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Equine Respiratory Medicine and Cardiology
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Equine Respiratory Medicine and Cardiology

A special issue of Animals (ISSN 2076-2615). This special issue belongs to the section "Equids".

Deadline for manuscript submissions: closed (20 January 2023) | Viewed by 26535

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editors

Prof. Dr. Francesco Ferrucci

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Guest Editor
Department of Veterinary Medicine, Università degli Studi di Milano, 20133 Milano, Italy
Interests: equine internal medicine; equine sports medicine; respiratory diseases; cardiac disorders
Dr. Chiara Maria Lo Feudo

E-Mail Website
Guest Editor
Department of Veterinary Medicine, Università degli Studi di Milano, 20133 Milano, Italy
Interests: equine; internal medicine; sports medicine; respiratory medicine; equine asthma
Dr. Luca Stucchi

E-Mail Website
Guest Editor
Department of Veterinary Medicine, Università degli Studi di Milano, 20133 Milano, Italy
Interests: equine; internal medicine; sports medicine; respiratory medicine; equine asthma

Special Issue Information

Dear Colleagues,

Diseases involving the respiratory system of the horse are a major concern in equine internal medicine. In fact, up to 15% of horses living in the Northern Hemisphere suffer from equine asthma. In foals, respiratory infections represent one of the most relevant issues in stud management; in racehorses, respiratory disorders are the second most common cause of reduced performance after orthopaedic diseases.

Moreover, respiratory affections are often associated with cardiovascular dysfunction. Racehorses with atrial fibrillation, for example, can suffer from exercise-induced pulmonary haemorrhage. Severe respiratory infections can be related to endocarditis; in severely asthmatic horses, the remodelling of the airways also involves the pulmonary arteries, leading to pulmonary hypertension and cor pulmonale.

Therefore, the study of respiratory and cardiovascular diseases is currently a hot topic in equine medicine. For this reason, we are proposing a Special Issue titled “Equine Respiratory Medicine and Cardiology”, and we invite you to submit your research papers reporting the latest results of your work or interesting clinical cases on this topic.

Prof. Dr. Francesco Ferrucci, DVM
Dr. Chiara Maria Lo Feudo
Dr. Luca Stucchi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Animals is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • horse
  • equine asthma
  • pneumonia
  • exercise-induced pulmonary hemorrhage
  • endoscopy
  • bronchoalveolar lavage fluid
  • poor performance
  • heart disease
  • echocardiography
  • cardiac arrhythmia

Published Papers (11 papers)

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Editorial

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3 pages, 185 KiB  
Editorial
Equine Respiratory Medicine and Cardiology
by Luca Stucchi, Chiara Maria Lo Feudo and Francesco Ferrucci
Animals 2023, 13(18), 2952; https://doi.org/10.3390/ani13182952 - 18 Sep 2023
Viewed by 969
Abstract
In the last few years, the attention regarding the health of the lungs and heart of equine patients has been continuously growing [...] Full article
(This article belongs to the Special Issue Equine Respiratory Medicine and Cardiology)

