Difference between revisions of "Summer Pasture-Associated Recurrent Airway Obstruction"

Revision as of 13:12, 26 August 2010

(SPA-RAO)

Also known as: Summer Pasture-Associated Obstructive Pulmonary Disease, Summer Pasture-Associated Heaves

Description

Summer Pasture-Associated Recurrent Airway Obstruction(SPA-RAO) is an inflammatory condition of the lower airways affecting pasture-kept horses. This is in contrast to Recurrent Airway Obstruction that affects horses that are stabled. The disease is characterised by airway inflammation, increased airway mucus production, reduced mucociliary clearance and bronchoconstriction. It occurs most commonly in the South of the United States but has also been reported in the United Kingdom.

Signalment

The average age of onset of SPA-RAO is 9 years of age. There is no reported sex predilection but Quarter Horses are over-represented.

Pathogenesis

The pathogenesis of the disease is largely unknown but suggested hypotheses include inhaled pollens or outdoor moulds or ingestion of a pasture-derived pneumotoxin.

Clinical signs

Clinical signs are similar to those associated with RAO but occur in horses kept out at pasture during the summer months, usually for more than twelve hours a day. Signs may include exercise intolerance, cough (often productive), dyspnoea, increased expiratory effort, nasal discharge and flared nostrils. Pyrexia may be a feature if a seconday bacterial infection has occurred in the airways. In severe cases, affected horses stand with their neck arched and elbows abducted. An abdominal 'heave' line may also be visible due to hypertrophy of the external abdominal oblique muscles. Lung field auscultation reveals fine crackles and wheezes. In severe cases, wheezes may be audible without a stethoscope.

Diagnosis

Diagnosis is usually based on the characteristic and seasonal appearance of clinical signs combined with a history of exposure to pasture during late spring or summer. Endoscopy may be used in order to evaluate the airways and to examine the presence of inflammation or mucus. A sample of the mucus may be taken in order to perform bacterial culture or cytology. Thoracic radiology is not commonly performed but may reveal an increased bronchointerstitial pattern.

Treatment and management

Affected horses should only be allowed access to pasture during late autumn, winter and early spring. They should ideally be kept stabled in a dust-free environment such as a stable with rubber matting and no bedding. If hay appears to act as a trigger to the horse, a complete pelleted diet may be fed or alternatively hay should be soaked. Alfalfa has been previously associated with less respiratory problems than grass hay and may be preferable.

In some cases, the response to environmental management may be significant and drug treatment may not be required. In other cases, drug therapy may be required to suffiently manage the clinical signs. Corticosteroids may be administered via nebuslisation using an inhaler in order to allow the maximum concentration of the drug in the respiratory tract, with minimal systemic side effects. This can be combined with a bronchodilator such as clenbuterol. Antibiotics may be required if seconday bacterial infection is present.

Preventinon

References

McGorum, B. C., Edward Robinson, N., Dixon, P. M., Schumacher, J. (2007) Equine respiratory medicine and surgery Elsevier Health Sciences
Orsini, J. A., Divers, T. (2007) Equine Emergencies: Treatment and Procedures Elsevier Health Sciences

