Effect of laryngeal hemiplegia and laryngoplasty on airway flow mechanics in exercising horses

The effect of left laryngeal hemiplegia on airway flow mechanics in 5 exercising horses was examined, and the efficacy of surgical repair by prosthetic laryngoplasty was evaluated. Measurements of the upper airway flow mechanics were made with horses on a treadmill (incline 6.38 degrees) while standing (period A); walking at 1.3 m/s (period B); trotting at 2.6 m/s (period C); trotting at 4.3 m/s (period D); and standing after exercise (period E). Experiments were done on healthy horses before any surgical manipulation (control), at 10 days after left recurrent laryngeal neurectomy, and at least 14 days after prosthetic larynogoplasty. Increasing treadmill speed from period A to period D progressively increased heart rate, respiratory frequency, peak inspiratory flow, and peak expiratory flow, but inspiratory resistance and expiratory resistance remained unchanged. Neither left recurrent laryngeal neutrectomy nor prosthetic laryngoplasty affected heart rate, respiratory frequency, peak expiratory flow, or expiratory resistance when compared with those values at the control measurement periods. Left recurrent laryngeal neurectomy resulted in inspiratory flow limitation at peak inspiratory flow of approximately 25 L/s, and increased inspiratory resistance at periods D and E. Subsequent prosthetic laryngoplasty alleviated the flow limitation and reduced inspiratory resistance at measurement periods D and E.     

Effect of topical anesthesia of the laryngeal mucosa on upper airway mechanics in exercising horses.

OBJECTIVE: To determine the effect of desensitization of the laryngeal mucosal mechanoreceptors on upper airway mechanics in exercising horses. ANIMALS: 6 Standardbreds. PROCEDURE: In study 1, videoendoscopic examinations were performed while horses ran on a treadmill with and without topical anesthesia of the laryngeal mucosa. In study 2, peak tracheal and nasopharyngeal pressures and airflows were obtained from horses during incremental treadmill exercise tests, with and without topical anesthesia of the laryngeal mucosa. A nasal occlusion test was performed on each horse while standing during an endoscopic examination for both trials. RESULTS: In study 1, horses had nasopharyngeal collapse while running on the treadmill when the laryngeal mucosa was anesthetized. In study 2, inspiratory upper airway and nasopharyngeal impedance were significantly higher, and peak tracheal inspiratory pressure, respiratory frequency, and minute ventilation were significantly lower in horses when the laryngeal mucosa was anesthetized, compared with values obtained when horses exercised without topical anesthesia. Peak inspiratory and expiratory airflows were lower in horses when the laryngeal mucosa was anesthetized, although differences did not quite reach significance (P = 0.06 and 0.09, respectively). During a nasal occlusion test, horses had episodes of nasopharyngeal collapse and dorsal displacement of the soft palate when the laryngeal mucosa was anesthetized. Upper airway function was normal in these horses without laryngeal mucosal anesthesia. CONCLUSIONS AND CLINICAL RELEVANCE: Receptors within the laryngeal mucosa may be important in maintaining upper airway patency in exercising horses.     

Effects of extrathoracic airway obstruction on intrathoracic pressure and pulmonary artery pressure in exercising horses

OBJECTIVE: To determine whether dorsal displacement of the soft palate (DDSP) results in pulmonary artery hypertension and leads to increases in transmural pulmonary artery pressure (TPAP); to determine whether pulmonary hypertension can be prevented by prior administration of furosemide; and to determine whether tracheostomy reduces pulmonary hypertension. ANIMALS: 7 healthy horses. PROCEDURE: Horses were subjected to 3 conditions (control conditions, conditions after induction of DDSP, and conditions after tracheostomy). Horses were evaluated during exercise after being given saline (0.9% NaCl) solution or furosemide. RESULTS: Controlling for drug, horse, and speed of treadmill, DDSP-induced increase in intrathoracic pressure was associated with a significant increase in minimum (36 mm Hg), mean (82 mm Hg), and maximum (141 mm Hg) pulmonary artery pressure, compared with values for control horses (30, 75, and 132 mm Hg, respectively). Increases in pulmonary artery pressure did not induce concomitant increases in TPAP. Tracheostomy led to a significant reduction of minimum (53 mm Hg), and mean (79 mm Hg) TPAP pressure, compared with values for control horses (56 and 83 mm Hg, respectively). When adjusted for horse, speed of treadmill, and type of obstruction, all aspects of the pulmonary artery and TPAP curves were significantly decreased after administration of furosemide, compared with those for horses given saline (0.9% NaCl) solution. CONCLUSIONS: DDSP was associated with increases in pulmonary artery pressure but not with increases in TPAP. CLINICAL RELEVANCE: Expiratory obstructions such as DDSP are likely to result in pulmonary hypertension during strenuous exercise, but may not have a role in the pathogenesis of exercise-induced pulmonary hemorrhage.     

