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Thursday, July 11

7-8:00 a.m. Breakfast

Lectures

8 – 8:25 a.m. Diagnosis and Management of Equine Inflammatory Airway Disease (IAD) - Laurent Couëtil

Review the current definition of IAD/mild equine asthma, to discuss the challenges of diagnosing mild equine asthma (IAD) and acquire the latest information regarding environmental management and medical therapy of the disease. Emphasis will be placed on field diagnostic tests and their interpretation as well as practical implementation of control measures and their effects on lung health. 
 
8:25 – 8:50 a.m. Diagnosis and Treatment of Equine Recurrent Airway Obstruction (RAO) - Laurent Couëtil

Review the current definition of RAO/severe equine asthma, to compare diagnostic tests applicable in the field and to presentacquire the latest information regarding environmental management and medical therapy. The pros and cons of systemic and aerosol therapy will be discussed as well as prognosis.
 
9 – 9:25 a.m. How to Use Inhalant Therapy for Management of Equine Respiratory Disorders - Laurent Couëtil

Gain an understanding of principles and indications for aerosol therapy in horses., We will including a review of the different aerosol delivery devices available and their performance. Aerosolization of antimicrobials will be discussed focusing on factors affecting drug deposition in the lung and pharmacokinetic data available in horses.
 
9:25 – 9:50 a.m.  BREAK
 
9:50 - 10:40 a.m. Sedation and Local Anesthesia for Standing Equine URT Procedures - Brad Simon and Cleet Griffin
 
10:40 – 11:30 a.m. Diagnosis and Management of Bronchopneumonia and Pleuropneumonia - Keith Chaffin

Learn the clinical signs, diagnostic evaluation, and treatment associated with bacterial lung infections.  Topics will include tracheal aspiration, thoracocentesis, pleural fluid evaluation, pleural drainage, pleural lavage, antimicrobial therapy, and supportive care. Prognostic assessment will be discussed as well as complications.  Surgical management of partially refractory cases will be described. 
 
11:30 – 11:55 a.m. Update on Exercise-Induced Pulmonary Hemorrhage (EIPH) – Laurent Couëtil

Gather the latest information regarding pathophysiology and management of EIPH. We will rReview risk factors for EIPH and how to manage it using diagnostic tools available to practitioners in the field.

12:00 – 1:00 p.m.   LUNCH

Labs

1 – 5:30 p.m. Attendees will break out into groups of 7 – 8 and rotate through each one-hour station.
 
  Station 1:    Use of Inhalant Therapy in Horses:  Metered Dose Inhalants, Nebulizers, Other - Laurent Couëtil

The objective of this wet lab is to discuss and demonstrate the different aerosol delivery methods and materials available in equine medicine. This will include metered-dose inhalers and associated delivery devices (AeroHippus™, Equine Haler) as well as nebulizers (jet nebulizers and ultrasonic nebulizers). We will discuss indication for aerosol therapy and the pros and cons of each approach. We will demonstrate proper delivery of aerosolized medications and care of the equipment.
 
  Station 2:    Diagnostic Airway Samples – Preparation/Submission to Laboratory, and Cytologic Examination – Karen Russell

During this wet lab session, the handling and processing of tracheal wash (TW) and bronchoalveolar lavage (BAL) samples in the laboratory will be discussed. The remainder of the time will be spent evaluating various TW and BAL samples from cases at a multi-headed microscope.
 
3 – 3:30 p.m. BREAK
 
  Station 3:    How to Acquire and Interpret Equine Thoracic Radiographs - Lindsey Gilmour and Betsy McCauley

Participants will split their time during this lab session between (1) practical positioning and selection of radiographic technique for thoracic radiographs and (2) guided interpretation of thoracic radiographs in a selection of clinical cases. Though not required, attendees may bring a tablet or laptop for radiographic interpretation. Activities will focus on systematic acquisition and principles of interpretation.
 
  Station 4:    Equine Head Nerve Blocks - Cleet Griffin and Luc Vallone

Goals of this lab are to perform various nerve blocks associated with standing airway, dental, and ophthalmologic procedures in horses. The lab will involve cadaveric heads and instructors with expertise in this area. The nerve blocks will be performed by the attendees under the guidance of individuals who perform these blocks on a regular basis.
 

