Rick Farr of Farr & Pursey Equine Vets shares his expert advice on Chronic Obstructive Pulmonary Disease, or equine asthma, how to manage it and what you can expect
Q: “My gelding has been diagnosed with COPD (Chronic Obstructive Pulmonary Disease) at 15 years old. We showjump up to 1m/1.05m and obviously I am concerned at the affect the COPD will have on our competing. Does anyone have a horse with COPD, how do you manage it, how debilitating is it, do horses go back to full work and do they eventually find they have to have a slower pace of life?”
A: It is strange how things move on within the veterinary industry and how we describe various conditions. COPD, or ‘Chronic Obstructive Pulmonary Disease’, was the term historically used to describe a condition in horses which was characterised by an increased respiratory effort as a result of allergic airway disease. However, COPD is actually a condition described within human medicine as a result of chronic smoking.
Over time, we as vets we started to use the term RAO, or ‘Recurrent Airway Obstruction, but again, this terminology was not ideal. Now we describe the old COPD/RAO cases as ‘Equine Asthma’ which, when put in context, is much easier to understand as most people are aware of asthma in people. Therefore, from this point on, I will refer to the condition as such.
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In both people and horses, asthma is a managed condition and should not prevent an individual from having a ‘normal’ life. The differences arise as a result of the severity of the condition within the individual and how responsive they are to medication, in conjunction with environmental management.
In the UK the prevalence of Equine Asthma is reported to be approximately 14%. Furthermore, there are suggestions that there is an increased risk of the condition in animals over four years old, Thoroughbred breeds, horse residing in urbanised areas and those that have been exposed to hay/straw in early life.
So, how is it diagnosed?
The best way to confirm the lower airway inflammation causing the condition is to perform two tests: a tracheal wash (fluid/sample taken from the trachea) and a broncheoalveolar lavage (a sample from the lung). The samples are then sent to the lab for analysis.
How do you treat the condition?
It is important to try to prevent exposure to certain causal factors, such as dusty hay/bedding. Horses should be kept in well ventilated stables. Very much like human asthma, some individuals are also worse when the weather is hot/humid or when pollen levels are high, therefore avoiding putting horses into these conditions can help. Environmental management is essential in all cases. Medication is also used to help — oral bronchodilators (drugs to open up the airways) in conjunction with steroids should be the basis for initial treatment. Often we progress onto treatment with inhaled medication, very much like in human medicine. This can either be administered via an inhaler or nebuliser.
You asked if the condition is debilitating. Initial management and control can always be a challenge, however medication with environmental changes can make sure your horse does not have to slow down. You do have to be aware though that, when competing under certain governing bodies, you may be required to check if any of the medications are on the prohibited substances list; this may affect your horse’s ability to compete in the future.
Once you have your diagnosis, getting the horse stable and managing the condition can take some time. However, once done, it is essential to monitor the response to any changes made. Some months the condition may be worse and require “tweaks” to the management — the condition will not disappear over night. With all this said, however, you should not be putting your horse in retirement just yet!