This is an archived Horseadvice.com Discussion. The parent article and menus are available on the navigation menu below:
HorseAdvice.com » Diseases of Horses » Respiratory System » Chronic Lower Airway Disease »
  Discussion on Breathing/perfomance problems
Author Message
New Member:
hayley

Posted on Tuesday, Jul 29, 2008 - 9:19 am:

I recently purchased (3m ago) my horse a 15hh 8yr old irish coloured cob. I had him vetted and he passed without problem. I was told he had not done much work lately but had been hunted the previous year. He rode out fine on two try out occassions but did seem only about 60% fit to me and I mentioned this to the vet at the time. Anyway some three weeks into having him he started to make odd noises mostly when decending any incline when we were out difficult to describe but 'a clear the throat' like repetitive noise. the vet(different vet same practice) was due to come out anyway to do a second flu jab so I asked him about this noise and he examined him and came out with me to listen (horse of course wouldn't do it much on that occasion!) anyway he said on examination his breathing rate at rest was too high at 20 per min but didn't think the 'noises' were related poss they were an anatomical cause. He Recommended a lung wash to go for analysis. that was done and it came back with result of infection and bacteria present vet said it was like bronchitus.I could carry on with light riding as he was not coughing or otherwise seeming ill. He was put on noradine antibiotic powders for two weeks with ventuplin for a week- during this time though his performance riding was not inproving neither were the noises which were getting more frequent and in the second week he was getting much tireder quickly to the point where he didn't want to trot without then puffing and I stopped riding. He then started the odd cough not in the field but when say encouraged to trot in from field which had not been present at all before. Vet came again did second lung wash more waiting then lab result says now gramme negative as well as positive bacteria and a high count of inflamation a score of 6 out of 9. Vet has put him on a 3 wk course of Baytril liquid to have in feed plus high initial dose ventipulin. I am obviously very distressed all this has arisen so soon and confused over whether it is a case of a lung infection that should untimately be cleared up or whether with reference to the inflammation score he has also got underlying COPD or similar - can this be established? - his symptoms seem to fit part into pnemonia catagory and part COPD and part CLAD given the info on this site- he has no history of these problems I am assured and he did pass his 5 star vetting so am at a loss. Has anyone had any similar experience? THe horse lives out and looks the picture of health and is very bolshy now not having been ridden much
Moderator:
DrO

Posted on Wednesday, Jul 30, 2008 - 7:44 am:

Welcome Hayley,
Concerning your direct question generally COPD and bacterial pneumonia do not look alike historically or clinically. In short I would not have expected a bacterial pneumonia to look the picture of health and, if I understand the word properly, bolshy. You will find descriptions of history and clinical signs in the articles:
Diseases of Horses » Respiratory System » Pneumonia & Pleuropneumonia
Diseases of Horses » Respiratory System » Heaves & Chronic Obstructive Pulmonary Disease
I would also expect the CBD and "lung wash" results to be worse (more neutrophils and a left shift) with bacterial pneumonia.

I would be interested in exactly which test was performed (tracheal or BAL) and the complete results of tests.
DrO
New Member:
hayley

Posted on Friday, Aug 1, 2008 - 1:23 pm:

Dear Dr O

The two tests were actually tracheal washes I now understand.

The results of the second and most recent are as follows:
Endoscopy :slight bilateral serous nasal discharge moderate mucopus no blood in trachea
Mucopus score 2/3
sample appearance translucent moderate flocculation

The sample was centrifuged and smears stained with haematoxylin and eosin

smear cell density - moderate/high
smear cell density score 2/3
predominant cell type - enlarged active macrophages with foamy cytoplasm occasionally with engulfed neutrophils
present in moderate proportions - cilated and uncileated columnar epithelial cells, neutrophils
A small proportion of cells lymphocytes
occassional cels only:-
No cells seen :eosinophils
neutrophil proportion score 2/3

mucas quatity - scant
mucas quality - basophilic strands
plant material - occasional extracellular
funal material- marked extracellular, moderate intracellular
baceria - occassional colonies of extracellular cocci
haemosiderophages - none seen
free red blood cells none seen
squames- occasional with associated baceria
debris- very occasional amorphous material
other - none
pattern diagnosis
inflammation- moderate neutrophilic
mucas - no evidence of inspissation or overproduction
haemorrhage - no evidence
cytology inflammation score 6/9

comment : "there is evidence of a significant degree of neutrophilic inflammation of hte lower airways and herefore bacerial infection may be in volved. The results of the bacterial culture will be sent under seperate cover. The possibility of sme underlying hypersensitivity disorder could not be ruled out. repeat tracheal wash sampling would be helpful to monitor progress and response to antibiotic therapy"

