Pulmonary ventilation and resistance in emphysematous and control horses

Can bronchoconstriction and bronchodilatation in horses be detected using electrical impedance tomography?

BACKGROUND

Electrical impedance tomography (EIT) generates images of the lungs based on impedance change and was able to detect changes in airflow after histamine challenge in horses.

OBJECTIVES

To confirm that EIT can detect histamine-provoked changes in airflow and subsequent drug-induced bronchodilatation. Novel EIT flow variables were developed and examined for changes in airflow.

METHODS

Bronchoconstriction was induced using stepwise histamine bronchoprovocation in 17 healthy sedated horses. The EIT variables were recorded at baseline, after saline nebulization (control), at the histamine concentration causing bronchoconstriction (Cmax ) and 2 and 10 minutes after albuterol (salbutamol) administration. Peak global inspiratory (PIFEIT ) and peak expiratory EIT (PEFEIT ) flow, slope of the global expiratory flow-volume curve (FVslope ), steepest FVslope over all pixels in the lung field, total impedance change (surrogate for tidal volume; VTEIT ) and intercept on the expiratory FV curve normalized to VTEIT (FVintercept /VTEIT ) were indexed to baseline and analyzed for a difference from the control, at Cmax , 2 and 10 minutes after albuterol. Multiple linear regression explored the explanation of the variance of Δflow, a validated variable to evaluate bronchoconstriction using all EIT variables.

RESULTS

At Cmax , PIFEIT , PEFEIT , and FVslope significantly increased whereas FVintercept /VT decreased. All variables returned to baseline 10 minutes after albuterol. The VTEIT did not change. Multivariable investigation suggested 51% of Δflow variance was explained by a combination of PIFEIT and PEFEIT .

CONCLUSIONS AND CLINICAL IMPORTANCE

Changes in airflow during histamine challenge and subsequent albuterol administration could be detected by various EIT flow volume variables.

Horses With Pasture Asthma Have Airway Remodeling That Is Characteristic of Human Asthma

Severe equine asthma, formerly recurrent airway obstruction (RAO), is the horse counterpart of human asthma, affecting horses maintained indoors in continental climates. Equine pasture asthma, formerly summer pasture RAO, is clinically similar but affects grazing horses during hot, humid conditions in the southeastern United States and United Kingdom. To advance translational relevance of equine pasture asthma to human asthma, histologic features of airway remodeling in human asthma were scored in lung lobes from 15 pasture asthma-affected and 9 control horses of mixed breeds. All noncartilaginous airways were scored using a standardized grading rubric (0-3) in hematoxylin and eosin (HE) and Movat's pentachrome-stained sections; 15 airways were chosen randomly from each lobe for analysis. Logistic regression identified disease, age, and lobe effects on probability of histologic outcomes. Airway smooth muscle (odds ratio [OR] = 2.5, P < .001), goblet cell hyperplasia/metaplasia (OR = 37.6, P < .0001), peribronchiolar elastic system fibers (OR = 4.2, P < .001), peribronchiolar fibrosis (OR = 3.8, P = .01), airway occlusion by mucus/inflammation (OR = 4.2, P = .04), and airway adventitial inflammation (OR = 3.0, P = .01) were significantly greater in diseased airways. A novel complex tissue disorganization, designated terminal bronchiolar remodeling, was overrepresented in diseased airways (OR = 3.7, P < .0001). Distribution of terminal bronchiolar remodeling corresponded to putative sites of air trapping in human asthma, at secondary pulmonary lobules. Age (>15 years) was an independent risk factor for increased peribronchiolar fibrosis, elastic system fibers, and terminal bronchiolar remodeling. Remodeling differed significantly between lung lobes, congruent with nonhomogeneous remodeling in human asthma. Equine pasture asthma recapitulates airway remodeling in human asthma in a manner not achieved in induced animal asthma models, endorsing its translational relevance for human asthma investigation.

