Bronchoalveolar lavage fluid in Standardbred racehorses: Influence of unilateral/bilateral profiles and cut-off values on lower airway disease diagnosis

The aim of this study was to determine whether the lung side being sampled would significantly influence bronchoalveolar lavage (BAL) cytological profiles and subsequent diagnosis in Standardbred racehorses. One hundred and thirty-eight French Trotters in active training and racing were included in a prospective observational study. BAL was performed using videoendoscopy in both right and left lungs during summer meetings in 2011 (64 horses) and 2012 (74 horses). Cytological data performed 24 h later from right and left lungs were compared and specifically used to classify horses as affected with exercise-induced pulmonary haemorrhage (EIPH), inflammatory airway disease (IAD), or were ‘controls’. For IAD, cytological definition was based on two different cut off values.Neutrophil percentages, haemosiderophage percentages and the haemosiderophage/macrophage (H/M) ratios were significantly higher in the right compared to the left lung. Measures of intra-class correlation coefficients revealed a fair agreement between left and right lungs for percentages of mast cells, eosinophils, and for the H/M ratio, and a moderate agreement for neutrophil percentages. Fair to moderate agreements were observed between left and right lungs for the diagnosis of IAD and/or EIPH based on kappa coefficients. When sampling one lung only, the risk of incorrectly classifying a horse as a ‘control’ increased with the use of the restraint cut-off values for IAD. As BAL from one lung is not representative of the other lung in the same horse, both lungs should be sampled for a better assessment of lung cellularity and for a precise diagnosis of lower airway diseases.     

The effect of palatal dysfunction on measures of ventilation and gas exchange in Thoroughbred racehorses during high intensity exercise

Reason for performing study: The effect of palatal instability (PI) on measures of ventilation and gas exchange is not well understood. Objectives: To assess to what degree different severities of naturally occurring palatal dysfunction affect ventilation and gas exchange during strenuous exercise. Methods: A retrospective study was performed using data collected from 40 Thoroughbred racehorses diagnosed with naturally occurring dynamic palatal dysfunction during high speed treadmill exercise. Upper airway videoendoscopic recordings were made concurrently with measurements of ventilation and gas exchange. Three categories of soft palate dysfunction were formed: mild palatal instability; moderate to severe palatal instability; and dorsal displacement of the soft palate (DDSP). Minute ventilation, tidal volume, breathing frequency, end‐tidal carbon dioxide and oxygen concentrations, oxygen consumption and carbon dioxide production were calculated during the last 10 s of the exercise test, when airway obstruction was at its worst. Results: There was a trend for minute ventilation, tidal volume, oxygen consumption and carbon dioxide production to decrease with increasing degree of palatal dysfunction, although statistically significant differences were only seen with DDSP. End‐tidal carbon dioxide increased and end‐tidal oxygen decreased with increasing obstruction, with both parameters showing significant differences between mild PI and moderate to severe PI. Conclusions: The results suggest that PI has a negative effect on certain respiratory parameters, although this is not as great as that associated with DDSP. Potential relevance: Palatal instability may be detrimental to athletic performance even when progression to DDSP does not occur.     

Effects of genetic and environmental factors on chronic lower airway disease in horses

Background : Environment and genetics influence the manifestation of recurrent airway obstruction (RAO), but the associations of specific factors with mild, moderate, and severe clinical signs are unknown.
Hypothesis : We hypothesized that sire, feed, bedding, time outdoors, sex, and age are associated with clinical manifestations of mild, moderate, and severe lower airway disease.
Animals : Direct offspring of 2 RAO-affected Warmblood stallions (F1S1, n = 172; F1S2, n = 135); maternal half-siblings of F1S1 (mHSS1, n = 66); and an age-matched, randomly chosen control group (CG, n = 33).
Methods : A standardized questionnaire was used to assess potential risk factors and to establish a horse owner assessed respiratory signs index (HOARSI 1–4, from healthy to severe) according to clinical signs of lower airway disease.
Results : More F1S1 and F1S2 horses showed moderate to severe clinical signs (HOARSI 3 and HOARSI 4 combined, 29.6 and 27.3%, respectively) compared with CG and mHSS1 horses (9.1 and 6.2%, respectively; contingency table overall test, P < .001). Sire, hay feeding, and age (in decreasing order of strength) were associated with more severe clinical signs (higher HOARSI), more frequent coughing, and nasal discharge.
Conclusions and Clinical Relevance : There is a genetic predisposition and lesser but also marked effects of hay feeding and age on the manifestation of moderate to severe clinical signs, most markedly on coughing frequency. In contrast, mild clinical signs were not associated with sire or hay feeding in our populations.     

