Slides to accompany the Better Breathing keynote presentation by Dr David Marlin. This presentation was delivered at the inaugural HorseTech Conference on the 18th October 2017 hosted by the Royal Veterinary College London.

1. Better Breathing?
Dr David Marlin
www.davidmarlin.co.uk
@DrDavidMarlin

2. O2
O2
O2
O2 O2
O2
O2
O2
Breathing – Bringing Oxygen into the body!

3. O2
O2
O2
O2 O2
O2
O2
O2
CO2 CO2
CO2
CO2
CO2
Breathing – Taking Carbon Dioxide out of the body!

4. O2
O2
O2O2
O2
O2
O2
O2
O2
O2
O2
O2
O2
CO2 CO2
CO2
CO2 CO2
CO2 CO2
CO2
CO2
CO2
Breathing > Exercise: most Oxygen goes to the MUSCLES

5. Control body
temperature
Immune
system Controls acidity
Protects against
infection
Hormones
Filters
The LUNGS have other important functions!

6. The lungs sit in the rib-cage which is
the largest structure of the skeleton

7. The lungs sit in the rib-cage which is
the largest structure of the skeleton

8. Horse lungs inflated outside the body

9. The lungs inside the body

10. The lungs inside the body

11. The lungs are the 3rd biggest
organ in the body of the horse
No.1: Skin
No.2: Digestive Tract
No.3: Lungs

12. Breathing, Oxygen & Performance

13. The harder the horse works the
more OXYGEN it uses
0
10
20
30
40
50
60
70
80
90
100
0
200
400
600
800
1000
1200
1400
1600
1800
2000
0 2 4 6 8 10 12 14 16 18
LitresofOxygenperMinute
LitresofAirperMinute
Speed (metres/second)
Litres of Air Moved Per Minute
Litres of Oxygen Used Per Minute

14. The harder the horse works the
more AIR it moves in and out
0
10
20
30
40
50
60
70
80
90
100
0
200
400
600
800
1000
1200
1400
1600
1800
2000
0 2 4 6 8 10 12 14 16 18
LitresofOxygenperMinute
LitresofAirperMinute
Speed (metres/second)
Litres of Air Moved Per Minute
Litres of Oxygen Used Per Minute

15. Breathing during exercise – at the limit!
Two buckets of air moved
IN & OUT
every SECOND

16. Six baths of air moved
IN & OUT
Every MINUTE
Breathing during exercise – at the limit!

17. Breathing during exercise – at the limit!
Air reaches speeds 3x faster than water flowing from
a fire hose at maximum expiration

18. Breathing, Oxygen & Performance

19. Breathing, Oxygen & Performance

20. At Canter and Gallop Breathing and
Stride are linked 1 to 1
1 Stride1 Breath
IN
OUT
OUT110 – 170 STRIDES per minute
110 – 170 BREATHS per minute

21. At Canter and Gallop Breathing and
Stride are linked 1 to 1
1 Stride1 Breath
IN
OUT
Anything that limits STRIDE (e.g. lameness) limits BREATHING
Anything that limits BREATHING, limits STRIDE

22. What limits performance?

23. What limits performance in
horses?
Untrained/Unfit

24. What limits performance in
horses?
Untrained/Unfit Trained/Fit

25. Why?
Untrained/Unfit Trained/Fit
Adaptation

26. Why?
Untrained/Unfit Trained/Fit
Adaptation
No Change
YOU CAN’T TRAIN BREATHING!

27. How do we know the lungs limit
performance?
Oxygen in air = 21%
21% O2
O2

28. How do we know the lungs limit
performance?
Oxygen in air = 21%
If we give 30% O2
then the heart can
pump it and the
muscles can use it!
↑ Performance!
30% O2
O2

29. How do we know the lungs limit
performance?
Air has a density of 1.25g/l
Breathing Heliox
(21% O2 in helium)
Density = 0.5g/l
= less work for the lungs
↑ Performance!
21% O2
O2

30. Problem areas…

31. Problem areas…

32. Problem areas…

33. Larynx Turbinates Nostrils
= where air flows

34. Upper Airway
“Roaring” Laryngeal hemiplegia
“Gurgling” DDSP
Straightforward
to diagnose
Treatment
Options

35. Tracheal Disease
Infectious; Allergic; Irritant
Straightforward
to diagnose

36. Tracheal Disease
Infectious; Allergic; Irritant
Treatment
Options
Straightforward
to diagnose

37. Lower Airway Disease/Dysfunction
Infectious; Allergic; Irritant
Treatment
Options
Straightforward
to diagnose

38. Lower Airway Disease/Dysfunction
Infectious; Allergic; Irritant
Treatment
Options
Non-invasive
Diagnosis?

39. Damage to the lung as a result of repeated
episodes of bleeding (EIPH)

40. Damage to the lung as a result of repeated
episodes of bleeding (EIPH)

41. Damage to the lung as a result of repeated
episodes of bleeding (EIPH)

42. Blood-Gas Barrier
gas
(air)
blood
Why do horses bleed in the lungs?

43. Human HairBlood-Gas Barrier
gas
(air)
blood
Why do horses bleed in the lungs?

44. Possible Causes/Types of Respiratory
Disease in Horses
Viruses
e.g. influenza, herpes virus
Bacteria
e.g. Pneumonia, Strangles,
“Shipping fever”
Allergens
e.g. mould, pollen, dust, mites
Irritants
e.g. pollution, cold air
Other
e.g. EIPH (“Bleeding”),
Roaring, Gurgling
Parasites
e.g. lungworm

45. Possible Causes/Types of Respiratory
Disease in Horses
Viruses
e.g. influenza, herpes virus
Bacteria
e.g. Pneumonia, Strangles,
“Shipping fever”
Allergens
e.g. mould, pollen, dust, mites
Other
e.g. EIPH (“Bleeding”),
Roaring, Gurgling
Parasites
e.g. lungworm
Irritants
e.g. pollution, cold air
↓ Performance

46. No Commercial, Practical, Accurate system
to allow us to measure Ventilation or
Oxygen Consumption in the field!

47. Air Quality & Human Performance

48. 48

49. Bedding
Forage
Ventilation
Stable
Air Quality

50. 0
10
20
30
40
Wood Shavings Good Straw Flax Straw Paper/Cardboard
particles/m3x1000
Stable Air Quality - Dust in Bedding

51. Stable Air Quality - Moulds in Bedding
0
5
10
15
20
25
Wood
Shavings
Good Straw Flax Straw Cardboard
cfu/litreAir

52. Opportunities for improving health &
performance through better respiratory
health & function