Observations on respiratory flow strategies during and after intense treadmill exercise to fatigue in Thoroughbred racehorses

Evaluation of the airway mechanics of modified toggle laryngoplasty constructs using a vacuum chamber airflow model

OBJECTIVE

To evaluate the airway mechanics of modified toggle LP constructs in an airflow chamber model and compare these to the airway mechanics of standard LP constructs.

STUDY DESIGN

Ex-vivo experimental study.

SAMPLE POPULATION

Fifty-one equine cadaveric larynges.

METHODS

Bilateral LP constructs were performed using a modified toggle (n = 23) or a standard (n = 21) LP technique. Constructs were tested in an airflow model before and after cyclic loading which was designed to mimic postoperative swallowing. The cross-sectional area (CSA), peak translaryngeal airflow (L/s), and impedance (cmH₂ 0/L/s) were determined and compared between LP constructs before and after cycling.

RESULTS

The mean CSA of the rima glottidis of the modified toggle LP constructs was 15.2 ± 2.6 cm² before and 14.7 ± 2.6 cm² after cyclic loading, and the mean CSA of the rima glottidis of the standard LP constructs was 16.4 ± 2.9 cm² before and 15.7 ± 2.8 cm² after cyclic loading. The modified toggle LP constructs had similar peak translaryngeal impedance before and after cyclic loading (p = .13); however, the standard LP constructs had higher peak translaryngeal impedance after cyclic loading (p = .02).

CONCLUSION

The modified toggle and standard LP constructs had comparable airway mechanics in an ex-vivo model.

CLINICAL SIGNIFICANCE

Further investigation is warranted to determine the extent to which the modified toggle LP technique restores normal airway function in horses with RLN.

Asthmatic Disease as an Underlying Cause of Dorsal Displacement of the Soft Palate in Horses

It is important to treat the upper and lower respiratory tracts as a single unit, as lower respiratory tract diseases can often cause upper respiratory functional disorders, whereas upper respiratory obstructions could be a factor in lower respiratory problems. The present study aimed to investigate the hypothesis that asthmatic diseases may be an underlying cause of dorsal displacement of the soft palate in horses. Pleasure or sport horses (n = 57) with a history of asthmatic disease were incorporated in the study. All horses were examined in the exacerbation phase of the asthmatic disease. Bronchoalveolar cytology and tracheal lavage bacteriology were performed in all cases. The upper respiratory tract was evaluated at rest in all horses and during exercising endoscopy in 11/57 with severe equine asthma. Binomial tests with P ≤ .05 significance were used to establish estimated intervals of the measured frequencies of dorsal displacement of the soft palate (DDSP) occurring in the studied groups. It was observed that more than 60% of horses with mild or moderate equine asthma and more than 79% of horses with severe equine asthma are presented with DDSP during resting endoscopy examination. During the exercising endoscopy, DDSP was detected in all cases of severe equine asthma. These findings support the proposed hypothesis that DDSP was common in horses with equine asthma. Both increasing negative pressure in the airways due to bronchoconstriction and inflammatory processes could be factors in the development of DDSP. The consequent step would be to investigate the same population of horses in the remission phase of the equine asthma.

Equine Welfare during Exercise: An Evaluation of Breathing, Breathlessness and Bridles

Simple Summary

Horses have superior athletic capabilities due largely to their exceptional cardiorespiratory responses during exercise. This has particular relevance to horses’ potential to experience breathlessness, especially when their athletic performance is reduced by impaired respiratory function. Breathlessness, incorporating three types of unpleasant experiences, has been noted as of significant animal welfare concern in other mammals. However, the potential for breathlessness to occur in horses as usually ridden wearing bitted bridles has not yet been evaluated in detail. Accordingly, key physiological responses to exercise and the consequences of impaired respiratory function are outlined. Then the physiological control of breathing and the generation of the aversive experiences of breathlessness are explained. Finally, the potential for horses with unimpaired and impaired respiratory function to experience the different types of breathlessness is evaluated. This information provides a basis for considering the circumstances in which breathlessness may have significant negative welfare impacts on horses as currently ridden wearing bitted bridles. Potential beneficial impacts on respiratory function of using bitless bridles are then discussed with emphasis on the underlying mechanisms and their relevance to breathlessness. It is noted that direct comparisons of cardiorespiratory responses to exercise in horses wearing bitless and bitted bridles are not available and it is recommended that such studies be undertaken.