Friday, July 12

7-8:00 a.m. Breakfast

Lectures

8 – 8:50 a.m. Resting Endoscopy of the Head and Sinuses – Canaan Whitfield

Review relevant anatomy and equipment for performing resting endoscopy of the head and sinuses of the standing horse. beforeThe major goals of this talk are to discussing techniques and clinical application of upper airway endoscopy and sinoscopy focusing on aspects that are pertinent to the equine general practitioner. Specific areas discussed will be nasal, laryngeal and pharyngeal anatomy (both normal and abnormal);, entering the guttural pouch and retrieving chondroids;, and endoscopic biopsy of the upper airway.; In addition, we will discussand techniques for performing endoscopic evaluation and treatment of the equine paranasal sinuses. 
 
8:50 – 9:15 a.m. Sonographic Evaluation of the Equine Lungs and Pleural Cavity – Cris Nava

Acquire tools to increase the yield of your thoracic sonograms. Clinicians interested in acquiring basic skills will learn (and practice during the supporting hands-on lab) the technique, normal appearance and sonographic abnormalities of  common pathologies such as pneumonia, pleuritis, fractured ribs or pneumothorax. Clinicians with a solid sonographic base will learn more advanced skills such as the evaluation of the cranial mediastinum, sternum and how to perform rapid assessment of the heart and pulmonary artery to identify pulmonary hypertension or differentiate respiratory from cardiac disease as a cause of tachypnea and tachycardia. 

Attendees will learn how to image the thorax of the horse and to identify relevant structures like lung, diaphragm, cranial mediastinal areas and ribs. Cardiac imaging for the non-cardiologist will be introduced as in pertains to the respiratory system to cardiovascular system interaction.
 
9:15 – 9:30 a.m. BREAK
 
9:30 – 10:20 a.m. Upper Respiratory Surgeries – Joanne Hardy
 

Labs

10:30 – 5:00 p.m. Attendees will break out into groups of 6 and rotate through each one-hour station.
 
  Station 1: How to Perform Thoracocentesis, Place Indwelling Chest Tubes and Perform Pleural Drainage and Lavage - 
                    Keith Chaffin and Kristin Chaney

This wet lab will utilize full-body equine  cadavers.  Goals are for attendees to place and secure indwelling chest tubes.  Also, they will learn to perform intermittent and continuous pleural drainage and pleural lavage of the pleural cavities.  Indications for pleural drainage and pleural lavage will be discussed as well as potential complications.
 
  Station 2: Percutaneous Tracheobronchial Aspiration – Michelle Coleman

This wet lab will utilize full-body equine cadavers.  Attendees will have the opportunity to perform percutaneous tracheal aspiration using a commercially available tracheal aspirate kit.  This technique is important to collect tracheal secretions for cytologic and microbiologic examinations.
 
12:30-2:00 p.m. LUNCH
 
  Station 3: Resting Endoscopy of the Upper Airway and Sinoscopy – Canaan Whitfield

Goals of this wet lab are to refresh the attendees’ knowledge of upper airway anatomy of horses, to teach the attendee how to perform sinoscopy including sinus anatomy, and how to enter the guttural pouch endoscopically and deploy retrieval instruments to remove chondroids from the guttural pouches. The lab will consist of cadaveric specimens (heads) and a full-body cadaver placed in standing position. In addition, there will be videos and slide shows of endoscopic images and procedures to link this lab with clinical aspects of these skills. Collectively, these skills are an important component of equine upper respiratory evaluation of horses. 
 
  Station 4: Equine Upper Respiratory Tract Surgeries (Tracheostomy, Sinus Trephination, Enucleation) – Joanne Hardy

Goals of this lab are to teach the attendee how to perform these surgeries proficiently and safely. This lab will consist of cadaveric equine heads, necks, and whole body specimens along with all appropriate surgical instrumentation. Attendees will be able to perform these procedures with help and guidance from equine surgeons. These surgical procedures are frequently needed as part of the treatment of equine respiratory conditions.  
 
