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Lo Feudo CM, Ferrucci F, Bizzotto D, Dellacà R, Lavoie J, Stucchi L. Differences in pulmonary function measured by oscillometry between horses with mild-moderate equine asthma and healthy controls. Equine Vet J 2025; 57:619-628. [PMID: 39134475 PMCID: PMC11982413 DOI: 10.1111/evj.14206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 07/01/2024] [Indexed: 04/11/2025]
Abstract
BACKGROUND The diagnosis of mild-moderate equine asthma (MEA) can be confirmed by airway endoscopy, bronchoalveolar lavage fluid (BALf) cytology, and lung function evaluation by indirect pleural pressure measurement. Oscillometry is a promising pulmonary function test method, but its ability to detect subclinical airway obstruction has been questioned. OBJECTIVES To evaluate the differences in lung function measured by oscillometry between healthy and MEA-affected horses. STUDY DESIGN Prospective case-control clinical study. METHODS Thirty-seven horses were divided into healthy and MEA groups, based on history and clinical score; the diagnosis of MEA was confirmed by airway endoscopy and BALf cytology. Horses underwent oscillometry at frequencies ranging from 2 to 6 Hz. Obtained parameters included whole-breath, inspiratory, expiratory, and the difference between inspiratory and expiratory resistance (Rrs) and reactance (Xrs). Differences between oscillometry parameters at different frequencies were evaluated within and between groups by repeated-measures two-way ANOVA and post hoc tests with Bonferroni correction. Frequency dependence was compared between groups by t test. For significant parameters, a receiver operating characteristics curve was designed, cut-off values were identified and their sensitivity and specificity were calculated. Statistical significance was set at p < 0.05. RESULTS No significant differences in Xrs and Rrs were observed between groups. The frequency dependence of whole-breath and inspiratory Xrs significantly differed between healthy (respectively, -0.03 ± 0.02 and -0.05 ± 0.02 cmH2O/L/s) and MEA (-0.1 ± 0.03 and -0.2 ± 0.02 cmH2O/L/s) groups (p < 0.05 and p < 0.01). For inspiratory Xrs frequency dependence, a cut-off value of -0.06 cmH2O/L/s was identified, with 86.4% (95% CI: 66.7%-95.3%) sensitivity and 66.7% (95% CI: 41.7%-84.8%) specificity. MAIN LIMITATIONS Sample size, no BALf cytology in some healthy horses. CONCLUSIONS Oscillometry can represent a useful non-invasive tool for the diagnosis of MEA. Specifically, the evaluation of the frequency dependence of Xrs may be of special interest.
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Affiliation(s)
- Chiara Maria Lo Feudo
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal SciencesUniversità Degli Studi di MilanoLodiItaly
| | - Francesco Ferrucci
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal SciencesUniversità Degli Studi di MilanoLodiItaly
| | - Davide Bizzotto
- TechRes Lab, Department of Electronics, Information and Biomedical EngineeringPolitecnico di MilanoMilanItaly
| | - Raffaele Dellacà
- TechRes Lab, Department of Electronics, Information and Biomedical EngineeringPolitecnico di MilanoMilanItaly
| | - Jean‐Pierre Lavoie
- Department of Clinical Sciences, Faculty of Veterinary MedicineUniversité de MontréalSaint‐HyacintheQuebecCanada
| | - Luca Stucchi
- Department of Veterinary MedicineUniversità degli Studi di SassariSassariItaly
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Lo Feudo CM, Stucchi L, Bizzotto D, Dellacà R, Lavoie JP, Ferrucci F. Respiratory oscillometry testing in relation to exercise in healthy and asthmatic Thoroughbreds. Equine Vet J 2025; 57:28-37. [PMID: 38247256 DOI: 10.1111/evj.14065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/04/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Racehorses may experience exercise-induced bronchodilation or bronchoconstriction, with potential differences between healthy and asthmatic individuals. OBJECTIVES To identify exercise-related lung function variations by oscillometry in racehorses, compare lung function between healthy and mild equine asthma (MEA) horses, assess oscillometry's potential as a predictor of racing fitness. STUDY DESIGN Prospective case-control clinical study. METHODS Fourteen Thoroughbred racehorses (5 healthy, 9 MEA) underwent a protocol including