Aerosol therapy in the equine species

Inhalation therapy plays an increasing role in the management of equine respiratory disorders. Thisalternative to systematic treatment permits a high concentration of medication to act locally while minimizing side effects and residues. In human medicine, literature in this field is prolific and continuously renewed, whereas in veterinary medicine, applications of aerosol therapy are less extensive. This review considers the principles of action of the different types of devices used for inhalation, i.e., nebulization, metered-dose inhalation and dry powder inhalation, describes the technical and practical requirements for their use in the equine species and considers the advantages and disadvantages of each inhalation device. The pharmacological agents currently administered to horses by inhalation are also discussed. Perspectives of aerosol therapy in the equine species, including aerosols already used in human medicine and their potential applications for horses are described.     

Relationship of plasma lactate production to cortisol release following completion of different types of sporting events in horses

Fifty-eight healthy horses were studied during five sporting events of various intensities and durations, namely show-jumping (n=6), cross-country in a three-day event (n=30), trotting races (n=7), galloping reces (n=7) and endurance rides (n=8). Venous blood samples were collected at rest and immediately after exercise and analysed for plasma cortisol (CORT) and lactate (LA) levels. The experimental procedure was the same throughout the investigation so as to permit a reliable comparison between the five types of exercise. The type of event significantly affected both the resting (p0.05) and the postexercise (p0.01) plasma CORT. The degree of exercise-induced hypercortisolaemia was related to both the intensity and the duration of exercise for all five sporting events, but the endurance ride induced the most and show-jumping the least serious post-exercise CORT changes. LA production was much more closely related to the intensity of the exercise than was CORT. It is concluded that simultaneous measurements of plasma CORT and LA levels may be useful to discriminate between different types of exercise, adjust training programmes, and improve our comprehension of the physiology of sport horses at exercise.Abbreviations CORT cortisol - E/R exercise to rest ratio - EDTA ethylenediaminetetraacetic acid - HR heart rate - LA lactate     

Monofrequency forced oscillation technique for the investigation of pulmonary function in calves: in vitro and in vivo studies

Parameters derived from the non-invasive and simple monofrequency forced oscillation technique were compared with classical parameters of ventilatory mechanics in order to assess its usefulness for the investigation of pulmonary function in calves. To facilitate this comparison, theoretical derivations were coupled with in vitro measurements, using an artificial lung model, and with in vivo studies. These studies compared the oscillatory resistance parameters (R_os and Re) and the respiratory system compliance (C_rs) against the classical pulmonary resistance (R_L) and the dynamic compliance (C_dyn), respectively. Ros and Re were highly correlated (r0·87) with R_L and the comparison between Crs and C_dyn gave a similarly high correlation (r0·88). Given its simplicity, its correspondence with classical parameters and its rapidity and reproducibility, monofrequency forced oscillation technique seems well suited for the investigation of pulmonary function under field conditions.     

Spirometric performance in Belgian Blue calves: I. Effects on economic losses due to the bovine respiratory disease complex

The aim of this study was to determine whether high spirometric performances in calves are associated with low economic losses due to the bovine respiratory disease complex (BRDC). Five spirometric variables (SV) were measured in 909 double-muscled Belgian Blue calves from 15 to 60 d of age. Afterward, calves were monitored for 6 mo to determine whether they developed BRDC and to determine the costs due to BRDC (i.e., medicine costs and veterinarians' fees, plus estimated financial losses due to mortality in case of death). To analyze the effects of spirometric performances on BRDC cost, a fixed linear model was used for each SV. In addition to SV, each model included the effects of sex, dam's parity, vaccination status, muscular development score, herd-period, and BW. Only herd-period and the maximal ventilation and the vital capacity had significant effects on costs due to BRDC, indicating that these two SV are major physiological determinants of economic losses associated with BRDC. Accordingly, it is assumed that an amelioration of maximal ventilation and vital capacity could result in increased resistance to BRDC in calves.     

Ketoprofen and phenylbutazone attenuation of PAF-induced lung inflammation in calves

