Antibiotic prophylaxis of lower respiratory tract contamination in horses confined with head elevation for 24 or 48 hours

Objective To evaluate the administration of procaine penicillin prior to or during confinement with head elevation as a means of reducing the associated accumulation of inflammatory lower respiratory tract secretions and increased numbers of bacteria within the lower respiratory tract of confined horses. Design and Procedure Two experiments were conducted to evaluate the efficacy of different dose rates and dosing frequencies. In experiment A a single low dose (15,000 IU/kg) of procaine penicillin was administered to four horses immediately prior to confinement with head elevation for 48 hours. The systemic leucocyte response, gross and cytologic characteristics of transtracheal aspirate and bacterial numbers in lower respiratory tract samples were compared with corresponding samples from two horses confined with heads elevated but not given penicillin. The efficacy of higher dose rates (20,000 IU/kg and 40,000 IU/kg) given before and during confinement with heads elevated for 24 hours was evaluated in experiment B. Results Treatment with procaine penicillin had no effect on the systemic leucocyte response or on the accumulation of inflammatory lower respiratory tract secretions at any of the dosing schedules evaluated. The number of bacteria isolated from trans-tracheal samples was reduced at 12 hours for treated horses in experiment A and at 24 hours for experiment B. β-haemolytic Streptococcus spp were not isolated from treated horses in either experiment. Bacterial species isolated from treated horses were predominantly Pasteurella and/or Actinobacillus spp, however, members of the family Enterobacteriaceaé and a Staphylococcus sp were isolated from treated horses. One treated horse in experiment A developed clinically apparent pulmonary disease. Conclusions The prophylactic administration of penicillin before or during confinement did not reliably reduce bacterial numbers or prevent the accumulation of purulent lower respiratory tract secretions in horses confined with their heads elevated. Numbers of β-haemolytic Streptococcus spp were reduced following treatment, suggesting that the repeated administration of procaine penicillin may have some merit as part of a strategy to prevent transport-associated respiratory disease. However, methods directed at minimising the duration of confinement with head elevation, augmentation of the clearance of accumulated secretions and prompt identification of animals in which airway inflammation has extended to the pulmonary parenchyma remain the best ways of minimising transport-associated respiratory disease.     

Effects of posture and accumulated airway secretions on tracheal mucociliary transport in the horse

Tracheal mucociliary clearance was determined in horses by measuring the rostrad transport of the radiopharmaceutical ^99mtechnetium-sulphur colloid following deposition on the tracheal epithelium by intratracheal injection. The effects of head position (head elevated to normal standing position vs head lowered) and of accumulated purulent secretions on tracheal mucociliary clearance were evaluated for the first time in the horse. In normal horses tracheal mucociliary clearance was greatly accelerated by lowering the head so that the cranial trachea was lower than the caudal trachea. Horses confined with their heads elevated for 24 hours developed an accumulation of purulent airway secretions (and associated increased numbers of bacteria) in the lower respiratory tract and showed a decrease in tracheal mucociliary clearance when compared with their previously measured rate when the lower airway contained only normal secretions. These findings have implications for management practices where horses are prevented from lowering their heads, such as transportation and cross-tying, which may therefore contribute to lower respiratory tract disease in horses.     

Influence of head posture on the respiratory tract of healthy horses

Twenty four normal, confined mares were unable to lower their heads for 24 or 48 h. In 21 mares this resulted in increases in the proportion of neutrophils and/or numbers of bacteria in transtracheal aspirates. In eight mares the changes in tracheal washes were accompanied by clinical evidence of mild respiratory disease. In three additional cases respiratory signs were accompanied by systemic illness. These changes reversed once the mares were able to lower their heads. Haematological changes (absolute neutrophilia and/or hyperfibrinogenamia) were mild and occurred more commonly in horses restrained for 48 h. The results suggest that keeping the heads of healthy horses raised leads to an increased bacterial burden in their tracheobronchial secretions. These changes appeared to be related to head posture effects and not simply confinement in stocks. These findings give further weight to the theory that postural drainage may facilitate clearance of bacteria from the tracheobronchial tree. The possible relevance of such findings to post-transportation pneumonia in horses is discussed.     