Endocrinal responses in exercising horses

The intensity and duration of exercise exert a major influence on energy expenditure and physiological changes in the horse. Stressful environmental conditions, acclimation, and training status may further modify these responses. To maintain functional homeostasis during exercise, changes in autonomic nervous activity and hormone secretion are coupled to both the feedforward and the feedback mechanisms that control substrate mobilisation and utilisation.During exercise, both the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis are activated, which increases the circulating levels of adrenocorticotropin (ACTH), cortisol, adrenaline and noradrenaline. Furthermore, adrenaline inhibits the release of insulin from the pancreas. Catecholamines, adrenaline, and noradrenaline increase glycogen breakdown in the muscles. In the liver, catecholamines, together with cortisol, increase blood glucose by activating glycogen breakdown and gluconeogenesis. Cortisol and catecholamines also enhance the mobilisation of free fatty acids from fat stores.In addition to efficient energy metabolism, the ability to exercise is highly dependent on the well-coordinated neuroendocrine control of cardiovascular function. Catecholamines increase oxygen delivery during exercise by enhancing cardiac output, splenic erythrocyte release, and skeletal muscle flow. Furthermore, cardiovascular homeostasis is maintained by changes in plasma renin activity and in plasma concentrations of atrial natriuretic peptide (ANP), arginine vasopressin, and aldosterone.     

Effect of frusemide on transvascular fluid fluxes across the lung in exercising horses

Reasons for performing study: Frusemide (Fru) is widely prescribed for management of racehorses experiencing EIPH. The effect of Fru in the lung appears to be a reduction in transcapillary pressures and inhibition of the erythrocyte anion exchange, which may lead to attenuation of transpulmonary fluid fluxes during exercise. Hypothesis: Treatment with Fru will attenuate transpulmonary fluid fluxes in horses during high intensity exercise. Methods: In a crossover study, 6 race‐fit Standardbred horses were treated with 250 mg of Fru i.v. (FruTr) or placebo (Con) 4 h before exercise on a high speed treadmill until fatigue. Arterial and central mixed venous blood, as well as CO₂ elimination and O₂ uptake, were sampled. Volume changes across the lung and transvascular fluid fluxes were calculated from changes in haemoglobin, packed cell volume, plasma protein and cardiac output (Q). Results: During exercise, Q increased in both Con and FruTr, with Q being significantly lower in FruTr (mean ± s.e. 301.8 ± 8.5 l/min at fatigue) compared to Con (336.5 ± 15.6 l/min) (P<0.01). At rest frusemide had no effect on erythrocyte (J_ER) and transvascular (J_V‐A) fluid fluxes across the lung. Exercise had a significant effect on J_ER and J_V‐A (P≤0.02). During exercise, J_ER (at fatigue 14.6 ± 2.3 l/min and 11.6 ± 2.2 l/min in Con and FruTr, respectively) and J_V‐A (at fatigue14.9 ± 2.3 l/min and 12.0 ± 2.2 l/min in Con and FruTr, respectively) were not significantly different between Con and FruTr (P = 0.6 and P = 0.8 for J_ER and J_V‐A, respectively). Conclusions and clinical importance: Fru does not have a measurable effect on J_ER and J_V‐A. Cardiac output was reduced in FruTr, suggesting that there were also smaller changes in the capillary recruitment and transvascular transmural hydrostatic pressures; however, this did not effect J_V‐A. Therefore, Fru at the dose of 250 mg does not appear to be an effective treatment for regulating pulmonary transvascular forces during exercise in horses.     

