Practical diagnostic approach to the coughing horse
Authors: Pirie R Scott
Journal: UK-Vet Equine
Summary
# Editorial Summary: Practical diagnostic approach to the coughing horse Cough in horses serves as a valuable clinical localiser, confirming involvement of the conducting airways through stimulation of cough receptors by chemical or mechanical irritants; however, the range of potential underlying respiratory diseases and disorders is broad enough that a systematic diagnostic approach is essential to reach definitive conclusions. Scott's review examines the physiological mechanisms triggering cough, catalogues the diseases presenting with this sign, and outlines evidence-based diagnostic strategies for practitioners working through respiratory cases in the field and clinic. The practical value lies in understanding that whilst cough confirms airway involvement, its absence does not exclude airway disease—a distinction that shapes how clinicians should interpret respiratory presentations and plan their investigations accordingly. For farriers, physiotherapists and coaches observing respiratory signs, recognising the diagnostic limitations of cough alone reinforces the importance of referring horses for formal airway evaluation rather than making assumptions based on clinical presentation alone. This framework proves particularly relevant given the prevalence of cough in equine practice and the potential for subtle or early-stage airway pathology to escape detection without methodical investigation.
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Practical Takeaways
- •A cough is diagnostically valuable because it localizes disease to the airways, but you'll need additional diagnostic work to identify the specific cause
- •Don't assume horses without a cough are free of airway disease—use other clinical signs and diagnostic tools to investigate respiratory compromise
- •Have a systematic diagnostic approach ready for coughing horses, as the differential list is extensive
Key Findings
- •Coughing results from chemical and/or mechanical stimulation of cough receptors in conducting airways, confirming primary or secondary airway involvement
- •Numerous respiratory diseases and disorders present with cough, requiring further diagnostic investigation beyond clinical signs alone for definitive diagnosis
- •Absence of cough does not exclude airway involvement; diagnosis in such cases must rely on other less specific clinical signs