Abstract

Horses engaged in strenuous exercise display physiological responses that approach the upper functional limits of key organ systems, in particular their cardiorespiratory systems. Maximum athletic performance is therefore vulnerable to factors that diminish these functional capacities, and such impairment might also lead to horses experiencing unpleasant respiratory sensations, i.e., breathlessness. The aim of this review is to use existing literature on equine cardiorespiratory physiology and athletic performance to evaluate the potential for various types of breathlessness to occur in exercising horses. In addition, we investigate the influence of management factors such as rein and bit use and of respiratory pathology on the likelihood and intensity of equine breathlessness occurring during exercise. In ridden horses, rein use that reduces the jowl angle, sometimes markedly, and conditions that partially obstruct the nasopharynx and/or larynx, impair airflow in the upper respiratory tract and lead to increased flow resistance. The associated upper airway pressure changes, transmitted to the lower airways, may have pathophysiological sequelae in the alveolae, which, in their turn, may increase airflow resistance in the lower airways and impede respiratory gas exchange. Other sequelae include decreases in respiratory minute volume and worsening of the hypoxaemia, hypercapnia and acidaemia commonly observed in healthy horses during strenuous exercise. These and other factors are implicated in the potential for ridden horses to experience three forms of breathlessness—”unpleasant respiratory effort”, “air hunger” and “chest tightness”—which arise when there is a mismatch between a heightened ventilatory drive and the adequacy of the respiratory response. It is not known to what extent, if at all, such mismatches would occur in strenuously exercising horses unhampered by low jowl angles or by pathophysiological changes at any level of the respiratory tract. However, different combinations of the three types of breathlessness seem much more likely to occur when pathophysiological conditions significantly reduce maximal athletic performance. Finally, most horses exhibit clear behavioural evidence of aversion to a bit in their mouths, varying from the bit being a mild irritant to very painful. This in itself is a significant animal welfare issue that should be addressed. A further major point is the potential for bits to disrupt the maintenance of negative pressure in the oropharynx, which apparently acts to prevent the soft palate from rising and obstructing the nasopharynx. The untoward respiratory outcomes and poor athletic performance due to this and other obstructions are well established, and suggest the potential for affected animals to experience significant intensities of breathlessness. Bitless bridle use may reduce or eliminate such effects. However, direct comparisons of the cardiorespiratory dynamics and the extent of any respiratory pathophysiology in horses wearing bitted and bitless bridles have not been conducted. Such studies would be helpful in confirming, or otherwise, the claimed potential benefits of bitless bridle use.

Horses Auto-Recruit Their Lungs by Inspiratory Breath Holding Following Recovery from General Anaesthesia

This study evaluated the breathing pattern and distribution of ventilation in horses prior to and following recovery from general anaesthesia using electrical impedance tomography (EIT). Six horses were anaesthetised for 6 hours in dorsal recumbency. Arterial blood gas and EIT measurements were performed 24 hours before (baseline) and 1, 2, 3, 4, 5 and 6 hours after horses stood following anaesthesia. At each time point 4 representative spontaneous breaths were analysed. The percentage of the total breath length during which impedance remained greater than 50% of the maximum inspiratory impedance change (breath holding), the fraction of total tidal ventilation within each of four stacked regions of interest (ROI) (distribution of ventilation) and the filling time and inflation period of seven ROI evenly distributed over the dorso-ventral height of the lungs were calculated. Mixed effects multi-linear regression and linear regression were used and significance was set at p<0.05. All horses demonstrated inspiratory breath holding until 5 hours after standing. No change from baseline was seen for the distribution of ventilation during inspiration. Filling time and inflation period were more rapid and shorter in ventral and slower and longer in most dorsal ROI compared to baseline, respectively. In a mixed effects multi-linear regression, breath holding was significantly correlated with PaCO₂ in both the univariate and multivariate regression. Following recovery from anaesthesia, horses showed inspiratory breath holding during which gas redistributed from ventral into dorsal regions of the lungs. This suggests auto-recruitment of lung tissue which would have been dependent and likely atelectic during anaesthesia.

The prevalence of abnormal breathing patterns during exercise and associations with dynamic upper respiratory tract obstructions

REASONS FOR PERFORMING STUDY

There is very limited published information on the prevalence and significance of abnormal breathing patterns adopted during canter/gallop.

OBJECTIVES

The aim of this study was to report the prevalence of abnormal breathing patterns during canter/gallop and to investigate whether these may be associated with dynamic upper respiratory tract (URT) obstructions.

STUDY DESIGN

Retrospective analysis of clinical records.

METHODS

Simultaneous audio and URT videoendoscopy recordings from 365 horses referred for treadmill evaluation were analysed.

