Lower Airway Disease in the Athletic Horse
Authors: Mazan Melissa R.
Journal: Veterinary Clinics of North America: Equine Practice
Summary
# Editorial Summary The lower airways represent a critical bottleneck in the oxygen transport chain for athletic horses, yet non-infectious lower respiratory tract disease often progresses silently for months or years before performance deficits become apparent to owners and trainers. Mazan's 2018 review examines two primary conditions affecting exercising horses—exercise-induced pulmonary haemorrhage (EIPH) and inflammatory airway disease (IAD)—highlighting that whilst EIPH may initially reflect physiological stress rather than true pathology, IAD represents a domestication-associated syndrome, with both conditions widespread in athletic populations and responsible for substantial performance losses. Even minor compromises to oxygen-carrying capacity can meaningfully impact performance in high-demand athletes, making early identification and management of lower airway disease essential for farriers, veterinarians and trainers working with performance horses. The review underscores that horses' evolutionarily large airways and lung capacity, whilst advantageous for athletic function, paradoxically mask early-stage disease progression, necessitating proactive screening and management strategies to optimise respiratory health and unlock athletic potential in horses currently underperforming due to undiagnosed or inadequately managed lower respiratory conditions.
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Practical Takeaways
- •Monitor athletic horses closely for subtle signs of lower airway disease, as clinical signs may not appear until performance is already compromised
- •Maintain optimal lung health in performance horses as a priority, since the lower airways are critical gatekeepers in the oxygen transport chain
- •Consider both exercise-induced pulmonary hemorrhage and inflammatory airway disease as causes of poor performance, particularly in noninfectious presentations
Key Findings
- •Exercise-induced pulmonary hemorrhage and inflammatory airway disease are the two primary lower respiratory conditions affecting athletic horses during exercise
- •Many horses tolerate noninfectious lower respiratory disease for months to years before performance effects are noticed by owners or trainers
- •Even minor insults to oxygen-carrying capacity can significantly affect athletic performance in horses with high oxygen demands