Exercise induced pulmonary hemorrhage in horses: American College of Veterinary Internal Medicine consensus statement.

BACKGROUND: Published studies of exercise-induced pulmonary hemorrhage (EIPH), when assessed individually, often provide equivocal or conflicting results. Systematic reviews aggregate evidence from individual studies to provide a global assessment of the quality of evidence and to inform recommendations. OBJECTIVES: Evaluate evidence to determine: if EIPH adversely affects the health, welfare or both of horses; if EIPH affects the athletic capacity of horses; the efficacy of prophylactic interventions for EIPH; and if furosemide affects the athletic capacity of horses. ANIMALS: None. MATERIALS AND METHODS: Systematic review. A panel of 7 experts was formed to assess evidence in the peer reviewed literature addressing each of the 4 objectives. Methodology followed that of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Publications were assessed for quality of evidence by working groups of the panel, and a summary of findings was presented in tables. Recommendations were based on quality of evidence and were determined by a vote of the panel. RESULTS: Much of the evidence was of low to very low quality. Experimental studies frequently lacked adequate statistical power. There was moderate to high quality evidence that EIPH is progressive, is associated with lung lesions, that it adversely affects racing performance, that severe EIPH (Grade 4) is associated with a shorter career duration, that furosemide is efficacious in decreasing the incidence and severity of EIPH, and that administration of furosemide is associated with superior race performance. CONCLUSIONS AND CLINICAL SIGNIFICANCE: Strong recommendation that EIPH be considered a disease and a weak recommendation for use of furosemide in management of racehorses with EIPH.

Dynamic respiratory videoendoscopy in ridden sport horses: effect of head flexion, riding and airway inflammation in 129 cases.

REASONS FOR PERFORMING STUDY: Dynamic upper airway obstruction (UAO) is a cause of respiratory noise and sometimes poor performance in sport horses. Riding, head flexion and airway inflammation may impact upper respiratory tract stability during exercise. OBJECTIVES: To evaluate upper airway mechanical behaviour in ridden sport horses using overground endoscopy and the effect of head flexion, rider intervention and underlying airway inflammation on the pharynx and larynx. METHODS: Resting and exercising videoendoscopic recordings during ridden exercise were obtained in 129 sport horses referred mainly for respiratory noise, poor performance or routine evaluation. The rider modified poll flexion and way of riding during the test and associated changes in UAO were recorded. Presence of upper and lower airway inflammation was also assessed. RESULTS: Dynamic UAO was diagnosed in 91% (64/70) of the horses referred for respiratory noise and in 71% (29/41) of horses referred for poor performance. Pharyngeal instability was the most frequently diagnosed problem. However, differences were observed between dressage horses and showjumpers. Rider interaction and head flexion exacerbated upper airway instability and promoted the occurrence of complex UAO. Both lower airway inflammation and pharyngeal lymphoid hyperplasia were associated with pharyngeal instability, but not with any other UAO. CONCLUSIONS: Rider intervention during ridden exercise (i.e. the various movements a horse might be asked to perform) influences upper airway morphology and function and, in cases of upper airway dynamic obstruction, can contribute to increasing laryngeal and/or pharyngeal instability in sport horses. POTENTIAL RELEVANCE: As these are changes that would not usually be seen with treadmill videoendoscopy, ridden videoendoscopy should be the preferred method for evaluation of the upper airway in sport horses.

Subclinical diseases underlying poor performance in endurance horses: diagnostic methods and predictive tests.

Thirty-eight endurance horses underwent clinical and ancillary examinations, including haematological and biochemical evaluation, standardised exercise tests both on a treadmill and in the field, Doppler echocardiography, impulse oscillometry, video endoscopy and collection of respiratory fluids. All of the examined poorly performing horses were affected by subclinical diseases, and most of them had multiple concomitant disorders. On the contrary, the well-performing horses were free of any subclinical disease. The most frequently diagnosed diseases were respiratory disorders, followed by musculoskeletal and cardiac problems. Poor performers exhibited lower speeds at blood lactate concentration of 4 mmol/l (VLA4) and at heart rates of 160 (V160) and 200 bpm (V200) on the treadmill and in the field, as well as slower recovery of heart rate.