Respiratory diseases and their effects on respiratory function and exercise capacity

Given that aerobic metabolism is the predominant energy pathway for most sports, the respiratory system can be a rate-limiting factor in the exercise capacity of fit and healthy horses. Consequently, respiratory diseases, even in mild forms, are potentially deleterious to any athletic performance. The functional impairment associated with a respiratory condition depends on the degree of severity of the disease and the equestrian discipline involved. Respiratory abnormalities generally result in an increase in respiratory impedance and work of breathing and a reduced level of ventilation that can be detected objectively by deterioration in breathing mechanics and arterial blood gas tensions and/or lactataemia. The overall prevalence of airway diseases is comparatively high in equine athletes and may affect the upper airways, lower airways or both. Diseases of the airways have been associated with a wide variety of anatomical and/or inflammatory conditions. In some instances, the diagnosis is challenging because conditions can be subclinical in horses at rest and become clinically relevant only during exercise. In such cases, an exercise test may be warranted in the evaluation of the patient. The design of the exercise test is critical to inducing the clinical signs of the problem and establishing an accurate diagnosis. Additional diagnostic techniques, such as airway sampling, can be valuable in the diagnosis of subclinical lower airway problems that have the capacity to impair performance. As all these techniques become more widely used in practice, they should inevitably enhance veterinarians' diagnostic capabilities and improve their assessment of treatment effectiveness and the long-term management of equine athletes.

Heaves, an asthma-like disease of horses

Animal models have been developed to investigate specific components of asthmatic airway inflammation, hyper-responsiveness or remodelling. However, all of these aspects are rarely observed in the same animal. Heaves is a naturally occurring disease of horses that combines these features. It is characterized by stable dust-induced inflammation, bronchospasm and remodelling. The evaluation of horses during well-controlled natural antigen exposure and avoidance in experimental settings allows the study of disease mechanisms in the asymptomatic and symptomatic stages, an approach rarely feasible in humans. Also, the disease can be followed over several years to observe the cumulative effect of repeated episodes of clinical exacerbation or to evaluate long-term treatment, contrasting most murine asthma models. This model has shown complex gene and environment interactions, the involvement of both innate and adaptive responses to inflammation, and the contribution of bronchospasm and tissue remodelling to airway obstruction, all occurring in a natural setting. Similarities with the human asthmatic airways are well described and the model is currently being used to evaluate airway remodelling and its reversibility in ways that are not possible in people for ethical reasons. Tools including antibodies, recombinant proteins or gene arrays, as well as methods for sampling tissues and assessing lung function in the horse are constantly evolving to facilitate the study of this animal model. Research perspectives that can be relevant to asthma include the role of neutrophils in airway inflammation and their response to corticosteroids, systemic response to pulmonary inflammation, and maintaining athletic capacities with early intervention.

Comparative efficacy of inhaled albuterol between two hand-held delivery devices in horses with recurrent airway obstruction

REASONS FOR PERFORMING STUDY

Studies investigating the clinical efficacy of albuterol administered with the same propellant and commercially available delivery devices in horses with recurrent airway obstruction (RAO) are not currently available.

OBJECTIVES

To determine the efficacy of aerosolised albuterol administered to horses with RAO by means of 2 commercially available, hand-held delivery devices.

METHODS

Ten horses with RAO were kept in a dusty environment and fed mouldy hay to induce airway obstruction. Lung mechanics were measured before and after the procedure. ΔP(max) was measured 5 min after administration of 180 µg of albuterol from a pressurised metered dose inhaler, using an aerosol delivery device chosen randomly. This process was repeated every 5 min until maximal bronchodilation was achieved. After a 24 h washout period, lung mechanics data were again collected using the other aerosol delivery device.

RESULTS

Aerosolised albuterol induced a significant and rapid bronchodilation in the horses using both aerosol delivery devices. No statistically significant difference in pulmonary function was observed in response to albuterol therapy between the 2 devices. The dose required to achieve 50% of maximal bronchodilation was not statistically different between the 2 devices (173.35 ± 78.35 µg with Device 1 and 228.49 ± 144.99 µg with Device 2, P = 0.26). The decrease in lung resistance tended to be more pronounced after albuterol administration with Device 1 (P = 0.066).

CONCLUSIONS

Aerosolised albuterol is an effective bronchodilator in horses with recurrent airway obstruction. There is no statistically significant difference between the 2 commercially available aerosol delivery devices in terms of efficacy.

POTENTIAL RELEVANCE

Aerosolised albuterol is effectively delivered using currently available devices leading to maximal bronchodilation in horses with RAO at an average dose of 540 µg.

