Equine Respiratory Diseases Quiz

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Questions and Answers

Which drug is indicated for early cases of EHV-5 infection?

Dexamethasone

Ciprofloxacin

Prednisone

Acyclovir (correct)

What is a common sign of equine multinodular pulmonary fibrosis?

Chronic fever

Hyperactivity

Increased appetite

Respiratory distress (correct)

At what average age is a granular cell tumor (myoblastoma) commonly diagnosed in horses?

13 years (correct)

10 years

5 years

20 years

What diagnostic methods are used for diagnosing chronic interstitial inflammatory diseases?

Radiography, ultrasound, and biopsy Signup and view all the answers

Which of the following statements best describes granular cell tumors in horses?

They are locally invasive but do not metastasize. Signup and view all the answers

What can lymphoid hyperplasia indicate in the context of infectious airway disease?

Infectious challenge Signup and view all the answers

What is the primary focus of the equine asthma model as it relates to airway remodeling?

Transitioning knowledge from veterinary to human medicine Signup and view all the answers

What is the significance of a tracheal wash (TW) in diagnosing airway diseases?

It complements other diagnostic techniques Signup and view all the answers

Which of the following statements regarding the inflammatory airway disease of horses is accurate?

It has been addressed in revised consensus statements. Signup and view all the answers

Which of the following grades in endoscopic scoring indicates poor performance in Thoroughbreds?

Grade 2/5 Signup and view all the answers

What aspect of airway mucus is related to the treatment and management of equine asthma?

Endoscopic scoring is used to evaluate mucus characteristics. Signup and view all the answers

Which acute phase protein is likely to be increased in response to infectious airway diseases?

Fibrinogen Signup and view all the answers

Which study primarily focuses on the immediate responses of airway mucus to environmental challenges?

Equine Veterinary Journal by Gerber et al. Signup and view all the answers

In the assessment of asthma, what is typically expected?

No changes in laboratory findings Signup and view all the answers

What can be inferred about the importance of mucus viscoelasticity in equine asthma?

It is critical in shaping the treatment strategies for airway diseases. Signup and view all the answers

Which muscarinic antagonist is specifically known to be used inhaled?

Ipratropium Signup and view all the answers

What is a recommended method to maintain a stable environment with minimized dust levels?

Ensure adequate ventilation Signup and view all the answers

Which alternative feeding option should be considered to reduce dust when managing a horse's diet?

Complete diet nuts Signup and view all the answers

Which of the following is NOT a common causative agent of respiratory issues in horses?

Staphylococcus Signup and view all the answers

What type of bedding is recommended to help maintain a dust-free environment in stables?

Sand Signup and view all the answers

Which type of respiratory dust is defined as respirable dust concentration?

Dust sufficiently sized for aerodynamics Signup and view all the answers

How long should a horse be removed from the stable after mucking out to minimize respiratory exposure?

30 minutes Signup and view all the answers

Which two types of equine herpesvirus are the most common in the UK?

EHV-1 and EHV-4 Signup and view all the answers

What is the main advantage of bronchoalveolar lavage (BAL) compared to transtracheal wash (TW) in terms of cellular identification?

BAL offers excellent cellular identification. Signup and view all the answers

In the context of neutrophilic inflammation, how do the findings of TW and BAL differ in cases of infectious airway disease?

TW shows moderate to severe neutrophilic inflammation while BAL shows mild to moderate. Signup and view all the answers

What is the limitation of transtracheal wash (TW) in terms of reference ranges when compared to bronchoalveolar lavage (BAL)?

TW has wide reference ranges. Signup and view all the answers

Which of the following statements accurately describes the association of cytology results with performance in BAL?

BAL cytology has a strong association with performance. Signup and view all the answers

What distinguishes the type of inflammatory cells present in BAL samples compared to TW samples for infectious airway disease?

BAL may show mixed inflammatory cells, while TW does not. Signup and view all the answers

In an analysis of airway inflammation, which statement is correct regarding the presence of Curschmann’s spirals?

Curschmann’s spirals are rarely documented in BAL. Signup and view all the answers

How does the sampling size differ between TW and BAL?