Hydration and electrolyte balance in horses during an endurance season.

REASONS FOR PERFORMING STUDY: Limited information exists about the physiological training-induced changes in electrolyte balance of horses competing in long distance endurance races. OBJECTIVES: To determine the effects of endurance training and racing on hydration and electrolyte balance in horses. METHODS: Blood and urine were sampled at rest in 8 endurance horses before training and after two 11 week training periods (T1 and T2). Each training was followed by a 120 km endurance ride and horses were sampled before, during and 2 h after the rides. Blood was analysed for packed cell volume (PCV), total protein (TP), urea, creatinine and electrolyte concentrations. Urine was analysed for pH, specific gravity, creatinine and electrolyte concentrations, which allowed calculation of fractional excretion of electrolytes (FE). Changes associated with training and with the rides were assessed using a Student paired t test (P ≤ 0.05). RESULTS: Plasma TP, urea, creatinine and sodium concentrations increased during T1 and PCV decreased significantly during T2. FE(Cl) increased during T1 then decreased. FE(K) increased significantly during both training periods. Other blood and urine parameters did not show remarkable changes with training. PCV, plasma TP, urea, creatinine and total Ca concentrations increased and plasma Na(+) and Cl(-) concentrations decreased during both rides. Urine concentrations of Na(+), K(+) and Cl(-), FE(Na) and FE(Cl) decreased during the rides while urinary creatinine increased. FE(K) increased during the first part of the rides then decreased. CONCLUSIONS: These data contribute to the understanding of changes associated with training and prolonged endurance exercise.

Altered systolic left ventricular function in horses completing a long distance endurance race.

REASONS FOR PERFORMING STUDY: It is unknown whether or not exercise-induced cardiac fatigue (EICF), as demonstrated in human athletes performing long duration exercise, occurs in endurance horses. OBJECTIVE: To examine the effects of a long distance endurance race on left ventricular systolic function in horses. METHODS: Echocardiography was performed before, and after, a 2 or 3 star international endurance race (106-132 km) in 11 horses. Systolic (s) and diastolic (d) interventricular and left ventricular free wall thickness (IVS and LVFW, respectively), left ventricular, left atrial and aortic internal diameter (LVID, LA and Ao, respectively), fractional shortening (FS) and ejection fraction (EF) were measured by echocardiography. Heart rate (HR), peak flow velocity (Vmax), flow velocity integral (FVI), ejection time (ET), pre-ejection period (PEP), velocity of circumferential fibre shortening (Vcf), stroke volume (SV) and cardiac output (CO) were measured from aortic Doppler wave recordings. RESULTS: After the race, LVIDd, Ao, LA, EF, FS, FVI, SV, ET and ET indexed for HR were significantly lower and IVSd, LVFWd, HR, PEP, PEP/ET and Vcf significantly higher as compared with prerace values. Pre- to post exercise changes in those parameters were not significantly correlated with changes in HR or in LVIDd. CONCLUSIONS: Results suggest that EICF, with a decrease in left ventricular systolic function, could occur post exercise in horses performing long duration endurance races. However, a multanecus effect of altered preload and heart rate on the studied variables cannot be discounted.

Alterations in mitochondrial respiratory function in response to endurance training and endurance racing.

