Equine multinodular pulmonary fibrosis (EMPF): Five case reports.

The research article discusses a study of equine multinodular pulmonary fibrosis (EMPF), a serious lung disease in horses that often leads to death. The researchers studied five case reports of the disease, which is thought to be linked with gammaherpesviruses, specifically Equine Herpesvirus-5 (EHV-5).

Objective of the Research

• The main purpose of the research was to investigate five cases of EMPF in horses, aiming to understand the clinical presentation, diagnostic procedures, comorbidities, and outcome of each case.

Findings of the Study

• In three of the horses, two from Hungary and one from the Czech Republic, EMPF was diagnosed prior to death. Common symptoms observed were difficulty breathing (dyspnoea) and weight loss. Laboratory tests showed that they had low blood oxygen levels (hypoxaemia) and markers indicative of inflammation (neutrophilia and hyperfibrinogenaemia).
• An endoscopic examination of the respiratory tract was performed, alongside cytology and culture of tracheobronchial secretion and bronchoalveolar lavage. A secondary bacterial infection was found in one of these cases.
• Diagnosis of EMPF was suspected based on positive EHV-5 PCR from bronchoalveolar lavage and findings from thoracic radiographs and ultrasound examination. In one case, the diagnosis was confirmed through a lung biopsy.
• Unfortunately, all horses either died naturally or had to be euthanized due to the severity of the disease, despite attempts at treatment.
• The remaining two horses, from Austria, were diagnosed with EMPF post mortem (after death). These horses not only had EMPF, but also other illnesses that seemed to be linked to immunosuppression.
• The five horses exhibited different forms of the disease, with three showing the discrete form and two the diffuse form of EMPF. In all cases, EHV-5 DNA was detected in lung tissue by PCR, reinforcing the proposed association between EHV-5 and EMPF.

Implications of the Research

• The study adds valuable information to EMPF research, providing detailed case accounts of the disease. It demonstrates the consistency of signs and symptoms across several horses, and the importance of thorough diagnostic procedures, such as blood tests, endoscopy, and imaging.
• The common detection of EHV-5 DNA in all cases studied strengthens the proposed association between this virus and EMPF. This may open avenues for future research into potential treatments or prevention strategies that target EHV-5.
• The finding that EMPF may be associated with other immune-suppressing conditions suggests that affected horses may need comprehensive veterinary care beyond treatment for EMPF.