A shot of a horse from head on with a focus on it's chest region.
A shot of a horse with the focus on the horse's chest area.

Respiratory Health

Free the lungs

Equine Respiratory Health

The horse’s respiratory tract is a highly specialized organ system. Due to its complexity, even a minor deviation from normal can affect a horse’s health and performance. 

 

While the process of breathing appears simple, it involves many nerves, muscles, cartilage and other anatomic structures so it is essential to ensure the flow of air is unobstructed. Due to the complex anatomy and physiology of the respiratory system, and the high demands placed upon it, it is not surprising that equine respiratory health related problems are the second-leading causes of poor performance in horses. 1

Common Equine Respiratory Diseases and Conditions

  • Respiratory tract infections:
    • Equine influenza
    • Equine herpes virus infection

 

  • Upper respiratory diseases and conditions:
    • Pharyngeal lymphoid hyperplasia (pharyngitis)
    • Dorsal displacement of the soft palate
    • Nasopharyngeal collapse
    • Laryngeal hemiplegia (roaring)
    • Epiglottic entrapment
    • Arytenoid chondritis
    • Nasopharyngeal cicatrix

 

  • Lower respiratory diseases and conditions:
    • Equine asthma syndrome: an umbrella term to describe chronic non-infectious inflammatory diseases affecting the lower airway in horses
      • Previous terminology includes heaves, recurrent airway obstruction (RAO), chronic obstructive pulmonary disease (COPD), broken wind and inflammatory airway disease (IAD)
      • Equine asthma syndrome can be further sub-classified based on the disease severity into mild-moderate equine asthma (the disease formerly known as IAD) and severe equine asthma (formerly known as RAO).
      • Severe equine asthma can be either barn-associated or summer pasture-associated
    • Exercise-induced pulmonary hemorrhage (EIPH)
    • Bacterial, viral, and fungal pneumonias

Managing horses with severe equine asthma

Severe equine asthma may result from, or be exacerbated by, exposure to dust and other airborne irritants. Besides dust, bacteria, mold and ammonia can irritate the horse’s respiratory tract and cause airway inflammation, which can lead to breathing difficulties. Dust particles can come from a variety of sources, including feed and bedding. Because of this, environmental management remains the most important non-pharmacologic intervention for horses with severe equine asthma.

 

While horses with severe equine asthma can display signs such as exercise intolerance, nasal discharge and couch, the most noticeable early sign is struggling to breathe while at rest. While a horse’s cough may be common, it’s not normal, and if it persists, a veterinarian should be contacted.

Treatment

The goals of treating severe equine asthma can be summarized using the following steps:

 

Step 1: Remove triggering factors (environmental management to reduce dust)

+ Step 2: Control airway inflammation (glucocorticoids)

+/- Step 3: Provide relief (bronchodilators)

 

Treatment with glucocorticoids, in combination with continuous environmental modification and antigen avoidance, have been shown to improve airway inflammation. Targeting therapy directly to the lungs by delivering drug via inhalation is considered preferable to systemic administration to reduce the risk of unintended adverse effects.

 

Aservo® EquiHaler® (ciclesonide inhalation spray), a unique treatment for horses, generates a slow-moving Soft Mist™ that is easy to inhale, delivering medication deep into the lung. ASERVO EQUIHALER is designed specifically for use in horses with severe equine asthma. An ergonomic handle and dosing lever make it simple to administer. The anatomically designed nostril adaptor fits inside the left nostril of the horse, making it easier for them to inhale the medicated mist.

 

For more information visit AservoEquihaler.com.

Aservo EquiHaler package

ASERVO® EQUIHALER® (ciclesonide inhalation spray)

A novel glucocorticoid delivered via a Soft MistTM inhaler indicated for the management of clinical signs associated with severe equine asthma. ASERVO EQUIHALER has not been evaluated in pregnant or lactating mares.

ASERVO® EQUIHALER® (ciclesonide inhalation spray)

A novel glucocorticoid delivered via a Soft MistTM inhaler indicated for the management of clinical signs associated with severe equine asthma. ASERVO EQUIHALER has not been evaluated in pregnant or lactating mares.

Aservo EquiHaler package

IMPORTANT SAFETY INFORMATION: ASERVO EQUIHALER has not been evaluated in pregnant or lactating mares. In a large clinical field study, the most common adverse reactions reported were coughing, nasal discharge, sneezing and nasal irritation/bleeding. Administration of glucocorticoids may worsen existing bacterial, fungal, or viral infection and may induce the first stage of parturition. Glucocorticoids should be used with caution in horses at a higher risk for laminitis. Not for use in humans. Keep this and all medications out of the reach of children. In case of accidental inhalation, seek medical advice immediately. INFORMATION FOR HORSE OWNERS: After veterinary consultation, please read and understand the entire contents of the user manual for instructions regarding proper handling and use of ASERVO EQUIHALER.


1. Martin BB, Reef VB, Parente EJ, Sage AD. Causes of poor performance of horses during training, racing, or showing: 348 cases (1992-1996). JAVMA. 2000;216:554-558

 

ASERVO® and EQUIHALER® are registered trademarks of Boehringer Ingelheim Vetmedica GmbH, used under license. All other trademarks are the property of their respective owners. ©2021 Boehringer Ingelheim Animal Health USA Inc., Duluth, GA. All Rights Reserved. US-EQU-0127-2021