REASONS FOR PERFORMING STUDY: Limited information exists about the muscle mitochondrial respiratory function changes that occur in horses during an endurance season. OBJECTIVES: To determine effects of training and racing on muscle oxidative phosphorylation (OXPHOS) and electron transport system (ETS) capacities in horses with high resolution respirometry (HRR). METHODS: Mitochondrial respiration was measured in microbiopsies taken from the triceps brachii (tb) and gluteus medius (gm) muscles in 8 endurance horses (7 purebred Arabians and 1 crossbred Arabian) before training (T0), after two 10 week training periods (T1, T2) and after 2 CEI** endurance races (R1, R2). Muscle OXPHOS capacity was determined using 2 titration protocols without (SUIT 1) or with pyruvate (SUIT 2) as substrate. Electrons enter at the level of Complex I, Complex II or both complexes simultaneously (Complexes I+II). Muscle ETS capacity was obtained by uncoupling Complexes I+II sustained respiration. RESULTS: T1 improved OXPHOS and ETS capacities in the tb as demonstrated by the significant increase of oxygen fluxes vs. T0 (Complex I: +67%; ETS: +37%). Training improved only OXPHOS in the gm (Complex I: +34%). Among horses that completed the race, a significant decrease in OXPHOS (Complex I: ∼ -35%) and ETS (-22%) capacities was found in the tb with SUIT 2 indicating a reduced aerobic glycolysis. Significant correlations between CK activities and changes in OXPHOS were found suggesting a relationship between exercise-induced muscle damage and depression of mitochondrial respiration. CONCLUSIONS: For the first time, OXPHOS and ETS capacities in equine muscle at different steps of an endurance season have been determined by HRR. Significant alterations in mitochondrial respiratory function in response to endurance training and endurance racing have been observed although these changes appeared to be muscle group specific.

Effect of a 120 km endurance race on plasma and muscular neutrophil elastase and myeloperoxidase concentrations in horses.

REASONS FOR PERFORMING STUDY: Intense physical exercise can induce the degranulation of neutrophils leading to an increase in plasma concentration of the neutrophil marker enzymes myeloperoxidase (MPO) and elastase (ELT). These enzymes have pro-oxidative and pro-inflammatory properties and may play a role in the exercised-induced muscular damage. OBJECTIVES: To measure MPO and ELT concentrations in plasma and muscles of endurance horses and to correlate them to the extent of exercise-induced muscular damage. METHODS: Seven endurance horses qualified on 120 km races were tested in this study. Neutrophil count, serum creatine kinase (CK), plasmatic and muscular MPO and ELT concentrations were measured before and 2 h after a 120 km endurance race. RESULTS: The race produced a significant increase of neutrophils, CK, and plasma MPO and ELT levels. A significant correlation was observed between the MPO and ELT values in plasma (r(2) = 0.92, P < 0.01) and in muscles (r(2) = 0.89, P < 0.01) while plasmatic concentrations of MPO and ELT were not significantly correlated to muscular ones. An increase of mean concentrations (± s.e.) of MPO (T0: 9.85 ± 3.9, T1: 228.9 ± 95.9 ng/mg proteins) and ELT (T0: 8.4 ± 2.4, T1: 74.5 ± 39.7 ng/mg proteins) in the muscles were observed after the race. Interestingly, the individual data showed large differences between the horses. Muscular MPO and ELT concentrations were significantly correlated to plasma CK levels. The coefficient of correlation (r(2)) was 0.69 (P < 0.01) for MPO and 0.66 (P < 0.01) for ELT, respectively. CONCLUSIONS: Results underline the possible role of MPO and ELT in exercise-induced muscular damage. POTENTIAL RELEVANCE: Further studies should investigate the effect of exercise type and intensity, as well as the role of the training state on MPO and ELT involvement in muscular damage. The assessment of the intensity of exercise-induced neutrophilic degranulation may have a potential role in the monitoring of the athletic career.

Specific immuno-extraction followed by enzymatic detection (SIEFED) of myeloperoxidase and mitochondrial complex I in muscular microbiopsies: preliminary results in endurance horses.

