asthma | Horse Racing Free Tips

Study: Heaves Can Wreak Havoc On More Than Just Lungs

Horses with uncontrolled respiratory disease have more organs at risk than simply their lungs, new Canadian research shows. Drs. Serena Ceriotti, Michela Bullone, Mathilde Leclere, Francesco Ferrucci and Jean-Pierre Lavoie have discovered that horses with uncontrolled respiratory disease are at risk of having pulmonary arterial changes that could lead to heart failure.

Horses that suffer from severe equine asthma have inflamed airways; they also cough and have difficulty breathing. The researchers hypothesized that this condition, which is triggered by dust and mold in a horse's hay and environment, can put horses at risk of pulmonary hypertension. Pulmonary hypertension occurs when the walls of the pulmonary arteries thicken and increase the horse's blood pressure.

For the study, the research team obtained multiple post-mortem lung samples from 18 horses: six that were in heaves episodes when they died; six that were in remission from heaves from being kept in a dust-free environment; and six that had no heaves and served as controls.

The researchers measured the thickness of the arteries and found that horses with uncontrolled asthma had thicker arterial walls than other horses in the study.

Why the artery walls thicken when a horse has breathing trouble is unknown, but it is hypothesized that the low oxygen content and inflammation may increase the amount of smooth muscle in the artery walls, which makes it more difficult for blood to move out of the lungs. Eventually, this condition could lead to an enlargement and failure of the right ventricle of the heart.

The final part of the team's study focused on potential treatments for pulmonary hypertension in horses: they used 11 asthmatic horses divided into two groups that were treated for a full year with two different treatment protocols. One group had reduced dust exposure, primarily through the feeding of hay alternatives. The second group went on a corticosteroid for the first six months, the had dust control measures added in. Both treatments led to a reversal in arterial wall thickness, but changes in the second group were not seen until the dust control measures were taken.

They scientists determined that the thickening of arterial walls in horses with heaves can be reversed, but environmental changes must be made; the administration of corticosteroids, while helpful, must be made in conjunction with changes in management.

Read the full study here.

Equine Asthma Causes Thickening of Arterial Walls In Lungs

Researchers have found that horses with severe asthma also have arterial walls that are thickened in the lung. This condition can also be found in humans that have chronic obstructive pulmonary disease; it contributes to pulmonary hypertension.

Severe asthma in horses is chronic lower airway disease; airway obstruction recurs when the horse is exposed to environmental triggers like hay mites and fungi. Drs. Serena Ceriotti, Michela Bullone, Mathilde Leclere, Francesco Ferrucci and Jean-Pierre Lavoie wanted to see if there were changes to the pulmonary arteries in asthmatic horses and how widely distributed these changes were. They also sought to see if the condition was reversible, either by inhaling corticosteroids or by avoiding allergens.

The study found that both actively asthmatic horses and those in remission had increased wall areas and that the pulmonary artery smooth muscle mass was increased. Both inhaled corticosteroids and allergen avoidance reversed the wall increase, but the smooth muscle only returned to normal during avoidance.

They concluded that equine asthma caused thickening of smooth muscle mass in pulmonary arteries. They also determined that the narrowing of the arteries could contribute to pulmonary hypertension. Avoiding triggers was found to be more effective than inhaled corticosteroids to control the disease.

Read the full study here.

Fall Allergies Can Trigger Equine Asthma, Impact Performance

Just as many humans start to sneeze in the fall, horses also can be affected by seasonal allergies.

Sometimes this is apparent by coughing, but other times, according to Laurent Couëtil, professor of large animal internal medicine in Purdue University's College of Veterinary Medicine, the only sign is that their performance suffers.

Couëtil has spent much of his career treating and researching equine respiratory disease, and he collaborated with three other researchers to argue for the adoption of equine asthma as an official diagnosis in the Equine Veterinary Journal. Equine asthma can flare up as a result of allergies, especially during the fall, which is when many of the traditional spring races were moved.

“We tend to see an increase in horses showing signs of equine asthma during crop harvest season,” he said. “Horses pastured near fields where crops are harvested may be exposed to the dust generated by the combine harvesting crops.” Horses affected by these allergies may develop signs like coughing or increased breathing efforts within a few days of exposure to the dust or allergens and may show impaired performance.

“Other horses with asthma tend to show signs when pollen and molds peak again in the fall,” Couëtil said. “So, the triggers may be different, but horses will show similar symptoms.”

