Abstract
Mild-moderate (MEA), severe (SEA) equine asthma and exercise-induced pulmonary hemorrhage (EIPH) are common respiratory disorders in horses. The present retrospective study aims to evaluate the role of ultrasonography and endoscopy in the diagnosis of these conditions. Three hundred and three horses were included and divided into SEA, MEA and MEA + EIPH groups, on the basis of history, clinical examination and bronchoalveolar lavage fluid (BALf) cytology; scores were assigned to lung ultrasonography, pharyngeal lymphoid hyperplasia (PLH), tracheal mucus (TM) and tracheal bifurcation edema (TB). These scores were compared between groups, and their associations with age, BALf cytology, tracheal wash microbiology and between endoscopic and ultrasonographic scores were statistically analyzed. Ultrasonographic scores were higher in the SEA and MEA + EIPH groups and associated with increased BALf neutrophils and hemosiderophages. The PLH score was higher in younger horses affected by MEA and EIPH and associated with increased eosinophils and hemosiderophages. TM and TB scores were greater in older horses affected by SEA, associated with increased neutrophils and inversely correlated with hemosiderophages. Moreover, TM grade was negatively correlated with mast cells. Thoracic ultrasonography and airway endoscopy can provide useful information about the inflammatory status of upper and lower airways in the horse.
Highlights
A significant difference was observed for age between the SEA group and the MEA group (SEA median 13 years, IQR 10–17 years; MEA median 4 years, IQR 3–8 years; p < 0.0001) and between the SEA group and the MEA + exercise-induced pulmonary hemorrhage (EIPH) group (MEA + EIPH median 4 years, IQR 3–5 years; p < 0.0001), while no difference was detected between the MEA group and the MEA + EIPH group
The current study presents and compares the findings of thoracic ultrasonography and airway endoscopy in 303 horses affected by SEA, MEA or concomitant MEA and EIPH
Ultrasonographic examination represents a useful and non-invasive diagnostic tool for horses affected by equine asthma and exercise-induced pulmonary hemorrhage, providing fast and easy information on the inflammatory status of the lung
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Equine asthma (EA) is a chronic and recurrent respiratory syndrome characterized by airflow obstruction, mucus hypersecretion and airway hyperreactivity [1]. Some clinical presentations, such as chronic cough and poor performance, are common to asthmatic horses of all severities [2], EA can be classified as mild-moderate (MEA) or severe (SEA) [1]; while SEA typically affects adult horses over 7 years of age [3], MEA can affect horses of any age but is more commonly reported in young horses [4]. A diagnosis of EA can be reached by collection of history, clinical examination, airway endoscopy and cytology of the bronchoalveolar lavage fluid (BALf) and/or tracheal wash (TW) [2]
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