Cases of Equine Multinodular Pulmonary Fibrosis in Japan.
Journal of comparative pathology    June 13, 2019   Volume 170 46-52 doi: 10.1016/j.jcpa.2019.05.007
Ochi A, Sekiguchi M, Tsujimura K, Kinoshita T, Ueno T, Katayama Y.Equine multinodular pulmonary fibrosis (EMPF) is a recently described form of interstitial pneumonia associated with equine herpesvirus type 5 (EHV-5). This disease has been reported in North and South America, Europe and Oceania but not, to our knowledge, in horses in Japan. We diagnosed EMPF in two Thoroughbred horses in Japan on the basis of gross and histopathological findings. In both cases, significant gross lesions, restricted to the lungs, consisted of numerous firm and coalescing nodules widely distributed throughout the lung. The nodules were <3 cm in diameter and pale white to t...
Intra-articular triamcinolone acetonide improves lung function in horses with severe asthma.
Equine veterinary journal    May 22, 2019   Volume 52, Issue 1 131-135 doi: 10.1111/evj.13128
Bessonnat A, Picotte K, Lavoie JP.Locally administered corticosteroids are commonly used to treat joint diseases in sport and racehorses. As they are also the most potent drugs for the treatment of equine asthma, we hypothesised that the intra-articular corticosteroids used to treat joint diseases also improve the lung function in horses with severe asthma, thus potentially delaying the diagnosis of this common lung condition. Objective: To compare the effects of intra-articular (IA) and intramuscular (IM) triamcinolone acetonide (TA) on lung function in horses with severe asthma. Methods: Randomised and controlled experiment ...
Effect of different doses of inhaled ciclesonide on lung function, clinical signs related to airflow limitation and serum cortisol levels in horses with experimentally induced mild to severe airway obstruction.
Equine veterinary journal    April 5, 2019   Volume 51, Issue 6 779-786 doi: 10.1111/evj.13093
Lavoie JP, Bullone M, Rodrigues N, Germim P, Albrecht B, von Salis-Soglio M.Inhaled corticosteroids are effective for the treatment of equine asthma but they induce cortisol suppression with potential side effects. Objective: To study the efficacy of ciclesonide, an inhaled corticosteroid with an improved safety profile, on lung function, clinical signs related to airway obstruction, and serum cortisol levels in asthmatic horses exposed to a mouldy hay challenge. Methods: Cross-over placebo controlled, blinded, randomised experiment. Methods: Sixteen horses were enrolled in three subsequent dose-titration studies (8 horses/study) to investigate the effects of inhaled ...
Insights into animal models for cell-based therapies in translational studies of lung diseases: Is the horse with naturally occurring asthma the right choice?
Cytotherapy    March 29, 2019   Volume 21, Issue 5 525-534 doi: 10.1016/j.jcyt.2019.02.010
Lange-Consiglio A, Stucchi L, Zucca E, Lavoie JP, Cremonesi F, Ferrucci F.Human asthma is a widespread disease associated with chronic inflammation of the airways, leading to loss of quality of life, disability and death. Corticosteroid administration is the mainstream treatment for asthmatic patients. Corticosteroids reduce airway obstruction and improve quality of life, although symptoms persist despite treatment in many patients. Moreover, available therapies failed to reverse the lung pathology present in asthma. Animal models, mostly rats and mice, in which the disease is experimentally induced, have been studied to identify new therapeutic targets for human as...
Nebulisation of dexamethasone sodium phosphate for the treatment of severe asthmatic horses.
Equine veterinary journal    March 28, 2019   Volume 51, Issue 5 641-645 doi: 10.1111/evj.13091
Mainguy-Seers S, Bessonnat A, Picotte K, Lavoie JP.Inhaled corticosteroids are effective in the treatment of equine asthma. A recent study reported that nebulisation of injectable dexamethasone had low systemic bioavailability in healthy horses and could represent a cost-effective therapy for equine inflammatory lung diseases. Objective: To determine the effects of dexamethasone nebulisation on lung function in severe asthmatic horses. It was hypothesised that dexamethasone administered by nebulisation would be more effective than the same dose administered orally. Methods: Randomised blinded experimental study in severe asthmatic horses. Meth...