Effect of transportation on lower respiratory tract contamination and peripheral blood neutrophil function

Objective To evaluate the effect of transportation on lower respiratory tract contamination and peripheral blood neutrophil function in horses and to compare results from transported horses with those obtained in earlier experiments from horses confined with heads elevated. Design A prospective study. Procedure Six horses were transported by road for 12 h. Clinical and haematological examination, transtracheal aspiration and cell function studies were conducted before and after transportation. Results obtained after transportation were compared to pre-transportation values. Results After transportation, peripheral blood leucocyte and neutrophil numbers were increased and rectal temperatures were elevated. Transtracheal aspirates showed an accumulation of purulent respiratory tract secretions with increased numbers of bacteria, particularly β-haemolytic Streptococcus spp and members of the Pasteurellaceae family. Three horses also had increased numbers of bacteria from the Enterobacteriaceae family relative to corresponding samples from earlier studies. Phagocytosis by peripheral blood neutrophils was significantly reduced, while the oxidative burst activity of peripheral blood leucocytes was either unchanged or enhanced. Clinical Implications Bacterial contamination of the lower respiratory tract occurs as a routine consequence of transportation of horses and is likely to be an important determinant in the development of transport-associated respiratory disease. Inflammatory airway secretions and increased numbers of bacteria were rapidly cleared, without clinical evidence of significant pulmonary disease and without additional treatment, in normal horses that were allowed to lower their heads after transportation. Peripheral blood neutrophilia and a reduction in neutrophil phagocytic function were evident for at least 36 h after transportation, suggesting that horses may require a number of days to recover from the stress of transportation. As the potential role of bacteria from the Enterobacteriaceae family in the development of transport-associated respiratory disease has not been elucidated, horses which develop clinical disease following transportation should undergo thorough bacteriological investigation to ensure appropriate treatment.     

Towards an understanding of equine pleuropneumonia: factors relevant for control

OBJECTIVE: To review relevant literature on factors associated with the development of equine pleuropneumonia. DESIGN: A review of the literature using a range of databases including Current Contents, Medline, ChemAbstracts, Biological Abstracts and CAB and a comprehensive search strategy which involved use of keywords, author and subject category searches. Additional sources included review of articles cited by key accumulated references. RESULTS: Since the early years of this century, many of the "gaps" in our knowledge of the pathogenesis of this disease have been filled. We now know that equine pleuropneumonia results from contamination of the lower respiratory tract with bacteria similar to the normal oropharyngeal microbiota of the horse and that transportation of any mode, especially over long distances (and consequently with no or short rest periods), is the single most important predisposing factor for this disease. This is associated with restraint of horses such that they are unable to lower their heads, which leads to increased opportunity for lower respiratory tract contamination and a reduced opportunity for clearance. Strenuous exercise also results in lower respiratory tract contamination and exercise subsequent to transportation exerts additive detrimental effects on the defenses of the lower respiratory tract. CLINICAL IMPLICATIONS: While modern veterinary medicine and surgery have significantly reduced the death rate from pleuropneumonia, horses that develop the disease have a high probability of not returning to their prior use. This underscores the importance of developing the most effective strategies for its prevention.     

Cytological and microbiological findings in guttural pouch lavages of clinically normal horses with head restraint

OBJECTIVE: To evaluate the cytological and microbiological contents of guttural pouch washes of ten randomly selected horses restrained so as to prevent them lowering their heads, and to assess the possible effects on the guttural pouch environment in these horses. PROCEDURE: Cytological and microbiological studies were performed on guttural pouch washes of ten clinically normal horses restrained in a standing position so as to prevent them from lowering their heads below normal, as would happen during transportation on long journeys. They were restrained for 12 or 24 h and cytological, bacteriological and mycological findings in guttural pouch washes were recorded. RESULTS: The cytological gradings and neutrophil concentrations of guttural pouch washings were higher in horses that had their heads restrained for a longer period. Washings from these horses were more likely to contain cultivable bacteria and were the only washes yielding potentially pathogenic bacterial species. CONCLUSION: Variation in the cytological differential counts and bacterial cultures of guttural pouch lavages may be found in clinically normal horses which have had their heads restrained in an elevated position for periods from 12 to 24 h. This should be considered when examining this site and care must be taken when interpreting cytology of guttural pouch lavages in samples taken after transportation for more than 12 h. Restriction of head movement could also affect the normal pouch enviroment and predispose it to disease.     