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-{{OpenPagesTop}}
+(SPA-RAO)
-Also known as: '''''SPA-RAO — Summer Pasture-Associated Obstructive Pulmonary Disease (SPAOPD) — Summer Pasture-Associated Heaves
+{{unfinished}}
-==Introduction==
+Also known as: Summer Pasture-Associated Obstructive Pulmonary Disease, Summer Pasture-Associated Heaves
-Summer Pasture-Associated Recurrent Airway Obstruction (SPA-RAO) is an inflammatory condition of the lower airways affecting pasture-kept horses. This is in contrast to [[Recurrent Airway Obstruction]] that affects horses kept in a stabled environment. SPA-RAO is characterised by airway inflammation, increased airway mucus production, reduced mucociliary clearance and bronchoconstriction in response to allergen exposure. The pathogenesis of the disease is largely unknown but suggested hypotheses include inhaled pollens or outdoor moulds, or ingestion of a pasture-derived pneumotoxin. It occurs most commonly in the southern states of America but has also been reported in the United Kingdom.
+==Description==
+Summer Pasture-Associated Recurrent Airway Obstruction(SPA-RAO) is an inflammatory condition of the lower airways affecting pasture-kept horses. This is in contrast to Recurrent Airway Obstruction that affects horses that are stabled. The disease is characterised by airway inflammation, increased airway mucus production, reduced mucociliary clearance and bronchoconstriction. It occurs most commonly in the South of the United States but has also been reported in the United Kingdom.
 ==Signalment==
-SPA-RAO generally affects adult horses only and the average age of onset is 9 years of age. There is no reported sex predilection but Quarter Horses and Appaloosas are more prone to developing the condition.
+The average age of onset of SPA-RAO is 9 years of age. There is no reported sex predilection but Quarter Horses are over-represented.
+==Pathogenesis==
+The pathogenesis of the disease is largely unknown but suggested hypotheses include inhaled pollens or outdoor moulds or ingestion of a pasture-derived pneumotoxin.
 ==Clinical signs==
-Clinical signs are similar to those associated with RAO but occur in horses kept out at pasture during the summer months, usually for more than twelve hours a day. Signs can include exercise intolerance, productive cough, dyspnoea, increased expiratory effort, nasal discharge and flared nostrils. Lung field auscultation reveals fine crackles and wheezes. In severe cases, wheezes may be audible without a stethoscope. Pyrexia may be a feature if a secondary bacterial infection of the airways has occurred. Affected horses often stand with their neck arched and elbows abducted and an abdominal 'heave' line may be visible due to hypertrophy of the external abdominal oblique muscles.
+Clinical signs are similar to those associated with RAO but occur in horses kept out at pasture during the summer months, usually for more than twelve hours a day. Signs may include exercise intolerance, cough (often productive), dyspnoea, increased expiratory effort, nasal discharge and flared nostrils. Pyrexia may be a feature if a seconday bacterial infection has occurred in the airways. In severe cases, affected horses stand with their neck arched and elbows abducted. An abdominal 'heave' line may also be visible due to hypertrophy of the external abdominal oblique muscles. Lung field auscultation reveals fine crackles and wheezes. In severe cases, wheezes may be audible without a stethoscope.
 ==Diagnosis==
-Diagnosis is usually based on the characteristic and seasonal appearance of clinical signs combined with a history of exposure to pasture during late spring or summer. Endoscopy may be used in order to examine the airways for the presence of inflammation or mucus. A sample of mucus can be obtained via bronchoalveolar lavage which often yields copious mucopurulent material. Cytology performed on the sample usually reveals >25% non-degenerate neutrophils confirming the presence of lower airway inflammation. Curschmann's spirals may also be observed, representing inspissated mucus in the obstructed lower airways.
+Diagnosis is usually based on the characteristic and seasonal appearance of clinical signs combined with a history of exposure to pasture during late spring or summer. Endoscopy may be used in order to evaluate the airways and to examine the presence of inflammation or mucus. A sample of the mucus may be taken in order to perform bacterial culture or cytology. Thoracic radiology is not commonly performed but may reveal an increased bronchointerstitial pattern.
-Thoracic radiology is not commonly performed but often reveals an increased bronchointerstitial pattern.
+==Treatment and management==
+Affected horses should only be allowed access to pasture during late autumn, winter and early spring. They should ideally be kept stabled in a dust-free environment such as a stable with rubber matting and no bedding. If hay appears to act as a trigger to the horse, a complete pelleted diet may be fed or alternatively hay should be soaked. Alfalfa has been previously associated with less respiratory problems than grass hay and may be preferable.
-==Treatment and management==
+In some cases, the response to environmental management may be significant and drug treatment may not be required. In other cases, drug therapy may be required to suffiently manage the clinical signs. Corticosteroids may be administered via nebuslisation using an inhaler in order to allow the maximum concentration of the drug in the respiratory tract, with minimal systemic side effects. This can be combined with a bronchodilator such as clenbuterol. Antibiotics may be required if seconday bacterial infection is present.
-Control of environmental exposure is essential in horses affected with SPA-RAO. Affected horses should only be allowed access to pasture during late autumn, winter and early spring. They should ideally be kept in a dust-free environment such as a clean stable with rubber matting and no bedding. If hay appears to act as a trigger to the horse, a complete pelleted diet can be fed or alternatively hay should be thoroughly soaked. Alfalfa hay has been previously associated with less respiratory problems than grass hay and may be a preferable source of roughage for affected horses. Horses with severely compromised respiratory function should be rested until their condition has improved.
-In some cases, the response to environmental management may be significant and further treatment may not be required. In more severe cases, drug therapy may be required to sufficiently manage the horse's condition. Corticosteroids (e.g. dexamethasone) are used in order to reduce airway inflammation and can be administered via nebulisation using an inhaler in order to produce the maximum concentration of the drug in the respiratory tract. Minimal systemic side effects are induced with this mode of administration. This treatment can be combined with a bronchodilator such as clenbuterol to reduce smooth muscle contraction in the lower airways. Antibiotics may be required if secondary bacterial infection is present.
+==Preventinon==
-{{Learning
-|literature search = [http://www.cabdirect.org/search.html?q=%28title%3A%28Summer+Pasture+Associated+Obstructive+Pulmonary+Disease%29+OR+title%3A%28SPA+RAO%29+OR+title%3A%28Summer+Pasture+Associated+Recurrent+Airway+Obstruction%29+OR+title%3A%28SPAOPD%29+OR+title%3A%28Summer+Pasture+Associated+Heaves%29%29+AND+od%3A%28horses%29 Summer Pasture-Associated Recurrent Airway Obstruction publications]
-}}
 ==References==
-*Lavoie, J. P., Hinchcliff, K. W. (2009) '''Blackwell's Five-Minute Veterinary Consult: Equine''' ''John Wiley and Sons''
 *McGorum, B. C., Edward Robinson, N., Dixon, P. M., Schumacher, J. (2007) '''Equine respiratory medicine and surgery''' ''Elsevier Health Sciences''
 *Orsini, J. A., Divers, T. (2007) '''Equine Emergencies: Treatment and Procedures''' ''Elsevier Health Sciences''
+[[Category:Allergic Respiratory Diseases]][[Category:Horse]][[Category:To Do - Blood]][[Category:To Do - SophieIgnarski]]
-{{review}}
-{{OpenPages}}
-[[Category:Allergic Respiratory Diseases]][[Category:Respiratory Diseases - Horse]]
-[[Category:Expert Review]]
-[[Category:Type III Hypersensitivity Diseases]]
-[[Category:Bronchi and Bronchioles - Pathology]]
-[[Category:Respiratory System - Inflammatory Pathology]]