p65 Homodimer activity in distal airway cells determines lung dysfunction in equine heaves

Nuclear factor-κB (NF-κB) activity, which is a key regulator of inflammatory gene expression, is increased in bronchial epithelial cells from horses suffering from heaves (a hypersensitivity-associated inflammatory condition of the lung). To determine whether this increased activity extends to distal airways and to other pulmonary cells, cells recovered by broncho-alveolar lavage (BAL) in healthy and heaves-affected horses were assessed for NF-κB activity. NF-κB activity was much higher in BAL cells from heaves-affected horses, especially during crisis (disease exacerbation), than in cells from healthy horses. Moreover, the level of NF-κB activity found in BAL cells was positively correlated to total lung resistance and to the proportion of neutrophils present in BAL fluid. Finally, prototypical p65–p50 NF-κB heterodimers were absent from BAL cells, which mostly contained p65 homodimers. These results (1) show that increased NF-κB activity is a general feature of heaves lung; (2) demonstrate the importance of p65 homodimers in neutrophilic inflammation; and (3) suggest that the use of specific NF-κB inhibitors could improve lung function in heaves-affected horses.     

Inflammatory airway disease of horses

The purpose of this consensus statement is to provide a review of current knowledge and opinions concerning inflammatory airway disease (IAD) and to help practitioners differentiate IAD from heaves (or recurrent airway obstruction; RAO) and other inflammatory respiratory diseases of horses.     

The effects of overtraining on blood volumes in standardbred racehorses

Red blood cell hypervolaemia has been used for diagnosis of overtraining in racehorses, and has been suggested as a mechanism of this cause of loss of racing performance. The effects of overload training (OLT) on the plasma, blood and red cell volumes were investigated in a prospective study in 12 Standardbred horses. Measurements of blood volumes were made after eight and 32 weeks of an exercise training study. Horses were randomly allocated to OLT and control groups (n=6) after 16 weeks of training. Training duration and intensity were increased more rapidly for the OLT group from week 16, until overtraining was diagnosed in week 32.There were no significant effects of OLT on plasma, blood or total red cell volumes between weeks eight and 32. These volumes significantly decreased with time. Maximal haematocrit after exercise was lower (P<0.05) in the OT group in week 32 (0.57+/-0.003% L/L) than in week eight (0.59+/-0.004 L/L). It was concluded that red cell hypervolaemia was not a mechanism for the decrease in capacity for exercise that occurs with overtraining.     

Arterial blood gas analysis in 53 racehorses with a diagnosis of Small Airway Inflammatory Disease (SAID)

In 53 racehorses with a mean age of 4.5 years old presented for poor performance, Small Airway Inflammatory Disease (SAID) was diagnosed by bronchoalveolar lavage (BAL). Thirty of these horses (58.5%) had arterial pCO₂ above normal range (> 46 mmHg), while pO₂ was within normal range (> 80 mmHg) in both hypercapnic (group A) and normocapnic (group B) horses although pO₂ was significantly lower in group A horses. The horses were subsequently subdivided into two groups according to the duration of symptoms (group 1: less than 4 weeks; group 2: longer than 4 weeks). Horses from group 2 had significantly higher values of pCO₂ (p < 0.01) , HCO₃- (p < 0.01) and TCO₂ (p < 0.05) when compared to horses from group 1. It was concluded that the duration of the inflammatory process may play a role in the alteration of blood/alveolar gas exchanges and acid-base status in SAID affected racehorses.     

Effects of frequency and airway pressure on gas exchange during interrupted high-frequency, positive-pressure ventilation in ponies