An investigation of the incidence of chronic obstructive pulmonary disease (COPD) in random populations of Swiss horses

The incidence of Chronic Obstructive Pulmonary Disease (COPD) in Switzerland was determined in three groups of horses selected at random. Group A (97 horses) and Group B (93 horses) had no history of respiratory disease, but Group C (113 horses) had a history of lower respiratory tract disease. All horses were examined by auscultation of the respiratory tract under forced breathing, endoscopic examination of the upper and lower respiratory tract, arterial blood gas analysis at rest and cytological examination of respiratory secretions (RS). Fifty-four per cent of the horses in Group A and 54.8 per cent of Group B were diagnosed as suffering clinical COPD and only 12.4 per cent of horses in Group A and 8.6 per cent in Group B had no detectable abnormalities in their lower respiratory tracts. In Group B, 19.4 per cent were considered to be suffering from parasitic pulmonary disease indicated by elevated numbers of eosinophils in their RS. Pharyngeal lymphoid hyperplasia was exhibited in 70.1 per cent of Group A and 74.2 per cent of Group B. Cytological examination of RS was useful to determine if the secretions found in the trachea originated from the upper or lower respiratory tract. Arterial blood gas analysis revealed no significant differences between healthy horses and those with subclinical or mild COPD.     

Results of Quantitative Cultures of Urine by Free Catch and Catheterization from Healthy Adult Horses

Quantitative urine cultures were performed on 11 male and 11 female healthy adult horses. Urine was collected by free catch and catheterization using standard methods. Results showed that all samples collected by free catch contained less than 20,000 colony-forming units (CFU)/mL. All samples collected by catheterization contained 500 CFU/mL or less. A significant difference was found between collection methods ( P < .005), with catheterization having less contamination. In samples collected by free catch, females had significantly greater contamination than did males ( P < .03). Predominant bacterial species isolated included Streptococcus spp., Escherichia coli, Enterohacter sp., Bacillus sp., Staphylococcus spp., Diptheroids sp., Proteus spp., and Enterococcus sp. Many samples contained multiple bacterial species. Bacterial isolates were representative of the normal bacterial flora of the equine urogenital tract. This paper establishes reference values for quantitative urine culture results in healthy adult horses to aid in the diagnosis of urinary tract infections.     

Surveillance programme for important equine infectious respiratory pathogens in the USA

The prevalence and epidemiology of important viral (equine influenza virus [EIV], equine herpesvirus type 1 [EHV-1] and EHV-4) and bacterial (Streptococcus equi subspecies equi) respiratory pathogens shed by horses presented to equine veterinarians with upper respiratory tract signs and/or acute febrile neurological disease were studied. Veterinarians from throughout the USA were enrolled in a surveillance programme and were asked to collect blood and nasal secretions from equine cases with acute infectious upper respiratory tract disease and/or acute onset of neurological disease. A questionnaire was used to collect information pertaining to each case and its clinical signs. Samples were tested by real-time PCR for the presence of EHV-1, EHV-4, EIV and S equi subspecies equi. A total of 761 horses, mules and donkeys were enrolled in the surveillance programme over a 24-month study period. In total, 201 (26.4 per cent) index cases tested PCR-positive for one or more of the four pathogens. The highest detection rate was for EHV-4 (82 cases), followed by EIV (60 cases), S equi subspecies equi (49 cases) and EHV-1 (23 cases). There were 15 horses with double infections and one horse with a triple infection. The detection rate by PCR for the different pathogens varied with season and with the age, breed, sex and use of the animal.     

Quantification of immunoglobulins in respiratory tract secretions of the horse

Lavage techniques were used to obtain secretions from the nasal cavity, trachea and bronchi of conscious horses. The techniques, which utilised fibreoptic endoscopy for recovery of tracheal and bronchial secretions, were well tolerated by the horses. The recovery rates of the lavaged fluids were acceptable, but were lowest for bronchial secretions, and there was minimal contamination by blood. The fluids were analysed for IgG and IgM by single radial immunodiffusion, and for IgA and albumin by rocket immunoelectrophoresis. Relative to albumin there was significantly more IgA and IgM, and significantly less IgG, in the nasal cavity than the trachea. IgA and IgM levels were greatest in the nasal cavity and decreased progressively to the bronchi, whereas IgG levels showed the reverse trend. The immunoglobulin: albumin ratios of secretions taken from many levels of the tract were significantly higher than those of serum, suggesting local production of immunoglobulin in the respiratory tract.     