REASONS FOR PERFORMING STUDY: Intense exercise in horses induces an increase of creatine kinase (CK) and stimulation of neutrophils which release the strong oxidant enzyme, myeloperoxidase (MPO) into the blood. It is not known whether active MPO is found in equine muscles and whether oxidant activity of neutrophils could affect muscular tissues and mitochondrial activity. OBJECTIVES: Specific immuno-extraction followed by enzymatic detection (SIEFED) methods will be employed for the first time to assess both the normal range of MPO and mitochondrial complex I (MCI) activities in equine muscular microbiopsies and to study the variation of these activities induced by endurance races. MATERIALS AND METHODS: Forty-six microbiopsies were taken from 8 endurance Arabian horses (age: 10 ± 2 years) in the triceps brachii (n = 23) or in the gluteus medius muscle (n = 23). Myeloperoxidase and MCI activities were measured in muscle extracts by enzyme immunocapture assays or SIEFED methods. Further, 7 endurance horses were sampled in the triceps brachii muscle before (T0) and after (T1) a 120 km endurance race (mean speed: 15.4 ± 1.4 km/h). RESULTS: The 46 microbiopsies from 8 horses revealed mean values for active MPO concentration and MCI activity of 21 ± 14 ng/mg proteins and 0.0172 ± 0.0066 mOD/min/µg proteins, respectively. No significant difference was observed between the 2 muscles. In 3 out of the 7 horses sampled after exercise, the 120 km endurance race induced a severe increase of muscle MPO activity (+118 ± 45% vs. T0), a large decrease of MCI activity (-63 ± 18% vs. T0) associated with a high mean plasma CK level (4642 ± 658 iu/l). In the 4 remaining horses, the 120 km endurance race did not modify the MPO and MCI activities and moderately increased the plasma CK level. CONCLUSIONS: Preliminary observations showed a possible link between MPO activity and mitochondrial functions.

Influence of subclinical inflammatory airway disease on equine respiratory function evaluated by impulse oscillometry.

REASONS FOR PERFORMING STUDY: Inflammatory airway disease (IAD) is a nonseptic condition of the lower respiratory tract. Its negative impact on respiratory function has previously been described using either forced expiration or forced oscillations techniques. However, sedation or drug-induced bronchoconstriction were usually required. The impulse oscillometry system (IOS) is a noninvasive and sensitive respiratory function test validated in horses, which could be useful to evaluate IAD-affected horses without further procedures. OBJECTIVES: To determine the sensitivity of IOS in detecting alterations of the respiratory function in subclinically IAD-affected horses without inducing bronchoprovocation and to characterise their respiratory impedance according to frequency for each respiratory phase. METHODS: Pulmonary function was evaluated at rest by IOS in 34 Standardbred trotters. According to the cytology of bronchoalveolar lavage fluid (BALF), 19 horses were defined as IAD-affected and 15 horses were used as control (CTL). Total respiratory resistance (Rrs) and reactance (Xrs) from 1-20 Hz as well as their inspiratory and expiratory components were compared between groups. RESULTS: A significant increase of Rrs at the lower frequencies (R1-10 Hz) as well as a significant decrease of Xrs beyond 5 Hz (X5-20 Hz) was observed in IAD compared to CTL horses. IOS-data was also significantly different between inspiration and expiration in IAD-affected horses. In the whole population, both BALF eosinophil and mast cell counts were significantly correlated with IOS measurements. CONCLUSIONS: Functional respiratory impairment may be measured, even in the absence of clinical signs of disease. In IAD-affected horses, the different parameters of respiratory function (Rrs or Xrs) may vary depending on the inflammatory cell profiles represented in BALF. POTENTIAL RELEVANCE: Impulse oscillometry could be used in a routine clinical setting as a noninvasive method for early detection of subclinical respiratory disease and of the results of treatment in horses.

Effects of exercise and oral antioxidant supplementation enriched in (n-3) fatty acids on blood oxidant markers and erythrocyte membrane fluidity in horses.

The aim of this study was to investigate in a placebo-controlled field study the effect of a (n-3)-vitamin supplementation on erythrocyte membrane fluidity (EMF), oxidant/antioxidant markers and plasmatic omega3/omega6 fatty acid ratio (FAR) in 12 eventing horses. Venous blood was sampled at rest before (PRE) and after (POST) a three week treatment period with either the supplement (group S, n=6) or a placebo (group P, n=6) as well as after 15min (POST E15') and 24h (POST E24h) after a standardised exercise test. The following markers were analysed: EMF, plasma antioxidant capacity of water and lipid soluble components, ascorbic acid, uric acid (UA), glutathione (reduced: GSH, oxidised: GSSG), vitamin E (Vit E), beta-carotene, glutathione peroxidase (GPx) and superoxide dismutase (SOD) activity, selenium, copper (Cu), zinc (Zn), oxidised proteins (Protox), lipid peroxides (Pool) and FAR. EMF did not differ between group S and P after treatment, but GPx remained unchanged in group S whereas it decreased in group P and plasma Cu/Zn ratio remained unchanged whereas it increased in group P. FAR were significantly increased in group S. Exercise induced a significant decrease of EMF (POST vs. E24h) in both groups, but which was significantly lower at E15' in group S than in group P. Exercise induced a significant increase of UA and ACW (POST vs. E15') and Protox (POST vs. E24h) in both groups. An exercise-related decrease in GSH and Pool (POST vs. E15') was found in group P, whereas Vit E and FAR (POST vs. E24h) significantly decreased in both groups. The study showed that exercise induced a decrease in EMF in horses associated with changes of blood oxidative balance. The (omega-3)-vitamin supplementation tested improved the oxidative balance poorly but delayed the exercise-induced decrease of EMF and increased the FAR.

