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- Author or Editor: Frederik J. Derksen x
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Abstract
Objective—To determine the effect of manual tongue protrusion on the dimensions of the hyoid apparatus, nasopharynx, and oropharynx in anesthetized horses.
Animals—5 adult horses.
Procedure—Horses were anesthetized and positioned in sternal recumbency for 2 sequential computed tomographic (CT) scans. Images were acquired with the tongue in a natural position inside the mouth. Then, the tongue was pulled rostrally and secured, and a second CT scan was performed. Dorsoventral length of the hyoid apparatus and angles of the basisphenoid, basihyoid, and ceratohyoid were measured on 3-dimensional reconstructed CT images. Cross-sectional diameters and areas of the nasopharynx and oropharynx were determined on reformatted images in the transverse and longitudinal planes, using osseous landmarks for consistency. Results were tested between the 2 groups to determine significant differences.
Results—We were unable to detect a significant difference between any of the lengths or angles of the hyoid apparatus measured with or without rostral protrusion of the tongue. Similarly, nasopharyngeal and oropharyngeal diameters and cross-sectional areas were not significantly different with or without rostral protrusion of the tongue.
Conclusions and Clinical Relevance—Tying the tongue rostrally out of a horse's mouth did not influence the position of the hyoid apparatus or dimensions of the nasopharynx or oropharynx in anesthetized horses. Currently, no data suggest that application of a tongue-tie is effective for maintaining stability and patency of the nasopharyngeal or orolaryngeal airways in horses during races. (Am J Vet Res 2001;62:1865–1869)
Abstract
Objective—To determine the effect of a commercially available nasal strip on airway mechanics in exercising horses.
Animals—6 horses (5 Standardbreds and 1 Thoroughbred).
Procedure—Horses exercised on a treadmill at speeds corresponding to 100 and 120% of maximal heart rate with and without application of a commercially available nasal strip. Concurrently, tracheal pressures, airflow, and heart rate were measured. Peak inspiratory and expiratory tracheal pressures, airflow, respiratory frequency, and tidal volume were recorded. Inspiratory and expiratory airway resistances were calculated by dividing peak pressures by peak flows. Endoscopic examination of the narrowest point of the nasal cavity (ie, nasal valve) was performed in 1 resting horse before, during, and after application of a nasal strip.
Results—During exercise on a treadmill, peak tracheal inspiratory pressure and inspiratory airway resistance were significantly less when nasal strips were applied to horses exercising at speeds corresponding to 100 and 120% of maximal heart rate. Application of the nasal strip pulled the dorsal conchal fold laterally, expanding the dorsal meatus.
Conclusions and Clinical Relevance—The commercially available nasal strip tented the skin over the nasal valve and dilated that section of the nasal passage, resulting in decreased airway resistance during inspiration. The nasal strip probably decreases the amount of work required for respiratory muscles in horses during intense exercise and may reduce the energy required for breathing in these horses. (Am J Vet Res 2002;63:1101–1105)
Abstract
Objective—To determine the effect of a tongue-tie on upper airway mechanics in exercising horses.
Animals—5 Standardbreds.
Procedure—Peak inspiratory and expiratory tracheal and pharyngeal pressures and airflow were measured while horses exercised on a treadmill with and without a tongue-tie. Respiratory rate was also measured. Horses ran at speeds that corresponded to 50 (HR50), 75, 90 (HR90), and 100% of maximal heart rate. The tongue-tie was applied by pulling the tongue forward out of the mouth as far as possible and tying it at the level of the base of the frenulum to the mandible with an elastic gauze bandage. Peak inspiratory and expiratory tracheal, pharyngeal, and translaryngeal resistance, minute ventilation, and tidal volume were calculated. Data were analyzed by use of 2-way repeated-measures ANOVA. For post hoc comparison of significant data, the Student-Newman- Keuls test was used.
Results—We were unable to detect significant differences between groups for peak inspiratory or expiratory tracheal or pharyngeal resistance, peak pressure, peak expiratory flow, tidal volume, respiratory rate, or minute ventilation. Horses that ran with a tongue-tie had significantly higher peak inspiratory flows, compared with horses that ran without a tongue-tie. In the post hoc comparison, this effect was significant at 4 m/s, HR50, and HR90.
Conclusion and Clinical Relevance—Application of a tongue-tie did not alter upper respiratory mechanics in exercising horses and may be beneficial in exercising horses with certain types of obstructive dysfunction of the upper airways. However, application of a tongue-tie does not improve upper airway mechanics in clinically normal horses. (Am J Vet Res 2001; 62:775-778)
Abstract
Objective—To determine the effect of desensitization of the laryngeal mucosal mechanoreceptors on upper airway mechanics in exercising horses.
Animals—6 Standardbreds.