The purposes of this study were: (1) to investigate which arachidonic acid metabolites contributed to platelet-activating factor (PAF) induced pulmonary dysfunction; and (2) to compare the effect of two non-steroidal anti-inflammatory drugs, phenylbutazone and ketoprofen in a model of PAF-induced reversible lung inflammation in six calves. In placebo and phenylbutazone groups, PAF infusion induced significant dysfunctions in the pattern of breathing, mechanics of breathing and gas exchange. These dysfunctions were prevented by ketoprofen pretreatment, except for the mechanics of breathing which was moderately but significantly altered by the PAF challenge. In all calves, leukotriene (LT) B4 plasma concentrations did not significantly increase above baseline values at any time. Prostaglandin (PG) E2 plasma concentrations showed a minor significant increase in phenylbutazone pretreated calves (55.8 +/- 25.8 pg/mL from 36.7 +/- 16.13 pg/mL). Thromboxane (TX) B2 plasma concentration was significantly increased during PAF challenge in placebo- and phenylbutazone-pretreated groups, but not in ketoprofen-pretreated calves (1580.0 +/- 1370 from 42.7 +/- 10.7 pg/mL; 2340 +/- 477 from 63 +/- 32 pg/mL; and 36.5 +/- 4.12 from 39.3 +/- 12.0 pg/mL, respectively). These data suggest that TXA2 is an important cyclooxygenase metabolite of arachidonic acid produced in response to PAF and that ketoprofen (intramuscular injection, 3 mg/kg) is more effective than phenylbutazone (intramuscular injection, 10 mg/kg) in preventing respiratory dysfunctions induced by the PAF challenge 30 min after drug administration. Ketoprofen did not suppress totally the PAF-induced changes in mechanics of breathing, which suggests that PAF or a secondary release of mediators could have a direct action on airway smooth muscle.     

Sternal recumbency or suspension by the hind legs immediately after delivery improves respiratory and metabolic adaptation to extra uterine life in newborn calves delivered by caesarean section

The aim of this study was to evaluate the effect of body positioning immediately after delivery on respiratory and metabolic adaptation to extra-uterine life in newborn calves. One hundred and one Belgian White and Blue calves were delivered at term by an elective caesarean section and were assigned into three categories according to the body position imposed immediately after umbilical cord rupture: 71 calves were placed in lateral recumbency; 16 calves were placed in sternal recumbency and 14 calves were suspended by the hind legs for less than 90 seconds (75 +/- 5 s). Following this initial body position, the calves were allowed to move without restraint. They were examined at birth, 5, 15, 30, 45 and 60 minutes, and 2, 3, 6, 12 and 24 hours after birth by the following measurements: physical examination, heart rate, arterial blood gas analysis, pulmonary function tests using the esophageal balloon catheter technique, arterial and venous blood acid-base balance analysis, rectal temperature, jugular venous blood sampling for the determination of blood glucose, plasma lactate and serum cortisol concentrations, haematologic variables and passive immune transfer variables. Body positioning immediately after delivery clearly influenced respiratory and metabolic adaptation to extra-uterine life in term calves delivered by an elective caesarean section. Systematic sternal recumbency and suspension by the hind legs for less than 90 seconds immediately after umbilical cord rupture had a positive functional impact on postnatal pulmonary mechanics and gas exchange and on postnatal correction of mixed acidosis present at birth, contributing in turn to an enhanced passive immune transfer. These two body positions should be encouraged to improve adaptation at birth in healthy term calves delivered by an elective caesarean section. Evaluation of possible side-effects is required before application in severely asphyxiated calves.     

Doppler ultrasonography and single-fiber laser Doppler flowmetry for measurement of hind limb blood flow in anesthetized horses

OBJECTIVE: To use Doppler ultrasonography and single-fiber laser Doppler flowmetry (LDF) to evaluate blood flow in the dependent and nondependent hind limbs of anesthetized horses and to evaluate changes in femoral arterial blood flow and microvascular skeletal muscle perfusion in response to administration of phenylephrine hydrochloride or dobutamine hydrochloride. ANIMALS: 6 healthy adult horses. PROCEDURE: Horses were anesthetized and positioned in left lateral recumbency. Doppler ultrasonography was used to measure velocity and volumetric flow in the femoral vessels. Single-fiber LDF was used to measure relative microvascular perfusion at a single site in the semimembranosus muscles. Phenylephrine or dobutamine was then administered to decrease or increase femoral arterial blood flow, and changes in blood flow and microvascular perfusion were recorded. RESULTS: Administration of phenylephrine resulted in significant decreases in femoral arterial and venous blood flows and cardiac output and significant increases in mean aortic blood pressure, systemic vascular resistance, and PCV. Administration of dobutamine resulted in significant increases in femoral arterial blood flow, mean aortic blood pressure, and PCV. Significant changes in microvascular perfusion were not detected. CONCLUSION AND CLINICAL RELEVANCE: Results suggest that Doppler ultrasonography and single-fiber LDF can be used to study blood flows in the hind limbs of anesthetized horses. However, further studies are required to determine why changes in femoral arterial blood flows were not associated with changes in microvascular perfusion.     