Qualitative and quantitative evaluation of equine respiratory mechanics by impulse oscillometry.

REASONS FOR PERFORMING STUDY: The long-established conventional reference technique (CRT) for measuring respiratory mechanics in horses lacks sensitivity and there is a need for further refinement in new technology, such as the impulse oscillometry system (IOS). OBJECTIVES: To evaluate the potential use of the IOS as a clinical respiratory function test and compare it to the current CRT in horses suffering from common upper and lower airway dysfunctions. METHODS: Six healthy horses were tested before and after induction of a unilateral nasal obstruction (UNO) or transient left laryngeal hemiplegia (LLH). Six heaves-affected horses were tested in clinical remission and during a heaves crisis, before and after nebulisation of cumulative doses of a bronchodilator therapy (ipratropium bromide; IPB). RESULTS: As opposed to the CRT, the IOS was able to detect partial upper airway obstruction (UAO) caused by UNO or LLH in resting horses, without differentiating both conditions. Upper airway obstruction caused an upward shift of resistance (R(rs)) from 5 to 35 Hz without altering reactance (X(rs)). As for the CRT, IOS respiratory parameters measured in heaves-affected horses in crisis differed significantly from values measured during remission. The difference in frequency-dependent behaviour of R(rs) and X(rs) allowed discrimination between upper and lower airway obstructions. Bronchodilator treatment induced significant dose-dependent changes in X(rs) at 5 and 10 Hz, from the first dose. Total pulmonary resistance (RL) and R(rs) at 5 Hz were affected from the second dose and displayed similar sensitivity. Although post treatment RL values were comparable to remission, R(rs) and X(rs) remained significantly different, characterising persistent peripheral obstruction. CONCLUSIONS: The IOS was more sensitive than the CRT in detecting partial UAO in resting horses and persistent post treatment peripheral dysfunction in heaves-affected horses. The IOS is a sensitive test that provides graded quantitative and qualitative information on disease-induced respiratory dysfunctions as well as on treatment efficiency in horses. POTENTIAL RELEVANCE: The IOS could represent a practical and sensitive alternative respiratory function test for routine clinical investigations of common airway obstructive diseases and therapy in horses.

The effects of dietary N-3 and antioxidant supplementation on erythrocyte membrane fatty acid composition and fluidity in exercising horses.

REASONS FOR PERFORMING STUDY: Fatty acid supplementation could modulate erythrocyte membrane fluidity in horses at rest and during exercise, but information is lacking on the effect of exercise. OBJECTIVES: To assess the effect of exercise with, and without, an oral antioxidant supplementation enriched with n-3 fatty acids on erythrocyte membrane fluidity (EMF) and fatty acid composition in eventing horses. METHODS: Twelve healthy and regularly trained horses were divided randomly into 2 groups: group S received an oral antioxidant cocktail enriched in n-3 fatty acid (alphatocopherol, eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) whereas group P was placebo-treated. At the end of 4 weeks, all horses performed a standardised exercise test (ET) under field conditions. Venous blood was sampled before starting treatment (TO), immediately before (T1) as well as 15 min (T2) and 24 h (T3) after ET. Spin labelled (16-DOXYL-stearic acid) red blood cell membranes were characterised using the relaxation correlation time (Tc in inverse proportion to EMF). Fatty acid composition (%) of the membrane was determined by gas-liquid chromatography. RESULTS: Supplementation did not induce changes in EMF (T1 vs. TO) but significant changes in membrane composition were observed and there were increases in n-3 polyunsaturated fatty acid PUFA, n-3/n-6 ratio, and total n-3 fatty acids. Exercise (T2 vs. T1) induced a significant decrease of EMF in group P (Tc: +19%, P<0.05) and nonsignificant decrease in group S (Tc: +5%), whereas membrane fatty acid composition did not change in either group. During the recovery period (T3 vs. T2), EMF decreased significantly in group S (Tc: +29%, P<0.05) and nonsignificantly in group P (Tc: +18%) without any significant changes in fatty acid composition. CONCLUSION AND POTENTIAL RELEVANCE: An enriched oral antioxidant supplementation induced changes in membrane composition, which modulated the decrease in EMF induced by exercise. Long chain n-3 fatty acid supplementation might therefore be beneficial.