Randomized, controlled study of inhaled fluticasone propionate, oral administration of prednisone, and environmental management of horses with recurrent airway obstruction

OBJECTIVE

To determine whether administration of glucocorticoids provides additional benefits to environmental management of horses with recurrent airway obstruction (RAO).

ANIMALS

28 horses with RAO.

PROCEDURE

Horses were classified as having mild, moderate, or severe RAO. Within each category, horses were randomly assigned to receive inhaled fluticasone propionate, inhaled control substance, or oral administration of prednisone. During the 4-week study, horses were maintained outdoors and fed a pelleted feed. Clinical scores, pulmonary function, results of cytologic examination of bronchoalveolar lavage fluid (BALF), and adrenal gland function were determined before and 2 and 4 weeks after initiation of treatment.

RESULTS

Clinical score and pulmonary function of all RAO-affected horses improved during the treatment period. After 4 weeks, clinical scores and pulmonary function of horses treated with a glucocorticoid were not different from those for the control treatment. In horses with severe RAO, treatment with fluticasone for 2 weeks resulted in significantly greater improvement in pulmonary function, compared with pulmonary function after treatment with prednisone or the control substance. Treatment with a glucocorticoid for 4 weeks and a low-dust environment did not have any effect on cellular content of BALF Treatment with prednisone for 2 weeks resulted in a significant decrease in serum cortisol concentration, compared with concentrations after administration of fluticasone or the control substance.

CONCLUSIONS AND CLINICAL RELEVANCE

Environmental management is the most important factor in the treatment of horses with RAO. Early treatment with inhaled fluticasone can help accelerate recovery of horses with severe RAO.

Clinical signs, evaluation of bronchoalveolar lavage fluid, and assessment of pulmonary function in horses with inflammatory respiratory disease

OBJECTIVE

To evaluate the association among clinical signs, results of cytologic evaluation of bronchoalveolar lavage (BAL) fluid, and measures of pulmonary function in horses with inflammatory respiratory disease.

ANIMALS

9 healthy horses, 5 horses with inflammatory airway disease (IAD), and 9 horses with chronic obstructive pulmonary disease (COPD).

PROCEDURES

Clinical examination, lung function tests, and BAL were performed on each horse.

RESULTS

Standard lung mechanics of horses with exacerbated COPD differed significantly from those of healthy horses; however, there were few differences among horses with IAD, horses with COPD during remission, and healthy horses. Most variables for forced expiration (FE) in horses with COPD or IAD differed significantly from those for healthy horses. Results of clinical examination had low to moderate sensitivity and predictive values for a diagnosis of COPD (range, 67 to 80%). Results of FE tests had high sensitivity, specificity, and predictive values for a diagnosis of COPD (79 to 100%), and results of standard lung mechanics tests had low sensitivity and predictive values (22 to 69%). Percentage of neutrophils in BAL fluid was highly sensitive (100%) but moderately specific (64%) for a diagnosis of COPD.

CONCLUSIONS AND CLINICAL RELEVANCE

Clinical examination is moderately accurate for establishing a diagnosis of COPD. Forced expiration tests can specifically detect early signs of airway obstruction in horses with COPD and IAD that may otherwise be inapparent. Cytologic evaluation of BAL fluid allows early detection of inflammatory respiratory disease, but it is not specific for COPD.

Allometric respiration/body mass data for animals to be used for estimates of inhalation toxicity to young adult humans

The relationship between body weight (BW) and respiratory minute volume (V(m)) was reviewed by collecting a database from the literature. The data were separated into anaesthetized and non-anaesthetized groups. Only young adult terrestrial mammals were included in the final data set. This database is the largest to be reported to date, is the first to separate the anaesthetized and non-anaesthetized groups and is matched to the target population of young, fit adult humans. The data set of non-anaesthetized animals contained 142 studies representing 2616 animals and 18 species from mice at 12 g body weight to horses and a giraffe at ca. 500 kg body weight. Analysis of the data indicated a power law (allometric) relationship between the minute volume and body weight. The resulting allometric equations for the empirical relationship between minute volume and body weight are: log(10)V()(m)= -0.302 + 0.809 log(10)BW and V(m) = 0.499 BW(0.809)where V(m) is the minute volume (l min(-1)) and BW is the body weight (kg). From these equations, a minute volume of 15.5 lmin(-1)was obtained for a 70 kg human in the same physiological and/or emotional state as the animals. The results of the analyses were compared to other empirical studies in the literature, the more recent of which also indicated a scaling factor of 0.8. The relationship between minute volume and body weight is recommended for use in estimating the inhalation toxicity to young adult humans (military personnel), because this is the first study to use a large database focused exclusively upon non-anaesthetized young adult terrestrial mammals.

