Robins Tyler-Jane, Bedenice Daniela, Mazan Melissa
Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA.
Animals (Basel). 2023 Nov 1;13(21):3387. doi: 10.3390/ani13213387.
(1) Background: Equine asthma (EA) is a pervasive and important cause of poor performance and respiratory morbidity in horses. Diagnosis of EA includes an owner complaint, clinical scoring, lung function testing, and cytological analysis of bronchoalveolar lavage (BAL) cytology. There is a paucity of information about the longitudinal course of the disease using these outcome assessments; thus, this study sought to describe and quantify, in horses with more than one visit to a specialty pulmonary clinic in New England, the type and range of clinical presentations with an eventual diagnosis of EA. It also aimed to develop and compare the outcomes of scoring systems for owner complaints and veterinary assessments, document and assess the diagnostic methods used, and evaluate the response of the horses to treatment and time. (2) Methods: This study was a retrospective, cross-sectional, STROBE-compliant observational analysis of equine patients who visited the Tufts Cummings Hospital for Large Animals (HLA) for evaluation of equine asthma (EA) from 1999-2023. The horses were categorized as having mild-moderate (mEA) or severe EA (sEA) using the ACVIM consensus statement guidelines. After excluding those with inadequate documentation or only one visit ( = 936), a total of 76 horses were included in the study. Of the 197 visits, 138 (70.0%) resulted in a diagnosis of mEA and 45 (22.8%) resulted in a diagnosis of sEA. Demographic information, owner complaints, clinical examination and scoring, lung function testing, BAL cytology, and recommendations for environmental remediation and pharmacologic treatment were recorded for all the visits. The data were analyzed for agreement between owner complaints (complaint score, CS) and clinical examination findings (examination score, ES), changes in CS and ES, lung function testing, and BAL cytology over time, with 197 visits recorded. (3) Results: A comparison between the CS and ES showed that the owners were more likely than veterinarians to detect cough, and a decrease in cough was the most common owner observation after treatment. The response to the histamine challenge, used to detect airway hyperreactivity, was significantly improved with treatment or time in the horses with mEA, whereas baseline lung function did not significantly change in mEA or sEA. (4) Conclusions: Owners can be astute observers of clinical signs, especially cough, in EA. Tests of airway hyperreactivity are more successful in detecting changes in mEA than are baseline lung function testing and assessment of BAL cytology.
(1) 背景：马哮喘（EA）是导致马匹表现不佳和呼吸道发病的普遍且重要的原因。EA的诊断包括主人的主诉、临床评分、肺功能测试以及支气管肺泡灌洗（BAL）细胞学分析。关于使用这些结果评估指标来了解该疾病的纵向病程的信息较少；因此，本研究旨在描述和量化在新英格兰一家专科肺病诊所就诊不止一次且最终被诊断为EA的马匹的临床表现类型和范围。它还旨在开发并比较针对主人主诉和兽医评估的评分系统的结果，记录并评估所使用的诊断方法，以及评估马匹对治疗和时间的反应。(2) 方法：本研究是一项对1999年至2023年期间前往塔夫茨卡明斯大型动物医院（HLA）评估马哮喘（EA）的马属动物患者进行的回顾性、横断面、符合STROBE标准的观察性分析。根据美国兽医内科学会（ACVIM）共识声明指南，将马匹分为轻度至中度（mEA）或重度EA（sEA）。在排除记录不充分或仅就诊一次的马匹（n = 936）后，共有76匹马被纳入研究。在197次就诊中，138次（70.0%）诊断为mEA，45次（22.8%）诊断为sEA。记录了所有就诊的人口统计学信息、主人主诉、临床检查和评分、肺功能测试、BAL细胞学检查以及环境整治和药物治疗建议。对197次就诊记录的数据进行分析，以了解主人主诉（主诉评分，CS）与临床检查结果（检查评分，ES）之间的一致性、CS和ES随时间的变化、肺功能测试以及BAL细胞学检查情况。(3) 结果：CS与ES的比较表明，主人比兽医更有可能察觉到咳嗽，且咳嗽减轻是治疗后主人最常观察到的情况。在mEA马匹中，用于检测气道高反应性的组胺激发试验的反应在治疗后或随时间推移有显著改善，而mEA或sEA的基线肺功能没有显著变化。(4) 结论：主人可以敏锐地观察到EA的临床症状，尤其是咳嗽。与基线肺功能测试和BAL细胞学评估相比，气道高反应性测试在检测mEA的变化方面更成功。