Validation of a portable equine metabolic measurement system.

REASONS FOR PERFORMING STUDY: In equine sports medicine, VO2 has been measured exclusively with stationary systems, in laboratories equipped with a treadmill. Measurement during exercise in field conditions has not previously been reported because of the lack of portable equipment designed for horses. OBJECTIVES: A commercially available portable metabolic measurement system, based on breath-to-breath gas analysis and flow spirometry, was adapted to the horse's physiology and morphology (Cosmed K4b2 and Equimask) and its validity tested by (1) repeatability of the measures and (2) comparing metabolic data to those obtained by a reference method (RM). METHODS: To test the reproducibility of the measurements, 5 healthy saddle horses were subjected twice at 2 day intervals to a similar submaximal standardised incremental exercise test on a treadmill. The same horses performed twice at one week interval an incremental treadmill test to fatigue: the oxygen consumption and ventilation were measured once with the K4b2 system and once with the RM. The metabolic and ventilatory data obtained with both systems were compared. RESULTS: There was a good reproducibility of the metabolic measurements obtained by the K4b2 system at any workload. The VO2 obtained by both systems at any workload was not significantly different. However, the K4b2 expired fraction in CO2 (FETCO2) and carbon dioxide production (VCO2) were significantly lower at high and at maximal workloads. As a consequence, the values of the respiratory exchange ratio were too low and incompatible with normal physiological values. CONCLUSIONS: The good reproducibility of the metabolic and ventilatory measurements and the fact that the VO2 measurements at any workload were similar to the data obtained with the reference method suggested that this system may be used for comparison of repeated VO2 measurements in practical field conditions. POTENTIAL RELEVANCE: The K4b2 system could be used to improve knowledge of the energetic cost in different equine sports disciplines and offer the opportunity to undertake performance tests with genuine track conditions, on ridden or harnessed horses, rather than under laboratory conditions.

Influence of breathing pattern and lung inflation on impulse oscillometry measurements in horses.

The objective of this paper was to determine if changes in ventilation patterns could influence the outcome of respiratory function measurements performed with our impulse oscillometry system (IOS) in horses. In a first study, IOS tests were performed in vitro on six isolated equine lungs. Lung inflation levels were controlled by modifying depressurisation inside an artificial thorax and different ventilation patterns were imposed. In a second in vivo study, transient variations in breathing pattern were evaluated both with the IOS and a current reference technique (CRT) in five healthy mature horses after an intravenous (i.v.) injection of lobeline hydrochloride. In both studies, respiratory rate (RR, range: 7-42 breaths/min.) and tidal volume (V(T), range: 0.4-25 L) had minor or no influence on IOS parameters. The influence of lung inflation, most marked for resistance at 5 Hz (R(5 Hz)), was limited for the considered physiological range. In vivo, statistical models indicated that maximal changes in pleural pressure (Max Delta Ppl) and peak flows were the main determinants of the variability of the resistance (R(rs)) and the reactance (X(rs)) of the respiratory system. The fourfold increase in baseline Max Delta Ppl and peak flows obtained during hyperpnoea caused a significant increase in R(rs) at 5 and 10 Hz and a decrease in X(rs) at all frequencies. We conclude that IOS parameters are not influenced by tachypnoea, but will reflect alterations in respiratory mechanics caused by hyperpnoeic breathing.