Comparison of the performance of linear resistance and ultrasonic pneumotachometers at rest and during lobeline-induced hyperpnoea

The performance of a Fleisch No. 5 pneumotachometer (F), and two commercial ultrasonic pneumotachometers, the BRDL (B) and the Spiroson (S) systems were compared in respect to their use for determination of ventilatory parameters at rest and during lobeline-induced hyperpnoea. Five clinically healthy Thoroughbred horses were tested with the three pneumotachometers in random order. Respiratory airflow, respired gas concentrations, oesophageal pressures, pressures within the mask systems and arterial blood gases were determined before and during lobeline-induced hyperpnoea. Because measured peak expiratory airflow rates exceeded the stated linear range of the Fleisch pneumotachometer ( approximately +/- 25 l s(-1)) differential pressure-flow curves were determined in vitro over the range of flows recorded in vivo. Expired flows greater than the linear range were corrected according to the derived regression equation. No differences in any of the measured variables among the three systems were present at rest. At peak ventilation of lobeline-induced hyperpnoea mask pressures [Delta P(mask)(mean (SEM)): F: 9.6 (2.8) cm H(2)O, B: 0.8 (0.4) cm H(2)O, S: 1.4 (0.8) cm H(2)O] and end tidal carbon dioxide [ ET CO(2)(mean (SEM)): F: 2. 6 (0.1)%, B: 2.1 (0.2)%, S: 2.1 (0.1)%] were significantly higher in system F. Despite a tendency for respiratory frequency and peak inspired and expired flows, to be lower with system F, no significant differences in the measurements of ventilatory mechanics were detected. In conclusion, the ultrasonic flowmeters pose significantly lower resistive loads onto the respiratory system during ventilation above resting levels than Fleisch No 5 pneumotachometers. However, at the flowrates achieved during lobeline-induced hyperpnoea an in vitro calibration of the differential pressure-flow relationship allows correction for expiratory alinearity in system F. In addition, the performance of the Spiroson flowmeter is accurate in determining ventilatory mechanics at rest and during lobeline-induced hyperpnoea.

Gas exchange during exercise in standardbred trotters with mild bronchiolitis

To investigate the gas exchange response during exercise in horses with mild bronchiolitis (MB), we studied 7 Standardbred trotters. In order to determine pulmonary gas exchange and red cell volume in relation to bodyweight (CV/BW), submaximal graded exercise tests were performed. VO2 was monitored from an open bias flow system without valves. Heart rate, respiratory rate and mean pulmonary and systemic artery pressures were measured. Cardiac output and alveolar ventilation were calculated. Arterial and mixed venous blood were drawn for blood gas analysis and pH measurements. Pulmonary gas exchange was assessed by conventional blood gas variables, and the ventilation-perfusion distribution was estimated using the multiple inert gas elimination technique. The dispersion of perfusion and ventilation distribution and the difference between measured arterial oxygen tension and that predicted on the basis of the amount of ventilation-perfusion mismatching and shunt were determined in order to reflect diffusion limitation. The results were compared, using analysis of variance, with data from an earlier study on healthy Standardbred trotters (LH) during a similar exercise test. No differences in pulmonary gas exchange were obtained between LH and MB. However, CV/BW, pulmonary artery mean pressure (PAP) and systemic arterial mean pressure (SAP) were significantly higher in MB than in LH. Lactate concentration, arteriovenous oxygen content differences C(av)O2[ and pH were significantly lower in MB horses than in LH. We conclude that Standardbred trotters with mild subclinical bronchiolitis can achieve an adequate gas exchange compared to healthy Standardbred trotters, during a graded exercise test; however, the significantly increased CV/BW in MB horses may be a compensatory mechanism for hypoxaemia during maximal work.

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.