  Station 5: Sonographic Examination of the Equine Thorax – Cris Navas and Susan Eades  

During this wet lab, attendees will learn how to perform a thorough sonographic examination of the right and left lung surfaces and pleural spaces.  This lab will utilize state-of-the-art sonographic equipment and examinations will be performed on normal adult horses. Specifically, attendees will learn how to image the thorax of the horse and identify relevant structures like lung, diaphragm, cranial mediastinal areas and ribs. Cardiac imaging for the non-cardiologist will be introduced as it pertains to the respiratory system to cardiovascular system interaction.
 


Saturday, July 13

7-8:00 a.m.  Breakfast

Lectures

8 – 8:50 a.m.  Poor Performance in the Equine Athlete: Pharyngeal and Laryngeal Disorders - Travis Tull

Explore disorders of the pharynx and larynx that affect performance, and discuss abnormalities seen on resting endoscopy, discuss and when to recommend dynamic (overground) endoscopy. Dynamic causes of poor performance will also be covered.
 
9 – 9:50 a.m. Radiographic and Ultrasonographic Examination of the Equine Head and Larynx - Cris Navas and Lindsey Gilmour 

Learn how to acquire and interpret radiographs of the equine head and ultrasonography of the equine pharynx and larynx. The normal appearance and the most common abnormalities: sinusitis, sinus masses, dental diseases, laryngeal neuropathy, laryngeal dysplasia and chondritis will be described.
 
9:50 – 10:20 a.m.  BREAK
 
10:20 – 11:10 a.m. Diagnosis, Treatment and Prevention of Rhodococcus equi, Foal Pneumonia – Michelle Coleman

Examine current recommendations in-depth regarding the management and treatment of Rhodococcus equi pneumonia in foals.
 
11:10 – 11:35 a.m. Management of Outbreaks of Contagious Equine Respiratory Infections – Michelle Coleman

Review several impactful events in equine biosecurity and learn how to help prevent the spread of disease in the future.
 
11:35 a.m. –        
1:00 p.m.    
LUNCH


Labs

1 – 5:30 p.m. Attendees will break out into groups of 7-8 and rotate through each one-hour station.
 
  Station 1:    How to Acquire and Interpret Radiographs of the Equine Head and Ultrasonography of the Equine Pharynx and Larynx                        - Cris Navas, Betsy McCauley, Lindsey Gilmour 

Goals for this wet lab are for attendees to learn how to acquire and interpret radiographs of the equine head and to perform ultrasonographic exams of the equine pharynx and larynx. The normal appearance and the most common abnormalities (sinusitis, sinus masses, dental diseases, laryngeal neuropathy, laryngeal dysplasia and chondritis) will be described.
 
  Station 2:    Bronchoscopy, Endoscopic-Assisted Airway Sampling (Tracheal Aspiration and Bronchoalveolar Lavage) and Blind BAL - Keith Chaffin 

Attendees will participate in performing 3 diagnostic airway sampling techniques including trans-endoscopic tracheal aspiration (TE-TA), transendoscopic bronchoalveolar lavage (TE-BAL) and bronchoalveolar lavage (BAL) using a blindly-passed BAL catheter.  Indications for each procedure, and advantages and disadvantages of each procedure will be described.  Each of the procedures will be performed on live normal horses.  For endoscopic-assisted procedures, aseptic preparation of the endoscope will be demonstrated.  Stall-side preparation of the samples for submission to a cytologist will be described. 
 
3 – 3:30 p.m. BREAK
 
  Station 3:    Live Dynamic Endoscopy of the Equine Upper Airway – Carolyn Arnold and Canaan Whitfield

This lab will involve placing a dynamic endoscope on a horse and then performing dynamic endoscopy. The attendees can see the video real-time and understand what goes into a dynamic endoscopic exam of a horse. This lab will help the attendee understand case selection for these exams and interpretation of the video. 
 
  Station 4:    Case Discussion of Upper Airway Abnormalities - Travis Tull

The goals of this lab are to apply the knowledge you learned previously in this course to real cases. Cases of upper airway abnormalities will be presented step-by-step with attendee participation in selection of diagnostics and treatments. The discussion will be led by experts in the field and reasoning behind the decision-making process for each step of the cases will be explained and discussed.