This is a long shot, but...My horse was just diagnosed with Interstitial Lung Disease, fibrosis/scar tissue in the lung. It's rare, I have found explanations on the web of what it is, but all say they don't know how a horse gets it, what causes the inflammation, how it will progress or how to cure it. Wonderful. The internal specialists at the equine hospital say there simply is not enough known about this for them to give me a prognosis, next step is a lung biopsy. I find only a few actual case histories on the web, none of which indicates the outcome for the horses. I'm wondering if anyone has heard of or had any experience with this? Thanks for any info.
Interstitial Lung Disease (ILD) is a general term that includes a variety of chronic lung disorders. When a person has ILD, the lung is affected in three ways. First, the lung tissue is damaged in some known or unknown way. Second, the walls of the air sacs in the lung become inflamed. Finally, scarring (or fibrosis) begins in the interstitium (or tissue between the air sacs), and the lung becomes stiff.
Breathlessness during exercise can be one of the first symptoms of these diseases. A dry cough also may be present. These are common symptoms that many people ignore. Someone with these symptoms may wait until they feel quite ill before going to the doctor.
People with different types of ILD may have the same kind of symptoms but their symptoms may vary in severity. Their chest X-rays may look alike. Further testing is usually recommended to identify the specific type of ILD a person has. Some ILDs have known causes and some (idiopathic) have unknown causes.
WHY IS IT CALLED INTERSTITIAL LUNG DISEASE?
The tissue between the air sacs of the lungs is called the interstitium. Interstitial lung disease is named after this tissue because this is the tissue affected by fibrosis (scarring). Interstitial lung disease is sometimes also known as "interstitial pulmonary fibrosis." The terms interstitial lung disease, pulmonary fibrosis and interstitial pulmonary fibrosis are often used to describe the same condition.
INTERSTITIAL LUNG DISEASES ARE PUZZLING
The course of these diseases is unpredictable. If they progress, the lung tissue thickens and becomes stiff. The work of breathing then becomes more difficult and demanding. Some of the diseases improve with medication if treated when inflammation occurs. Some people may need oxygen therapy as part of their treatment.
The diseases may run a gradual course or a rapid course. People with ILD may notice variations in symptoms -- from very mild to moderate to very severe. Their condition may remain the same for long periods of time or it may change quickly. It's important to stay in touch with your doctor and report any changes in symptoms. You and your doctor can work together to manage ILD.
COMMON LINK IN INTERSTITIAL LUNG DISEASE
While the progress and symptoms of these diseases may vary from person to person, there is one common link between the many forms of ILD. They all begin with an inflammation. The inflammation may affect different parts of the lung, as explained below:
1. The walls of the bronchioles (small airways). When inflammation involves the bronchioles, it is called bronchiolitis.
The diagram below shows the changes that happen in lung tissue with interstitial lung disease.
2. The walls and air spaces of the alveoli (air sacs). When inflammation involves the alveoli, it is called alveolitis.
3. The small blood vessels (capillaries) of the lungs. When inflammation involves the small blood vessels, it is called vasculitis.
Inflammation of these parts of the lung may heal or may lead to permanent scarring of the lung tissue. When scarring of the lung tissue takes place, the condition is called pulmonary fibrosis.
Fibrosis, or scarring of the lung tissue, results in permanent loss of that tissue's ability to transport oxygen. The level of disability that a person experiences depends on the amount of scarring of the tissue. This is because the air sacs, as well as the lung tissue between and surrounding the air sacs, and the lung capillaries, are destroyed by the formation of scar tissue. If this happens, your doctor may prescribe oxygen to help you breathe easier.
KNOWN CAUSES OF PULMONARY FIBROSIS
Several causes of pulmonary fibrosis are known. They include:
1. Occupational and environmental exposures. Many jobs - particularly those that involve mining or that expose workers to asbestos or metal dusts -- can cause pulmonary fibrosis. Workers doing these kinds of jobs may inhale small particles (like silica dusts or asbestos fibers) that can damage the lungs, especially the small airways and air sacs, and cause scarring (fibrosis).
Agricultural workers also can be affected. Some organic substances, such as moldy hay, cause an allergic reaction in the lung. This reaction is called Farmer's Lung and can cause pulmonary fibrosis. Other fumes found on farms are directly toxic to the lungs.
2. Sarcoidosis. A disease characterized by the formation of granulomas (areas of inflammatory cells), which can attack any area of the body but most frequently affects the lungs.
3. Drugs. Certain medicines may have the undersirable side effect of causing pulmonary fibrosis. Check with your doctor about the medicines you are taking and ask about any possible side effects.