respiratory oscillometry at rest, exercise with fitness monitoring, oscillometry at 15 and 45 min post-exercise, and bronchoalveolar lavage fluid (BALf) cytology. Oscillometry parameters (resistance [Rrs] and reactance [Xrs]) were compared within and between healthy and MEA groups at different timepoints. Associations between Rrs and Xrs at rest and 15 min post-exercise and BALf cytology and fitness indices were evaluated. RESULTS MEA horses showed higher Rrs at 15 min post-exercise (0.6 ± 0.2 cmH2O/L/s) than healthy horses (0.3 ± 0.1 cmH2O/L/s) (p < 0.01). In healthy horses, Rrs decreased at 15 min post-exercise compared with resting values (0.5 ± 0.1 cmH2O/L/s) (p = 0.04). In MEA horses, oscillometry parameters did not vary with time. Post-exercise Xrs inversely correlated with total haemosiderin score (p < 0.01, r2 = 0.51). Resting Rrs inversely correlated with speed at 200 bpm (p = 0.03, r2 = -0.61), and Xrs with maximum heart rate (HR) during exercise (p = 0.02, r2 = -0.62). Post-exercise Rrs inversely correlated with mean (p = 0.04, r2 = -0.60) and maximum speed (p = 0.04, r2 = -0.60), and HR variability (p < 0.01, r2 = -0.74). MAIN LIMITATIONS Small sample size, oscillometry repeatability not assessed, potential interference of upper airway obstructions, external variables influencing fitness indices. CONCLUSIONS Oscillometry identified lung function differences between healthy and MEA horses at 15 min post-exercise. Only healthy horses exhibited exercise-induced bronchodilation. Oscillometry showed potential in predicting subclinical airway obstruction.
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Affiliation(s)
- Chiara Maria Lo Feudo
- Equine Sports Medicine Laboratory "Franco Tradati", Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Lodi, Italy
| | - Luca Stucchi
- Department of Veterinary Medicine, Università degli Studi di Sassari, Sassari, Italy
| | - Davide Bizzotto
- TechRes Lab, Department of Electronics, Information and Biomedical Engineering, Politecnico di Milano, Milan, Italy
| | - Raffaele Dellacà
- TechRes Lab, Department of Electronics, Information and Biomedical Engineering, Politecnico di Milano, Milan, Italy
| | - Jean-Pierre Lavoie
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - Francesco Ferrucci
- Equine Sports Medicine Laboratory "Franco Tradati", Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Lodi, Italy
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Lendl L, Barton AK. Equine Asthma Diagnostics: Review of Influencing Factors and Difficulties in Diagnosing Subclinical Disease. Animals (Basel) 2024; 14:3504. [PMID: 39682469 DOI: 10.3390/ani14233504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Revised: 11/24/2024] [Accepted: 12/02/2024] [Indexed: 12/18/2024] Open
Abstract
This literature review focuses on diagnostics of equine asthma (EA), possible influencing factors on diagnostic techniques and latest developments in diagnosing horses during EA remission or with subclinical disease. Routine EA diagnostics include a clinical examination of the respiratory system with percussion and auscultation including a rebreathing examination, and clinical pathology including white blood cells and arterial blood gas analysis. Subsequent diagnostics include bronchoscopy to evaluate the amount and viscosity of respiratory secretion, bronchoalveolar lavage, and the cytology of tracheal aspirates (TAs) and bronchoalveolar lavage fluid (BALF). The grading of EA severity is built on respiratory effort at rest, which is increased in severe equine asthma. The inflammatory subtype is based on BALF cytology, while TA cytology helps to rule out previous bacterial infections. Different factors have an impact on the airways regarding the structure of the epithelium, cytology, and inflammatory markers possibly influencing the diagnosis of EA. Short-term exercise increases the total cell count and inflammatory mediators identified in the BALF of human patients, asymptomatic horses, and other species. Other factors involve cold or chlorinated air, long-term training effects, and concurrent additional respiratory disease, in particular exercise-induced pulmonary hemorrhage. As BALF cytology may be unremarkable during EA remission and low-grade disease, exercise tests and other factors stressing the bronchial epithelium may help to diagnose these patients.