Airflow mechanics in models of equine obstructive airway disease under conditions simulating exercise

Effects of respiratory tract obstructions on ventilatory mechanics in horses exercising at high speeds were tested with a fibreglass replica of the airways (nares to mainstem bronchi) of an adult horse. Segmental pressures were recorded at six sites along the model at four different unidirectional flows (1300-4100 litre min-1), and the respective resistances (R) to airflow were calculated. The external nares and the larynx made the greatest contributions to the total resistance (RTOT) when no obstruction was present. Modifying the model to simulate severe pharyngeal lymphoid hyperplasia (PLH) had no effect on R at the larynx or at any point in the trachea under these flow conditions. Two 16 litre anaesthetic rebreathing bags were attached to the bronchial end of the model, and tidal ventilation generated by a piston pump. Upper (nares to pharynx) and lower tract R (RU and RL) and RTOT, and dynamic compliance were determined for pump volumes (Vp) of six and 12 litres, at pumping frequencies (fp) of 20-100 min-1 while the airway was clear, and after modifying it to simulate either PLH or partial bronchial obstruction. Model condition had no effect on RU. However, RL and RTOT were higher in the PLH simulated condition when fp > or = 90 and Vp = 12 litres (P < 0.05). This suggested that severe PLH may significantly interfere with airflow distal to the site of the lesions during high frequency high volume ventilation of the type seen in galloping horses. With partial bronchial obstruction RL and RTOT were increased when fp > 34 with each Vp. The applicability of the model was verified by comparing results from the unobstructed state with those from normal horses exercising on a treadmill.

Phenotypic characterization of lymphocyte subpopulations in horses affected with chronic obstructive pulmonary disease and in normal controls

The alterations in lymphocyte subsets in chronic obstructive pulmonary disease (COPD) in the horse were investigated by using monoclonal antibodies to identify CD3+, CD4+, CD8+, and surface immunoglobulin positive (sIg+) lymphocytes in peripheral blood, bronchoalveolar lavage fluid (BALF), and pulmonary biopsy frozen tissue sections. COPD-affected horses (n = 5) and normal controls (n = 5) were sampled prestabling and 14 days poststabling, at which time the COPD-affected horses wee exhibiting clinical signs of COPD. The peripheral blood absolute CD4+ lymphocyte count was significantly elevated in the COPD-affected horses pre- and poststabling. The CD4:CD8 ratio in peripheral blood of COPD-affect horses was unaffected by stabling, but the same ratio in the control horses was significantly decreased. These findings support a hypothesis of deficient regulation of a systemic immune response to indoor air in the COPD-affected horses. A large population of leukocytes in pulmonary biopsy immunohistochemical sections from both groups of horses appeared to be CD3+ CD4- CD8-, an uncommon phenotype in both the peripheral blood and BALF.

A model for predicting ventilation rates in mammals

The relationship between ventilation rate (1/min) and body weight (kg) in mammals was examined using regression techniques. The initial hypothesis of a single power function relationship was rejected. An additional model of the log-log relationship was developed which is piece-wise linear. Results showed the piece-wise linear model gave a better overall fit to the data suggesting a complex relationship with body weight. The breakpoint in the function occurred at approximately 5 kg. Nonlinear regression of untransformed data gave a better fit than linear regression of the log-transformed data.

The pathogenesis of chronic obstructive pulmonary disease of horses

Present evidence suggests that chronic obstructive pulmonary disease (COPD) of horses is a delayed hypersensitivity response to inhaled antigens, particularly the thermophilic moulds and actinomycetes that grow in damp hay. Within several hours of exposing COPD-susceptible horses to such hay, neutrophils invade the lung and accumulate in the lumens of airways, particularly bronchioles. The inflammatory response is accompanied by increased levels of histamine in bronchoalveolar lavage fluid, increased plasma levels of the inflammatory mediators thromboxane and 15-hydroxyeicosatetraenoic acid (15-HETE), and a decrease in the production of prostaglandin (PG) E2 by the airway mucosa. During acute exacerbations of COPD, airways exhibit nonspecific hyperresponsiveness and become obstructed as a result of bronchospasm and the accumulation of mucus and exudates. Bronchospasm is due largely to activation of smooth muscle muscarinic receptors by acetylcholine (ACh). Because the in vitro response of smooth muscle to ACh is unaltered, the increase in airway smooth muscle tone is probably a result of activation of airway reflexes by inflammatory mediators and decreases in inhibitory mechanisms such as the intrapulmonary nonadrenergic noncholinergic nervous system and the production of PGE2 in affected horses. The diffuse airway obstruction leads to uneven distribution of ventilation, ventilation/perfusion mismatching, and hypoxaemia. As a result of the increased respiratory drive caused by hypoxaemia and the presence of airway obstruction, horses adopt a characteristic breathing strategy in which very high peak flows at the start of exhalation rapidly diminish as exhalation proceeds.

