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  Discussion on Research Summary: Equine Multinodular Pulmonary Fibrosis
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DrO

Posted on Thursday, Apr 10, 2008 - 12:36 pm:

I find this condition interesting because of its similarity to the very common recurrent obstructive airway disease (COPD or RAOD) of horses. Though treatment is similar it does not always respond well and may require more prolonged steroid therapy. It should be suspected in acute cases where there is no history of exposure and does not respond well to proper management and corticosteroid therapy.

J Am Vet Med Assoc. 2008 Mar 15;232(6):898-905.
Multinodular pulmonary fibrosis in five horses.

Wong DM, Belgrave RL, Williams KJ, Del Piero F, Alcott CJ, Bolin SR, Marr CM, Nolen-Walston R, Myers RK, Wilkins PA.

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011.

Case Description-5 horses were evaluated because of decreased appetite, weight loss, fever, cough, tachypnea, and respiratory distress. Clinical Findings-Tachycardia, tachypnea, increased respiratory effort, lethargy, fever, poor body condition, and nasal discharge were detected in various combinations on initial physical examination. Evaluation of the lower portion of the respiratory tract via radiography and ultrasonography revealed a severe nodular interstitial pattern. Histologic examination of lung tissue revealed interstitial expansion of alveolar parenchyma with collagen, intraluminal accumulation of neutrophils and macrophages within the alveoli, and occasional intranuclear inclusion bodies within alveolar macrophages. Equine herpesvirus type 5 was detected in samples of lung tissue, bronchoalveolar lavage fluid, or both via polymerase chain reaction assay in all cases. A diagnosis of equine multinodular pulmonary fibrosis (EMPF) was established. Treatment and Outcome-Horses were provided supportive treatment and were administered a variety of medications including corticosteroids and acyclovir. Two horses survived and returned to their previous level of activity. Three horses were euthanized because of either deterioration of clinical condition (n = 2) or failure to improve within 4 weeks of initiation of treatment (1). Clinical Relevance-EMPF should be considered as a differential diagnosis for adult horses with interstitial pneumonia and should be suspected on the basis of characteristic radiographic, ultrasonographic, and histopathologic findings. Equine herpesvirus type 5 is found in association with EMPF; although the exact pathogenic role this virus plays in EMPF is unknown, equine herpesvirus type 5 may be an etiologic agent or cofactor in the development of EMPF.
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