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Affiliation(s)
- Lioba Lendl
- Equine Clinic Hochmoor, Ruthmannstr. 10, 48712 Gescher, Germany
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Mainguy-Seers S, Holcombe SJ, Lavoie JP. Serum Vitamin D Level Is Unchanged in Equine Asthma. Animals (Basel) 2024; 14:3310. [PMID: 39595361 PMCID: PMC11591496 DOI: 10.3390/ani14223310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2024] [Revised: 11/09/2024] [Accepted: 11/15/2024] [Indexed: 11/28/2024] Open
Abstract
Vitamin D deficiency is associated with asthma development and severity of symptoms in humans, but whether the same occurs in horses is unknown. We aimed to determine whether the serum vitamin D levels differ in horses with asthma compared to control animals and, secondarily, to explore clinical, respiratory, and environmental parameters associated with its concentration in equids in a retrospective cross-sectional study. The total serum vitamin D (25(OH)D) was measured by radioimmunoassay in 45 serum samples from the Equine Respiratory Tissue Biobank (15 control animals, 14 horses with mild or moderate asthma (MEA), and 16 horses with severe asthma (SEA)). Descriptive clinical and environmental parameters, bronchoalveolar lavage fluid cytology, and lung function data were extracted. There was no difference in serum 25(OH)D levels between healthy controls, horses with MEA, and horses with SEA (respectively, means of 57.9 ± 11.6, 55.6 ± 20.0, and 64.6 ± 14.5 nmol/L; p = 0.3), suggesting that this micronutrient does not play a major role in equine asthma pathophysiology.
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Affiliation(s)
- Sophie Mainguy-Seers
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada;
| | - Susan J. Holcombe
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48823, USA
| | - Jean-Pierre Lavoie
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada;
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Morales CJ, Costa LRR. Chronic Cough and Hyperpnea: Clinical Approach to Equine Asthma. Vet Clin North Am Equine Pract 2024; 40:e21-e39. [PMID: 39809608 DOI: 10.1016/j.cveq.2024.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2025] Open
Abstract
Exercise intolerance, chronic cough, and hyperpnea are the clinical hallmarks of equine asthma. Diagnosis of severe equine asthma in horses is multistep; determination of the phenotype will help guide future recommendations. Management of equine asthma is largely reduction/elimination of triggering agents/conditions. Immunosuppressive therapies and bronchodilators are the mainstay of treatment of equine asthma. Rescue therapy with short-acting bronchodilators is the first goal when managing a horse with hyperpnea. The second goal is to control/reduce inflammation and airway remodeling. Immunosuppressive therapies alone will not be effective. Environmental and management changes must be established to minimize or eliminate exposure to triggering agents/factors.
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Affiliation(s)
- Camilo J Morales
- William R. Pritchard Veterinary Teaching Hospital and K.L. Maddy Equine Lab, School of Veterinary Medicine, University of California - Davis, Davis, CA 95616, USA.
| | - Lais R R Costa
- Veterinary Medicine Cooperative Extension, Department of Population Health & Reproduction, School of Veterinary Medicine, University of California - Davis, Davis, CA 95616, USA.