Research

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9 pages, 980 KiB  
Article
Effect of the Administration of a Nutraceutical Supplement in Racehorses with Lower Airway Inflammation
by Luca Stucchi, Chiara Maria Lo Feudo, Giovanni Stancari, Bianca Conturba and Francesco Ferrucci
Animals 2022, 12(18), 2479; https://doi.org/10.3390/ani12182479 - 19 Sep 2022
Cited by 2 | Viewed by 1485
Abstract
Mild–moderate equine asthma (MEA) is a chronic inflammatory disorder of the lower airways of the horse, characterized by tracheal mucus accumulation, cough and poor performance. The therapeutic approach is based on pharmacological treatment and environmental management. Moreover, the efficacy of the administration of [...] Read more.
Mild–moderate equine asthma (MEA) is a chronic inflammatory disorder of the lower airways of the horse, characterized by tracheal mucus accumulation, cough and poor performance. The therapeutic approach is based on pharmacological treatment and environmental management. Moreover, the efficacy of the administration of antioxidant molecules has been reported. The aim of the present study was to evaluate the effect of the administration of a commercial nutraceutical supplement, composed of several herbal extracts, on lower airway inflammation in racehorses. Twelve Thoroughbreds affected by MEA were selected. All horses underwent a clinical examination with assignment of a clinical score, airway endoscopy and cytological examination of bronchoalveolar lavage fluid. In seven horses, the supplement was administered for 21 days in association with environmental changes, while in five horses only environmental changes were performed. All procedures were repeated at the end of the study. Data concerning the clinical score, the endoscopic scores and the cytology at the beginning and at the end of the study were statistically compared. Data showed a significant reduction (p < 0.0156) of the clinical score and a significant reduction (p < 0.0156) of the tracheal mucus score. The results showed the beneficial effect of the supplement on mild–moderate lower airway inflammation, probably due to its antioxidant activity. Full article
(This article belongs to the Special Issue Equine Respiratory Medicine and Cardiology)
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13 pages, 679 KiB  
Article
Reference Values and Repeatability of Pulsed Wave Doppler Echocardiography Parameters in Normal Donkeys
by Mohamed Marzok, Adel I. Almubarak, Zakriya Al Mohamad, Mohamed Salem, Alshimaa M. Farag, Hussam M. Ibrahim, Maged R. El-Ashker and Sabry El-khodery
Animals 2022, 12(17), 2296; https://doi.org/10.3390/ani12172296 - 05 Sep 2022
Cited by 4 | Viewed by 1563
Abstract
In the present study, thirty clinically healthy donkeys were used to establish the reference values and repeatability for Pulsed Wave Doppler echocardiographic variables of the mitral valve, aortic valve and myocardial performance. 2-dimensional Color flow mapping and spectral Doppler modes were performed. For [...] Read more.
In the present study, thirty clinically healthy donkeys were used to establish the reference values and repeatability for Pulsed Wave Doppler echocardiographic variables of the mitral valve, aortic valve and myocardial performance. 2-dimensional Color flow mapping and spectral Doppler modes were performed. For the mitral valve, the mean velocity, pressure gradient and duration of E-wave were 57.7 ± 12.5 cm/s, 1.4 ± 0.7 mmHg and 0.4 ± 0.13 s, respectively. The velocity, pressure gradient and duration of the A-wave were 32.3 ± 9.1 cm/s, 0.3 ± 0.04 mmHg and 0.3 ± 0.1 s, respectively. The mitral valve area, pressure half time, pulsatility index (PI), resistance index (RI) and velocity time integral (VTI) were 1.8 ± 0.5 cm2, 66 ± 17 ms, 2.8 ± 1.4, 0.9 ± 0.03 and 19.1 ± 5.7 cm, respectively. For the aortic valve, the mean velocity was 64.9 ± 10.4 cm/s, pressure gradient was 1.8 ± 0.4 mmHg, pulsatility