Exogenous Expression of Equine MHC Class I Molecules in Mice Increases Susceptibility to Equine Herpesvirus 1 Pulmonary Infection.
Veterinary pathology    March 13, 2019   Volume 56, Issue 5 703-710 doi: 10.1177/0300985819834616
Minato E, Aoshima K, Kobayashi A, Ohnishi N, Sasaki N, Kimura T.Equine herpesvirus 1 (EHV-1) uses equine major histocompatibility complex class I (MHC class I) as an entry receptor. Exogenous expression of equine MHC class I genes in murine cell lines confers susceptibility to EHV-1 infection. To examine the in vivo role of equine MHC class I as an entry receptor for EHV-1, we generated transgenic (Tg) mice expressing equine MHC class I under the control of the CAG promoter. Equine MHC class I protein was expressed in the liver, spleen, lung, and brain of Tg mice, which was confirmed by Western blot. However, equine MHC class I antigen was only detected in...
Mediastinal Ectopic Thyroid Carcinoma and Concurrent Multinodular Pulmonary Fibrosis in a Horse.
Journal of equine veterinary science    February 26, 2019   Volume 77 8-11 doi: 10.1016/j.jevs.2019.02.016
Manso-Díaz G, Jiménez Martínez MLÁ, García-Fernández RA, Herrán R, Santiago I.A 30-year-old Standardbred gelding was referred for chronic pleural effusion. Thoracic ultrasound revealed marked bilateral pleural effusion and a large heterogeneous mass within the cranial mediastinum, which extended from the right 5th to the 11th intercostal space. Subsequently, on thoracic radiographs, the cranial mediastinal mass was confirmed, and a nodular interstitial pattern was identified in the lungs. Because of progressive clinical deterioration of the patient, the owners elected humane euthanasia and necropsy was performed. The mediastinal mass was consistent with an ectopic thyro...
The effect of single pretreatment with salbutamol on recovery of bronchoalveolar lavage fluid in horses with suspected or confirmed severe equine asthma.
Journal of veterinary internal medicine    February 1, 2019   Volume 33, Issue 2 976-980 doi: 10.1111/jvim.15359
Varegg MS, Kløverød KM, Austnes MK, Siwinska N, Slowikowska M, Zak A, Niedzwiedz A.Bronchoalveolar lavage (BAL) is a method for the recovery of respiratory secretion from the lower airways. Objective: To investigate if the administration of a single dose of a bronchodilatator in horses with a suspected or confirmed severe equine asthma could improve recovery of bronchoalveolar lavage fluid (BALF). Methods: Twenty-eight horses with severe equine asthma. Methods: Horses were divided into 2 groups: group "treated" was given salbutamol before endoscopic examination and BALF collection, whereas group "not treated" was not given. BAL was performed with BAL-catheter by instilling 3...
Garlic (Allium Sativum) Supplementation Improves Respiratory Health but Has Increased Risk of Lower Hematologic Values in Horses.
Animals : an open access journal from MDPI    January 2, 2019   Volume 9, Issue 1 13 doi: 10.3390/ani9010013
Saastamoinen M, Särkijärvi S, Hyyppä S.Garlic () is claimed to have numerous beneficial properties to the health of humans and animals. It is commonly used for example to treat respiratory diseases and infections in horses' lungs. However, in addition to its possible positive influences, garlic may also have adverse health effects. The hypotheses of this study were that garlic supplementation may help to clear mucus in the airways, but also causes declining hematologic values in prolonged feeding. To our knowledge, this is the first organized study in controlled conditions to show the health effects of garlic supplementation for ho...
Contribution of lung function tests to the staging of severe equine asthma syndrome in the field.
Research in veterinary science    December 18, 2018   Volume 123 112-117 doi: 10.1016/j.rvsc.2018.12.014
Simões J, Sales Luís J, Tilley P.Staging methods are useful tools for monitoring disease and response to treatment, and because Severe Equine Asthma Syndrome (SEAS) has a high prevalence in the equine population, a clinical staging method can provide important information to optimize equine care. Our team has previously developed and published a clinical staging method for SEAS and in the present study we further evaluated information provided by lung function tests, in order to determine their contribution to disease staging. Using discriminant analysis we set out to produce a new staging method with applicability in the fie...
