ISSN 2398-2977      

Lung: pneumonia - interstitial (foals)

pequis

Introduction

  • Interstitial pneumonia in foals is an uncommon condition that usually occurs secondary to a primary respiratory infection. It is also sometimes known as acute lung injury and can progress to acute respiratory distress syndrome (ADRS)
  • Cause: infectious most likely in foals, toxic, chemical and allergic causes also reported in adults.
  • Signs: respiratory distress.
  • Diagnosis: radiology and histology.
  • Treatment: oxygen therapy, DMSO, steroids, antimicrobials, NSAIDs.
  • Prognosis: guarded.

Pathogenesis

Etiology

Predisposing factors

General
  • Primary respiratory tract infection in foals.

Pathophysiology

  • Initiating insult, eg micro-organism   →    activation of leukocytes and pro-inflammatory transcription factors   →    amplification of inflammatory cycle   →    release of oxygen free radicals   →    interstitial edema and alveolar flooding with protein rich fluid   →    sudden onset respiratory distress.

Foals
Acute

  • Coagulative necrosis of alveolar septa, red blood cell diapedesis, fibrin microthrombi in alveolar capillaries and hyaline membrane formation.

Chronic

  • Adenomatoid epithelialization of the alveolar walls due to Type 2 pneumocyte proliferation.

Timecourse

  • Rapid (<48 h) onset of acute respiratory distress, although may have more prolonged (2-14 day) history of respiratory disease.

Epidemiology

  • Unclear - at present, only small number of case reports available.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Dunkel B, Dolente B & Boston R (2005) Acute lung injury/acute respiratory distress syndrome in 15 foals. Equine Vet J 37 (5), 435-440 PubMed.
  • Peek S F et al (2004) Acute respiratory distress syndrome and fatal interstitial pneumonia associated with equine influenza in a neonatal foal. J Vet Intern Med 18 (1), 132-134 PubMed.
  • Beurgelt C D (1995) Interstitial pneumonia in the horse - a fledgling morphologic entity with mysterious causes. Equine Vet J 27 (1), 4-5 (Excellent account of the pathogenesis and possible etiology of this condition) PubMed
  • Prescott J F et al (1991) Sporadic, severe bronchointerstitial pneumonia of foals. Can Vet J 32, 421 PubMed.
  • Winder C et al (1988) Interstitial pneumonia in the horse - two unusual cases .Equine Vet J 20 (4), 298-301 PubMed.
  • Ainsworth D M et al (1985) Recognition of Pneumocystis carinii in foals with respiratory distress. Equine Vet J 25, 103-108 PubMed.

Other sources of information

  • McKenzie H C (2010) Foal Pneumonia. In: Proc NAVC, Orlando, Florida, USA. pp 219-223.

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