Effects of lumbosacral subarachnoid catheterization in horses

OBJECTIVES: To evaluate the effects of long duration subarachnoid catheterization in horses on cerebrospinal fluid (CSF) cellularity and bacteriology, arterial blood pressure, heart rate, respiratory rate, rectal body temperature, and spontaneous locomotor activity. STUDY DESIGN: Prospective experimental study. ANIMAL: Five clinically normal healthy adults horses weighing 511 +/- 47 kg. METHODS: Subarachnoid catheters were placed using sedation and local anesthesia and maintained for 48 hours in standing horses. Cerebrospinal fluid samples were tested for cellularity and bacteria growth. Heart rate, respiratory rate, arterial blood pressure, and body temperature were recorded. Locomotor activity was graded. One-way repeated measures ANOVA and Bonferroni's test were used to statistically compare data from baseline to 12, 24, and 48 hours. RESULTS: Subarachnoid catheterization in horses produced an acute inflammatory reaction after 12 hours of catheterization, as evidenced by a statistically significant increase in CSF white blood cell count. No bacterial contamination was encountered. No significant differences were found in heart rate, respiratory rate, body temperature, and arterial blood pressure. The horses did not develop motor ataxia or proprioceptive deficits during 48 hours of catheterization. CONCLUSIONS: Results of this study suggest that 48 hours of subarachnoid catheterization in horses does not produce clinical signs of neurologic dysfunction or cardiovascular and respiratory changes, even though an inflammatory reaction occurred. CLINICAL RELEVANCE: Subarachnoid catheterization in horses is preferred for monitoring CSF pressure or for repeated collection. Understanding the effects of catheterization alone, allows the clinician to better interpret abnormalities in CSF collected.     

MMP-9 as a marker of inflammation in tracheal epithelial lining fluid (TELF) and in bronchoalveolar fluid (BALF) of COPD horses

Gelatinolytic activity was analysed to study whether elevated activity previously found at the tracheal level of the respiratory tract of horses with chronic obstructive pulmonary disease (COPD) could also be found at the lower part of the respiratory tract. Furthermore, presence and significance of the gelatinolytic matrix metalloproteinases (MMPs) MMP-2 and MMP-9 in respiratory secretions of healthy and COPD horses were determined. Elevated gelatinolytic matrix metalloproteinases were detected in bronchoalveolar and tracheobronchial secretions from COPD horses. The main pathologically elevated MMP was characterised to be MMP-9. Significantly increased MMP-9 activities as measured by gelatin zymography and Western blotting were found in all the respiratory samples from COPD horses compared to healthy horses. Elevation of active MMP-9 paralleled with increased gelatinase-associated lipocalin levels. Bronchoalveolar lavage fluid (BALF) epithelial cells, macrophages, neutrophils and lymphocytes expressed MMP-9 immunoreactivity demonstrated by immunocytochemistry and MMP-9 mRNA was expressed by bronchial epithelial cells of lung tissue section shown by in situ hybridisation. MMP-2 seems not to play a major role in chronic lung inflammation. No clear differences in MMP-2 or MMP-14 (a potent MMP-2 activator) levels were found when comparing the samples from COPD or healthy horses. These results suggests that MMP-9 could serve as a potential diagnostic marker for the active ongoing tissue remodelling in the acute phase of equine COPD. Increased gelatinolytic activity could be found at both tested respiratory tract levels. Therefore, tracheal epithelial lining fluid (TELF) samples can usefully serve as diagnostic material for detection of increased levels of the main gelatinolytic MMP, MMP-9, representing the entire diseased lung.     

Antimicrobial susceptibility of Klebsiella spp. and Proteus spp. from various organ systems of horses, dogs and cats as determined in the BfT-GermVet monitoring program 2004-2006

A total of 120 isolates of Klebsiella spp. and Proteus spp. collected from horses and small animals (dogs and cats) were screened for their susceptibility to 24 different antimicrobial agents. Klebsiella spp. were included from infections of the genital tract (GT) of horses (36 isolates) and the urinary/genital tract (UGT) from dogs and cats (17 isolates), while Proteus spp. were from small animal (dogs and cats) infections of the UGT (37 strains) and the skin (incl. ear/mouth) (30 isolates). In Klebsiella spp. resistance appeared most frequently to ampicillin (53-67%), sulfamethoxazole (19-29%) and potentiated sulfonamides (trimethoprim/sulfamethoxazole 1/19 combination) (19-24%). A further 29% of enrofloxacin resistant Klebsiella isolates were observed for the UGT of small animals. From the GT of horses for this antimicrobial agent there was no isolate detected with a comparably high minimum inhibitory concentration (MIC) value. In Proteus spp. highest percentages of resistance occurred against tetracycline (90-92%). Due to drug efflux proteins, high MIC values against this antimicrobial agent have been frequently reported in literature. In Proteus spp. relevant resistance percentages also occurred for potentiated sulfonamides (27-37%), sulfamethoxazole (24-37%) and chloramphenicol (24-37%).     