Bronchoalveolar lavage fluid from both lungs in horses: Diagnostic reliability of cytology from pooled samples.
Veterinary journal (London, England : 1997)    December 6, 2018   Volume 244 28-33 doi: 10.1016/j.tvjl.2018.12.002
Hermange T, Le Corre S, Bizon C, Richard EA, Couroucé A.Cytology of bronchoalveolar lavage fluid (BALF) from one lung may not predict findings in the contralateral lung of the same horse. The aim of this study was to determine whether a pooled BALF from both lungs was representative of corresponding individual samples. Fifty-one horses referred for poor performance and/or respiratory signs and for which a BALF was collected from both lungs, were included in the study. Cytology of pooled and individual BALF samples were performed using a masked protocol. Based on clinical signs and individual BALF cytologies, horses were classified as control (CTL),...
Equine lung decellularization: a potential approach for in vitro modeling the role of the extracellular matrix in asthma.
Journal of tissue engineering    November 12, 2018   Volume 9 2041731418810164 doi: 10.1177/2041731418810164
da Palma RK, Fratini P, Schiavo Matias GS, Cereta AD, Guimarães LL, Anunciação ARA, de Oliveira LVF, Farre R, Miglino MA.Contrary to conventional research animals, horses naturally develop asthma, a disease in which the extracellular matrix of the lung plays a significant role. Hence, the horse lung extracellular matrix appears to be an ideal candidate model for in vitro studying the mechanisms and potential treatments for asthma. However, so far, such model to study cell-extracellular matrix interactions in asthma has not been developed. The aim of this study was to establish a protocol for equine lung decellularization that maintains the architecture of the extracellular matrix and could be used in the future ...
Monitoring changes in distribution of pulmonary ventilation by functional electrical impedance tomography in anaesthetized ponies.
Veterinary anaesthesia and analgesia    October 28, 2018   Volume 46, Issue 2 200-208 doi: 10.1016/j.vaa.2018.09.048
Auer U, Schramel JP, Moens YP, Mosing M, Braun C.To assess changes in the distribution in pulmonary ventilation in anaesthetized ponies using electrical impedance tomography (EIT). Methods: Prospective experimental study. Methods: A group of eight adult pony geldings. Methods: General anaesthesia was induced and maintained using isoflurane in oxygen with volume-controlled ventilation [tidal volume (VT) (10 mL kg-1), respiratory rate (8-12 breaths minute-1)] to maintain end-tidal carbon dioxide between 35 and 40 mmHg (4.66-5.32 kPa). Regional distribution of ventilation was assessed with EIT (plane of fifth to sixth intercostal space) at 30, ...
SRSF6 is upregulated in asthmatic horses and involved in the MYH11 SMB expression.
Physiological reports    October 24, 2018   Volume 6, Issue 20 e13896 doi: 10.14814/phy2.13896
Issouf M, Vargas A, Boivin R, Lavoie JP.Smooth muscle has a central role in bronchospasm-induced airway obstruction in asthma. Alternative mRNA splicing of the smooth muscle myosin heavy chain (myh11) gene produces four different isoforms, one of which (SMB) is characterized by the inclusion of the exon5b, which doubles the smooth muscle cells contraction velocity. Deciphering the regulation of the expression levels of the SMB isoform would represent a major step for the understanding of the triggers and pathways leading to airway smooth muscle contraction in asthma. Our objective was therefore, to study the splicing regulation mech...
Sequence variant analysis of RNA sequences in severe equine asthma.
PeerJ    October 11, 2018   Volume 6 e5759 doi: 10.7717/peerj.5759
Tessier L, Côté O, Bienzle D.Severe equine asthma is a chronic inflammatory disease of the lung in horses similar to low-Th2 late-onset asthma in humans. This study aimed to determine the utility of RNA-Seq to call gene sequence variants, and to identify sequence variants of potential relevance to the pathogenesis of asthma. Methods: RNA-Seq data were generated from endobronchial biopsies collected from six asthmatic and seven non-asthmatic horses before and after challenge (26 samples total). Sequences were aligned to the equine genome with Spliced Transcripts Alignment to Reference software. Read preparation for sequenc...