Cardiovascular effects and pulmonary gas exchange were compared during conventional mechanical ventilation (CMV) and interrupted high-frequency, positive-pressure ventilation (IHFPPV) in 6 anesthetized ponies in dorsal recumbency. When the peak airway pressure (Paw) was held constant at control values attained during CMV (18 to 20 cm of H2O), and the ventilator frequency of IHFPPV was varied over the range, 2.5 to 12.5 Hz, significant (P less than 0.05) changes from control values were observed only in the ratio of dead-space volume to tidal volume (VD/VT) and in the respiratory minute volume (VE). The mean (+/- SEM) carbon dioxide excretion (VCO2) was 2.12 +/- 0.1 ml/kg/min during IHFPPV. Dead-space ventilation ranged from 40 to 73.7% of total ventilation and increased directly with increasing frequency. The VE also increased, from 89 ml/kg/min at a ventilatory frequency of 2.5 Hz to 145 ml/kg/min at a frequency of 12.5 Hz. Maintaining the frequency of IHFPPV constant at 12.5 Hz and increasing the Paw over the range of 5 to 30 cm of H2O caused significant (P less than 0.05) changes in arterial partial pressure of O2 (PaO2), VCO2, pulmonary shunt fraction (QS/QT), VE, arterial-alveolar differences in oxygen tension (AaDO2), VD/VT, and cardiac output, compared with CMV. The PaO2 and the VCO2 increased linearly with increasing Paw. With increasing Paw, VD/VT decreased directly with increasing Paw from 98 to 69.3%. Gas exchange at a Paw of 15 cm of H2O during IHFPPV was equivalent to conditions at Paw of 20 cm of H2O during CMV. At a higher Paw during IHFPPV, improvements over control values were observed in gas exchange.     

Arterial blood gas anomaly in canine hepatobiliary disease

Arterial blood gas analysis is an important diagnostic and monitoring tool for respiratory abnormalities. In human medicine, lung complications often occur as a result of liver disease. Although pulmonary complications of liver disease have not been reported in dogs, we have frequently encountered hypoxemia in dogs with liver disorders, especially extrahepatic biliary obstruction. In addition, respiratory disorders account for 20% of perioperative fatalities in dogs. Therefore, in this study, we evaluated the respiratory status in dogs with hepatobiliary disease by arterial blood gas analysis. PaO₂ and PaCO₂ were measured. Alveolar-arterial oxygen difference (AaDO₂), the indicator of gas exchange efficiency, was calculated. Compared to healthy dogs (control group), hepatobiliary disease dogs had significantly lower PaO₂ and higher AaDO₂. Hypoxemia (PaO₂ of ≤80 mmHg) was observed in 28/71 dogs with hepatobiliary disease. AaDO₂ was higher (≥30 mmHg) than the control group range (11.6 to 26.4 mmHg) in 32/71 hepatobiliary disease dogs. By classifying type of hepatobiliary disease, dogs with extrahepatic biliary obstruction and chronic hepatitis showed significantly lower PaO₂ and higher AaDO₂ than in a control group. Dogs with chronic hepatitis also had significantly lower PaCO₂. The present study shows that dogs with hepatobiliary disease have respiratory abnormalities more than healthy dogs. Preanesthetic or routine arterial blood gas analysis is likely beneficial to detect the respiratory abnormalities in dogs with hepatobiliary disease, especially extrahepatic biliary obstruction and chronic hepatitis.     

Descriptive results from a longitudinal study of airway inflammation in British National Hunt racehorses

Reasons for performing study: Rates of airway inflammation in young racehorses decrease with time but it is not clear whether this is associated with increasing age or time exposed to the training environment. The structure of the British National Hunt (NH) population allowed closer examination of this relationship. Objectives: To compare rates of inflammatory airway disease diagnosed by tracheal sampling (trIAD), and its components, in NH racehorses by age and training history and with published rates in young racehorses. Methods: A prospective, longitudinal study was conducted on 5 NH yards over 2 years. Period sample prevalences of nasal discharge, tracheal mucus, airway neutrophilia and trIAD (defined by a combination of tracheal mucus and airway neutrophilia) were estimated and compared between horses with different ages and time in training. Results: Horses new to training had twice the odds of visible tracheal mucus as ex‐flat trained horses (OR 2.0; 95% CI: 1.4–2.8; P<0.001) but no significantly increased odds of airway neutrophilia (OR 1.3; 95% CI: 0.8–1.9; P = 0.3) and inconclusive evidence of increased odds of trIAD (OR 1.8; CI: 0.9–3.5; P = 0.08). However, a lower median time in training was significantly associated with the presence of visible mucus (P<0.001), increased mucus (P = 0.005) and trIAD (P = 0.03). No disease measure varied significantly with age. Conclusions: Tracheal mucus and trIAD, but not neutrophilia detected in tracheal wash samples, were less prevalent in horses that had been exposed to the training environment for longer, explaining previously reported associations with age. Potential relevance: Neutrophil proportion in tracheal wash samples is not as useful a clinical tool as measures of visible tracheal mucus for identifying horses requiring treatment or changes in management. The inclusion of tracheal wash neutrophils in the assessment of equine airways, or at least their relative weighting in definitions of trIAD, should be re‐evaluated.     

