Equine multinodular pulmonary fibrosis: Diagnosis and treatment

Wilkins, Pamela A.

doi:10.1111/eve.12044

Cited by 16 publications

(26 citation statements)

References 50 publications

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“…One horse in the study had consistent clinicopathological and diagnostic imaging findings and was qPCR positive for EHV‐5 testing of BALF but EMPF was not confirmed on lung biopsy specimen or on postmortem examination. Recent studies have displayed that detection of EHV‐5 in BALF is very strongly associated with EMPF . The detection of EHV‐5 in BALF combined with consistent diagnostic imaging findings warranted inclusion of this horse as a presumptive case of EMPF.…”

Section: Discussionmentioning

confidence: 84%

“…The exact pathogenesis and predisposing factors currently remain elusive; however, there is increasing evidence that equine herpesvirus‐5 (EHV‐5) is associated with EMPF. Equine herpesvirus‐5 has been detected from the lungs of the majority of EMPF cases described in the literature, suggesting an etiological link . Furthermore, pulmonary fibrosis has recently been experimentally induced with EHV‐5 isolated from the lungs of horses with EMPF and inoculated endoscopically into the accessory lung lobe of clinically normally horses.…”

Section: Introductionmentioning

confidence: 99%

“…Current treatment of EMPF cases is focused on attempting to control the ongoing pulmonary inflammation and prevent further fibrosis . Corticosteroids and nonsteroidal anti‐inflammatory drugs (NSAIDs) are frequently used to reduce pulmonary inflammation and control pyrexia.…”

Section: Introductionmentioning

confidence: 99%

“…Tetracycline antimicrobial drugs, including minocycline and doxycycline, can attenuate the activity of metalloproteinases and are beneficial in murine models of pulmonary disease . Tetracycline antimicrobial drugs are often employed for their antifibrotic and anticollagenase effects . Use of the antiviral prodrug valacyclovir has been described in 1 horse with EMPF that was reported to be clinically healthy 2 years after treatment .…”

Section: Introductionmentioning

confidence: 99%

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Effect of valacyclovir on EHV‐5 viral kinetics in horses with equine multinodular pulmonary fibrosis

Easton-Jones

Madigan

Barnum

et al. 2018

Veterinary Internal Medicne

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BackgroundEquine herpesvirus‐5 is commonly isolated from the lungs of horses with EMPF, suggesting an etiological link. Valacyclovir is used empirically to treat EMPF; however, no data is available concerning its impact on EHV‐5 viral kinetics.ObjectivesTo determine the effect of oral administration of valacyclovir on EHV‐5 viral load measured by qPCR in blood, nasal secretions (NS) and BALF in horses with EMPF.AnimalsSix horses diagnosed with EMPF.MethodsA prospective clinical trial was performed. Horses received 10 days of PO administered valacyclovir (loading dose 30 mg/kg, maintenance dose 20 mg/kg). Blood, NS, and BALF were collected for EHV‐5 viral kinetics analyses during treatment. Blood and NS were collected every other day. BALF was collected on day 0 and day 10.ResultsThere was no statistical difference in median EHV‐5 viral load between day 0 and day 10 for all samples tested. In blood median EHV‐5 viral load was 7676 (range 575‐39 781) on day 0 and 6822 (range 1136‐18 635) glycoprotein B (gB) gene copies per million cells on day 10. For NS median EHV‐5 viral load was 2.944 × 106 (range 184 691‐3.394 × 109) on day 0 and 8.803 × 106 (range 251 186‐9.868 × 108) gB gene copies per million cells on day 10. For BALF median EHV‐5 viral load was 59,842 (range 61‐315 655) on day 0 and 185 083 (range 3562‐542 417) gB gene copies per million cells on day 10.Conclusions and Clinical ImportanceValacyclovir might not be an effective short‐term antiviral treatment but efficacy in treatment of EMPF is unknown.

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Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of valacyclovir on EHV‐5 viral kinetics in horses with equine multinodular pulmonary fibrosis

Easton-Jones

Madigan

Barnum

et al. 2018

Veterinary Internal Medicne

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“…This may have skewed the prognosis, especially given the small number of recent reports of successful treatment of EMPF with acyclovir and prednisolone . A recent review summarises treatment options …”

Section: Discussionmentioning

confidence: 99%

Diagnostic challenge: mare with clinical history of chronic respiratory disease

et al. 2014

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Section 1Clinical history and physical examination A 430-kg 15-year-old Australian Stockhorse mare was referred to the Veterinary Clinical Centre (VCC), Charles Sturt University, for investigation of a 6-week history of clinical signs of respiratory disease and weight loss and no response to administration of systemic antimicrobials. Clinical signs included coughing on exertion and increased rate and effort of respiration. Clinicopathological abnormalities detected by the referring veterinarian included anaemia and hyperfibrinogenaemia.On presentation to the VCC, the mare was lethargic and had a rectal temperature of 39.8°C. Wheezes and crackles were audible over the left and right hemithoraces. The mare was tachypnoeic with increased respiratory effort, especially during inspiration. Distal limbs were oedematous, and the mare was moderately thin (body condition score 4/9). Ancillary testsA complete blood count and blood biochemistry revealed a mild to moderate anaemia (packed cell volume (PCV) 0.20L/L, reference range 0.32-0.52 L/L), a mild left shift with normal neutrophil number (segmented neutrophils 4.8 × 10 9 /L, band neutrophils 0.3 × 10 9 /L, reference range 2.5-8.0 × 10 9 /L and 0.0-0.2 × 10 9 /L respectively), a moderate to marked hyperfibrinogenaemia (10 g/L, reference range 0-4 g/L) and a mild hypoalbuminaemia (24 g/L, reference range 28-38 g/L). A transendoscopic tracheal wash (TW) was performed and cytological examination of the obtained sample showed 85% neutrophils (reference range <20%) and small to moderate numbers of Curschmann's spirals. Arterial blood gas analysis revealed a partial pressure of oxygen of 71 mmHg (normal >98 mmHg) and oxygen saturation of 94% (normal >95%).

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Equine Lower Respiratory System

Nykamp¹

2018

Textbook of Veterinary Diagnostic Radiology

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Equine multinodular pulmonary fibrosis: Diagnosis and treatment

Cited by 16 publications

References 50 publications

Effect of valacyclovir on EHV‐5 viral kinetics in horses with equine multinodular pulmonary fibrosis

Effect of valacyclovir on EHV‐5 viral kinetics in horses with equine multinodular pulmonary fibrosis

Diagnostic challenge: mare with clinical history of chronic respiratory disease

Equine Lower Respiratory System

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