noninfectious resp disease

Question 1

first clinical signs of equine asthma

Answer 1

cough, exercise intolerance, inc RR and HR

Question 2

what are the three common noninfectious airway diseases

Answer 2

equine asthma
inflammatory airway disease
exercise induced pulmonary hemorrhage

Question 3

generally what is the pathogenesis of equine asthma

Answer 3

particles get into the lungs. these particles incite an unnecessary immune response causing: neutrophils, mucus hypersecretion and bronchoconstriction

Question 4

what are the main ways we differentiate an infectious and noninfectious respiratory disease

Answer 4

infectious- FEVER, acute, degenerate neutrophils on TTW

noninfectious- recurrent, chronic, happens around feeding time, nondegenerate neutrophils

Question 5

what is our diagnostic method of choice if we suspect asthma but want to confirm

Answer 5

TTW with culture and cytology.

Question 6

if we are rechecking an asthma case, what test do we run to see if treatment is working

Answer 6

BAL

Question 7

treatment for equine asthma

Answer 7

fix environment- dust, hay, etc
corticosteroids for inflammation
bronchodilators

Question 8

what is our M3 antagonist drug

Answer 8

ipratropium bromide

Question 9

what does the M3 receptor antag do

Answer 9

blocks ach from acting on the smooth muscle, causing decreased constriction

Question 10

what does the A2 receptor agonist do

Answer 10

binds in the end plate where epi binds causing ACh to not be released

Question 11

what is our sympathetic modulation drug class

Answer 11

B2 agonist

Question 12

what does B2 agonist do

Answer 12

binds to the B2 receptor on smooth muscle causing bronchodilation

Question 13

B2 agonist drug?

Answer 13

clenbuterol

Question 14

what to remember about clenbuterol

Answer 14

dont work great in the face of inflammation because cytokines downregulate B2 receptors.

Question 15

what are our inhaled corticosteroids

Answer 15

fluticasone and ciclesonide

Question 16

how do we administer corticosteroids to asthmatic horses

Answer 16

if severe episode: start IV and switch to oral.

inhalants have the best long term treatment

Question 17

when do we stop giving steroids? aka remission

Answer 17

BAL is normal. no clinical signs

Question 18

what are issues we can see with advanced chronic asthma

Answer 18

increased weight loss.
if refractory to treatment: bronchial malacia or bronchiectasis.

Question 19

what causes IAD

Answer 19

racehorses get a viral infection that they then clear. the epithelial cells are still damaged when they try and race again, this causes more inflammation and more airway injury

Question 20

if you are highly suspicious of IAD, what diagnostic test is best

Answer 20

BAL.

Question 21

treatment for IAD

Answer 21

rest the horse. fix environment. if refractory, give steroids

Question 22

what causes EIPH

Answer 22

max intensity exercise causes large negative pressure in alveoli. It also causes large positive pressure in capillaries because of high demands for oxygenated blood.

difference between extreme negative and extreme positive pressure pulls blood into alveoli

Question 23

how to diagnose EIPH

Answer 23

BAL for hemosiderophages– DIAGNOSTIC

also blood on endoscopy

Question 24

treatment plan for EIPH

Answer 24

furosemide 1hr before racing to pee out extra blood volume?

nasal strips!!!