index was 1.4 ± 0.3, resistance index was 0.9 ± 0.02, VTI was 25.02 ± 6.2 cm, systolic/diastolic was 19 ± 4.7 and heart rate was 95.7 ± 28.9 per minute. For Myocardial Performance Index (LV)–Tei Index, the mean ejection, isovolumic relaxation, isovolumic contraction time and myocardial performance index were 0.24 ± 0.01, 0.14 ± 0.01, 0.14 ± 0.02 and 1.2 ± 0.1 s, respectively. The results of the present study provide the reference values of PW echocardiographic parameter measurements in normal adult donkeys. Such reference values are helpful, especially when confronted with clinical cases with cardiovascular disorders. Full article
(This article belongs to the Special Issue Equine Respiratory Medicine and Cardiology)
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15 pages, 1332 KiB  
Article
Upper and Lower Airways Evaluation and Its Relationship with Dynamic Upper Airway Obstruction in Racehorses
by Chiara Maria Lo Feudo, Giovanni Stancari, Federica Collavo, Luca Stucchi, Bianca Conturba, Enrica Zucca and Francesco Ferrucci
Animals 2022, 12(12), 1563; https://doi.org/10.3390/ani12121563 - 17 Jun 2022
Cited by 8 | Viewed by 2133
Abstract
Dynamic upper airway obstructions (DUAO) are common in racehorses, but their pathogenetic mechanisms have not been completely clarified yet. Multiple studies suggest that alterations of the pharyngo-laryngeal region visible at resting endoscopy may be predictive of the onset of DUAO, and the development [...] Read more.
Dynamic upper airway obstructions (DUAO) are common in racehorses, but their pathogenetic mechanisms have not been completely clarified yet. Multiple studies suggest that alterations of the pharyngo-laryngeal region visible at resting endoscopy may be predictive of the onset of DUAO, and the development of DUAO may be associated with pharyngeal lymphoid hyperplasia (PLH), lower airway inflammation (LAI) and exercise-induced pulmonary hemorrhage (EIPH). The present study aims to investigate the possible relationship between the findings of a complete resting evaluation of the upper and lower airways and DUAO. In this retrospective study, 360 racehorses (Standardbreds and Thoroughbreds) referred for poor performance or abnormal respiratory noises were enrolled and underwent a diagnostic protocol including resting and high-speed treadmill endoscopy, cytological examination of the bronchoalveolar lavage fluid and radiographic assessment of the epiglottis length. In this population, epiglottis flaccidity was associated with dorsal displacement of the soft palate, while no relationship was detected between DUAO and epiglottis length. No associations were detected between DUAO and PLH, LAI or EIPH. In conclusion, it is likely that epiglottis plays a role in upper airway stability, while airways inflammation does not seem to be involved in the pathogenesis of DUAO. Full article
(This article belongs to the Special Issue Equine Respiratory Medicine and Cardiology)
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13 pages, 976 KiB  
Article
Giant Multinucleated Cells Are Associated with Mastocytic Inflammatory Signature Equine Asthma
by Ilaria Basano, Alessandra Romolo, Giulia Iamone, Giulia Memoli, Barbara Riccio, Jean-Pierre Lavoie, Barbara Miniscalco and Michela Bullone
Animals 2022, 12(9), 1070; https://doi.org/10.3390/ani12091070 - 20 Apr 2022
Cited by 3 | Viewed by 1904
Abstract
Equine asthma is currently diagnosed by the presence of increased neutrophil (>5%), mast cell (>2%), and/or eosinophil (>1%) differential cell count. Macrophages are normal resident cells within the alveoli. Their presence in BALF is considered normal, but the clinical implication of the presence [...] Read more.