Reduction of renal function in exercising horses

Glomerular filtration rate (GFR) and extracellular volume (ECFV) were measured before, during and after treadmill exercise in 5 trained Thoroughbred horses (mean weight 483 kg). GFR/ECFV was determined by plasma disappearance of Tc-DTPA and ECFV was measured independently as thiocyanate space. Resting GFR averaged 1.6 l/min (3.3 ml/kg/min) and fell by over 40% during exercise, moreover the fall was severe even during the first walk, prior to trotting. The results suggest that rather than being protected, GFR is allowed to fall, even with mild exercise and that this is probably an adaptation to allow greater perfusion of muscle and skin. In man, GFR appears to be more resistant to the effects of exercise but it is hard to compare intensity of exercise between such different species.     

Effect of protein source on nitrogen balance and plasma amino acids in exercising horses

Plasma AA in horses fed either an all-hay or a hay and grain diet in a traditional format have not been investigated. Eight horses were divided into 2 groups: a hay group fed only grass hay or a hay and a grain group (HG) fed in a crossover design for two 5-wk periods. After the first period, horses were fasted overnight, followed by feeding with blood sampling every hour for 6 h. A 4-d total fecal and urine collection to evaluate N balance followed. A 10-d washout period separated the 5-wk feeding periods, during which horses switched diets. The second period was also followed by fasting, feeding, blood sampling, and a 4-d collection period. Horses consumed 840 g of CP in the hay group and 865 g of CP in the HG group. Horses in the hay group had a 2.4 ± 2.4 g/d N balance, which was not different from 0 (P = 0.34), whereas horses in the HG group had 5.4 ± 2.4 g/d N balance, which was different from 0 (P = 0.045). Fecal N excretion was greater for the hay group compared with the HG group (hay = 51.1 ± 1.3 g/d and HG = 45.5 ± 1.3 g/d; P = 0.011), and urine N excretion was greater for the HG group compared with the hay group (hay = 79.3 ± 2.8 g/d and HG = 89.2 ± 2.8 g/d; P = 0.026). Plasma AA concentrations were greater in the HG group compared with the hay group for Met (P = 0.001), Lys (P = 0.001), Ile (P = 0.047), Arg (P < 0.001), Gln (P = 0.009), and Orn (P = 0.002). Plasma concentrations were less for the HG group compared with the hay group for Thr (P < 0.001) and Ala (P < 0.001). Plasma concentrations of urea were greater for the HG group compared with the hay group (P < 0.001), whereas 3-methyl-histidine concentrations were greater for the hay group compared with the HG group (P < 0.001). The effect of diet on the excretion of N via feces vs. urine in the hay and HG groups is typical. The early increases in the plasma concentrations of Met, Val, Ile, Leu, Phe, Lys, Arg, and Ala during the postfeeding phase are most likely due to increased foregut digestibility as well as a greater quality AA profile in the grain. The greater concentrations of Thr, Leu, and Val later in the postfeeding phase for the hay group most likely reflects slower digestion because of prolonged consumption time compared with the HG group. Improved N balance observed in the HG group supports the fact that the HG group had more available AA via the AA profile and foregut digestibility of the HG diet. Despite the fact that both groups consumed similar amounts of CP, the AA profile and availability affected N balance.     

Evaluation of a commercially available apparatus for measuring the acute phase protein serum amyloid A in horses

The aim of this study was to investigate the reliability of an immunoturbidometric assay for measuring the acute phase protein serum amyloid A (SAA) in horses in clinical practice. The assay was compared to a previously validated assay, and overlap performance was assessed by measuring the concentration of SAA in clinically healthy horses and horses with inflammatory and non-inflammatory diseases. In pools of serum with low and high SAA concentrations the assay's intra-assay coefficients of variation were 11.7 per cent and 4.6 per cent, and its interassay coefficients of variation were 9.1 per cent and 5.6 per cent, respectively. Slight inaccuracies were observed, but they were negligible in comparison with the range of the SAA response. The assay systematically underestimated the concentrations of SAA in comparison with the results of the validated assay. The assay detected the expected difference in SAA concentrations between the healthy and diseased horses.     