The effects of three models of airway disease on tidal breathing flow-volume loops of thoroughbred horses

The effects of histamine and methacholine aerosols and of a fixed inspiratory resistance on tidal breathing flow-volume loops (TBFVL) were investigated using 18 unsedated, standing, healthy thoroughbred horses. The data were first analysed using traditional flow-volume loop indices and then reduced using standardized factor scoring coefficients obtained in a previous study in this laboratory using similar experimental techniques. On the basis of resting TBFVL analysis, the degree of pulmonary dysfunction caused by inhalation of histamine and methacholine aerosols with concentrations of 10 and 2 mg/ml, respectively, was similar. The fixed resistance also caused significant changes in the resting spirogram and TBFVL indices, suggesting that this model may prove valuable for further studies involving upper respiratory tract (URT) conditions. Administration of histamine and methacholine aerosols resulted in significant changes in all factor scores, although most of the observed changes were due to the effects of these aerosols on the respiratory rate. These findings re-emphasize the importance of the effects of respiratory rate on pulmonary mechanics. Application of the resistance resulted in significant changes in factor score 3, the 'inspiratory' factor, which lends support to the validity of this model for URT conditions. The close agreement between the factor scores obtained under controlled conditions in this study and in a previous study in this laboratory confirms that the factor analysis used for both of these studies provides an adequate means of reducing TBFVL data obtained from thoroughbred horses. The large intra- and inter-individual variation observed both with the indices of TBFVL and with the factor scores limits the potential of these variables for detecting individual animals with obstructive airway disease. Re-evaluation of these indices under the stress of exercise may reduce the variability observed in these data and may increase the magnitude of differences between different animals, providing a means of detecting individual animals with subclinical obstructive airway conditions.

Oxygen cost of ventilation in the resting horse

The purpose of this study was to develop a technique to measure the oxygen cost of ventilation and the values of ventilatory parameters in seven normal horses rebreathing carbon dioxide (CO2). All the horses responded to increased inspiratory levels of CO2 by increasing their tidal volume (VT) and frequency of breathing (Vf). The mean (SE) oxygen cost litre-1 of ventilation, measured at rates of ventilation greater than 200 litres min-1 was 1.7 (0.04) ml litre-1, similar to that of normal human subjects ventilating submaximally. It was concluded that the CO2 rebreathing test is a practical, non-invasive means of measuring the oxygen cost of breathing and the ventilatory response to CO2 in horses.

Characterization of normal tidal breathing flow-volume loops for thoroughbred horses

The purpose of this study was to characterize the normal equine tidal breathing flow-volume loop (TBFVL). The study was performed using 18 healthy Thoroughbred horses. TBFVLs constructed from data collected from resting horses had a typical biphasic inspiratory and expiratory phase. The interindividual variability of the indices used to describe TBFVLs was in the range 16-32%, which is comparable to the variability of other measures of equine pulmonary mechanics. The large variability of these data probably limits the value of resting TBFVL indices for detecting subclinical respiratory conditions in individual horses. Factor analysis of these data revealed that in excess of 90% of the variance of the initial response variables could be explained in terms of three common factors. Varimax rotation of these three common factors provided three subsequent factors that were readily identifiable as (1) a factor describing the time-volume relationships of TBFVLs, responsible for 81% of the total variance, (2) a factor explaining the expiratory portion of the TBFVL, explaining 12% of the variance, and (3) a factor describing the inspiratory portion of the loops, responsible for the remaining 7% of the variance. The analysis also provided standardized factor scoring coefficients for use in subsequent studies using similar experimental techniques.

Autologous blood instillation alters respiratory mechanics in horses

To investigate physiological consequences of autologous blood instillation in the lungs of healthy horses, respiratory mechanics and bronchial response to histamine were studied in 8 Thoroughbreds before and after introducing autologous blood (n = 5) and sterile saline solution (n = 3) into their lungs. Blood instillation resulted in a decrease in dynamic compliance (Cdyn) and increased respiratory resistance (R). Bronchial sensitivity and reactivity were unchanged after blood introduction. There were no significant changes in pulmonary mechanics or bronchial response after saline instillation.