Procedure—In study 1, videoendoscopic examinations were performed while horses ran on a treadmill with and without topical anesthesia of the laryngeal mucosa. In study 2, peak tracheal and nasopharyngeal pressures and airflows were obtained from horses during incremental treadmill exercise tests, with and without topical anesthesia of the laryngeal mucosa. A nasal occlusion test was performed on each horse while standing during an endoscopic examination for both trials.
Results—In study 1, horses had nasopharyngeal collapse while running on the treadmill when the laryngeal mucosa was anesthetized. In study 2, inspiratory upper airway and nasopharyngeal impedance were significantly higher, and peak tracheal inspiratory pressure, respiratory frequency, and minute ventilation were significantly lower in horses when the laryngeal mucosa was anesthetized, compared with values obtained when horses exercised without topical anesthesia. Peak inspiratory and expiratory airflows were lower in horses when the laryngeal mucosa was anesthetized, although differences did not quite reach significance (P = 0.06 and 0.09, respectively). During a nasal occlusion test, horses had episodes of nasopharyngeal collapse and dorsal displacement of the soft palate when the laryngeal mucosa was anesthetized. Upper airway function was normal in these horses without laryngeal mucosal anesthesia.
Conclusions and Clinical Relevance—Receptors within the laryngeal mucosa may be important in maintaining upper airway patency in exercising horses. (Am J Vet Res 2001;62:1706–1710)
Abstract
Objective—To record respiratory sounds in exercising horses and determine whether spectrum analysis could be use to identify sounds specific for laryngeal hemiplegia (LH) and dorsal displacement of the soft palate (DDSP).
Animals—5 Standardbred horses.
Procedure—Respiratory sounds were recorded and pharyngeal pressure and stride frequency were measured while horses exercised at speeds corresponding to maximum heart rate, before and after induction of LH and DDSP.
Results—When airway function was normal, expiratory sounds predominated and lasted throughout exhalation. After induction of LH, expiratory sounds were unaffected; however, all horses produced inspiratory sounds characterized by 3 frequency bands centered at approximately 0.3, 1.6, and 3.8 kHz. After induction of DDSP, inspiratory sounds were unaffected, but a broad-frequency expiratory sound, characterized by rapid periodicity (rattling) was heard throughout expiration. This sound was not consistently detected in all horses.
Conclusions and Clinical Relevance—The technique used to record respiratory sounds was well tolerated by the horses, easy, and inexpensive. Spectrum analysis of respiratory sounds from exercising horses after experimental induction of LH or DDSP revealed unique sound patterns. If other conditions causing airway obstruction are also associated with unique sound patterns, spectrum analysis of respiratory sounds may prove to be useful in the diagnosis of airway abnormalities in horses. (Am J Vet Res 2001;62:659–664)
Abstract
Objective—To evaluate the safety and efficacy of thoracoscopically guided pulmonary wedge resection in horses.
Animals—10 horses (5 control horses and 5 horses affected with recurrent airway obstruction [ie, heaves]).
Procedure—Each horse underwent a thoracoscopically guided pulmonary wedge resection. Before, during, and after surgery, heart rate, respiratory rate, arterial blood gases, and systemic and pulmonary arterial pressures were measured. Physical examination, CBC, and thoracic radiography and ultrasonography were performed 24 hours before and 2 and 48 hours after surgery. Pulmonary specimens were assessed by histologic examination. A second thoracoscopic procedure 14 days later was used to evaluate the resection site.
Results—The technique provided excellent specimens for histologic evaluation of the lung. Heart and respiratory rates decreased significantly after horses were administered sedatives. A significant transient decrease in PaO2 was detected immediately after pulmonary wedge resection, but we did not detect significant effects on arterial pH, Paco2, or mean arterial and pulmonary arterial pressures. All horses except 1 were clinically normal after thoracoscopic surgery; that horse developed hemothorax attributable to iatrogenic injury to the diaphragm. The second thoracoscopy revealed minimal inflammation, and there were no adhesions.
Conclusion and Clinical Relevance—Thoracoscopically guided pulmonary wedge resection provides a minimally invasive method for use in obtaining specimens of lung tissues from healthy horses and those with lung disease. This technique may be useful for the diagnosis of diseases of the lungs and thoracic cavity. (Am J Vet Res 2002;63:1232–1240)
Abstract
Objective—To compare endoscopic findings of the upper portion of the respiratory tract in Thoroughbred yearlings with their subsequent race records to determine whether subjective assessment of airway function may be used as a predictor of future racing performance.
Design—Retrospective study.
Animals—427 Thoroughbred yearlings.
