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BACKGROUND Electrical impedance tomography (EIT) generates thoracic impedance images of the lungs and has been used to assess ventilation in horses. This technique may have application in the detection of changes in airflow associated with equine asthma. OBJECTIVES The objective was to determine if histamine-induced airflow changes observed with flowmetric plethysmography (Δflow) could also be explained using global and regional respiratory gas flow signals calculated from EIT signals. STUDY DESIGN Experimental in vivo study. METHODS Six horses, sedated using detomidine were fitted with a thoracic EIT belt and flowmetric plethysmography hardware. Saline (baseline = BL) and increasing concentrations of histamine (C1-4) were nebulised into the face mask until a change in breathing pattern was clinically confirmed and Δflow increased greater or equal to 50%. After nebulisation Δflow and EIT images were recorded over 3 minutes and peak global inspiratory (InFglobal ) and expiratory (ExFglobal ) flow as well as peak regional expiratory and inspiratory flow for the dorsal and the ventral area of the right and left lungs were evaluated. Delta flow, InFglobal and ExFglobal at subsequent concentrations were indexed to baseline (yi = Ci /BL-1). Indexed and nonindexed variables were evaluated for a difference from baseline at sequential histamine doses (time). Multiple linear regression assessment of variance in delta flow was also investigated. RESULTS Consistent with histamine-provoked increases in Δflow, the global flow indices increased significantly. A significant increase in regional inspiratory flow was seen in the right and left ventral lung and dorsal right lung. Multiple regression revealed that the variance in ExFglobal , and right and left ventral expiratory flow best explained the variance in Δflow (r2 = .82). MAIN LIMITATIONS Low number of horses and horses were healthy. CONCLUSIONS Standardised changes in airflow during histamine challenge could be detected using EIT gas flow variables.

Background: Electrical impedance tomography (EIT) is a method to measure regional impedance changes within the thorax. The total tidal impedance variation has been used to measure changes in tidal volumes in pigs, dogs and men. Objectives: To assess the ability of EIT to quantify changes in tidal volume in anaesthetised mechanically ventilated horses. Study design: In vivo experimental study. Methods: Six horses (mean ± s.d.: age 11.5 ± 7.5 years and body weight 491 ± 40 kg) were anaesthetised using isoflurane in oxygen. The lungs were mechanically ventilated using a volume-controlled mode. With an end-tidal carbon dioxide tension in the physiological range, and a set tidal volume (VTvent) of 11–16 mL/kg (baseline volume), EIT data and VT measured by conventional spirometry were collected over 1 min. Thereafter, VTvent was changed in 1 L steps until reaching 10 L. After, VTvent was reduced to 1 L below the baseline volume and then further reduced in 1 L steps until 4 L. On each VT step data were recorded for 1 min after allowing 1 min of stabilisation. Impedance changes within the predefined two lung regions of interest (EITROI) and the whole image (EITthorax) were calculated. Linear regression analysis was used to assess the relationship between spirometry data and EITROI and EITthorax for individual horses and pooled data. Results: Both EITROI and EITthorax significantly predicted spirometry data for individual horses with R2 ranging from 0.937 to 0.999 and from 0.954 to 0.997 respectively. This was similar for pooled data from all six horses with EITROI (R2 = 0.799; P