Brain cooling and respiratory heat exchange in camels during rest and exercise

Respiration in relation to brain temperature (Tb) and body temperature (Tc) were investigated in two camels at rest and one during exercise (running at 10 km/h). The animals were subjected to natural ambient conditions (day: 25-30 degrees C, relative humidity (RH) about 65%; night: 15-20 degrees C, RH approx. 90%). They were studied when fully hydrated and during progressive dehydration by up to 15% of initial weight. At low Tc (less than 38 degrees C) Tb greater than Tc by approximately 0.2 degrees C, at higher Tc significant brain cooling was observed by as much as 1.5 degrees C during exercise. Minute ventilation (VE) and respiratory rate (f) increased with Tc such that tidal volume was constant and similar at rest and during exercise (Tc-Tb) increased linearly with f and hence VE. The cooling, dependent on turbinate heat exchange was related to certain features of the air flow pattern and f which have also been described in other large mammals.

A critical assessment of pulmonary function testing in exercising ponies

Pulmonary function measurements during exercise were tested for accuracy and reproducibility in 5 saddle ponies weighing 267 +/- 9 Kg. Airflow (V) and tidal volume (VT) were measured with a Fleisch pneumotachograph mounted on a face mask. The linearity of the response and the symmetry of this device were carefully checked. Pleural pressure changes were measured by pleural puncture (Ppl) and with an esophageal balloon catheter (Pes). The elastance of the esophageal wall and the effect of the position of the esophageal catheter tip on Pes were also investigated. Airflow, VT, Ppl, Pes, mask pressure, an electrocardiogram and limb movements were simultaneously recorded before, during and after exercise. These recordings were used to assess the validity of some pulmonary function measurements and to evaluate the influence of the breathing apparatus on the respiratory pattern. Maximal intrathoracic pressure changes and total pulmonary resistance values did not differ significantly when calculated on the basis of the Ppl and the Pes curves respectively. Although the absolute Ppl values were significantly different from the absolute Pes values, both pressures recorded at different workloads were closely correlated (R = 0.99). The mean specific elastance of the esophagus was 1.56 +/- 0.24 kPa.cm.ml.-1. Changes in the position of the esophageal catheter tip induced significant differences in the recorded Pes values. The pressure/flow relationship of the pneumotachograph pressure transducer system was linear within the range of the V measured during exercise. The mask had a significant influence on respiratory frequency and maximum difference in Pes, but did not modify the exercise-induced changes in these parameters. It was concluded that the technique and methods used in this study can allow accurate pulmonary function measurements in exercising ponies.

Diurnal variation of dynamic compliance, resistance and viscous work of breathing in normal horses and horses with lung disorders

Dynamic compliance, airway resistance, viscous work and respiratory frequency were measured at intervals in horses over 12 h periods. Variation, daily averages and circadian patterns were recorded. Examinations were performed on 24 horses. They were divided into three groups: Normal horses, horses with chronic latent bronchitis and horses with manifest chronic obstructive pulmonary disease (COPD). Significant differences were found between the daily averages and the fluctuations when the normal group and the COPD group were compared. In most cases differences between all three groups were significant. A significant circadian rhythm for airway resistance was detected in diseased horses. It was also established that single measurements give an incomplete picture of lung function. As has been established in humans, analysis of fluctuations in respiratory mechanics may be of diagnostic value. The above results should be taken into account particularly in trials with bronchodilators in horses with COPD.

Respiratory adaptations to exercise

The primary function of the equine respiratory system is the exchange of oxygen and carbon dioxide at a rate that is matched to metabolism. Gas exchange requires ventilation, distribution of gas within the lung, perfusion of blood through pulmonary capillaries, matching of ventilation and blood flow, diffusion of gases between air and blood, and transport of gases to and from the muscles. In this article, the author reviews what is known about each of these processes in the resting and exercising horse.

