A Longitudinal Analysis of Equine Asthma Presentation and Response to Treatment Using Lung Function Testing and BAL Cytology Analysis in Combination with Owner Perception.
Authors: Robins Tyler-Jane, Bedenice Daniela, Mazan Melissa
Journal: Animals : an open access journal from MDPI
Summary
# Editorial Summary Equine asthma remains a significant source of performance loss and respiratory disease, yet longitudinal data tracking disease progression and treatment response across multiple clinic visits has been limited. Robins and colleagues conducted a retrospective analysis of 76 horses presenting to Tufts Cummings Hospital with multiple visits between 1999 and 2023, examining the concordance between owner-reported signs and veterinary clinical findings alongside objective measures including lung function testing and bronchoalveolar lavage cytology across 197 visits. Owners demonstrated reliable perception of cough specifically and identified its improvement as the most common sign of treatment success; notably, histamine challenge testing—a measure of airway reactivity—showed significant improvement in mild-to-moderate equine asthma (mEA) following treatment or over time, whereas baseline lung function parameters and BAL cell counts remained largely static in both mEA and severe EA (sEA) groups. These findings suggest that whilst owner observations warrant serious clinical consideration, reactivity-based testing protocols are more sensitive indicators of treatment efficacy in mEA than conventional pulmonary function assessment, potentially reshaping how clinicians approach monitoring asthmatic horses and informing owners about realistic expectations for recovery and objective improvement.
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Practical Takeaways
- •Owner-reported cough is a reliable clinical indicator in equine asthma and should be valued as part of the diagnostic and monitoring process alongside objective testing
- •When evaluating treatment response in mild-moderate asthma, airway reactivity testing (histamine challenge) is more informative than baseline lung function measurements or BAL cytology alone
- •A combination of owner perception, clinical scoring, airway reactivity testing, and BAL analysis provides the most complete picture of equine asthma presentation and treatment response
Key Findings
- •Of 197 clinic visits in 76 horses, 70.0% resulted in mild-moderate EA diagnosis and 22.8% in severe EA diagnosis
- •Owners detected cough more frequently than veterinarians and reported decreased cough as the most common post-treatment improvement
- •Histamine challenge response significantly improved with treatment or time in mild-moderate EA, whereas baseline lung function did not significantly change in either disease severity
- •Tests of airway hyperreactivity were more sensitive to treatment-related changes than baseline lung function testing or BAL cytology analysis