Equine Haler – Inhalation device
The Equine Haler is an inhalation device, which has been developed specifically for accurate
administration of pharmaceuticals to horses with inflammatory respiratory diseases includingchronic obstructive pulmonary disease (recurrent airway obstruction—RAO). The EquineHaler is a convenient method of administering all available types of metered dose inhalers(MDI) to horses. The MDI delivers the medicine at a suitable particle size (< 5 microns) fordirect distribution to the small airways. Equine Haler has been developed in Denmark andtested at the Centre for Equine Studies, Animal Health Trust, Newmarket, UK.
One treatment takes 1–2 minutes.
Recommended dosages for
aerosol use in horses
(Fluticasone propionate) inhalation aerosol 250 µg/actuation. CFC Free: 120 actuations
Recurrent airway obstruction (RAO): 7–8 actuations once or twice daily for a period of 2–3 weeks
When corticosteroids are administered it may be worth considering ending treatment over a few days with
an incrementally decreasing dose.
(Salmeterol) inhalation aerosol 25 µg/actuation. 120 actuations
Recurrent airway obstruction (RAO): 8 actuations once or twice daily for a period of 2–3 weeks
(Salbutamol) inhalation aerosol 100 µg/actuation. Free: 200 actuations
Recurrent airway obstruction (RAO): 5–10 actuations 2–3 times daily for a period of 2–3 weeks
Mast cell stabiliser
(Sodium Cromoglicate) inhalation aerosol 1 µg/actuation, 10 actuations once or twice daily
If necessary the treatment can be extended to one month or longer.
For further information see alternative product recommendations and dosage-recommendations in EQUINEVETERINARY EDUCATION (1999) 11 (3) 124–130, but please note that: the clenbuterol dose, which is said to bemilligrams, should be micrograms, and the beclomethasone dose 1320 mg/kg is in some cases better at lower doses.
Please check doping restrictions and minimum withdrawal period.
Jorgensen Labs, Inc.
1450 North Van Buren Ave.
Loveland, Colorado 80538
1-800-525-5614 • Fax: 970-663-5042
EVALUATION OF A NEW SPACER DEVICE FOR DELIVERY OF DRUGS INTO THE EQUINE RESPIRATORY TRACT
Funch-Nielsen, H., Roberts, C.A.1, Weekes, J.S.1, Deaton, C.M.1 and Marlin, D.J.1
Equine Healthcare APS, Denmark and 1Centre for Equine Studies, Animal Health Trust, Newmarket, UK.
Pulmonary inflammatory disorders occur commonly in the horse
PSD was determined with the MDI, actuator and spacer combined
In Vitro Studies
Systemic administration of corticosteroids may be associated withadverse sequelae
Particle size distribution (PSD) was determined on
The mean PSD of FP and radiolabel for 99mTc Labelled Fp were
• Unlabelled FP
found to be similar (Figure 2) indicating that the deposition of the
Delivery of drugs directly into the affected airways may improve local
• 99mTc Labelled FP - low activity
radiolabel within the lungs was likely to reflect that of FP.
drug concentrations as well as reducing systemic uptake
• 99mTc Labelled FP - high activity
Inhaled corticosteroids are widely used in the treatment of human
The activity and PSD of each MDI was determined prior to use
inflammatory lung conditions, including asthma and chronic
obstructive pulmonary disease
Prior to each use, the count rate per second (cps) per actuation of
the MDI was determined at a recorded time for subsequent decay
Equine recurrent airway obstruction (RAO) is characterised by a
correction to allow quantitative analysis of images
marked inflammatory response in the presence of aeroallergens,
Nebulisation of liquid corticosteroid preparations has been used, but
a number of spacer devices have been developed to allow
Figure 4. Distribution of 99mTc-labelled fluticasone propionate
administration to horses of metered dose inhalers (MDI) designed for
after administration of 3.5ug/kg bodyweight using the
Particle size cutoff (um)
Figure 2. Mean PSD for FP and 99mTechnetium as a % of totalmetered dose from 99mTc labelled FP.
