Technical validation of a face mask adapted for dry powder inhalation in the equine species

Effects of inhaled ipratropium bromide on breathing mechanics and gas exchange in exercising horses with chronic obstructive pulmonary disease

Six Warmblood horses suffering an acute exacerbation of COPD were tested to investigate whether inhalation of ipratropium bromide (IB) dry powder (2,400 microg) 30 min preexercise would improve their exercise capacity. A cross-over protocol with an inert powder placebo (P) was used. Mechanics of breathing and arterial blood gases were determined before treatment, after treatment but pre-exercise, and during an incremental exercise test. Oxygen consumption (VO2) was also measured before and during exercise, and the time to fatigue recorded. Inhalation of IB reduced total pulmonary resistance (RL) and maximum intrapleural pressure changes (deltaPpl(max)) and increased dynamic compliance before exercise. The onset of exercise was associated with a marked decrease in RL in P-treated horses but not those receiving IB, so that RL during exercise was not affected by treatment. Although deltaPpl(max) was lower at 8,9 and 10 m/s with IB, there were no treatment-related changes in VO2, blood gases, time to fatigue or any other measurement of breathing mechanics. Therefore, although inhalation of IB prior to exercise may have improved deltaPpl(max), it had no apparent impact on the horses' capacity for exercise.

Equine respiratory pharmacology

Differentiation of diseases of the equine respiratory tract is based on history, clinical signs, auscultation, endoscopy, imaging, and sampling of airway exudate. Upper respiratory therapies include surgical correction of airway obstructions; flushing of localized abscesses (strangles), guttural pouch disease, or sinusitis; and oral or parenteral antibiotic and anti-inflammatory therapy if deemed necessary. Pneumonia usually is treated with antimicrobials, anti-inflammatories, and bronchodilators. Pleural drainage is indicated if significant pleural effusion is present. The most commonly used therapies for early inflammatory and chronic allergic obstructive conditions include bronchodilators and anti-inflammatories. Acute respiratory distress, particularly acute pulmonary edema, is treated with diuretics (usually furosemide), intranasal oxygen, bronchodilators, corticosteroids, and alleviation of the underlying cause. Furosemide also had been used in North America as a race-day preventative for exercise-induced pulmonary hemorrhage (EIPH), but recent data have shown that furosemide may be a performance-enhancing agent itself.

Effects of inhaled dry powder ipratropium bromide on recovery from exercise of horses with COPD

The present study evaluated ventilatory, cardiovascular and metabolic parameters during recovery from strenuous exercise in horses suffering from a crisis of chronic obstructive pulmonary disease (COPD) and to determine whether ipratropium dry powder inhalation (DPI) before exercise has an effect on these parameters. When 6 saddle horses, affected with COPD, developed airway obstruction, they inhaled placebo and ipratropium (2400 microg/horse), the order being randomly chosen. Pulmonary function tests were then recorded 15 min after inhalation. Following these tests, the horses underwent a strenuous treadmill exercise, followed by a recovery period that consisted of a 10 min walk. Measurements were made at the first and tenth min of recovery. Respiratory flow, O2 and CO2 fractions in the respired gas, pleural pressure changes and heart rate were recorded. Arterial and mixed venous blood samples were analysed for gas tensions, haemoglobin and plasma lactate concentrations. Oxygen consumption (VO2), CO2 production, tidal volume, alveolar oxygen tension (PAO2), alveolar ventilation, the alveolar-pulmonary capillary oxygen difference ((A-a)dO2) and total pulmonary resistance (RL) were measured. The PAO2 was the only parameter significantly improved during recovery following ipratropium DPI. This improvement was not accompanied by evidence of improvement of other ventilatory or cardiorespiratory parameters. The results showed that in horses suffering from a crisis of COPD, recovery is characterised by an exercise-induced bronchodilation. Secondly, ipratropium DPI at a dose of 2400 microg/horse is an effective bronchodilator in these horses at rest but it has little effect on the airway calibre during the recovery period. It is suggested that the short term recovery period is still influenced by exercise-induced adjustments that may exceed the bronchodilatory effect of inhaled ipratropium that are observed before exercise.

Environmental control to maintain stabled COPD horses in clinical remission: effects on pulmonary function

The objective of this study was to test the hypothesis that stabled COPD horses can be maintained in clinical remission by replacing hay by grass silage and bedding made of wood shavings (Period B) and of wheat straw (Period C) during 6 weeks, respectively. At the end of these different periods, the pulmonary function of the horses was assessed by mechanics of breathing and arterial blood analyses. These results were compared to those measured in clinical remission obtained after 2 months in pasture (Period A). No significant difference was observed between these 3 periods neither to values obtained for healthy horses placed during 6 weeks in a hay environment. For all that, COPD horses placed in contact with hay in the same barn developed within mean +/- s.d. 8+/-3 days clinical signs of heaves and significant alterations of pulmonary function parameters.