Effect of a 30-minute infusion of dobutamine hydrochloride on hind limb blood flow and hemodynamics in halothane-anesthetized horses

OBJECTIVE: To evaluate the hemodynamic effects of dobutamine hydrochloride (0.5 microg/kg of body weight/min) in halothane-anesthetized horses. ANIMALS: 6 adult Thoroughbred horses. PROCEDURE: Anesthesia was induced by use of romifidine (100 microg/kg) and ketamine (2.2 mg/kg), IV. Anesthesia was maintained by halothane (end-tidal concentration 0.9 to 1.0%). Aortic, left ventricular, and right atrial pressures were measured, using catheter-mounted strain gauge transducers. Cardiac output (CO), velocity time integral, maximal aortic blood flow velocity and acceleration, and left ventricular preejection period and ejection time were measured from aortic velocity waveforms obtained by transesophageal Doppler echocardiography. Velocity waveforms were recorded from the femoral vessels, using Doppler ultrasonography. The time-averaged mean velocity and early diastolic deceleration slope (EDDS) were measured. Pulsatility index (PI) and volumetric flow were calculated. Microvascular perfusion was measured in the semimembranosus muscles by laser Doppler flowmetry. Data were recorded 60 minutes after induction of anesthesia (control) and at 15 and 30 minutes after start of an infusion of dobutamine (0.5 microg/kg/min). RESULTS: Aortic pressures were significantly increased during the infusion of dobutamine. No change was observed in the indices of left ventricular systolic function including CO. Femoral arterial flow significantly increased, and the PI and EDDS decreased. No change was observed in the femoral venous flow or in microvascular perfusion. CONCLUSIONS AND CLINICAL RELEVANCE: At this dosage, dobutamine did not alter left ventricular systolic function. Femoral blood flow was preferentially increased as the result of local vasodilatation. The lack of effect of dobutamine on microvascular perfusion suggests that increased femoral flow is not necessarily associated with improved perfusion of skeletal muscles.     

Comparison of the performance of linear resistance and ultrasonic pneumotachometers at rest and during lobeline-induced hyperpnoea

The performance of a Fleisch No. 5 pneumotachometer (F), and two commercial ultrasonic pneumotachometers, the BRDL (B) and the Spiroson (S) systems were compared in respect to their use for determination of ventilatory parameters at rest and during lobeline-induced hyperpnoea. Five clinically healthy Thoroughbred horses were tested with the three pneumotachometers in random order. Respiratory airflow, respired gas concentrations, oesophageal pressures, pressures within the mask systems and arterial blood gases were determined before and during lobeline-induced hyperpnoea. Because measured peak expiratory airflow rates exceeded the stated linear range of the Fleisch pneumotachometer ( approximately +/- 25 l s(-1)) differential pressure-flow curves were determined in vitro over the range of flows recorded in vivo. Expired flows greater than the linear range were corrected according to the derived regression equation. No differences in any of the measured variables among the three systems were present at rest. At peak ventilation of lobeline-induced hyperpnoea mask pressures [Delta P(mask)(mean (SEM)): F: 9.6 (2.8) cm H(2)O, B: 0.8 (0.4) cm H(2)O, S: 1.4 (0.8) cm H(2)O] and end tidal carbon dioxide [ ET CO(2)(mean (SEM)): F: 2. 6 (0.1)%, B: 2.1 (0.2)%, S: 2.1 (0.1)%] were significantly higher in system F. Despite a tendency for respiratory frequency and peak inspired and expired flows, to be lower with system F, no significant differences in the measurements of ventilatory mechanics were detected. In conclusion, the ultrasonic flowmeters pose significantly lower resistive loads onto the respiratory system during ventilation above resting levels than Fleisch No 5 pneumotachometers. However, at the flowrates achieved during lobeline-induced hyperpnoea an in vitro calibration of the differential pressure-flow relationship allows correction for expiratory alinearity in system F. In addition, the performance of the Spiroson flowmeter is accurate in determining ventilatory mechanics at rest and during lobeline-induced hyperpnoea.     

Growth-related changes in the pulmonary function of goats

Growth-related changes in pulmonary function values were investigated in 20 healthy French Alpine goats, aged between 20 and 550 days, weighing 7–55 kg. Pulmonary ventilation, mechanics of breathing and arterial oxyten tension were measured using standardized techniques and methods adapted for goats of different body sizes. The Ppl values and the tI/tTOT ratio showed no significant changes with age and body size. The ventilation values (Vt, Ve, mVI and mVE) increased linearly with growth. There was a significant correlation of age and body weight with dynamic lung compliance (Cdyn), total pulmonary resistance (RL), viscous work of breathing (Wvis tot) and minute viscous work (Wvis min) throughout the age range studied. Cdyn, Wvis tot and Wvis min increased and RL decreased with age and body weight. Arterial blood gases (PaO₂ and PaCO₂) did not show significant changes over the age range studied. Regression equations for each pulmonary function parameter are given with body weight as the independent variable. Data for the mechanics of breathing were compared with those elsewhere for cattle, horses, man and dogs.