To determine the efficiency of the Equine HalerTM for deliveringfluticasone propionate from a metered dose inhaler into the equine
To determine the pulmonary distribution of inhaled fluticasone
propionate administered with the Equine HalerTM
Figure 5. a) Distribution of 99mTc-labelled fluticasone propionate
after administration of 3.5ug/kg bodyweight using theEquine Haler within the lung of one horse and approximate lung
Figure 1. Equine HalerTM spacer for delivery of pharmaceuticals from
MATERIALS & METHODS
border as determined by subsequent 99mTc-MAA. b) Example of
metered dose inhalers to horses
lung image obtained during inhalation of 81mkrypton gas in a
horse with no history of respiratory disease.
Particle size cutoff (um)
6 healthy adult horses and 2 healthy adult ponies were studied. Allhorses were considered healthy based on TW & BAL cytology &
Figure 3. Particle size distribution (ug) of FP delivered from a
Images were obtained using a large field of view gamma camera
bacteriology, clinical examination, thoracic radiographs and V/Q
Flixotide Evohaler with and without a Volumatic spacer (data from
fitted with a low energy general purpose collimator
Cripps et al
2000) and PSD of FP from the Flixotide Evohalerused in conjunction with the Equine HalerTM.
Acquisition parameters: dynamic acquisition; 128 x 128 matrix; 60 x 2
The Equine Haler appears to achieve an acceptable and even
Horses were administered 3.5 ug/kg of fluticasone propionate
deposition of labelled FP within the equine lung.
labelled with 99mTechnetium from a new design of spacer
The mass of respirable particles (sum of deposition on stages 3 to 5
or 1.1 - 4.7 um) of FP delivered from the spacer was 96 ± 28 ug
Low delivery may be related to the angle at which the MDI is
(mean ± sd; range 72-127 ug). It was noted that the variation
actuated into the spacer.
Horses were sedated with romifidine 50 µg/kg bodyweight for
appeared to be related to the angle of the MDI when actuated. It was
Images were analysed using HERMES software (Nuclear
observed that when the MDI actuator port was not facing directly at
The Equine Haler was tolerated by all animals after a short
the second inspiratory valve that the delivery was low. When care
familiarisation prior to the study.
Sequential overlapping scintigraphic images were obtained of the
was taken to ensure the MDI actuator port was facing directly at the
right caudal lung, right cranial lung, cranial thorax, trachea, and head
All images were motion corrected. Inhalation and MAA perfusion
second inspiratory valve the delivery was always higher.
images were registered
Estimates of the lung border were obtained with 99mTechnetium-MAA
In Vivo Studies
Markers containing 99mTechnetium were placed within each image to
Cripps, A., Riebe, M., Schulze, M. and Woodhouse, R. (2000)
allow referencing between images
As expected, there was relatively high deposition of labelled FP
, 94 (Supplement B), S3-S9.
around the nostril and upper airways as far as the larynx (Figure 4).
The labelled FP appeared to be distributed throughout the lungaccording to the distribution of Krypton gas used for ventilation
A single batch of Flixotide Evohalers (250ug per actuation) were
studies. The labelled FP also appeared to reach the periphery of the
lung as judged from comparison with images of perfusion obtainedwith Tc-MAA (Figure 5).
Radiolabelling was performed as described by Newman et al
(1999)using a seven stage Anderson Cascade Impactor Mk and a flow rate
Mean lung deposition for all animals was 8.2 ± 5.2 % of the dose
administered (range 2.3 -18.6%).
PSD determined with MDI, actuator and spacer combined
Chazel et al. Ann Clin Microbiol Antimicrob (2016) 15:30 Annals of Clinical Microbiology and Antimicrobials Open Access Evaluation of the SLOMYCO Sensititre® panel for testing the antimicrobial susceptibility of Mycobacterium marinum isolatesMarion Chazel1, Hélène Marchandin1,2, Nicolas Keck3, Dominique Terru1, Christian Carrière1,5,6, Michael Ponsoda4, Véronique Jacomo4, Gilles Panteix4, Nicolas Bouzinbi1, Anne‑Laure Bañuls7, Marc Choisy7, Jérôme Solassol6,8,9, Alexandra Aubry10,11,12,13† and Sylvain Godreuil1,5,6*†
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