The effect of dietary protein level on exercising horses

Six mature Quarter Horse mares were used in a crossover design to assess the effect of dietary protein level on metabolic response to exercise. After a 2-wk adaptation period to either a 12.9% (control) or an 18.5% CP (high-protein) diet, each mare performed a standard exercise test. The test consisted of a 15-min exercise period at 4.5 m/sec on a 9% grade motorized treadmill. Exercise resulted in an increase in heart rate (P less than .001), but there was no difference (P less than .05) between dietary treatments. In the jugular vein, lactate increased (P less than .01) from 6.3 to 52.0 mg/100 ml in the control group and increased from 6.3 to 45.6 mg/100 ml in the high-protein group. There was an interaction (P less than .05) between diet and exercise for lactate. Plasma NH3 increased (P less than .001) during exercise, but not until the 15th min, at which time NH3 increased over fourfold in both groups. Dietary protein did not affect NH3; however, urea-N was higher (P less than .001) in horses receiving the high-protein diet. Plasma alanine increased from 13.6 to 30.3 mumol/100 ml and glutamine increased from 49.3 to 62.5 mumol/100 ml in the control group. In the high-protein group, alanine increased from 10.2 to 25.8 mumol/100 ml, whereas glutamine increased from 39.3 to 49.2 mumol/100 ml. Our study detected no metabolic evidence for a detrimental effect of excess dietary protein in horses exercising on a graded treadmill at 4.5 m/sec for 15 min.     

Effects of stylopharyngeus muscle dysfunction on the nasopharynx in exercising horses

REASONS FOR PERFORMING STUDY: Nasopharyngeal collapse has been observed in horses as a potential cause of exercise intolerance and upper respiratory noise. No treatment is currently available and affected horses are often retired from performance. OBJECTIVE: To determine the effect of bilateral glossopharyngeal nerve block and stylopharyngeus muscle dysfunction on nasopharyngeal function and airway pressures in exercising horses. METHODS: Endoscopic examinations were performed on horses at rest and while running on a treadmill at speeds corresponding to HRmax50, HRmax75 and HRmax, with upper airway pressures measured with and without bilateral glossopharyngeal nerve block. RESULTS: Bilateral glossopharyngeal nerve block caused stylopharyngeus muscle dysfunction and dorsal nasopharyngeal collapse in all horses. Peak inspiratory upper airway pressure was significantly (P = 0.0069) more negative at all speeds and respiratory frequency was lower (P = 0.017) in horses with bilateral glossopharyngeal nerve block and stylopharyngeus muscle dysfunction compared to control values. CONCLUSIONS: Bilateral glossopharyngeal nerve anaesthesia produced stylopharyngeus muscle dysfunction, dorsal pharyngeal collapse and airway obstruction in all horses. POTENTIAL RELEVANCE: The stylopharyngeus muscle is probably an important nasopharyngeal dilating muscle in horses and dysfunction of this muscle may be implicated in clinical cases of dorsal nasopharyngeal collapse. Before this information can be clinically useful, further research on the possible aetiology of stylopharyngeus dysfunction and dysfunction of other muscles that dilate the dorsal and lateral walls of the nasopharynx in horses is needed.     

Effect of a tongue-tie on upper airway mechanics in horses during exercise

OBJECTIVE: To determine the effect of a tongue-tie on upper airway mechanics in exercising horses. ANIMALS: 5 Standardbreds. PROCEDURE: Peak inspiratory and expiratory tracheal and pharyngeal pressures and airflow were measured while horses exercised on a treadmill with and without a tongue-tie. Respiratory rate was also measured. Horses ran at speeds that corresponded to 50 (HR50), 75, 90 (HR90), and 100% of maximal heart rate. The tongue-tie was applied by pulling the tongue forward out of the mouth as far as possible and tying it at the level of the base of the frenulum to the mandible with an elastic gauze bandage. Peak inspiratory and expiratory tracheal, pharyngeal, and translaryngeal resistance, minute ventilation, and tidal volume were calculated. Data were analyzed by use of 2-way repeated-measures ANOVA. For post hoc comparison of significant data, the Student-Newman-Keuls test was used. RESULTS: We were unable to detect significant differences between groups for peak inspiratory or expiratory tracheal or pharyngeal resistance, peak pressure, peak expiratory flow, tidal volume, respiratory rate, or minute ventilation. Horses that ran with a tongue-tie had significantly higher peak inspiratory flows, compared with horses that ran without a tongue-tie. In the post hoc comparison, this effect was significant at 4 m/s, HR50, and HR90. CONCLUSION AND CLINICAL RELEVANCE: Application of a tongue-tie did not alter upper respiratory mechanics in exercising horses and may be beneficial in exercising horses with certain types of obstructive dysfunction of the upper airways. However, application of a tongue-tie does not improve upper airway mechanics in clinically normal horses.     