Having now seen the above I am a little hopeful that there may not be an underlying problem once the bacerial infection can be cleared up - am I right or wrong? And guess that can only be established at the end of this current three wk course of Baytril( we are half way in) by another tracheal wash and to see if neutrophils reduced to normal and bacteria gone or reduced down and bacteria still present or bacteria gone but neutrophils still too high which will show an underlying and therefore ongoing problem - am I right here or on the wrong track? Is this drug likely to do the job or another possible waste of valuable time when he should maybe be having something intermuscular and stronger? I obviously have to have faith in my vets judgment but other people I speak to are surprised that he is getting the antibiotics via his food and over a long period.

The weeks ventapulin has finished now and he does not seem adversly affected at present but I have not ridden him since to see how he rides now which is the only way I think I will be able to have an idea of how his stamina is at present. The vet did not say anything about not riding in fact during the first course of antibiotic powders he said was ok to carry on riding if he wasnot coughing and appeared happy - so I am unsure whether I can take him out for some regular light excercise now or not - that is the only way I will be able to tell whether or not he appears to be improving - stamina wise - as he looks and acts fine. I did tack him up a couple of nights back to walk him around our fields but as it happend he ended up galloping off with me he is so full of it with no regular excercise. I am trying to get hold of a stethoscope to try to check his respiratory rate - the vet said counting the breaths from the nose was not as good evidently -

Your comments would be appreciated - thank you
Moderator:
DrO

Posted on Sunday, Aug 3, 2008 - 8:59 am:

Hello Hayley,
There is nothing in your posts to suggest your horse is not going to get well, the question is one of proper diagnosis and treatment.

Concerning the transtracheal washes the information above is presented in largely subjective format so we must use the labtech's interpretation. The presence of bacteria is normal and the occasional presence of extracellular cocci is not strong evidence for bacterial pneumonia. I agree with the labs statement that the findings are consistent with chronic (neutrophilic) inflammatory disease. What sounds like the most remarkable finding besides the neutrophils is "marked" amounts of fungal material and the intracellular finding suggests the body is reacting to it. What type fungal material is this? Fungal spores would provide a strong basis for diagnosing COPD due to mold spore exposure.

Again it is important to consider the history, clinical findings, and lab results in total for an accurate diagnosis. You can get an accurate respiratory rate looking at the rib cage go in and out.
DrO
New Member:
hayley

Posted on Monday, Aug 4, 2008 - 9:14 am:

Thank you for your response. Is there a way of establishing which fungal material it is from the lab? ie from hay (which would have been pre my owning him) and you would have thought that then living out would have removed the cause? ..or something out in the field which I can only think of as something like dead leaves possibly giving off mould when his head is eating near them but that seems a bit far fetched and cannot see that you can do anything about that? He does eat absolutely anything ie trees etc and have seen him digging out and eating soil on occassion though he has abundant grass he is not discerning at all. I measured his breathing rate at rest yesterday at 8 per min which I rechecked serval times as cannot believe it has gone down from the intial 20 some weeks ago now and I made it 20 on only Friday last too. Hopefully is a good sign anibios are clicking in..... I guess the next 'tracheal wash' in a week or so will be telling. The dealer who sold him to me is very adamant from knowing the horse locally for the last 18m that he should not have on going COPD and appears genuine over this and has said I could take him back if he was proven to have a permenant problem but of course I do not want to do that and would be a last resort.
Moderator:
DrO

Posted on Monday, Aug 4, 2008 - 11:01 pm:

The appearance of the mold spores is very characteristic.
DrO
Home Page | Top of Page | Join Us!
Horseadvice.com is a BBB Accredited Business. Click for the BBB Business Review of this Horse Training in Stokesdale NC