Procedures—Endoscopic examination findings were obtained from the medical records and the videoendoscopic repository of the Keeneland 1996 September yearling sales. Racing records were requested for the yearlings through the end of their 4-year-old racing season (1997–2000). Twenty-nine measures of racing performance were correlated with endoscopic findings. Subjective arytenoid cartilage movement grades were determined, using a 4-point grading scale (grade 1 = symmetrical synchronous abduction of the arytenoid cartilages; grade 4 = no substantial movement of the left arytenoid cartilage).
Results—Of the 427 Thoroughbred yearlings included in this study, 364 established race records, and 63 did not. Opinions regarding suitability for purchase, meeting conditions of the sale, and the presence of epiglottic abnormalities had no significant association with racing performance. Arytenoid cartilage movement grades were significantly associated with many of the dependent variables. However, palatine abnormalities were not predictive of inferior racing performance.
Conclusions and Clinical Relevance—Thoroughbred yearlings with grade-1 and -2 arytenoid cartilage movements had significantly better racing performance as adults, compared with yearlings with grade- 3 arytenoid cartilage movements. In contrast, epiglottic and palatine abnormalities were not predictive of inferior racing performance. Therefore, evaluation of laryngeal function, but not epiglottic or palatine abnormalities, using the 4-point grading system, should be the major factor in developing recommendations for prospective buyers. (J Am Vet Med Assoc 2001;219: xxx–xxx)
Abstract
Objective—To investigate relationships between cough frequency and mucus accumulation, airway obstruction, and airway inflammation and to determine effects of dexamethasone on coughing and mucus score.
Animals—13 horses with recurrent airway obstruction( RAO and 6 control horses.
Procedure—6 RAO-affected and 6 control horses were stabled for 3 days. Coughing was counted for 4 hours before and on each day horses were stabled. Before and on day 3 of stabling, tracheal mucus accumulation was scored, airway obstruction was assessed via maximal change in pleural pressure (ΔPplmax), and airway inflammation was evaluated by use of cytologic examination of bronchoalveolar lavage fluid (BALF). Effects of dexamethasone (0.1 mg/kg, IV, q 24 h for 7 days) were determined in 12 RAO-affected horses.
Results—To assess frequency, coughing had to be counted for 1 hour. In RAO-affected horses, stabling was associated with increases in cough frequency, mucus score, and ΔPplmax. Control horses coughed transiently when first stabled. In RAO-affected horses, coughing was correlated with ΔPplmax, mucus score, and airway inflammation and was a sensitive and specific indicator of ΔPplmax > 6 cm H2O, mucus score > 1.0, and > 100 neutrophils/µL and > 20% neutrophils in BALF. Dexamethasone reduced cough frequency, mucus score, and ΔPplmax, but BALF neutrophil count remained increased.
Conclusions and Clinical Relevance—Because of its sporadic nature, coughing cannot be assessed accurately by counting during brief periods. In RAO-affected horses, coughing is an indicator of airway inflammation and obstruction. Corticosteroid treatment reduces cough frequency concurrently with reductions in ΔPplmax and mucus accumulation in RAO-affected horses. ( Am J Vet Res 2003;64:550–557)
Abstract
Objective—To determine the effects of 2 weeks of intense exercise on expression of markers of pulmonary venous remodeling in the caudodorsal and cranioventral regions of the lungs of horses.
Animals—6 horses.
Procedures—Tissue samples of the caudodorsal and cranioventral regions of lungs were obtained before and after conditioning and 2 weeks of intense exercise. Pulmonary veins were isolated, and a quantitative real-time PCR assay was used to determine mRNA expression of matrix metalloproteinase-2 and −9, tissue inhibitor of metalloproteinase-1 and −2, collagen type I, tenascin-C, endothelin-1, platelet-derived growth factor, transforming growth factor (TGF)-β, and vascular endothelial growth factor (VEGF). Protein expression of collagen (via morphometric analysis) and tenascin-C, TGF-β, and VEGF (via immunohistochemistry) was determined.
Results—Exercise-induced pulmonary hemorrhage was detected in 2 horses after exercise. The mRNA expression of matrix metalloproteinase-2 and −9, tissue inhibitor of metalloproteinase-2, TGF-β, and VEGF was significantly lower in pulmonary veins obtained after exercise versus those obtained before exercise for both the caudodorsal and cranioventral regions of the lungs. Collagen content was significantly higher in tissue samples obtained from the caudodorsal regions of the lungs versus content in samples obtained from the cranioventral regions of the lungs both before and after exercise. Exercise did not alter protein expression of tenascin-C, TGF-β, or VEGF.
Conclusions and Clinical Relevance—Results of this study indicated 2 weeks of intense exercise did not alter expression of marker genes in a manner expected to favor venous remodeling. Pulmonary venous remodeling is complex, and > 2 weeks of intense exercise may be required to induce such remodeling.