The work was done in the Equine Pulmonary Laboratory, Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, MI. This work was performed under contracts from Stirling Products, Perth, Australia.
Fluticasone Propionate Aerosol is More Effective for Prevention than Treatment of Recurrent Airway Obstruction
Article first published online: 11 SEP 2009
Copyright © 2009 by the American College of Veterinary Internal Medicine
Journal of Veterinary Internal Medicine
Volume 23, Issue 6, pages 1247–1253, November/December 2009
How to Cite
Robinson, N.E., Berney, C., Behan, A. and Derksen, F.J. (2009), Fluticasone Propionate Aerosol is More Effective for Prevention than Treatment of Recurrent Airway Obstruction. Journal of Veterinary Internal Medicine, 23: 1247–1253. doi: 10.1111/j.1939-1676.2009.0382.x
- Issue published online: 27 OCT 2009
- Article first published online: 11 SEP 2009
- Submitted April 14, 2009; Revised July 7, 2009; Accepted July 28, 2009.
Background: Efficacy of inhaled fluticasone propionate (FP) for management of recurrent airway obstruction (RAO) has only been evaluated after several weeks' treatment.
Objectives: To compare efficacy of (1) 3-day treatments with FP to dexamethasone (DEX) for management of RAO; and (2) FP and DEX to no treatment in prevention of acute RAO exacerbations.
Animals: Nine RAO affected horses.
Methods: Crossover studies in RAO-affected horses compared (a) 3-day treatment of RAO exacerbation with FP (3 and 6 mg q12h) and DEX (0.1 mg/kg q24h) and (b) FP (6 mg q12h) and DEX (0.1 mg/kg q24h) to no treatment for prevention of acute exacerbations of RAO. Treatment efficacy and unwanted effects were judged from maximal change in pleural pressure (ΔPplmax), serum cortisol (COR), bronchoalveolar lavage (BAL) cytology, and subjective scores for respiratory distress and lameness.
Results: In treatment trial, DEX and FP (6 mg) significantly decreased ΔPplmax by 48 and 72 hours, respectively; FP (3 mg) had no significant effect. DEX decreased COR more than did FP. In prevention trial, both DEX and FP (6 mg) prevented the increase in ΔPplmax that occurred in untreated horses. Both treatments decreased COR to the same degree. FP and DEX had no effects on bronchoalveolar lavage fluid (BALF) cytology and there was no evidence of laminitis.
Conclusions and Clinical Importance: FP (6 mg q12h) is as effective as DEX for prevention of acute exacerbations of RAO and lower doses should be evaluated. High-dose FP is not as effective as DEX for treatment of RAO exacerbations.