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Höglund N, Rossi H, Javela HM, Oikari S, Nieminen P, Mustonen AM, Airas N, Kärjä V, Mykkänen A. The amount of hyaluronic acid and airway remodelling increase with the severity of inflammation in neutrophilic equine asthma. BMC Vet Res 2024; 20:273. [PMID: 38918797 PMCID: PMC11197223 DOI: 10.1186/s12917-024-04136-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 06/12/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Equine asthma (EA) is a chronic lower airway inflammation that leads to structural and functional changes. Hyaluronic acid (HA) has crucial functions in the extracellular matrix homeostasis and inflammatory mediator activity. HA concentration in the lungs increases in several human airway diseases. However, its associations with naturally occurring EA and airway remodelling have not been previously studied. Our aim was to investigate the association of equine neutrophilic airway inflammation (NAI) severity, airway remodelling, and HA concentration in horses with naturally occurring EA. We hypothesised that HA concentration and airway remodelling would increase with the severity of NAI. HA concentrations of bronchoalveolar lavage fluid supernatant (SUP) and plasma of 27 neutrophilic EA horses, and 28 control horses were measured. Additionally, remodelling and HA staining intensity were assessed from endobronchial biopsies from 10 moderate NAI horses, 5 severe NAI horses, and 15 control horses. RESULTS The HA concentration in SUP was higher in EA horses compared to controls (p = 0.007). Plasma HA concentrations were not different between the groups. In the endobronchial biopsies, moderate NAI horses showed epithelial hyperplasia and inflammatory cell infiltrate, while severe NAI horses also showed fibrosis and desquamation of the epithelium. The degree of remodelling was higher in severe NAI compared to moderate NAI (p = 0.048) and controls (p = 0.016). Intense HA staining was observed in bronchial cell membranes, basement membranes, and connective tissue without significant differences between the groups. CONCLUSION The release of HA to the airway lumen increases in naturally occurring neutrophilic EA without clear changes in its tissue distribution, and significant airway remodelling only develops in severe NAI.
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Affiliation(s)
- Nina Höglund
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, FI-00014, Finland.
| | - Heini Rossi
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, FI-00014, Finland
| | - Hanna-Maaria Javela
- Department of Veterinary Biosciences, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, FI-00014, Finland
| | - Sanna Oikari
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, FI-70211, Finland
| | - Petteri Nieminen
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, FI-70211, Finland
| | - Anne-Mari Mustonen
- Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, FI-70211, Finland
- Department of Environmental and Biological Sciences, Faculty of Science, Forestry and Technology, University of Eastern Finland, Joensuu, FI-80101, Finland
| | - Niina Airas
- Department of Veterinary Biosciences, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, FI-00014, Finland
| | - Vesa Kärjä
- Department of Clinical Pathology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, FI-70210, Finland
| | - Anna Mykkänen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, FI-00014, Finland
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Mönki J, Holopainen M, Ruhanen H, Karikoski N, Käkelä R, Mykkänen A. Lipid species profiling of bronchoalveolar lavage fluid cells of horses housed on two different bedding materials. Sci Rep 2023; 13:21778. [PMID: 38066223 PMCID: PMC10709413 DOI: 10.1038/s41598-023-49032-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 12/03/2023] [Indexed: 12/18/2023] Open
Abstract
The lipidome of equine BALF cells has not been described. The objectives of this prospective repeated-measures study were to explore the BALF cells' lipidome in horses and to identify lipids associated with progression or resolution of airway inflammation. BALF cells from 22 horses exposed to two bedding materials (Peat 1-Wood shavings [WS]-Peat 2) were studied by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The effects of bedding on lipid class and species compositions were tested with rmANOVA. Correlations between lipids and cell counts were examined. The BALF cells' lipidome showed bedding-related differences for molar percentage (mol%) of 60 species. Whole phosphatidylcholine (PC) class and its species PC 32:0 (main molecular species 16:0_16:0) had higher mol% after Peat 2 compared with WS. Phosphatidylinositol 38:4 (main molecular species 18:0_20:4) was higher after WS compared with both peat periods. BALF cell count correlated positively with mol% of the lipid classes phosphatidylserine, sphingomyelin, ceramide, hexosylceramide, and triacylglycerol but negatively with PC. BALF cell count correlated positively with phosphatidylinositol 38:4 mol%. In conclusion, equine BALF cells' lipid profiles explored with MS-based lipidomics indicated subclinical inflammatory changes after WS. Inflammatory reactions in the cellular lipid species composition were detected although cytological responses indicating inflammation were weak.