Electromyographic activity of the stylopharyngeus muscle in exercising horses

REASONS FOR PERFORMING STUDY: There is a need to understand the process which leads to failure of recruitment of the stylopharyngeus muscle in clinical cases of nasopharygeal collapse. We therefore studied the timing and intensity of stylopharyngeus muscle activity during exercise in horses. OBJECTIVE: To measure the electromyographic (EMG) activity of the stylopharyngeus muscle in exercising horses and correlate it with the breathing pattern. METHODS: Five horses were equipped with a bipolar fine wire electrode placed on the stylopharyngeus muscle and a pharyngeal catheter. The horses exercised on a treadmill at speeds corresponding to 50 (HRmax50), 75 and 100% of maximum heart rate, and EMG activity of the stylopharyngeus muscle and upper airway pressures were recorded. The EMG activity of the stylopharyngeus muscle was then correlated to the breathing pattern and the activity quantified and reported as a percentage of the baseline activity measured at HRmax50. RESULTS: There was ongoing activity of the stylopharyngeus muscle throughout the breathing cycle; however, activity increased towards the end of expiration and peaked early during inspiration. Tonic activity was present during expiration. Peak, mean electrical and tonic EMG activity increased significantly (P<0.05) with exercise intensity. CONCLUSION: The stylopharyngeus muscle has inspiratory-related activity and tonic activity that increases with speed. POTENTIAL RELEVANCE: The stylopharyngeus muscle is one of a group of upper airway muscles that function to support and maintain the patency of the nasopharynx during inspiration. Failure of recruitment of the stylopharyngeus muscle during exercise is a potential explanation for clinical cases of dorsal pharyngeal collapse, but further work investigating the activity of the stylopharyngeus muscle in horses affected by this disease is needed.     

The effect of dietary fish oil supplementation on exercising horses

Ten horses of Thoroughbred or Standardbred breeding were used to study the effects of dietary fish oil supplementation on the metabolic response to a high-intensity incremental exercise test. Horses were assigned to either a fish oil (n = 6) or corn oil (n = 4) treatment. The fish oil (Omega Protein, Hammond, LA) contained 10.6% eicosapentaenoic acid and 8% docosahexaenoic acid. Each horse received timothy hay and a textured concentrate at a rate necessary to meet its energy needs. The supplemental oil was top-dressed on the concentrate daily at a rate of 324 mg/kg BW. Horses received their assigned diet for 63 d, during which time they were exercised 5 d/wk in a round pen or on a treadmill. During wk 1, horses exercised for 10 min at a trot. After wk 1, exercise time and intensity were increased so that at wk 5, exercise time in the round pen increased to 30 min (10 min of cantering and 20 min of trotting) per day. Starting at wk 6, horses were exercised 3 d/wk in the round pen for 30 min and 2 d/wk on a treadmill for 20 min. After 63 d, all horses performed an exercise test consisting of a 5-min warm-up at 1.9 m/s, 0% grade, followed by a step test on a 10% grade at incremental speeds of 2 to 8 m/s. Blood samples were taken throughout exercise. During exercise, horses receiving fish oil had a lower heart rate (treatment x time interaction; P < 0.05) and tended to have lower packed cell volume (treatment effect; P = 0.087). Plasma lactate concentrations were not affected by treatment. Plasma glucose concentrations were not different between groups during exercise but were lower (treatment x time interaction; P < 0.01) for the fish oil group during recovery. Serum insulin tended to be lower in fish oil horses throughout exercise (treatment effect; P = 0.064). There was a tendency for glucose:insulin ratios to be higher for fish oil-treated horses throughout exercise (treatment effect; P = 0.065). Plasma FFA were lower (treatment x time interaction; P < 0.01) in horses receiving fish oil than in horses receiving corn oil during the initial stages of the exercise test. Serum glycerol concentrations also were lower in fish oil-treated horses (P < 0.05). Serum cholesterol concentrations were lower in horses receiving fish oil (treatment effect; P < 0.05), but serum triglycerides were not affected by treatment (P = 0.55). These data suggest that addition of fish oil to the diet alters exercise metabolism in conditioned horses.     