Equine asthma is currently diagnosed by the presence of increased neutrophil (>5%), mast cell (>2%), and/or eosinophil (>1%) differential cell count. Macrophages are normal resident cells within the alveoli. Their presence in BALF is considered normal, but the clinical implication of the presence of activated or fused macrophages (giant multinucleated cells, GMC) is currently overlooked. We aimed to assess the prevalence, cytological determinants, and clinical significance of increased GMC counts in BALF of 34 asthmatic horses compared to 10 controls. Counts were performed on 15 randomly selected high magnification fields per cytospin slide (40×), and expressed as GMC:single macrophage (GMC:M) ratio. Regression models were used for statistical analysis. GMC was frequently observed in both asthmatic and control horses, with an increased prevalence of equine asthma (p = 0.01). GMC:M ratio was significantly higher in severe vs. mild to moderate equine asthmatic and control horses. In asthmatic horses, an increased GMC:M ratio was significantly associated with BALF mastocytosis (p = 0.01), once adjusting for age and the presence and severity of clinical signs of the horses. Tachypnea was the only clinical sign that tended to be positively associated with GMC:M ratio after adjustment (p = 0.08). In conclusion, our data suggest that a relationship might exist between molecular mechanisms regulating GMC formation and mast cell recruitment in the equine lung. The same mechanisms could lead to tachypnea even in the absence of respiratory effort at rest. We suggest including GMC count in the basic cytological assessment of BALF samples to gain more insights into their role in equine asthma. Full article
(This article belongs to the Special Issue Equine Respiratory Medicine and Cardiology)
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11 pages, 988 KiB  
Article
Lung Function Variation during the Estrus Cycle of Mares Affected by Severe Asthma
by Sophie Mainguy-Seers, Mouhamadou Diaw and Jean-Pierre Lavoie
Animals 2022, 12(4), 494; https://doi.org/10.3390/ani12040494 - 17 Feb 2022
Cited by 4 | Viewed by 1597
Abstract
While the prevalence of asthma is higher in boys than in girls during childhood, this tendency reverses at puberty, suggesting an effect of sex hormones on the disease pathophysiology. Fluctuations of asthma severity concurring with the estrus cycle are reported in women, but [...] Read more.
While the prevalence of asthma is higher in boys than in girls during childhood, this tendency reverses at puberty, suggesting an effect of sex hormones on the disease pathophysiology. Fluctuations of asthma severity concurring with the estrus cycle are reported in women, but this phenomenon has never been investigated in mares to date. The objective of this exploratory study was to determine whether the estrus cycle modulates airway obstruction in severe equine asthma (SEA). Five mares with SEA during exacerbation of the disease were studied. The whole breath, expiratory and inspiratory resistance, and reactance were compared during the follicular and luteal phases of the estrus cycle. The reproductive tract was evaluated by rectal palpation, ultrasound, and serum progesterone levels. The inspiratory resistance and reactance improved during the luteal phase of the estrus cycle, and variation in progesterone levels and the dominant follicle size correlated with several lung function parameters. The fluctuation of airway dysfunction during the estrus cycle is noteworthy as deterioration of the disease could perhaps be expected and prevented by horse owners and veterinarians. Further studies are required to determine if the equine species could be a suitable model to evaluate the effects of sex hormones on asthma. Full article
(This article belongs to the Special Issue Equine Respiratory Medicine and Cardiology)
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11 pages, 514 KiB  
Article
Associations between Exercise-Induced Pulmonary Hemorrhage (EIPH) and Fitness Parameters Measured by Incremental Treadmill Test in Standardbred Racehorses
by Chiara Maria Lo Feudo, Luca Stucchi, Giovanni Stancari, Elena Alberti, Bianca Conturba, Enrica Zucca and Francesco Ferrucci