RESULTS

Thirty percent of horses had an abnormal breathing pattern at canter or gallop, of which 23% had a 2:1 breathing pattern (i.e. one breath is taken over two strides). The prevalence of abnormal breathing patterns was higher at low canter speeds than during strenuous exercise. There was a significant association between breathing pattern during strenuous exercise and the presence of an URT obstruction.

CONCLUSIONS

This study suggests that abnormal breathing patterns during canter and gallop may be associated with dynamic URT obstructions; therefore, horses identified by owners or veterinary surgeons to have an abnormal breathing pattern during exercise, in particular a 2:1 breathing pattern, may warrant investigations for diagnosis of respiratory tract disease.

Pulmonary function measurements immediately after exercise are correlated with neutrophil percentage in tracheal aspirates in horses with poor racing performance

Inflammatory airway disease (IAD) is common in racehorses, and is a cause of wastage in the industry. IAD has been diagnosed by measurement of percent neutrophils (N%) in tracheal aspirates (TA). The aim of this study was to investigate whether spirometric indices of pulmonary function were correlated with N% in TAs. Limits to breathing were measured by analyses of relationships between relative times and relative respiratory gas flows during inspiration and expiration in individual breaths recorded after exercise. Horses with higher N% had significantly lower relative gas flows at the same relative times during inspiration and expiration, suggesting a limit to breathing. These findings confirm a physiological basis for the measurement of N% in TA after exercise for diagnosis of IAD. Spirometric pulmonary function testing using analyses of individual breaths after exercise has application for assessment of pulmonary function and poor exercise performance.

Development of equine upper airway fluid mechanics model for Thoroughbred racehorses

REASON FOR PERFORMING STUDY

Computational fluid dynamics (CFD) models provide the means to evaluate airflow in the upper airways without requiring in vivo experiments.

HYPOTHESIS

The physiological conditions of a Thoroughbred racehorse's upper airway during exercise could be simulated.

METHODS

Computed tomography scanned images of a 3-year-old intact male Thoroughbred racehorse cadaver were used to simulate in vivo geometry. Airway pressure traces from a live Thoroughbred horse, during exercise was used to set the boundary condition. Fluid-flow equations were solved for turbulent flow in the airway during inspiratory and expiratory phases. The wall pressure turbulent kinetic energy and velocity distributions were studied at different cross-sections along the airway. This provided insight into the general flow pattern and helped identify regions susceptible to dynamic collapse.

RESULTS

The airflow velocity and static tracheal pressure were comparable to data of horses exercising on a high-speed treadmill reported in recent literature. The cross-sectional area of the fully dilated rima glottidis was 7% greater than the trachea. During inspiration, the area of highest turbulence (i.e. kinetic energy) was in the larynx, the rostral aspect of the nasopharynx was subjected to the most negative wall pressure and the highest airflow velocity is more caudal on the ventral aspect of the nasopharynx (i.e. the soft palate). During exhalation, the area of highest turbulence was in the rostral and mid-nasopharynx, the maximum positive pressure was observed at the caudal aspect of the soft palate and the highest airflow velocity at the front of the nasopharynx.

CONCLUSIONS AND CLINICAL RELEVANCE

In the equine upper airway collapsible area, the floor of the rostral aspect of the nasopharynx is subjected to the most significant collapsing pressure with high average turbulent kinetic during inhalation, which may lead to palatal instability and explain the high prevalence of dorsal displacement of the soft palate (DDSP) in racehorses. Maximal abduction of the arytenoid cartilage may not be needed for optimal performance, since the trachea cross-sectional area is 7% smaller than the rima glottidis.

Physiology of equine performance and associated tests of function

This review addresses the physiology of performance horses in the context of functional tests aimed at assisting clinicians in the search for explanations of the individual's limitations, actual or perceived as below expectation. The intention is to assist clinicians who are faced frequently by owners or trainers seeking explanations for poor performance; and for research workers as a basis on which to proceed in their search for new methodologies, particularly those that can be applied in the field as for treadmill exercise. The review sets out fundamental physiological pathways, the entailment of which may represent a limiting factor to performance, while taking into account the individual's status, including anamnesis and the possibility of actual disease being present. Tests that assess the possible roles of several body systems, as causes of limited performance, are discussed. These systems include pulmonary, cardiovascular and neuromuscular systems. The evaluation of anaerobic and aerobic energy pathways is also discussed. Emphasis is given to the assessment of pulmonary ventilation by techniques such as spirometry and ergospirometry. These techniques are considered to be of particular potential for further development.