Scaling respiratory pattern and respiratory 'drive'

We tested three predictions regarding the relationship between body size and respiratory 'drive' and timing in mammals. Mechanical considerations had led to the prediction that TE/TTOT and probably TI/TTOT would be interspecific constants. In eleven species of mammals, ranging in size from 0.033 kg to 520 kg, TE/TTOT during awake quiet breathing was an interspecific constant with a value of 0.65 (+/- 0.004); TI/TTOT was 0.345 (+/- 0.004). Given that VT is directly proportional to BW1.0 (Stahl, 1967), if TE and TI are directly proportional to BW0.28 (Bennett and Tenney, 1982), and if VT/TI is an index of respiratory 'drive', then 'drive' should be directly proportional to BW0.72, following the same proportionality with body size as does basal metabolic rate (VO2). Data for the same eleven species gave the relationship VT/TI BW0.74. Testing further the notion that 'drive', on a weight specific basis, is proportional to BW-0.26, we studied the response, % delta VI, in eleven species to approximately 12% inspired O2. This 'output' of the system in response to a hypoxic stimulus was found to scale with BW-0.27. The question whether this reflects a higher set 'gain' of the respiratory controller of smaller animals and/or some feature of the innervation, or intrinsic properties of the respiratory muscles that varies with body size is discussed.

Chronic obstructive pulmonary disease in the horse. 1: Nature of the disease

The aetiology, pathophysiological changes, pathology and clinical signs of the disease as presently understood are discussed. The condition appears to be a hypersensitivity of the respiratory system in some horses to poor quality hay and straw. Micropolyspora faeni is the chief agent identified in the northern part of the United Kingdom. In other locations, the chief agent is probably different. The principal changes are spasm of the airways and bronchiolitis of the small airways. Onset may be acute or insidious. The chief clinical signs are well known but the disease process is reversible if the source of the antigen is removed. In early cases, determination of increased maximum intrathoracic pressure changes and co-existent subnormal arterial oxygen pressure are the best objective confirmation of diagnosis. The same measurements may be made on asymptomatic horses if they have been challenged 4 to 5 h earlier by inhalation of the appropriate antigen, or even exposed to poor quality hay or straw. Other methods available to the clinician are discussed.

Cardiopulmonary effects of clenbuterol in the horse

Clenbuterol, a bronchospasmolytic agent (beta 2 agonist) was studied in terms of its hemodynamic and airflow response in eight, healthy horses. Four animals were instrumented to record intrapleural pressure and air flow, these were used to compute pulmonary resistance, peak flow rates, and tidal volumes. Four animals were instrumented to record pulmonary arterial pressure, carotid arterial pressure, cardiac output, and arterial gas tensions. After control values were recorded, clenbuterol (0.8 microgram/kg) was intravenously administered to each horse in each experiment group. Following clenbuterol administration, non-elastic resistance of the lung or pulmonary resistance significantly decreased, 33.6% reduction at 10 min post-clenbuterol. Pulmonary resistance remained lowered during the entire procedure and showed no tendency of returning toward control values by 3 h post-clenbuterol. Within 30 sec following clenbuterol injection carotid arterial pressure decreased (mean pressure decrease 28.2%). Accompanying the change in arterial pressure, the heart rate drastically increased, 99.0%. Both changes were transient and returned to control ranges within 2 min. Clenbuterol appears to be effective in reducing non-elastic resistance of the lung, however intravenous administration to an animal with pre-existing cardiovascular or cardiopulmonary disease should be avoided.

Chronic obstructive pulmonary disease (COPD): effects of bronchodilator drugs on normal and affected horses

The effects of the bronchodilator drugs, atropine, isoprenaline and terbutaline, on normal horses and on horses affected with chronic obstructive pulmonary disease (COPD), were assessed by pulmonary function tests and clinical examination. Normal horses were not affected but COPD horses responded by a marked decrease in intrathoracic pressure, a decrease in respiratory rate, an initial decrease followed by an increase in arterial oxygen partial pressure and clinical improvement after treatment with all 3 drugs. These changes were temporary.

Pulmonary function testing in horses

Pulmonary function tests in horses are in the early stages of development and there will be a limit in the range of tests available since those requiring patient cooperation cannot be conducted in animals. Some tests such as blood gas analysis, A-aDo2 and delta Ppl measurements could presently be used to a greater extent under field conditions. Others that require expensive equipment and considerable technical assistance will be limited to the larger referral type veterinary clinics until the time is reached when there is adequate information to select those procedures that give a reasonable cost to benefit ratio to make their use more widespread.