Effect of intravenous administration of furosemide on mass-specific maximal oxygen consumption and breathing mechanics in exercising horses

OBJECTIVES: To determine whether i.v. administration of furosemide (250 mg) to horses before maximal exercise affected maximal oxygen consumption (VO2max), breathing mechanics, or gas exchange during exercise. ANIMALS: 7 healthy, well-conditioned Thoroughbred horses. PROCEDURES: 5 horses initially performed an incremental treadmill exercise test to determine VO2max 4 hours after i.v. administration of furosemide (250 mg i.v.) or placebo (saline [0.9% NaCl] solution). Time to fatigue and distance run were recorded. All 7 horses were then used to determine the effects of furosemide on gas exchange and breathing mechanics at 40, 60, 80, and 100% of VO2max. Horses were weighed immediately before exercise. RESULTS: Furosemide treatment significantly increased mass-specific VO2max (5.3%), but absolute VO2max was not significantly altered. In the 2 parts of the study, body weights were 2.9 and 2.5% higher when horses were given placebo than when they were given furosemide. Time and distance run at speeds > or = 11.0 m/s were significantly greater following furosemide administration. Furosemide treatment had no effect on breathing mechanics or gas exchange. CONCLUSIONS AND CLINICAL RELEVANCE: Previous studies have suggested that prerace administration of furosemide may have a positive effect on performance. Results of this study indicate that this may be attributable, in part, to an increase in mass-specific VO2max but not to improvements in breathing mechanics or gas exchange. Most of the increase in mass-specific VO2max appeared to be attributable to weight loss associated with diuresis induced by furosemide.     

Effect of end-inspiratory pause on airway and physiological dead space in anesthetized horses

ObjectiveTo evaluate the impact of a 30% end-inspiratory pause (EIP) on alveolar tidal volume (V_Talv), airway (V_Daw) and physiological (V_Dphys) dead spaces in mechanically ventilated horses using volumetric capnography, and to evaluate the effect of EIP on carbon dioxide (CO₂) elimination per breath (Vco₂br^–1), PaCO_2, and the ratio of PaO₂-to-fractional inspired oxygen (PaO₂:FiO₂).Study designProspective research study.AnimalsA group of eight healthy research horses undergoing laparotomy.MethodsAnesthetized horses were mechanically ventilated as follows: 6 breaths minute^–1, tidal volume (V_T) 13 mL kg^–1, inspiratory-to-expiratory time ratio 1:2, positive end-expiratory pressure 5 cmH₂O and EIP 0%. Vco₂br^–1 and expired tidal volume (V_TE) of 10 consecutive breaths were recorded 30 minutes after induction, after adding 30% EIP and upon EIP removal to construct volumetric capnograms. A stabilization period of 15 minutes was allowed between phases. Data were analyzed using a mixed-effect linear model. Significance was set at p < 0.05.ResultsThe EIP decreased V_Daw from 6.6 (6.1–6.7) to 5.5 (5.3–6.1) mL kg^–1 (p < 0.001) and increased V_Talv from 7.7 ± 0.7 to 8.6 ± 0.6 mL kg^–1 (p = 0.002) without changing the V_TE. The V_Dphys to V_TE ratio decreased from 51.0% to 45.5% (p < 0.001) with EIP. The EIP also increased PaO₂:FiO₂ from 393.3 ± 160.7 to 450.5 ± 182.5 mmHg (52.5 ± 21.4 to 60.0 ± 24.3 kPa; p < 0.001) and Vco₂br^–1 from 0.49 (0.45–0.50) to 0.59 (0.45–0.61) mL kg^–1 (p = 0.008) without reducing PaCO₂.Conclusions and clinical relevanceThe EIP improved oxygenation and reduced V_Daw and V_Dphys, without reductions in PaCO₂. Future studies should evaluate the impact of different EIP in healthy and pathological equine populations under anesthesia.