A case-control study of respiratory disease in Thoroughbred racehorses in Sydney, Australia

In order to investigate the role of infectious agents in the aetiology of lower respiratory tract disease in Thoroughbred racehorses, a matched case-control study was conducted. Cases were identified by the presence of coughing, and were compared to a control population matched on time of sample collection and location within the same training establishment. Tracheal wash samples were collected from 100 cases and 148 controls. Case horses were more likely than controls to have endoscopic and cytological evidence of airway inflammation. There was no significant association between serological evidence of infection by commonly implicated respiratory viruses and coughing. Similarly, mycoplasma were rarely isolated and were not associated with disease. In contrast, there was a strong association between isolation of greater than a total of 10(3) colony-forming units/ml of tracheal wash and coughing. Individual bacterial species associated with disease included Streptococcus zooepidemicus, Streptococcus pneumoniae, Streptococcus suis, Streptococcus sanguis, Pasteurella spp and Bordetella bronchiseptica. This study provides evidence of the role of bacterial infection in the aetiology of lower respiratory tract inflammation in racehorses. However, in 58% of cases, few or no bacteria were isolated. Hence, at the time of identification of disease, there was no evidence of viral, bacterial or mycoplasmal infection in the majority of coughing horses. The aetiology of the signs observed in these horses requires further investigation.     

Cytologic examination of specimens obtained by means of tracheal washes performed before and after high-speed treadmill exercise in horses with a history of poor performance

OBJECTIVE: To evaluate results of cytologic examination of specimens obtained by means of tracheal washes (TW) in 42 horses with a history of poor performance. DESIGN: Cross-sectional case series. ANIMALS: 42 horses with a history of poor performance. PROCEDURE: A TW was performed via endoscopy before and after horses exercised on a high-speed treadmill, and specimens were evaluated microscopically and graded. RESULTS: Ten (24%) horses were considered to be clinically normal before and after exercise. Pulmonary hemorrhage was diagnosed in 8 (19%) horses. One horse had evidence of exercise-induced pulmonary hemorrhage (EIPH) before exercise and pulmonary hemorrhage and allergic or inflammatory airway disease (IAD) after exercise. Five (12%) horses had IAD, and 1 had IAD and pulmonary hemorrhage after exercise. Seven (17%) horses had evidence of EIPH and IAD in both specimens. Four (10%) horses with EIPH had an increase in the proportion of hemosiderophages in the specimen obtained after exercise. Specimens obtained before exercise in 6 (14%) horses were not representative of the respiratory tract and could not be compared with specimens obtained after exercise. CLINICAL IMPLICATIONS: Interpretation of TW specimens obtained before and after exercise differed for only 5 of 36 (14%) horses. Specimens obtained after exercise were more likely to reveal airway disease. All specimens obtained after exercise adequately represented the respiratory tract, whereas 6 specimens obtained before exercise did not. Specimens obtained after exercise contained more airway secretions and had less cytologic evidence of pharyngeal contamination. Therefore, we recommend that TW samples be obtained after exercise in horses.     

Specific antibody response in porcine respiratory tract secretion following intraperitoneal immunization

Experiments were conducted to determine whether intraperitoneal (IP) immunization and subsequent intratracheal (IT) challenge were able to augment the specific antibody response in secretions of the porcine respiratory tract. Following IP immunization and two IT challenges within a period of 18 days the specific IgG and IgA antibody response was elevated in respiratory tract secretions and serum. While a portion of the anti-ovalbumin (OVA) IgG in respiratory tract secretions was generated locally, it would appear that the bulk of anti-OVA IgA was derived from serum.     

