Chronic Cough and Hyperpnea: Clinical Approach to Equine Asthma.
Authors: Camilo J Morales, L. R. Costa
Journal: The Veterinary clinics of North America. Equine practice
Summary
# Equine Asthma: A Clinical Framework for Diagnosis and Management Chronic cough, hyperpnea, and exercise intolerance represent the cardinal signs of equine asthma, a condition requiring systematic diagnostic evaluation to determine the specific phenotype and tailor therapeutic interventions accordingly. Morales and Costa outline a multistep diagnostic approach that moves beyond symptom recognition towards identifying the underlying airway pathology, enabling practitioners to make evidence-based decisions about treatment strategy. Pharmacological management relies on two complementary pillars: short-acting bronchodilators for acute symptom relief during hyperpneic episodes, followed by immunosuppressive therapy targeting chronic inflammation and structural airway remodeling that characterises the disease process. Critically, the authors emphasise that medical intervention alone will be insufficient—concurrent environmental modification and management changes are essential to eliminate or minimise exposure to triggering factors such as poor air quality, dust, and ammonia. For equine professionals involved in diagnostics, treatment planning, or rehabilitation, this integrated approach underscores the importance of addressing both the acute respiratory crisis and the underlying environmental drivers, ensuring sustainable improvement rather than symptomatic cycling.
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Practical Takeaways
- •When you see a horse with chronic cough and exercise intolerance, perform systematic diagnostic workup to determine the asthma phenotype—this classification will directly inform your treatment plan
- •Medication alone won't solve equine asthma; you must identify and eliminate environmental triggers (dust, mold, ammonia, poor ventilation) or the horse will remain symptomatic despite therapy
- •Use short-acting bronchodilators for immediate relief during hyperpneic episodes, but build your management around long-term anti-inflammatory drugs and environmental control to prevent progressive airway damage
Key Findings
- •Exercise intolerance, chronic cough, and hyperpnea are the primary clinical hallmarks of equine asthma
- •Diagnosis of severe equine asthma requires a multistep approach with phenotype determination to guide management recommendations
- •Management success depends on both pharmacological interventions (bronchodilators and immunosuppressive therapies) and environmental/management modifications to eliminate triggering agents
- •Short-acting bronchodilators provide rescue therapy for acute hyperpnea, while long-term control requires inflammation reduction and prevention of airway remodeling