BAL samples only a small lung segment. Signup and view all the answers

What is a significant disadvantage of using TW over BAL in bacteriological analysis?

Bacteriological results from TW are often inaccurate. Signup and view all the answers

What does prolonged and laboured expiration indicate?

Exaggeration of the biphasic expiratory phase Signup and view all the answers

What breathing pattern is typical for small airway obstruction?

Prolonged and laboured expiration Signup and view all the answers

Which sound is associated with inspiratory dyspnoea?

Stertorous or stridorous noise Signup and view all the answers

What is indicated by a heave line in chronic cases?

Exaggerated expiratory contraction of the abdominal muscles Signup and view all the answers

What could be a potential cause for inspiratory dyspnoea?

Pneumonia Signup and view all the answers

Which characteristic is observed in breathing during respiratory distress from upper airway obstruction?

Increased respiratory effort Signup and view all the answers

What might a typical presentation of rapid and shallow breathing suggest?

Severe lower airway obstruction Signup and view all the answers

What is a respiratory pattern that indicates severe restrictive lung diseases?

Combined inspiratory & expiratory dyspnoea Signup and view all the answers

Study Notes

Equine Lower Respiratory Tract Disorders

Learning Objectives:
- Develop understanding of common conditions affecting the lower respiratory tract of the horse.
- Describe diagnostic modalities used to investigate respiratory conditions in horses and understand their benefits.
- Outline diagnosis, treatment, and control of infectious respiratory disease in horses.

Signs of Airway Disease in Horses

Cough
Nasal discharge
Abnormal breathing patterns/sounds

Abnormal Breathing Patterns in Horses

Normal:
- Respiration in resting adult horses is slow (8-16 breaths/min).
- Minimal chest and abdominal wall movement.
- Costo-abdominal movement (slight movement of costal arch followed by slight end-expiratory abdominal lift).
- Slight movement of the nostrils.
Abnormal:
- Increased rate and depth.
- Changed breathing pattern.
- Abnormal sounds associated with breathing.
- Note: Ponies may have slightly higher resting respiratory rates (upto 20 breaths/min).

Expiratory Dyspnea

Exaggeration of biphasic expiratory phase.
Increased incorporation of abdominal muscles.
Obvious biphasic or double expiratory lift ('heave').
Typical for small airway obstruction.
Associated with stertorous or stridorous noise during inspiration.

Inspiratory Dyspnea

Indicative of upper airway obstruction.
May occur with severe restrictive lung diseases (e.g pneumonia, interstitial disease, pneumothorax, rib fracture).
Usually with tachypnoea.
Suggestive of severe upper or lower airway obstruction, diffuse pulmonary disease or pleural disease.

Combined Inspiratory & Expiratory Dyspnea

Suggestive of severe upper or lower airway obstruction, diffuse pulmonary disease or pleural disease.
Associated with rapid, shallow breathing.

Understanding Abnormal Auscultation Sounds - Clinical Implications

Normal lung sounds: Vary depending on body condition and depth of breathing.
- Can be accentuated in fat horses by using re-breathing bag.
- Most intense over the distal cervical trachea and carina.
- May be difficult to perceive at the lung periphery.
Abnormal lung sounds:
- Increased audibility of normal breath sounds occur with hyperventilation and in consolidated areas.
- Suggests lower airway disease (e.g inflamed airways).
- Reduced audibility in obese horses.
- Absence of sounds in ventral thorax (may be bilateral) suggests pleural effusion.
- Absence of sounds in dorsal thorax suggests pneumothorax.
Adventitious sounds: Crackles, wheezes and pleural friction sounds.

Equine Lower Respiratory Tract Disorders - Classification

Classification of Equine Respiratory Disease: Infectious vs Non-infectious (contagious/non-contagious). Infectious further subdivided into Bacterial, Viral and Parasitic. Non-infectious further subdivided into inflammatory, airway disease, neoplasia and other.
Includes detailed information differentiating between upper and lower respiratory tract disorders based on symptoms.

