Test 2 - IAD & RAO Flashcards
Recurrent Airway obstruction is also known as ______.
Heaves
IAD or RAO?
- Exercise intolerance
- Young - Middle aged
- Poor Performance
- Occasional Cough
- Airway Remodeling
- Exercise intolerance: RAO
- Young - Middle aged: IAD
- Poor Performance - IAD
- Occasional Cough: IAD
- Airway Remodeling: Both
IAD or RAO?
- > 7 y/o
- Improves spontaneousy or with minor treatment
- Seasonal
- Regular to frequent cough
- Cannot be cured but can be controlled
- Airway Hyper-responsiveness
- > 7 y/o : RAO
- Improves spontaneousy or with minor treatment: IAD
- Seasonal: RAO
- Regular to frequent cough: RAO
- Cannot be cured but can be controlled: RAO
- Airway Hyper-responsiveness: Both
What are the BAL findings associated with IAD?
neurtrophilia >10%
mast cells >5%
eosinophils >5%
TRUE/FALSE
Cough is not always seen in IAD
TRUE
What are the diagnostic test for IAD?
BAL
Pulmonary function Test
Histamine Bronchoprovocation
What is the treatment of IAD?
Treatment:
↓ of air borne dust
bedding
Feed
Anti-inflammatories
Broncho-dilators
What is RAO characterized by?
Excessive mucus production
Neutrophil accumulation
Bronchial hyperreactivity
Reversible bronchospasm (bronchoconstriction)
TRUE/FALSE
RAO occurs in a wet and cool climate and is associated with poor ventilation & dusty or moldy hay (round bales), dust, pollen & mold exposure.
TRUE
Nostril flaring & markedly accentuated expiratory effort is known as ________.
Heave
TRUE/FALSE
Anxious facial expression, reluctance to move, and tachypnea >40breaths/min is associated with IAD.
FALSE
It is associated with RAO
In RAO, exposure to moldy hay, endotoxins, fungal spores result in air way _________.
In RAO, exposure to moldy hay, endotoxins, fungal spores result in air way neutrophilia.
What are the inflammatory mediators released that causes bronchoconstriction?
Histamine & 5-HT
They augment the release of Ach which activates PSNS muscarinic receptors
What are the histological findings associated with RAO?
Goblet cell hyperplasia
Epithelial cell damage
Bronchial and bronchiolar epithelial cell hyperplasia
Smooth muscle hypertrophy & hyperplasia
Collagen deposition
overinflation of the alveoli
What are the cytological findings of RAO?
Suppurative non-septic inflammation
Neutrophilia >25%, ↓ lymphocyte and alveolar macrophages
Tracheal mucus accumulation
% of eosinophils and mast cells are not affected
Upon endoscopic exam of a horse with RAO, you will see…..
- Demonstrates tracheobronchial secretions that originate from bronchial segments
- Distal airways are edematous and inflamed and airways easily collapse during expiration
The Hay Challenge Test is a diagnostic test for _____.
RAO
The Pulmonary Function test is a diagnostic test for _____.
IAD
What is the most important aspect of treatment of RAO?
↓ environmental challenges: most important aspect.
Well-ventilated stall, adequate bedding, minimized
dust, pellet feed, hay cubes, soak hay in water.
What is the big picture treatment of RAO?
- Bronchodilator
- Anti-inflammatory
What are the 2 anticholinergics that may be used in the treatment of RAO?
Which has a longer duration of action and minimal systemic effects?
Atropine and Ipratropium bromide
Ipratriopium Bromide has longer duration of action and minimal effects.
What is important to know about dosing clenbuteral (B2 agonists) when treating RAO?
If clinical improvement is not observed within 3 days, ↑ dose for another 3
days. Effective dose of clenbuterol may vary. AE: anxiety, shivering, sweating, tachycardia. Occurs @
higher doses but appear to minimize when clenbuterol is ↑ in a stepwise manner. Also has antiinflammatory
effect.
______ have similar effects to those produced with atropine except no AEs (in the treatment of RAO)
Phosphodiesterase Inhibitors
What is the MAO of B2 agonists when treating RAO?
Give some examples.
relaxation of muscle by ↑ intracellular levels of cAMP.
Albuterol (preferred), clenbuterol,
fenoterol, pirbuterol, salmeterol