Effect of sedation with detomidine and butorphanol on pulmonary gas exchange in the horse

Background

Sedation with α₂-agonists in the horse is reported to be accompanied by impairment of arterial oxygenation. The present study was undertaken to investigate pulmonary gas exchange using the Multiple Inert Gas Elimination Technique (MIGET), during sedation with the α₂-agonist detomidine alone and in combination with the opioid butorphanol.

Methods

Seven Standardbred trotter horses aged 3–7 years and weighing 380–520 kg, were studied. The protocol consisted of three consecutive measurements; in the unsedated horse, after intravenous administration of detomidine (0.02 mg/kg) and after subsequent butorphanol administration (0.025 mg/kg). Pulmonary function and haemodynamic effects were investigated. The distribution of ventilation-perfusion ratios (V_A/Q) was estimated with MIGET.

Results

During detomidine sedation, arterial oxygen tension (PaO₂) decreased (12.8 ± 0.7 to 10.8 ± 1.2 kPa) and arterial carbon dioxide tension (PaCO₂) increased (5.9 ± 0.3 to 6.1 ± 0.2 kPa) compared to measurements in the unsedated horse. Mismatch between ventilation and perfusion in the lungs was evident, but no increase in intrapulmonary shunt could be detected. Respiratory rate and minute ventilation did not change. Heart rate and cardiac output decreased, while pulmonary and systemic blood pressure and vascular resistance increased. Addition of butorphanol resulted in a significant decrease in ventilation and increase in PaCO₂. Alveolar-arterial oxygen content difference P(A-a)O₂ remained impaired after butorphanol administration, the V_A/Q distribution improved as the decreased ventilation and persistent low blood flow was well matched. Also after subsequent butorphanol no increase in intrapulmonary shunt was evident.

Conclusion

The results of the present study suggest that both pulmonary and cardiovascular factors contribute to the impaired pulmonary gas exchange during detomidine and butorphanol sedation in the horse.     

Effect of furosemide on urine specific gravity and osmolality in thoroughbred racehorses

Postrace urine samples from thoroughbred horses were examined to compare osmolality and specific gravity between horses treated with furosemide and those not treated. Samples were assigned to groups in relation to reported medication (furosemide) status, race finish position, and distance of race. Urine osmolality was significantly (P <.05) lower in samples from horses treated with furosemide when compared with untreated horses. Specific gravity determinations are less precise at measuring urine osmolality at lower levels (1.01 g/ml or less). The measurement of osmolality is a superior method for determining the urine solute concentration and facilitating the regulation of furosemide.     

Effect of tracheal mucus and tracheal cytology on racing performance in Thoroughbred racehorses

REASON FOR PERFORMING STUDY: Accumulations of mucus within the trachea are often found during endoscopic examinations of the airways of poorly performing racehorses, but the clinical importance of this finding is unknown. OBJECTIVES: To determine the effect of tracheal mucus, pharyngeal lymphoid hyperplasia (PLH) and cytological indices of tracheal aspirate on racing performance in Thoroughbred horses assessed by race place and whether the horse was raced. METHODS: Endoscopic examination of the nasopharynx, larynx and trachea was performed, and a tracheal aspirate obtained monthly at Thistledown racetrack from April to December, 2002 and 2003. Horses received a score of 0-4 for the degree of PLH and 0-4 for the amount of mucus visible in the trachea. The tracheal aspirate was assessed for turbidity, and total and differential cell counts. Generalised estimating equations models were used as repeated measures models for each risk factor and the level of association assessed through the risk factor's P value in the model. RESULTS: Moderate to severe tracheal mucus (2-4) was a risk factor for poor racing performance. There was no association between degree of PLH, cell counts or turbidity of tracheal wash fluid and racing performance. However, horses that raced had higher total neutrophil counts in tracheal wash aspirates than horses that did not race. CONCLUSIONS: Grades 2-4 tracheal mucus should be considered a potential cause of poor racing performance in Thoroughbred horses. CLINICAL RELEVANCE: Because moderate to severe tracheal mucus accumulation, and not increased tracheal neutrophils, was a risk factor for poor racing performance, functionally significant airway inflammation may best be confirmed by the presence of mucus rather than increased number of neutrophils in the trachea.     