Diseases of the Airways

Asthma (Mild/Severe, also IAD, Inflammatory Airway Disease, RAO, Recurrent Airway Obstruction)
Infectious airway diseases (specific examples not listed)

Diseases of the Lung Tissues

Pneumonia, Bacterial, Sterile (Chronic Interstitial Inflammatory Infiltrates/pneumonitis), Equine Multinodular Pulmonary Fibrosis, Neoplasia, Other (e.g, Exercise-Induced Pulmonary Haemorrhage, Congestive Heart Failure)

Equine Asthma

Severe Equine Asthma (SEA): includes Equine Pasture Asthma.
Mild/Moderate Equine Asthma (MEA): characterised by a poor performance condition commonly found in young horses.

Mild Equine Asthma (MEA)

Clinical picture: Common in young performance horses, any age - young > older, subacute-chronic presentation, poor performance, intermittent cough (often only 38% of cases).
Causation: Poor ventilation, dusty hay/bedding, NH3/H2S, infectious agents.

Severe Equine Asthma (SEA)

Clinical Picture: Common in mature horses and ponies, typically older, subacute-chronic presentation, audible abdominal effort/nostril flaring, coughing, 'wheezes and crackles".
Causation: Poor ventilation, dusty hay/straw bedding (moulds), NH3/H2S, seasonal environmental allergens (e.g pasture asthma)

Severe Equine Asthma - Pathophysiology

Airway hyperresponsiveness, inflammation, airway wall thickening, increased mucus production, bronchospasm, and airway remodeling.
Main characteristic is reversible airway obstruction.

Thoracic Neoplasia (Primary and Metastatic Tumours)

Primary Tumours: Granular cell tumor (myoblastoma) is the most common primary lung tumour. Average age of horses affected is 13 yrs but affected racehorses can be younger.
Metastatic Tumours: media-stinal lymphoma which commonly affects mature to elderly horses, as well as other types of metastatic tumours such as Hemangiosarcoma, Adenocarcinoma, Melanoma and Squamous cell carcinoma.

Exercise-Induced Pulmonary Haemorrhage (EIPH)

Clinical picture: Bleeding from the caudodorsal lung lobes during exercise.
Consequences: Depends on many risk factors, Intensity, duration, fitness, harder tracks (faster), cooler temperatures.
Horses less likely to bleed if they are: Fitter, lighter, healthy, non-inflamed airways, no respiratory obstructions (upper or lower), normal cardiac output.
Prevalence: Epistaxis, Tracheal endoscopy, repeated endoscopy, bronchoalveolar lavage.

Congestive Heart Failure

Clinical picture: Mitral insufficiency, rare, tachycardia, severe left-sided systolic murmur; pulmonary oedema, white frothy nasal discharge.
Treatment: might respond to digoxin/furosemide in short-term, benazepril.

Diagnostic Approaches for Lower Tract Respiratory Disorders in Horses

Multifaceted Approach: History/signalment, clinical signs, blood tests, endoscopy findings, airway cytology, airway microbiology.

Clinical Examination

General: Rectal temperature (normal vs abnormal), nasal discharge (assessment of quality, quantity), lymph nodes, laryngeal squeezing, lung sounds (auscultation - crackles, wheezes, silence), rebreathing bag, coughing, heart.

Clinical Differentiation of Airway Diseases

Tables present a comparison of characteristics (age, time, fever, cough, nasal discharge, heaving/nostril flare) for infectious airway diseases, MEA, and SEA.

Haematology/Acute Phase Proteins

Normal versus abnormal results for horses with suspected respiratory issues, such as neutrophilia or SAA.

Visual Assessment of Airway – Endoscopy

Examination of the airway using endoscopy, grades for the severity of mucus present.

TW vs BAL - Diagnostic Value

Comparison of tracheal wash versus bronchoalveolar lavage for use in diagnosis of respiratory disease. Detailed data of performance in use.

TW and BAL Cytology in Disease

Table showing cytological findings in TW and BAL for different conditions (infectious airway disease, MEA, SEA).

References (Page Numbers 42-43)

List of references provided for further study.

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Description

Test your knowledge on equine respiratory diseases, including EHV-5 infection, pulmonary fibrosis, and diagnostic methods. This quiz covers common signs, treatment indications, and the implications of specific conditions in horses. Perfect for veterinary students or equine health professionals.