4. Radiation. (treatment for breast cancer)
4. Connective tissue or collagen diseases such as rheumatoid arthritis and systemic sclerosis.
5. Genetic/familial. This is not as common as the other causes listed.
IDIOPATHIC PULMONARY FIBROSIS (IPF)
When all known causes of interstitial lung disease have been ruled out, the condition is called "idiopathic" (of unknown origin) pulmonary fibrosis (IPF).
There are several theories as to what may cause IPF; including viral illness and allergic or environmental exposure (including tobacco smoke). These theories are still being researched. Bacteria and other microorganisms are not thought to be the cause of IPF.
There is also a familial form of the disease, known as familial idiopathic pulmonary fibrosis. Additional research is being done to determine whether there is a genetic tendency to develop the disease, as well as to determine other causes of IPF.
WHAT ARE THE SYMPTOMS OF IPF?
Shortness of breath is the main symptom of idiopathic pulmonary fibrosis. Since this is a symptom of many types of lung disease, making the correct diagnosis may be difficult. The shortness of breath may first appear during exercise. The condition then may progress to the point where any exertion is impossible. If the disease progresses, the person with IPF eventually may be short of breath even at rest.
Other symptoms may include a dry cough (without sputum). When the disease is severe and prolonged, heart failure with swelling of the legs may occur.
HOW IS IPF DIAGNOSED?
A very careful patient history is an important tool for diagnosis. The history will include environmental and occupational factors, hobbies, legal and illegal drug use, arthritis, and risk factors for diseases that affect the immune system. A physical examination, chest X-ray, pulmonary function tests, and blood tests are important. These tests will help your doctor rule out other lung diseases and determine the extent of disease.
Bronchoalveolar lavage (BAL) -- a test which permits removal and examination of cells from the lower respiratory tract -- may be used to diagnose IPF: this test helps a doctor identify inflammation in lung tissue, and also helps exclude infections and malignancies (cancer) as a cause of a patient's symptoms. The test is done during bronchoscopy, a special examination of the lung.
Lung biopsy --Either done during bronchoscopy or as a surgical procedure that removes a sample of lung tissue for your doctor to study -- this proceedure is usually required for for diagnosis of IPF.
Diagnostic Tests That May Be Used to Identify Pulmonary Fibrosis or Interstitial Lung Disease
1. Blood Tests
2. Pulmonary Function Tests
3. Chest X-ray
4. CT Scan
5. Bronchoscopy
6. Bronchoalveolar Lavage
7. Lung Biopsy
8. CT Scan
WHAT IS THE TREATMENT FOR IPF?
Corticosteroids may be administered to treat the inflammation present in some people with IPF. The success of this treatment for many forms of pulmonary fibrosis is variable and is still being researched. Other drugs are occasionally added when it is clear that the steroids are not effective in reversing the disease.
Some doctors may use corticosteroids in combination with other drugs when the diagnosis is first established. Which drug treatment plan is effective, and how long to use the drugs is the focus of current research.
Oxygen therapy may be prescribed for some people with IPF. The need for oxygen will be determined by your doctor and may depend on the severity of disease, as well as your activity level. Talk with you doctor if you think you may need oxygen or if you have concerns about oxygen.
Influenza vaccine and pneumococcal pneumonia vaccine are both recommended for people with IPF or any lung disease. These two shots may help prevent infection and keep you healthy.
Lung transplantation may offer hope for selected people with severe IPF and other lung diseases. Speak with your doctor about eligibility criteria for lung transplant recipients.
Rehabilitation and education programs may help some people with IPF. Local support groups have been of benefit for people with IPF and their family members and friends.
Posted 2007-01-05 4:03 AM (#53317 - in reply to #53271) Subject: RE: Rare lung disorder anyone?
Location: Del Mar, CA
Thanks very much for the article, it explains the progression better than the articles I’ve been finding. As for the symptoms? My energetic horse got pokey. I thought he tweaked his back so I hand walked him all last Winter, had chiro/ massage therapy, vet check his throat for his spitting up pieces of carrot, had the dentist. He improved in the Spring, started very easy riding, but he slowed down again, this time would stop and pant on little hills, so vet did blood work showing high infection. Antibiotics make him better but then he gets bad again. Finally did xrays, cultures, scoped his throat. I wish we had done a blood test a year ago, but he never seemed sick, just lazy. It was vague enough that my friends thought I was imagining it, they said he was bored, needed spurs, needed hotter food, why was I complaining that he was quieter, etc. But I knew that a horse that eagerly walked fast for 4 to 5 hours a day when camping in the mountains did not suddenly get slow for no reason, some days he’d be a little brighter, some days more tired. I have racked my brain trying to come up with how or where he could have gotten something that all the horses around him didn't get, and it’s frustrating to have no idea at all what to expect. Thanks again for your input, I appreciate it.
Posted 2007-01-07 5:07 AM (#53435 - in reply to #53270) Subject: RE: Rare lung disorder anyone?
