Recurrent Airway Obstruction (RAO) in Horses

Testing this sample can reveal the presence of infection and/or inflammatory changes in the cells.1

Occasionally, your vet might order x-rays of the horse's chest, particularly if there is a concern that the horse has pneumonia or a secondary infection as well as RAO.

Treatment

Unfortunately, recurrent airway obstruction is a chronic disease that can be managed, but not cured. The mainstay of treatment for RAO is to remove the horse as much as is feasible from the allergy triggers. That means letting a stabled horse outside into a pasture whenever possible, storing hay away from the afflicted horse's stall, and switching from straw bedding to low-dust bedding such as shredded paper or cardboard.

Feeding the horse water-soaked hay is an option if the RAO is mild. However, horses with more severe disease will need a switch to a complete pellet feed instead of hay. The barn or stable should be kept as dust-free as possible.

Some horses will also require medications to control their condition, particularly during flares of symptoms. The most commonly prescribed medications include systemic or inhaled bronchodilators, which help to open the constricted airways, and systemic or inhaled corticosteroids, which help to relieve inflammation. These medications might be used only when the horse is in respiratory distress due to a flare of symptoms, or long-term to help manage symptoms in horses with severe disease that cannot easily be kept away from allergy-triggering antigens.

Prognosis for Horses With Recurrent Airway Obstruction

With proper management and treatment, horses with mild to moderate cases of RAO can lead fairly normal lives. However, they will need to be closely monitored for flare-ups of symptoms, and may never be able to work or exercise as hard as healthy horses.

More severely affected horses are not able to work or exercise, and are likelier to develop secondary pneumonia or other respiratory infections. These horses have a poorer prognosis.

How to Prevent Recurrent Airway Obstruction

It may be difficult to prevent RAO entirely, as it's hard to predict if your horse will develop the disease or not. But this chronic lung condition builds gradually. If recognized early, good feed and stable management may slow or prevent its progression, and the horse may be able to take on an almost normal workload. If the horse is continually exposed to the irritants, however, the disease may progress to the point where it is unable to thrive.

Make sure that any fodder and bedding are mold and dust-free. A well-ventilated stable is essential for keeping your horse’s lungs healthy. Outdoor turnout is the best way to provide lots of fresh air as well as fresh grass—rather than dusty hay—for feeding.