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Respiratory Assessment

Clinical signs that would warrant a respiratory assessment by a veterinarian:

Nasal discharge
Coughing
An abnormal respiratory noise, either at rest or when exercising
Excessive sneezing or snorting
Swelling under the jaw (lymph nodes)
Poor performance, winded easily
Persistently elevated respiration
Difficulty breathing, wheezing

A respiratory evaluation begins with a complete history provided by the owner and trainer (when applicable). Next, the veterinarian will perform a thorough physical exam including a rebreathing exam. A rebreathing exam involves placing a bag over the horse’s nose and mouth for one minute, which allows for the build-up of carbon dioxide stimulating the horse to take deeper breaths. Upon removal of the bag, the horse will sense fresh air and usually take a few even deeper breaths allowing for better evaluation of your horse’s lungs with auscultation. This is analogous to your physician asking you to take a few deep breaths while he/she listens with a stethoscope.

Based on the findings of this assessment, the veterinarian may recommend specific treatments. If further information is needed to institute a proper treatment plan, some of the following diagnostics may be offered depending on the clinical signs presented:

General blood work (complete blood count, chemistry, fibrinogen, SAA) – allows for assessment of the systemic response to a respiratory issue
Infectious disease testing on nasal swabs, blood or fluid obtained from the respiratory tract (Strangles, EHV-1/4, influenza, rhinitis viruses, Strep. zoo, etc.)
Upper airway endoscopy – a live camera view of the respiratory tract used to identify a structural or functional defect, the source of discharge or hemorrhage, a mass, a foreign body, etc; also provides a means of collecting samples for disease testing
Thoracic ultrasound – looking for signs of fluid, infection, neoplasia, etc.
Thoracic radiography – limited use in the horse due to their size but may help identify fibrosis or other infiltrative diseases of the lungs; also can be used for defects or injuries to the trachea or abnormalities of the pharynx, sinuses and nasal passages
Transtracheal wash – the vet will instill sterile fluid into the trachea, usually, through the scope, collect the fluid and analyze it for infectious organisms
Bronchoalveolar lavage (BAL) – fluid collected by the vet from the deeper portions of the lungs for identifying infection, equine asthma, neoplasia, etc.
Dynamic endoscopy – a specialized scope that can be used when the horse is ridden, for conditions or respiratory noises that are noted only when the horse exerts itself