Objective—To evaluate the association among clinical
signs, results of cytologic evaluation of bronchoalveolar
lavage (BAL) fluid, and measures of pulmonary
function in horses with inflammatory respiratory
Animals—9 healthy horses, 5 horses with inflammatory
airway disease (IAD), and 9 horses with chronic
obstructive pulmonary disease (COPD).
Procedure—Clinical examination, lung function
tests, and BAL were performed on each horse.
Results—Standard lung mechanics of horses with
exacerbated COPD differed significantly from those
of healthy horses; however, there were few differences
among horses with IAD, horses with COPD
during remission, and healthy horses. Most variables
for forced expiration (FE) in horses with COPD or IAD
differed significantly from those for healthy horses.
Results of clinical examination had low to moderate
sensitivity and predictive values for a diagnosis of
COPD (range, 67 to 80%). Results of FE tests had
high sensitivity, specificity, and predictive values for a
diagnosis of COPD (79 to 100%), and results of standard
lung mechanics tests had low sensitivity and
predictive values (22 to 69%). Percentage of neutrophils
in BAL fluid was highly sensitive (100%) but
moderately specific (64%) for a diagnosis of COPD.
Conclusion and Clinical Relevance—Clinical examination
is moderately accurate for establishing a diagnosis
of COPD. Forced expiration tests can specifically
detect early signs of airway obstruction in horses
with COPD and IAD that may otherwise be inapparent.
Cytologic evaluation of BAL fluid allows early
detection of inflammatory respiratory disease, but it
is not specific for COPD. (Am J Vet Res 2001;62:
Animals—124 dogs with compensated mitral valve regurgitation (MR).
Procedures—Dogs randomly assigned to receive enalapril or placebo were monitored for the primary endpoint of onset of CHF for ≤ 58 months. Secondary endpoints included time from study entry to the combined endpoint of CHF-all-cause death; number of dogs free of CHF at 500, 1,000, and 1,500 days; and mean number of CHF-free days.
Results—Kaplan-Meier estimates of the effect of enalapril on the primary endpoint did not reveal a significant treatment benefit. Chronic enalapril administration did have a significant benefit on the combined endpoint of CHF-all-cause death (benefit was 317 days [10.6 months]). Dogs receiving enalapril remained free of CHF for a significantly longer time than those receiving placebo and were significantly more likely to be free of CHF at day 500 and at study end.
Conclusions and Clinical Relevance—Chronic enalapril treatment of dogs with naturally occurring, moderate to severe MR significantly delayed onset of CHF, compared with placebo, on the basis of number of CHF-free days, number of dogs free of CHF at days 500 and study end, and increased time to a combined secondary endpoint of CHF-all-cause death. Improvement in the primary endpoint, CHF-free survival, was not significant. Results suggest that enalapril modestly delays the onset of CHF in dogs with moderate to severe MR.