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Overview of Management and Medical Treatment Options for Equine Asthma
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The long-term management of equine asthma is best achieved by decreasing the inhalation of antigens responsible for the lower airway inflammation and obstruction resulting in its clinical manifestation. While keeping horses on pasture is preferable, feeding affected horses with grass silage or pelleted and cubed hay combined with outdoor paddocks, or wood shavings or other less dusty bedding if stabled, has been shown to be appropriate alternatives. Hay pasteurization (using a “steamer”) is also commonly used, but its efficacy has not been critically evaluated. A hay treatment incorporating vegetable oil to mechanically processed hay was recently shown to be as effective as pelleted hay in treating asthmatic horses. However, three months or more in a low dust environment may be required before maximal improvement in airway function is observed. Failure to respect this timeframe often leads to the erroneous conclusion by the owners that this approach is not effective for their horses. Importantly, clinical signs and lower airway inflammation and obstruction will recur in most asthmatic horses (and in all severe asthmatic horses), if they are returned to an offending environment.
CORTICOSTEROIDS ARE THE MOST EFFECTIVE TREATMENT FOR EQUINE ASTHMA
Systemically administered corticosteroids are rarely used for prolonged therapy in horses, because of the adverse effects that have been associated with them. A treatment of two (2) weeks or more, combined with decreased hay dust exposure, is recommended to control equine asthma. A one-week delay can be expected between the initiation of therapy and maximal clinical response in severely affected horses, although marked improvement is usually observed within a few days of drug administration. If a con- current environmental control is not implemented, clinical signs are likely to recur soon after treat- ment has ceased. Dexamethasone (initial dose 0.04-0.06 mg/kg, PO, IM or IV for 7 to 10 days, followed by decremental doses or alternate day dosing) is efficacious in controlling equine asthma. Oral prednisolone, even at high dosages (1–4 mg/kg bwt, once a day), is less potent than dexamethasone. […]
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Affiliation of the authors at the time of publication
Director, Equine Asthma Laboratory, Associate Dean - Research, University of Montreal, Canada.
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