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Animals : an open access journal from MDPI2025; 15(16); 2428; doi: 10.3390/ani15162428

Influence of a Standardized Lunging Exercise Test on BALF Cytology in Horses Suffering from Mild-Moderate Equine Asthma.

Abstract: Mild-moderate equine asthma (MEA) is a very common but underdiagnosed pulmonary disease in horses, with mild cases not showing clinical respiratory signs. This study evaluates the influence of a standardized lunging exercise test (SLET) on bronchoalveolar lavage fluid (BALF) cytology in MEA horses. We hypothesized that SLET would increase the total nucleated cell count (TNCC) and/or percentages of inflammatory cells associated with EA. In a prospective, randomized, non-blinded, between-subjects study design of two independent groups, 39 horses (17 mild and 22 moderate) were included. They were chosen out of a cohort of horses undergoing respiratory investigations (history, clinical examination, and clinical pathology (white blood cells (WBC) and arterial blood gas analysis (aBGA)) consistent with MEA, using a scoring system in a clinical setting of an equine referral clinic. Bronchoalveolar lavage (BAL) was performed 30 min post-SLET in 16 randomly chosen horses. The other horses underwent BAL without SLET. The SLET resulted in a statistically significant increase ( < 0.001) in the proportions of neutrophils in BALF cytology, and in an increased chance of confirmation of the presumed diagnosis in horses with mild phenotypes ( < 0.001, OR = 8.00, CI = 1.28-50.04), while moderate phenotypes were less frequently diagnosed. Exercise had no association with cytology across all horses. Unexpectedly, the SLET group of horses with a moderate phenotype had a statistically significant lower TNCC ( = 0.035). In conclusion, an SLET prior to BAL might increase the chance of an MEA diagnosis.
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Publication Date: 2025-08-19 PubMed ID: 40867756PubMed Central: PMC12382838DOI: 10.3390/ani15162428Google Scholar: Lookup
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Overview

  • This study investigates how a standardized lunging exercise test (SLET) affects lung fluid cell composition in horses with mild to moderate equine asthma (MEA).
  • The goal was to see if exercising horses before sampling their lung fluid would reveal more signs of inflammation useful for diagnosis.

Background on Mild-Moderate Equine Asthma (MEA)

  • MEA is a common but often underdiagnosed lung disease in horses.
  • Mild cases may not show obvious respiratory symptoms, which complicates diagnosis.
  • This condition involves inflammation in the lungs that can be detected by analyzing bronchoalveolar lavage fluid (BALF), a sample taken from the lungs.

Purpose of the Study

  • To evaluate if performing a standardized lunging exercise test (SLET) before collecting BALF influences the cellular makeup of the lung fluid in horses with MEA.
  • Specifically, researchers hypothesized that SLET would increase the total nucleated cell count (TNCC) and/or the percentage of inflammatory cells like neutrophils in BALF.
  • The idea was to determine if exercise could help better identify horses with MEA, especially those with mild disease that is hard to diagnose.

Study Design

  • The study was prospective, randomized, and non-blinded with two independent horse groups.
  • 39 horses diagnosed with mild (17 horses) or moderate (22 horses) MEA based on clinical examination, history, and pathology were included.
  • Horses underwent standard respiratory investigations including white blood cell counts and blood gas analysis to confirm MEA.
  • 16 horses were randomly assigned to undergo the SLET, with BALF collected 30 minutes after exercise.
  • The other horses had BALF collected without prior lunging exercise.

Key Findings

  • The SLET caused a statistically significant increase (p < 0.001) in the proportion of neutrophils detected in the BALF, indicating more inflammation was visible after exercise.
  • Horses with mild MEA were 8 times more likely to have their diagnosis confirmed after SLET (Odds Ratio 8.00, CI 1.28-50.04, p < 0.001); this suggests exercise helps unmask mild disease.
  • In contrast, horses with moderate MEA were less frequently diagnosed using this method following exercise.
  • Unexpectedly, moderate phenotype horses in the SLET group showed a statistically significant lower total nucleated cell count (TNCC) (p = 0.035) after exercise.
  • Across all horses, exercise did not have a consistent association with overall cytology changes.

Interpretation and Conclusion

  • The exercise induced by SLET likely mobilizes inflammatory cells, particularly neutrophils, making mild MEA easier to detect through BALF cytology.
  • In mild cases that do not show clinical signs, exercising horses before sampling their lung fluid might improve diagnostic accuracy.
  • The finding that moderate MEA cases had a lower TNCC after exercise is unexpected and indicates that disease severity may influence how inflammation markers respond post-exercise.
  • Overall, incorporating a standardized lunging exercise test before collecting BALF could be a useful clinical tool to better identify mild equine asthma cases.
  • Further research is needed to understand the mechanisms behind these observations and to optimize diagnostic protocols for differing disease severities.

Cite This Article

APA
Lendl L, Wirth C, Merle R, Barton AK. (2025). Influence of a Standardized Lunging Exercise Test on BALF Cytology in Horses Suffering from Mild-Moderate Equine Asthma. Animals (Basel), 15(16), 2428. https://doi.org/10.3390/ani15162428

Publication

Animals : an open access journal from MDPI
ISSN: 2076-2615
NlmUniqueID: 101635614
Country: Switzerland
Language: English
Volume: 15
Issue: 16
PII: 2428

Researcher Affiliations

Lendl, Lioba
  • Equine Clinic Hochmoor, 48712 Gescher, Germany.
  • School of Veterinary Medicine, Freie Universitaet Berlin, 14163 Berlin, Germany.
Wirth, Caroline
  • Equine Clinic Hochmoor, 48712 Gescher, Germany.
Merle, Roswitha
  • Institute of Veterinary Epidemiology and Biostatistics, School of Veterinary Medicine, Freie Universitaet Berlin, 14163 Berlin, Germany.
Barton, Ann Kristin
  • Equine Clinic Hochmoor, 48712 Gescher, Germany.
  • School of Veterinary Medicine, Freie Universitaet Berlin, 14163 Berlin, Germany.

Conflict of Interest Statement

The authors declare no conflicts of interest.

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