Extreme Veteran
Posts: 378 Location: Nebraska
Interstitial pneumonias are one of three classification of pneumonias, with four broad groups: respiratory distress (fog fever), hypersensitivity (heaves), parasites, and chronic. Depending on how much lung has been consolidated will determine the outcome. Inflamation is part of the body's immune system, so is the fluid building in the lungs, with no treatment an animal can drown in it's own body fluids. Besides antibiotics and NSAID's they may use lasix, or some other diuretic. I don't know what signs your horse has now but you may hear crackles, see dyspnea or he may have tachycardia. Just wondering do you vacinate for rhino or influenza. Good luck and I hope things work out for you
Posted 2007-01-07 1:03 PM (#53454 - in reply to #53270) Subject: RE: Rare lung disorder anyone?
Location: KY
Appyrider: So sorry about your horse. I have a horse with heaves who cannot take oral steriods because of her propensity to founder, so got her the equine AeroMask which she uses (well I have to put it on her) with albuterol and flovent inhalers (the kind for people with asthma, need prescript from vet). The inhalation of the medicines made a huge difference in her ability to breathe and her comfort level. Hope this helps.
Posted 2007-01-08 3:21 AM (#53494 - in reply to #53270) Subject: RE: Rare lung disorder anyone?
Location: Del Mar, CA
Thanks for your input! Vaccs - For the 2-1/2 years I've had him: Flu-Rhino every 4 mths, Enceph-Tet, Strep yrly, West Nile every 6 mths, ivermectin twice, then strongid once, rotation. I'd wondered if he'd maybe always had this, but vet said he could not have had this disease 18 mths ago camping doing 4 hr rides daily in mountains, walking fast, never tired. She said the xrays didn't show fluid, just "severe interstitial pattern over entire lung," but said a biopsy will tell for sure. My horse never had a runny nose or a real cough, just got slow, when ridden he'd drop his head, few coughs - spit up pieces of carrot, in May he worsened, he'd stop and pant, cough a few times. Blood tests were weird (WBC 17k, neut./eosinophils, fibrinogen very high), did Tucoprim 10 wks, later SMZ's, improved with each for awhile. His only symptom now is that he wears out, "exercise intolerant." In roundpen he'll canter and buck a few times around, but then he's done, I make him walk and jog 10 min to maintain some strength, he doesn't cough, but he's gradually needing more effort on my part to make him keep jogging on lunge line. His personality is still bright, hasn't gotten lethargic like he was before. I'll read up on the types of pneumonia mentioned, it does help to know what to learn so as to better discuss things with the vets. Thanks again.
Posted 2007-01-08 1:41 PM (#53522 - in reply to #53270) Subject: RE: Rare lung disorder anyone?
Veteran
Posts: 247 Location: NW
I am so sorry to hear about your horse. I don't know if you've heard about the company called Total Health. Their website is http://www.totalhealthenhance.com/equinehealth.htm You might try calling them & see what they recommend. There have been alot of miracluous (sp?) recoveries for a wide range of ailments from their products. It's 100% money back guarantee, so what do you have to lose??
Posted 2007-01-09 12:23 AM (#53573 - in reply to #53270) Subject: RE: Rare lung disorder anyone?
Extreme Veteran
Posts: 378 Location: Nebraska
Interstitial is more common in cattle than horses because their lungs are 1/3 the size of a horse and managed in a way that puts them more at risk. but interstitial does not care what the species is. eosino/ neutrophils are part of inflammation. To explain their presents (these are the bacis) Neutrophils- high indicates bacterial infections, stress, and steroids. Low indicates-viral infections, toxins, and certain drugs. Eosinophils- high indicates hypersensitivty, parasites, tissue injury, estrus and pregnancy. Low is caused by antiinflammatory drugs. Fibrinogen is protein use by the body for repairs. It is a shame the lungs is one of the organs that don't regenerate themselves.
Posted 2007-01-11 3:43 AM (#53689 - in reply to #53270) Subject: RE: Rare lung disorder anyone?
Location: Del Mar, CA
Studying the blood work explains what the vets were thinking, and some of the symptoms, lot to learn there. Hypersensitivity...as in histamine reactions like horrendous fly allergies? His full brother was a breeding stallion who also had serious fly allergies, maybe I can find out if any of his “siblings” had similar problems. One thing I read was that this illness seems to take hold in horses who already have something going on in them, and that makes sense as my little guy has always been a hard keeper. I’m guessing the cattle don’t live long enough to see the end of the disease? interesting though, my horse was bred and trained for sorting at a stable with a small herd of cows. Thanks AbbyB for Total Health web site, will be interesting to see what nitric oxide’s about. Thanks again for info and things for me to check into. :)
Rare lung disorder anyone?