Efficacy of an alveolar recruitment maneuver for improving gas exchange and pulmonary mechanics in anesthetized horses ventilated with oxygen or a helium-oxygen mixture.
American journal of veterinary research    September 27, 2018   Volume 79, Issue 10 1021-1027 doi: 10.2460/ajvr.79.10.1021
Hopster K, D○ LR, Hopster-Iversen CCS, Driessen B.OBJECTIVE To evaluate efficacy of an alveolar recruitment maneuver (ARM) with positive end-expiratory pressures (PEEPs) in anesthetized horses ventilated with oxygen or heliox (70% helium and 30% oxygen). ANIMALS 6 healthy adult horses. PROCEDURES In a randomized crossover study, horses were anesthetized and positioned in dorsal recumbency. Volume-controlled ventilation was performed with heliox or oxygen (fraction of inspired oxygen [Fio] > 90%). Sixty minutes after mechanical ventilation commenced, an ARM with PEEP (0 to 30 cm HO in steps of 5 cm HO every 5 minutes, followed by incremental s...
Efficacy of inhaled budesonide for the treatment of severe equine asthma.
Equine veterinary journal    September 25, 2018   Volume 51, Issue 3 401-407 doi: 10.1111/evj.13018
Lavoie JP, Leclere M, Rodrigues N, Lemos KR, Bourzac C, Lefebvre-Lavoie J, Beauchamp G, Albrecht B.Corticosteroids are the most potent drugs for the control of severe equine asthma, but adverse effects limit their chronic systemic administration. Inhaled medications allow for drug delivery directly into the airways, reducing the harmful effects of these drugs. Objective: To evaluate the efficacy of inhaled budesonide specifically formulated for the equine use and administered by a novel inhalation device in horses with severe asthma. Methods: Experimental studies in horses with naturally occurring asthma with cross-over, randomised, blinded experimental designs. Methods: In Study 1, budeson...
Effect of valacyclovir on EHV-5 viral kinetics in horses with equine multinodular pulmonary fibrosis.
Journal of veterinary internal medicine    September 17, 2018   Volume 32, Issue 5 1763-1767 doi: 10.1111/jvim.15230
Easton-Jones CA, Madigan JE, Barnum S, Maxwell LK, Taylor SD, Arnesen T, Pusterla N.Equine herpesvirus-5 is commonly isolated from the lungs of horses with EMPF, suggesting an etiological link. Valacyclovir is used empirically to treat EMPF; however, no data is available concerning its impact on EHV-5 viral kinetics. Objective: To determine the effect of oral administration of valacyclovir on EHV-5 viral load measured by qPCR in blood, nasal secretions (NS) and BALF in horses with EMPF. Methods: Six horses diagnosed with EMPF. Methods: A prospective clinical trial was performed. Horses received 10 days of PO administered valacyclovir (loading dose 30 mg/kg, maintenance dose 2...
Lung Microbiome Is Influenced by the Environment and Asthmatic Status in an Equine Model of Asthma.
American journal of respiratory cell and molecular biology    September 6, 2018   Volume 60, Issue 2 189-197 doi: 10.1165/rcmb.2017-0228OC
Fillion-Bertrand G, Dickson RP, Boivin R, Lavoie JP, Huffnagle GB, Leclere M.There is evidence that the lung microbiome differs between patients with asthma and healthy humans, but the effect of environmental conditions and medication is unknown and difficult to study. Equine asthma is a naturally occurring chronic airway disease characterized by reversible airway inflammation and bronchoconstriction upon exposure to inhaled antigens. In the present study, we evaluated the effect that environmental conditions and disease status have on pulmonary, nasal, and oral microbiomes. Six asthmatic and six healthy horses were studied while at pasture ("low antigen exposure"), as...
Monitoring of tidal ventilation by electrical impedance tomography in anaesthetised horses.