SummaryReasons for performing study Hypoxaemia is a common problem during equine anaesthesia. Continuous positive airway pressure (CPAP) is a ventilation mode routinely employed in man to overcome hypoxaemia but has not been objectively assessed in horses. Objectives To test the effects of CPAP on oxygenation and its indices in anaesthetised horses in a clinical setting. Methods Twenty-four healthy horses requiring anaesthesia in dorsal recumbency were anaesthetised using a standard protocol. Following orotracheal intubation and connection to an anaesthetic machine capable of applying CPAP, horses were randomly allocated to ventilate at physiological airway pressure measured at the airway opening (Group PAP) or to receive CPAP of 8 cmH2O (Group CPAP). Arterial blood gas analysis was performed as soon as arterial cannulation was achieved and 30, 60 and 90 min after induction. If PaCO2 increased above 9.31 kPa controlled ventilation was initiated. Groups were compared using a general linear model. Results Horses receiving CPAP had significantly higher PaO2 and calculated oxygen indices than horses receiving PAP. No significant differences in ventilation indices were observed between the 2 groups. Eight horses receiving PAP and 5 receiving CPAP required controlled ventilation. No differences in dobutamine requirements or mean arterial pressures were recorded. Conclusions Continuous positive airway pressure of 8 cmH2O improved oxygenation indices in dorsally recumbent horses without significantly influencing ventilation. Potential relevance Continuous positive airway pressure reduces the incidence of hypoxaemia in anaesthetised horses. Further research is warranted to elucidate the effects of CPAP on the cardiovascular system.

Summary Reasons for performing study: Anaesthesia of the maxillary nerve of the horse has been described using several approaches, but sparse data exist to evaluate the accuracy of these methods. Objectives: This study compared 2 previously described approaches to the maxillary nerve to assess their relative accuracies. Methods: Thirty severed heads from horse cadavers were arranged to approximate the position of a live horse. Methylene blue (0.25 or 0.1 ml) was injected using a 19 gauge 90 mm spinal needle by one of 2 approaches, the method used being randomly allocated in each instance. Method ANG: angulated needle insertion on the ventral border of the zygomatic process of the temporal bone and directed rostromedially. Method PER: needle inserted perpendicular to the skin surface, ventral to the zygomatic process of the malar bone, level with the temporal canthus of the eye. Accuracy of dye deposition was assessed following dissection. Placement was categorised as ‘full hit’ (complete nerve coverage or dye deposition centred on nerve), ‘partial hit’ (partial nerve discolouration but dye not centred on nerve) or ‘miss’ (no nerve discolouration). Deposition of dye relative to the nerve and whether injection was performed on the left or right side of the head was recorded. A Chi-squared test was performed to examine the relationship between the 2 methods. Results: Method ANG was performed 31 times, Method PER 28 times. Full hits were 10/31 (32%) vs. 9/28 (32%), partial hits 15/31 (49%) vs. 14/28 (50%) and misses 6/31 (19%) vs. 5/28 (18%) (Methods ANG vs. PER, respectively). Results were not statistically significantly different between the methods. Dye was deposited in the deep facial vein once by each method. Bone was contacted consistently with Method PER and 8/31 times with Method ANG. Conclusion and clinical relevance: Both methods appeared equivalent in terms of accuracy. Aspiration should always precede injection.

Reasons for performing study: The intestinal microbiota is important for health and disease. Factors that disturb the equine intestinal microbiota need further investigation. Objectives: To determine the effects of transport, fasting and anaesthesia on the faecal microbiota of healthy adult horses using next-generation sequencing. Study design: Experimental trial. Methods: Faecal samples were taken from 8 horses at baseline, after transport, 12 h of fasting and 24, 48 and 72 h after a 6 h anaesthesia. Next generation sequencing of the V4 region of the 16S rRNA gene was used to assess the microbial composition of faeces. Alpha diversity, phylogenetic structures and beta diversity were assessed. Results: There were significant changes in the relative abundances of phyla, classes, orders and families after transport, fasting and anaesthesia. Most notably horses had a significantly lower abundance of Clostridiales after transport compared with baseline (P = 0.03) and a decreased abundance of Rickettsiales after fasting (P = 0.024). Alpha diversity was not significantly different between time points (all P>0.21). When parsimony analysis was applied, anaesthesia had a significant effect on community membership and structure (Jaccard index and Yue and Clayton index both P = 0.02). Conclusions: There was some effect of transport, fasting and anaesthesia on the composition and structure of the microbiota of healthy horses. This indicates these are potentially stress factors for the equine intestinal microbiota. Further investigation is required to look at the potential impact of changes in the microbiota on the development of disease in the post anaesthetic period.