One reason for so many allergy and asthma flare-ups in the fall has to do with feeding. As grass becomes sparse toward the end of the summer or early fall and horses are supplemented with dry hay, more susceptible horses may develop asthma flare-ups.

“Most asthmatic horses are allergic to hay dust,” Couëtil said, “and, therefore, they usually develop clinical signs when fed hay in the barn during the winter months.”

Additionally, feeding round bales is associated with more severe signs because horses are exposed to higher dust levels compared with eating from square bales.

“This is especially true when round bales are left in the field uncovered as they tend to become moldy from exposure to rain and moisture,” Couëtil said.

Couëtil has found that often, less severe asthma symptoms improve when horses are on grass pasture, but during the fall months, this isn't always possible. Feeding low-dust forages can help horses recover and also prevent flare-ups.

“Our recent research demonstrated that athletic horses, such as racehorses, benefit from being fed steamed hay or haylage instead of dry hay,” he said. “These forages result in lower exposure to dust as compared to dry hay, and this translates in lower levels of airway inflammation. Haylage appears to have the strongest beneficial effect, and this effect seems to be linked to higher omega-3 fatty acid content.”

Additional supplementation with nutrients rich in omega-3 fatty acids, like EPA and DHA found in fish oil and algae, can help keep asthmatic horses healthy.

Avoiding exposure to allergy triggers, such as by feeding low-dust forages, can help horses stay healthy and perform at peak levels. During crop harvest season, this might mean keeping the horse in the barn while crops around the stable are harvested.

“If horses continue to show signs of asthma despite environmental management, your veterinarian may prescribe treatment with aerosolized corticosteroids,” Couëtil said.

Taking preventive measures can help minimize horses' exposure to allergens and prevent asthma flare-ups, keeping horses healthy and performing at their best levels.

Couëtil's research is supported by the Grayson Jockey-Club Research Foundation, the state of Indiana and the Purdue Veterinary Medicine research account.

First Inhaled Therapy For Severely Asthmatic Horses Launched In U.S.

Boehringer Ingelheim today announced the U.S. launch of the Aservo EquiHaler (ciclesonide inhalation spray), the first FDA-approved inhalant therapy for horses with severe equine asthma.

Developed after a decade of collaboration between Boehringer Ingelheim's human pharmaceutical and animal health businesses, the Aservo EquiHaler offers the promise of relief to thousands of horses that suffer from severe equine asthma, which affects 11 to 17 percent of horses.

Horses with severe equine asthma typically have clinical signs that include difficulty breathing, coughing and nasal discharge, which can have a significant impact on a horse's performance and quality of life. Over time, severely asthmatic horses may develop changes in the lung, which makes it difficult to breathe, even at rest.

“We understand the unique and inextricable link between animals and people. By delivering value through innovation, we strive to enhance the wellbeing of both and help shape the future direction of the industry,” said Caroline Belmont, Head of US Global Innovation and US Regulatory Affairs at Boehringer Ingelheim Animal Health. “We are focused on developing breakthrough therapeutics, like the Aservo EquiHaler, for animal disease areas with unmet needs to make a true impact in the lives of horses and their owners.”

The Aservo EquiHaler marks an industry first in equine medicine, as until now, there has been no FDA-approved inhalant therapy for use in horses with severe equine asthma. Severe equine asthma is an inflammatory disease of the lower airways caused by breathing in high concentrations of organic dust particles small enough to pass with air to the lower airways. Such particles are commonly found in hay and bedding.

Boehringer Ingelheim Animal Health used the Respimat inhaler, developed by the company's human pharmaceutical business, as a basis to develop the unique Soft Mist Technology of the Aservo EquiHaler, which is designed specifically for use in horses. The Aservo EquiHaler includes an ergonomic handle and dosing lever for ease of user handling, and a nostril adapter that fits inside the nostril of the horse, allowing them to easily inhale the medicated mist into their lungs.

The active ingredient in the Aservo EquiHaler (ciclesonide inhalation spray) is ciclesonide, a glucocorticoid (steroid) that becomes activated in the lungs, which allows for the targeted delivery and activation of the medication. Studies in horses with severe asthma have demonstrated that administration of ciclesonide reversed airway obstruction associated with severe asthma, and to date, ciclesonide is the only glucocorticoid not associated with suppression of serum cortisol, a desired treatment outcome.

To learn more about Aservo EquiHaler, click here.

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