Animals 2022, 12(4), 449; https://doi.org/10.3390/ani12040449 - 12 Feb 2022
Cited by 10 | Viewed by 2628
Abstract
Exercise-induced pulmonary hemorrhage (EIPH) is a condition affecting up to 95% of racehorses, diagnosed by detecting blood in the trachea after exercise and/or the presence of hemosiderophages in the bronchoalveolar lavage fluid (BALf). Although EIPH is commonly associated with poor performance, scientific evidence [...] Read more.
Exercise-induced pulmonary hemorrhage (EIPH) is a condition affecting up to 95% of racehorses, diagnosed by detecting blood in the trachea after exercise and/or the presence of hemosiderophages in the bronchoalveolar lavage fluid (BALf). Although EIPH is commonly associated with poor performance, scientific evidence is scarce. The athletic capacity of racehorses can be quantified through some parameters obtained during an incremental treadmill test; in particular, the speed at a heart rate of 200 bpm (V200), and the speed (VLa4) and the heart rate (HRLa4) at which the blood lactate concentration reaches 4 mmol/L are considered good fitness indicators. The present retrospective study aims to evaluate whether EIPH could influence fitness parameters in poorly performing Standardbreds. For this purpose, data from 81 patients regarding their V200, VLa4, HRLa4, peak lactate, maximum speed, minimum pH, and maximum hematocrit were reviewed; EIPH scores were assigned based on tracheobronchoscopy and BALf cytology. The association between the fitness parameters and EIPH was evaluated through Spearman’s correlation analysis. No relationship between EIPH and V200, VLa4, and HRLa4 was observed. Interestingly, EIPH-positive horses showed higher hematocrit values (p = 0.0072, r = 0.47), suggesting the possible influence of the hemoconcentration on the increase of pulmonary capillary pressure as a part of the pathogenesis of EIPH. Full article
(This article belongs to the Special Issue Equine Respiratory Medicine and Cardiology)
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7 pages, 247 KiB  
Article
Within-Breath Oscillatory Mechanics in Horses Affected by Severe Equine Asthma in Exacerbation and in Remission of the Disease
by Luca Stucchi, Francesco Ferrucci, Michela Bullone, Raffaele L. Dellacà and Jean Pierre Lavoie
Animals 2022, 12(1), 4; https://doi.org/10.3390/ani12010004 - 21 Dec 2021
Cited by 8 | Viewed by 2478
Abstract
Oscillometry is a technique that measures the resistance (R) and the reactance (X) of the respiratory system. In humans, analysis of inspiratory and expiratory R and X allows to identify the presence of tidal expiratory flow limitation (EFLt). The aim of this study [...] Read more.
Oscillometry is a technique that measures the resistance (R) and the reactance (X) of the respiratory system. In humans, analysis of inspiratory and expiratory R and X allows to identify the presence of tidal expiratory flow limitation (EFLt). The aim of this study was to describe inspiratory and expiratory R and X measured by impulse oscillometry system (IOS) in horses with severe asthma (SEA) when in clinical remission (n = 7) or in exacerbation (n = 7) of the condition. Seven healthy, age-matched control horses were also studied. Data at 3, 5, and 7 Hz with coherence > 0.85 at 3 Hz and >0.9 at 5 and 7 Hz were considered. The mean, inspiratory and expiratory R and X and the difference between inspiratory and expiratory X (ΔX) were calculated at each frequency. The data from the three groups were statistically compared. Results indicated that in horses during exacerbation of severe asthma, X during expiratory phase is more negative than during inspiration, such as in humans in presence of EFLt. The evaluation of X during inspiration is promising in discriminating between horses with SEA in remission and control horses. Full article
(This article belongs to the Special Issue Equine Respiratory Medicine and Cardiology)

