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Journal of veterinary internal medicine2021; 35(3); 1604-1611; doi: 10.1111/jvim.16113

Nebulized dexamethasone sodium phosphate in the treatment of horses with severe asthma.

Abstract: A study reported low systemic availability of injectable dexamethasone nebulized to healthy horses using the Flexineb mask. When used in horses with severe asthma and a different nebulizer, lack of efficacy and cortisol suppression were observed. Objective: Nebulized dexamethasone is as effective as PO administration for the treatment of severe asthma in horses. Methods: Twelve horses with severe asthma from a research herd. Methods: Randomized clinical trial. Horses were divided into 2 groups and received 5 mg of dexamethasone sodium phosphate by nebulization using a Flexineb mask (NE, n = 6) or PO (OR, n = 6) q24h for 7 days. Lung function and serum cortisol concentrations were evaluated at baseline, after 4 days of treatment (D4) and 1 day after the last treatment (D8). Data were analyzed using linear mixed models with Benjamini-Hochberg adjustments. Results: Lung resistance significantly improved at D4 (mean decrease ± SD, -1.5 ± 0.45 cm H₂O/L/s; 95% confidence interval [CI], -2; -0.6) and D8 (-1.4 ± 0.45 cm H₂O/L/s; 95% CI, -2.4; -0.5) compared to baseline in the OR group only (P = .004 and .01, respectively). Serum cortisol concentration was significantly decreased at D4 and D8 for both groups (maximum decrease, -1.2 ± 0.3 μg/dL; 95% CI, -1.9; -0.6 at D4 for NE group and -2.2 ± 0.3 μg/dL; 95% CI, -2.8; -1.6 at D8 for OR group; P < .001). Conclusions: Oral, but not nebulized dexamethasone is an effective therapy for horses with severe asthma and both treatment modalities inhibit the hypothalamic-pituitary-adrenal axis.
© 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
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Publication Date: 2021-04-04 PubMed ID: 33817859PubMed Central: PMC8162592DOI: 10.1111/jvim.16113Google Scholar: Lookup
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  • Journal Article
  • Randomized Controlled Trial
  • Veterinary

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.

The research investigates and compares the efficacy of nebulized and oral administration of dexamethasone sodium phosphate in treating severe asthma in horses. It concluded that oral administration was effective, but not the nebulized method, and both treatments impacted the hypothalamic-pituitary-adrenal axis.

Objective of the Study

The main aim of the study was to compare the effectiveness of nebulized and orally administered dexamethasone sodium phosphate, a corticosteroid medication, in treating horses with severe asthma. The researchers hypothesized that nebulized dexamethasone would be as effective as oral administration.

Methods Employed

  • The study involved twelve horses diagnosed with severe asthma from a research herd.
  • The horses were divided into two groups, each group receiving the medication in a different form: nebulized (NE, n = 6) and oral (OR, n = 6).
  • The medication was administered once daily for a total of seven days at a dose of 5 mg.
  • Lung function and serum cortisol concentrations were measured before treatment (baseline), four days into the treatment (D4), and one day after the last treatment (D8).
  • Data were analyzed using linear mixed models with Benjamini-Hochberg adjustments.

Key Findings

  • At the fourth and eighth day, significant improvement in lung resistance was observed in the orally-treated group compared to the baseline results.
  • Interestingly, cortisol levels decreased significantly at D4 and D8 for both treatment groups. This indicates that both forms of treatment affected the hypothalamic-pituitary-adrenal axis, the system that controls reactions to stress and regulates various body processes including immune response and regulation of metabolism.

Conclusion of the Study

The study concluded that oral administration of dexamethasone is effective in treating severe asthma in horses. However, nebulized dexamethasone did not demonstrate similar efficacy. Both forms of treatment significantly affected the hypothalamic-pituitary-adrenal axis, as evidenced by the decreased cortisol levels. Thus, the initial hypothesis that nebulized dexamethasone would be as effective as its oral counterpart was refuted. This finding has implications for therapy selection in equine asthma treatment.

Cite This Article

APA
de Wasseige S, Picotte K, Lavoie JP. (2021). Nebulized dexamethasone sodium phosphate in the treatment of horses with severe asthma. J Vet Intern Med, 35(3), 1604-1611. https://doi.org/10.1111/jvim.16113

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 35
Issue: 3
Pages: 1604-1611

Researcher Affiliations

de Wasseige, Selena
  • Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Q, Canada.
Picotte, Khristine
  • Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Q, Canada.
Lavoie, Jean-Pierre
  • Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Q, Canada.

MeSH Terms

  • Animals
  • Asthma / drug therapy
  • Asthma / veterinary
  • Dexamethasone / analogs & derivatives
  • Dexamethasone / therapeutic use
  • Horse Diseases / drug therapy
  • Horses
  • Hydrocortisone
  • Hypothalamo-Hypophyseal System
  • Pituitary-Adrenal System

Grant Funding

  • Fonds du Centenaire - Faculty of Veterinary Medicine of the University of Montreal
  • Nortev

Conflict of Interest Statement

Nortev provided funding and equipment for this experiment.

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Citations

This article has been cited 4 times.
  1. Minuto J, Bedenice D, Ceresia M, Zaghloul I, Böhlke M, Mazan MR. Clinical effects and pharmacokinetics of nebulized lidocaine in healthy horses. Front Vet Sci 2022;9:984108.
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  2. Mahalingam-Dhingra A, Mazan MR, Bedenice D, Ceresia M, Minuto J, Deveney EF. A CONSORT-guided, randomized, double-blind, controlled pilot clinical trial of inhaled lidocaine for the treatment of equine asthma. Can J Vet Res 2022 Apr;86(2):116-124.
    pubmed: 35388235
  3. Talavera-López J, Tudela-González A, Muñoz-Prieto A. Use of a Capsaicin Cough Challenge Test to Compare Four Different Techniques for Nebulization Delivery in Cats. Vet Sci 2024 Jul 17;11(7).
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  4. Bond S, Léguillette R. A CONSORT-guided, randomized controlled clinical trial of nebulized administration of dexamethasone and saline on lower airway cytokine mRNA expression in horses with moderate asthma. J Vet Intern Med 2024 Mar-Apr;38(2):1214-1223.
    doi: 10.1111/jvim.16983pubmed: 38205666google scholar: lookup
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