Melissa R. Mazan, DVM, DACVIM

The first and most important thing is to recognize the horse with a respiratory emergency.

Approximately 80% of stabled horses show evidence of airway inflammation, and a recent survey performed by the Tufts Cummings School of Veterinary Medicine shows that at least 25% of horses show overt signs of inflammatory airway disease, such as cough or exercise intolerance.

Sensitivity is poor diseases such as IAD can be clinically silent for many years. Specificity is also poor, as many diseases share similar signs such as cough

Pleuropneumonia is a devastating disease, which can result in permanent respiratory impairment if not treated promptly and properly.

The bronchoalveolar lavage has been described as a liquid biopsy, and, indeed, this is an apt description.

For any practitioner engaged in sport horse practice, a familiarity with upper airway endoscopy is extremely useful.

Recurrent airway obstruction (RAO, or heaves) and inflammatory airway disease (IAD) are highly prevalent in stabled horses, and require treatment with corticosteroids and bronchodilators in addition to environmental modification.