Measurement of respiratory function by impulse oscillometry in horses.

REASONS FOR PERFORMING STUDY: Due to technical implementations and lack of sensitivity, pulmonary function tests are seldom used in clinical practice. Impulse oscillometry (IOS) could represent an alternative method. OBJECTIVES: To define feasibility, methodology and repeatability of IOS, a forced oscillation technique that measures respiratory resistance (Rrs) and reactance (Xrs) from 5 to 35 Hz during spontaneous breathing, in horses. METHODS: Using 38 healthy horses, Rrs and Xrs reference values were defined and influence of individual biometrical parameters was investigated. In addition, IOS measurements of 6 horses showing clinical signs of heaves were compared to those of 6 healthy horses. RESULTS: Airtightness and minimal dead space in the facemask were prerequisites to IOS testing and standardisation of head position was necessary to avoid variations in Rrs due to modified upper airway geometry. In both healthy and diseased animals, measurements were repeatable. In standard-type breeds, the influence of the horse's size on IOS parameters was negligible. An increase in R5Hz greater than 0.10 kPa/l/sec and R5Hz>R10Hz, combined with negative values of Xrs between 5 and 20 Hz, was indicative of heaves crisis. CONCLUSIONS: IOS is a quick, minimally invasive and informative method for pulmonary function testing in healthy and diseased horses. POTENTIAL RELEVANCE: IOS is a promising method for routine and/or field respiratory clinical testing in the equine species.

Alveolar clearance in horses with chronic obstructive pulmonary disease.

OBJECTIVE: To assess sensitivity of scintigraphic alveolar clearance rate as an indicator of alveolar epithelium damage in horses. ANIMALS: 5 healthy horses (group A) and 5 with chronic obstructive pulmonary disease (COPD; group B). PROCEDURE: Horses underwent clearance rate (k [%/min]) determination. Clearance rate of group-B horses was determined after remission of the disease following 2 months at pasture (remission 1), stabling in a controlled environment (remission 2), and during crisis induced by exposure to moldy hay and straw. Methacholine challenge test was performed at each investigation period to determine nonspecific pulmonary airway hyperresponsiveness. Pulmonary function tests (PFT) also were performed, and cell populations in bronchoalveolar lavage (BAL) fluid were determined on another occasion. RESULTS: Group-B horses had significantly faster mean clearance rate during crisis (k = 4.30+/-0.95%/min), compared with that for remission 1(k = 1.98+/-0.55%/min), which did not differ from the rate in group-A horses (k = 1.95+/-0.33%/min). Despite lack of clinical signs of COPD during remission when stabled in a controlled environment, an intermediate value was found (k = 3.20+/-0.72%/min). CONCLUSIONS: This technique allowed grading of lung damage induced by COPD, whereas use of PFT and determination of BAL fluid cell populations failed to differentiate between remission 1 and remission 2. CLINICAL RELEVANCE: Determination of alveolar clearance rate by use of scintigraphy is a sensitive indicator of lung damage. A modified clearance rate was found despite the lack of clinical and functional changes.

Effect of a set stabled environmental control on pulmonary function and airway reactivity of COPD affected horses.

The aim of this study was to evaluate the respiratory function of horses affected with chronic obstructive pulmonary disease (COPD) when maintained in a barn on wood shavings and fed grass silage for a period of 6 weeks. The mechanics of breathing, blood gas analysis and bronchial reactivity were examined on five horses with COPD at the end of the environment-controlled period (Period B) and the results compared with values obtained after 2 months at pasture (Period A) and after the onset of clinical signs of acute crisis (Period C). The results showed that clinical and functional parameters were similar in healthy horses and in COPD horses placed on pasture or stabled and fed grass silage. Moreover, the bronchial reactivity of COPD horses at pasture was similar to the bronchial reactivity of healthy horses. COPD horses fed grass silage however presented a bronchial reactivity intermediate between those measured after Period A and Period C which suggested they would be more susceptible to develop bronchoconstriction when in contact with inhaled irritants.