Review

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24 pages, 2122 KiB  
Review
Inhalative Nanoparticulate CpG Immunotherapy in Severe Equine Asthma: An Innovative Therapeutic Concept and Potential Animal Model for Human Asthma Treatment
by John Klier, Sebastian Fuchs, Gerhard Winter and Heidrun Gehlen
Animals 2022, 12(16), 2087; https://doi.org/10.3390/ani12162087 - 16 Aug 2022
Cited by 4 | Viewed by 2599
Abstract
Severe equine asthma is the most common globally widespread non-infectious equine respiratory disease (together with its mild and moderate form), which is associated with exposure to hay dust and mold spores, has certain similarities to human asthma, and continues to represent a therapeutic [...] Read more.
Severe equine asthma is the most common globally widespread non-infectious equine respiratory disease (together with its mild and moderate form), which is associated with exposure to hay dust and mold spores, has certain similarities to human asthma, and continues to represent a therapeutic problem. Immunomodulatory CpG-ODN, bound to gelatin nanoparticles as a drug delivery system, were successfully administered by inhalation to severe equine asthmatic patients in several studies. It was possible to demonstrate a significant, sustained, and allergen-independent one-to-eight-week improvement in key clinical parameters: the arterial partial pressure of oxygen, the quantity and viscosity of tracheal mucus, and neutrophilic inflammatory cells in the respiratory tracts of the severe equine asthmatic subjects. At the immunological level, an upregulation of the regulatory antiallergic and anti-inflammatory cytokine IL-10 as well as a downregulation of the proallergic IL-4 and proinflammatory IFN-γ in the respiratory tracts of the severe equine asthmatic patients were identified in the treatment groups. CD4+ T lymphocytes in the respiratory tracts of the asthmatic horses were demonstrated to downregulate the mRNA expression of Tbet and IL-8. Concentrations of matrix metalloproteinase-2 and -9 and tissue inhibitors of metalloproteinase-2 were significantly decreased directly after the treatment as well as six weeks post-treatment. This innovative therapeutic concept thus opens new perspectives in the treatment of severe equine asthma and possibly also that of human asthma. Full article
(This article belongs to the Special Issue Equine Respiratory Medicine and Cardiology)
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26 pages, 495 KiB  
Review
The Immune Mechanisms of Severe Equine Asthma—Current Understanding and What Is Missing
by Joana Simões, Mariana Batista and Paula Tilley
Animals 2022, 12(6), 744; https://doi.org/10.3390/ani12060744 - 16 Mar 2022
Cited by 13 | Viewed by 3817
Abstract
Severe equine asthma is a chronic respiratory disease of adult horses, occurring when genetically susceptible individuals are exposed to environmental aeroallergens. This results in airway inflammation, mucus accumulation and bronchial constriction. Although several studies aimed at evaluating the genetic and immune pathways associated [...] Read more.
Severe equine asthma is a chronic respiratory disease of adult horses, occurring when genetically susceptible individuals are exposed to environmental aeroallergens. This results in airway inflammation, mucus accumulation and bronchial constriction. Although several studies aimed at evaluating the genetic and immune pathways associated with the disease, the results reported are inconsistent. Furthermore, the complexity and heterogeneity of this disease bears great similarity to what is described for human asthma. Currently available studies identified two chromosome regions (ECA13 and ECA15) and several genes associated with the disease. The inflammatory response appears to be mediated by T helper cells (Th1, Th2, Th17) and neutrophilic inflammation significantly contributes to the persistence of airway inflammatory status. This review evaluates the reported findings pertaining to the genetical and immunological background of severe equine asthma and reflects on their implications in the pathophysiology of the disease whilst discussing further areas of research interest aiming at advancing treatment and prognosis of affected individuals. Full article
(This article belongs to the Special Issue Equine Respiratory Medicine and Cardiology)
20 pages, 766 KiB  
Review
Advances in the Diagnosis of Equine Respiratory Diseases: A Review of Novel Imaging and Functional Techniques
by Natalia Kozłowska, Małgorzata Wierzbicka, Tomasz Jasiński and Małgorzata Domino
Animals 2022, 12(3), 381; https://doi.org/10.3390/ani12030381 - 04 Feb 2022
Cited by 5 | Viewed by 3956
Abstract
The horse, as a flight animal with a survival strategy involving rapid escape from predators, is a natural-born athlete with enormous functional plasticity of the respiratory system. Any respiratory dysfunction can cause a decline in ventilation and gas exchange. Therefore, respiratory diseases often [...] Read more.
The horse, as a flight animal with a survival strategy involving rapid escape from predators, is a natural-born athlete with enormous functional plasticity of the respiratory system. Any respiratory dysfunction can cause a decline in ventilation and gas exchange. Therefore, respiratory diseases often lead to exercise intolerance and poor performance. This is one of the most frequent problems encountered by equine internists. Routine techniques used to evaluate respiratory tract diseases include clinical examination, endoscopic examination, radiographic and ultrasonographic imaging, cytological evaluation, and bacterial culture of respiratory secretions. New diagnostic challenges and the growing development of equine medicine has led to the implementation of advanced diagnostic techniques successfully used in human medicine. Among them, the use of computed tomography (CT) and magnetic resonance (MR) imaging significantly broadened the possibilities of anatomical imaging, especially in the diagnosis of upper respiratory tract diseases. Moreover, the implementation of spirometry, electrical impedance tomography (EIT), and impulse oscillation system (IOS) sheds new light on functional diagnostics of respiratory tract diseases, especially those affecting the lower part. Therefore, this review aimed to familiarize the clinicians with the advantages and disadvantages of the advanced diagnostic techniques of the equine respiratory tract and introduce their recent clinical applications in equine medicine. Full article
(This article belongs to the Special Issue Equine Respiratory Medicine and Cardiology)
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