Effect of Repeated Arthrocentesis on Cytologic Analysis of Synovial Fluid in Dogs

Background: Serial arthrocentesis and synovial fluid examination can be used to monitor treatment efficacy in immune-mediated polyarthritis (IMPA), but whether this procedure induces inflammation that interferes with test result interpretation is unknown.
Objectives: The aim of this study was to determine the effect of repeated arthrocentesis on synovial fluid cytology in healthy dogs.
Animals: Nine healthy client-owned dogs.
Methods: Prospective study. Arthrocentesis was performed under sedation on 4 joints (both carpi, 1 tarsus, 1 stifle) on each dog every 3 weeks, a total of 4 times. Automated cell counts were done on stifle fluid, smears were made, and differential cell counts done on smears from all joints. Slides were evaluated microscopically for erythrocyte numbers, total nucleated cell count, differential cell count, and cell morphology. Data were analyzed by 2-way analysis of variance.
Results: A total of 144 synovial fluid samples were examined. Repeated arthrocentesis was not associated with increases in synovial fluid neutrophil numbers. Mild mononuclear inflammation was detected in 13 samples from 6 dogs.
Conclusions and Clinical Importance: Serial arthrocentesis at 3-week intervals can rarely be associated with mild mononuclear joint inflammation, but does not appear to induce neutrophilic inflammation, at least in healthy dogs, and can be useful to monitor treatment response in canine IMPA.     

Relative incidence of dorsal metacarpal disease in young Thoroughbred racehorses training on two different surfaces

The relative incidence of dorsal metacarpal disease was examined in two groups of Thoroughbred racehorses training on dissimilar surfaces (dirt and wood fibre). The horses and training methods appeared to be similar. The incidence of disease was significantly greater in the group training on dirt. There was no significant difference in the age distribution of incidence between the two groups and there was no association of incidence with sex or age within the training group. The number of fast miles worked by the two groups prior to the onset of dorsal metacarpal disease was lower in the group training on dirt.     

硅对NaCl胁迫下柳枝稷叶片光合色素及气体交换特性的影响

以两个不同生态型的柳枝稷(Panicum virgatum)Alamo(低地型)和Cave-in-Rock(高地型)为试验材料,研究在0、50、100和150mmol·L~(-1) NaCl浓度下,分别添加0、0.5、1.0和2.0mmol·L~(-1)的外源硅(Na_2SiO_3·9H_2O)对其叶片光合色素含量及光合气体交换参数的影响。结果表明,Alamo叶片的叶绿素a、叶绿素b以及叶绿素a+b的含量均随着NaCl浓度的升高呈现降低趋势,但是Cave-in-Rock的变化趋势则相反。在无外源Si处理下,Alamo叶片净光合速率(Pn)和气孔导度(Gs)在50mmol·L~(-1) NaCl浓度下升高,100和150mmol·L~(-1)下降低;Cave-in-Rock的Pn、Gs和胞间CO_2浓度(Ci)随着NaCl浓度的增加逐渐降低。盐胁迫下,适当浓度外源硅(Si)的添加对Alamo和Cave-inRock叶绿素a、叶绿素a+b和叶绿素b、类胡萝卜素含量的提高具有积极的作用。外源Si的添加同样提高了盐胁迫下Pn、Gs和Ci等参数。本研究中,1~2mmol·L~(-1) Na_2SiO_3·9H_2O对盐胁迫下柳枝稷叶片光合色素及光合气体交换的促进作用较明显。     

Effect of adrenalectomy in the dog on blood gas tensions and oxygen content.

Arterial and venous blood gas tensions and pH were determined in 8 dogs during a control interval, while adrenal deficient, and following replacement therapy with corticosteroids. Additionally, erythrocyte 2,3-diphosphoglycerate (DPG) values were measured, and oxygen tension (mm of Hg) when hemoglobin is half-saturated with oxygen (P50) values were calculated. Mixed venous oxygen tension (PVO2), but not arterial oxygen tension (Pao2), decreased significantly (P less than 0.001) during adrenal insufficiency. This change was reflected in a significantly decreased (P less than 0.001) venous oxygen content and a significant increase (P less than 0.001) of the arterial-venous oxygen content difference. Other changes during adrenal insufficiency were nonsignificant decreases in DPG and P50 values. Treatment with corticosteroids for 2 to 3 days resulted in a significant (P less than 0.001) increase in DPG concentrations, a significant (P less than 0.025) increase in P50, and a reduction in the arterial-venous oxygen content difference compared with those values found in the adrenal-deficient dog.