Equine veterinary journal    August 18, 2018   Volume 51, Issue 2 222-226 doi: 10.1111/evj.12998
Mosing M, Waldmann AD, Raisis A, Böhm SH, Drynan E, Wilson K.Electrical impedance tomography (EIT) is a method to measure regional impedance changes within the thorax. The total tidal impedance variation has been used to measure changes in tidal volumes in pigs, dogs and men. Objective: To assess the ability of EIT to quantify changes in tidal volume in anaesthetised mechanically ventilated horses. Methods: In vivo experimental study. Methods: Six horses (mean ± s.d.: age 11.5 ± 7.5 years and body weight 491 ± 40 kg) were anaesthetised using isoflurane in oxygen. The lungs were mechanically ventilated using a volume-controlled mode. With an end-tidal...
Effects of magnesium sulfate infusion on clinical signs and lung function of horses with severe asthma.
American journal of veterinary research    August 8, 2018   Volume 79, Issue 6 664-673 doi: 10.2460/ajvr.79.6.664
Tanquerel L, Fillion-Bertrand G, Lavoie JP, Leclere M.OBJECTIVE To evaluate whether MgSO solution administered IV would improve the clinical signs and lung function of horses with severe asthma and potentiate the effects of salbutamol inhalation in those horses. ANIMALS 6 adult horses with severe asthma. PROCEDURES Asthmatic horses were used in 3 crossover design experiments (6 treatments/horse). Clinical scores for nasal flaring and the abdominal component associated with breathing and lung function were determined before and after administration of salbutamol (800 μg, by inhalation), MgSO solution (2.2 mg/kg/min, IV, over 20 minutes), and comb...
Efficacy of tamoxifen for the treatment of severe equine asthma.
Journal of veterinary internal medicine    August 7, 2018   Volume 32, Issue 5 1748-1753 doi: 10.1111/jvim.15289
Mainguy-Seers S, Picotte K, Lavoie JP.Tamoxifen, a selective estrogen receptor modulator, decreased airway neutrophilia and improved clinical signs in an experimental model of equine asthma, and induced neutrophilic apoptosis in vitro. Objective: Tamoxifen reduces airway neutrophilia and improves lung function in severe asthmatic horses. Methods: Twelve severe asthmatic horses from a research herd. Methods: Randomized controlled blinded study design. The effects of a 12-day oral treatment with tamoxifen (0.22 mg/kg, q24h) or dexamethasone (0.06 mg/kg, q24h) on lung function, endoscopic tracheal mucus score and bronchoalveolar ...
Exhaled breath condensate hydrogen peroxide, pH and leukotriene B4 are associated with lower airway inflammation and airway cytology in the horse.
Equine veterinary journal    July 19, 2018   Volume 51, Issue 1 24-32 doi: 10.1111/evj.12979
du Preez S, Raidal SL, Doran GS, Prescott M, Hughes KJ.Exhaled breath condensate (EBC) analysis is a noninvasive method to assess the lower respiratory tract. In human subjects, EBC hydrogen peroxide (H O ), pH and leukotriene B (LTB ) are useful for detection and monitoring of inflammatory lung diseases, including asthma. Objective: To determine associations between EBC biomarkers and cytological and endoscopic definitions of lower airway inflammation (LAI) while controlling for sampling and environmental variables. Methods: Prospective, cross-sectional study. Methods: Clinical, endoscopic and airway cytological findings from 47 horses were compa...
Lower Airway Disease in the Athletic Horse.
The Veterinary clinics of North America. Equine practice    July 17, 2018   Volume 34, Issue 2 443-460 doi: 10.1016/j.cveq.2018.04.010
Mazan MR.The airways are the first part of the pathway in the oxygen transport chain that is critical to excellent athletic performance, and the lower airways are considered the final gatekeeper before oxygen enters the blood and carbon dioxide exits. Horses are blessed with large airways and lungs that allow them to be superb athletes, but the down side of this largesse on the part of evolution is that unless they are truly elite athletes they may withstand noninfectious disease of the lower respiratory tract for months to years before the owner or trainer notices. The two conditions of the lower resp...