Equine Internal Medicine Q&A 22

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A 14-year-old Thoroughbred gelding has a six-year history of a chronic cough and an intermittent nasal discharge. Thoracic auscultation revealed loud end expiratory wheezes. A tracheobronchial aspirate specimen is seen in the image.

Question	Answer		Article
What are the cell types seen?	Macrophages, a Curshman spiral, a multinucleated giant cell, respiratory epithelial cells, mucus and debris.		[[|Link to Article]]
What is the likely diagnosis?	Chronic obstructive pulmonary disease (COPD).		Link to Article
What treatment is required?	The key means of controlling COPD is by reducing the horse’s exposure to the offending agents, most often airborne dust and moulds. Pharmaceutical intervention may be necessary and could include the use of bronchodilators, mucolytics and anti-inflammatory agents. Bronchodilators may include drugs from these three groups: muscarinic receptor antagonists – parasympatholytics; adrenoceptor agonists – sympathomimetics; and methylxanthine derivates. Mucokinetic drugs increase the transport of the complex and incompletely understood airway secretions by differing mechanisms. Mucokinetic agents to consider in the horse include bromhexine, dembrexine, theophylline and clenbuterol. Anti-inflammatory drugs primarily affect the delayed response and bronchial hyperreactivity. Corticosteriods most commonly used are prednisolone and dexamethasone.		Link to Article