The microflora of the lower respiratory tract of the horse: an autopsy study

A series of 31 thoroughbreds and 18 non-thoroughbreds was examined post mortem to assess what bacteria might be present in the lower respiratory tract, and to assess their significance by correlating the bacteriological findings with histological changes in the lung. The distal trachea and seven representative lung sites were swabbed in each case. Sixty-six per cent of the sites were sterile with remaining sites producing scanty growths of mainly coagulase negative Staphylococcus spp., E. coli, Bacillus spp. and Pseudomonas spp. Anaerobes, mainly Clostridium perfringens, Bacteroides fragilis and Bacteroides oralis, were only recovered on enrichment media and were isolated more frequently from the right lung than the left. More bacterial species were isolated from thoroughbreds than non-thoroughbreds. Significant inflammation was absent in the majority of lungs examined and this correlated well with the large percentage of sterile sites and low number of potential pathogens. The results indicate that the lower respiratory tract of horses is normally sterile or may contain small numbers of bacteria of low pathogenicity. Chlamydia and respiratory viruses were not isolated from any horse.     

Respiratory tract distribution and bioavailability of spiramycin in calves

Pharmacokinetic determinants of spiramycin and its distribution into the respiratory tract were studied in 2 groups of calves, 4 to 10 weeks old. Group-A calves (n = 4) were used to determine pharmacokinetic variables of spiramycin after IV (15 and 30 mg/kg of body weight) and oral administrations of the drug (30 mg/kg) and to measure distribution of spiramycin into nasal and bronchial secretions. Group-B calves (n = 4) were used to determine distribution of spiramycin into lung tissue and bronchial mucosa. Spiramycin disposition was best described by use of an open 3-compartment model. Mean (+/- SD) elimination half-life was 28.7 +/- 12.3 hours, and steady-state volume of distribution was 23.5 +/- 6.0 L/kg. Bio-availability after oral administration was 4 +/- 3%. High and persistent concentrations of spiramycin were achieved in the respiratory tract tissues and fluids. Tissue-to-plasma concentration ratio was 58 for lung tissue and 18 for bronchial mucosa at 3 hours after spiramycin administration and 137 and 49, respectively at 24 hours. Secretion-to-plasma concentration ratio was 4 for nasal secretions and 7 for bronchial secretions, and remained almost constant with time. Thus, spiramycin penetrates well into the respiratory tract, although the value in bronchial secretions is lower than that in lung tissues and bronchial mucosa. Calculations indicate that a loading dose of 45 mg/kg, administered IV, followed by a maintenance dose of 20 mg/kg, IV, once daily is required to maintain active concentrations of spiramycin against bovine pathogens in bronchial secretions.     

Cytology of the lower respiratory tract in horses: An updated review

The diagnosis of respiratory diseases in horses can be difficult due to the nonspecific nature of the clinical signs, which overlap between the different diseases. Cytological examination of the respiratory secretions is a helpful diagnostic tool that, when combined with clinical features and other diagnostic techniques, has the potential to improve diagnostic accuracy significantly. This review article should help readers to become familiar with the cytology of the normal respiratory tract and with the cytopathological abnormalities associated with common respiratory disorders in horses.     

Cytologic and bacteriologic evaluation of tracheobronchial aspirates from clinically normal foals

Thirty-eight tracheobronchial aspirates (TBA) were collected from twenty 1 to 6-month-old foals, which were free of clinical signs of respiratory tract or other infectious disease. We collected TBA from 9 of the foals 3 times when they were approximately 8, 16, and 24 weeks old. Aspirates were examined cytologically after staining with modified Wright-Giemsa, Gram, toluidine blue, and prussian blue stains. Aerobic bacterial culturing was performed on all aspirates. Of the 20 initial TBA, 4 (20%) were normal cytologically on the basis of previously defined criteria for TBA from clinically normal horses, 6 (30%) had a high percentage of eosinophils (greater than 5%), 8 (40%) were classified as indicative of subacute inflammation, and 2 (10%) were classified as indicative of acute inflammation. Nine (45%) were positive for mast cells and none were positive for hemosiderin-laden macrophages (hemosiderophages). Of the 9 foals from which samples were collected at 16 and 24 weeks of age, results were similar, except for an increase in the number of TBA classified as indicative of chronic inflammation (33% and 22% respectively) and the number positive for hemosiderophages (33% and 88%, respectively). One TBA was considered nondiagnostic because of pharyngeal contamination. Culturing of 12 of the 37 aspirates (32%) yielded a potential microbial pathogen. Only 2 were positive cultures from the same foal. The following organisms were isolated: beta-hemolytic Streptococci spp (4), Actinobacillus/Pasteurella spp (4), Rhodococcus equi (2), unidentified nonenteric Gram-negative rod (1), and Escherichia coli (1). Thirty-four of the 37 aspirates (92%) yielded light growth of various organisms considered to be nonpathogenic and normal inhabitants of the upper respiratory tract.