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Affiliation(s)
- Jenni Mönki
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49, P.O. Box 57, 00014, Helsinki, Finland.
| | - Minna Holopainen
- Helsinki University Lipidomics Unit (HiLIPID), Helsinki Institute of Life Science (HiLIFE), and Biocenter Finland, University of Helsinki, Biocenter 3 Viikinkaari 1, P.O. Box 65, 00014, Helsinki, Finland
- Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Viikinkaari 1, P.O. Box 65, 00014, Helsinki, Finland
| | - Hanna Ruhanen
- Helsinki University Lipidomics Unit (HiLIPID), Helsinki Institute of Life Science (HiLIFE), and Biocenter Finland, University of Helsinki, Biocenter 3 Viikinkaari 1, P.O. Box 65, 00014, Helsinki, Finland
- Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Viikinkaari 1, P.O. Box 65, 00014, Helsinki, Finland
| | - Ninja Karikoski
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49, P.O. Box 57, 00014, Helsinki, Finland
| | - Reijo Käkelä
- Helsinki University Lipidomics Unit (HiLIPID), Helsinki Institute of Life Science (HiLIFE), and Biocenter Finland, University of Helsinki, Biocenter 3 Viikinkaari 1, P.O. Box 65, 00014, Helsinki, Finland
- Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Viikinkaari 1, P.O. Box 65, 00014, Helsinki, Finland
| | - Anna Mykkänen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49, P.O. Box 57, 00014, Helsinki, Finland
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Cullinane A, Garvey M, Walsh C, Gibbons J, Creighton A. A Scoping Review of Non-Structural Airway Disease as a Cause of Poor Performance in Racehorses. Animals (Basel) 2023; 13:429. [PMID: 36766318 PMCID: PMC9913315 DOI: 10.3390/ani13030429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/19/2023] [Accepted: 01/23/2023] [Indexed: 02/02/2023] Open
Abstract
The association between poor performance and respiratory disease in Thoroughbred racehorses that do not have a structural abnormality of the respiratory tract, is often based on anecdotal evidence. The objective of this scoping review was to examine the scientific evidence for such associations. Publications were selected based on a search of three databases (PubMed, Scopus, and CAB Direct), in English and without date restriction, followed by a screening process to exclude non-relevant papers, duplicates, and reviews. This process identified 996 publications of which 20 were analysed using the Quality in Prognosis Studies (QUIPS) tool. The results indicated that the evidence supporting the relationship between proposed diagnostic indicators and poor performance is variable. There is a need for better quality evidence. In particular, there are conflicting reports relating to the impact of equine asthma and EIPH on athletic performance. Furthermore, a lack of standardisation in the measurement of racehorse performance makes it difficult to compare findings from different studies. The industry would benefit from high-level guidance concerning the design of controlled performance studies in Thoroughbred racehorses to collect comprehensive data and facilitate targeted interventions.
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Affiliation(s)
- Ann Cullinane
- The Irish Equine Centre, Johnstown, Naas, Co., W91 RH93 Kildare, Ireland
| | - Marie Garvey
- The Irish Equine Centre, Johnstown, Naas, Co., W91 RH93 Kildare, Ireland
| | - Cathal Walsh
- Department of Mathematics and Statistics, University of Limerick, V94 T9PX Limerick, Ireland
| | - James Gibbons
- The Irish Equine Centre, Johnstown, Naas, Co., W91 RH93 Kildare, Ireland
| | - Alan Creighton
- The Irish Equine Centre, Johnstown, Naas, Co., W91 RH93 Kildare, Ireland
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