Non-infectious Lower Airway Dz Flashcards

1
Q

What is equine asthma (heaves, RAO, COPD)

A

A chronic respiratory disease that causes inflammation in a horse’s airways, making it difficult for them to breathe

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2
Q

What is small airway inflammatory dz (SAID)?

A

Group of inflammatory conditions of the lower respiratory tract
Cause of impaired performance and interruption of training

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3
Q

What age of horses suffer from equine asthma?

A

Older horses

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4
Q

What is the age range of horses that suffer form SAID?

A

Young racehorses

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5
Q

CS of equine asthma

A

Elevated respiration
Expiratory wheezes
Heave line (hypertrophy of rectus abdominus and EAO muscles)

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6
Q

CS of SAID

A

Poor racing performance
Cough
Tracheal exudate

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7
Q

What are the predisposing causes of SAID?

A

Unknown but could be: resp. viruses, bacteria, lung parasites, dust, exercise and elderly

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8
Q

What are the predisposing causes of equine asthma?

A

Seasonal disorder (summer)
Change in husbandry: hay and housing

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9
Q

Normal % of differential cell count in a bronchoalveolar lavage?

A

Macros: 40-60%
Lymphos: 40-60%
Neutros: <5%
Mast cells: <2%
Eosins: <1%
lower the volume, higher the neutro count

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10
Q

% differential cell count in a horse with equine asthma and SAID

A

Neutros: >20%
Mast cells and eosins: >5%

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11
Q

Increased # of eosinophils in a BAL, ddx?

A

Astham
SAID
Parasitic pulmonary dz
Hypersensitivity pneumonitis
Idiopathic interstitial pneumonia
Sarcoidosis
langerhands cell histcytosis

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12
Q

Advantages of the transendoscopic tracheal wash

A

Bacteriology
Represents all lung regions
Quick and easy screening

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13
Q

Disadvantagesof the transendoscopic tracheal wash

A

Less precise reference ranges than BAL
Epistaxis

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14
Q

Advantages of a bronchoalveolar wash

A

Cytology
Simple to collect

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15
Q

Disadvantages of a bronchoalveolar lavage

A

Mild coughing, depression, fever
Small area and relies on lung dz being diffuse and homogenous
Can’t take BAL sample without nasopharyngeal contamination

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16
Q

How would a tracheal wash from a horse with equine asthma differ from a horse with bacterial pneumonia?

A

Asthma: eosinophilia
Pneumonia: neutrophilia without eosinophilia

17
Q

Tx for equine asthma

A

Environmental control (steam hay, 2-3w)
Systemic corticosteroids: Prednisolone, dexmethasone, triamicinolone)
Systemic bronchodilators (buscopan, clenbuterol

18
Q

Inhalation therapy of equine asthma (medication)

A

Anticholinergic (ipatropium bromide)
B2 agonists (albuterol and clenbuterol)
Mast cell stabilizer (Na cromoglycate)
Corticosteroids(beclomethasone and fluticasone and ciclosenide)
Mucokinesis (acetylcysteine)

19
Q

Mechanical inhalation therapy

A

Metered-dose inhalers
Aeromask (with pirbuterol and albuterol)

20
Q

Environmental management for equine asthma and SAID

A

Soak hay for 30 minutes to get rid of dust (steamed hay)
Good ventilation
Feed small amounts

21
Q

Tx protocol for SAID

A

Outdoors or bed on sand, shavings, peat moss
Pelleted feed or soaked hay
Corticosteroids, systemic, inhaled (ciclosenide)
Bronchodilator drugs
Abx

22
Q

What is exercise-induced pulmonary hemorrhage?

A

Blood is present in the airways of the lungs after strenuous physical activity
Causes a horse to stop on the track and finish last

23
Q

What causes EIPH?

A

High pulmonary capillary blood pressure during exercise
A. Fib
Blood viscosity, small airway dz, upper airway obstruction, high BP

24
Q

Pathophysiology of EIPH

A

Exercise —> pulmonary capillary rupture —> hemorrhage—> inflammation and fibrosis—> reduced lung compliance and angiogenesis

25
Q

Dx EPIH

A

Endoscopy (0.2-2 hr post exercise)
Transtracheal wash (hemosiderophages)
Rads (unreliable): ↑ density in the caudodorsal lungs

26
Q

How do you tx EPIH? Issues with giving this in horses with competition sports?

A

Furosemide (weight reduction?)
Nasal strips
Correction of layngeal hemiplegia
Aminocaproic acid and conjugated estrogens