Evidence-based treatment of severe equine asthma

Equine asthma is one of the most common non-infectious respiratory conditions associated with inhalation of dust that affects horses worldwide. The disease causes airway inflammation, bronchoconstriction and increased mucus production. Severe equine asthma causes the most profound clinical signs, and although the disease cannot be cured, it can be managed successfully. Environmental modifications remain the most important strategy to decrease clinical signs in horses with severe equine asthma, while medical treatment relies on the use of anti-inflammatories (usually corticosteroids) and bronchodilators. In an acute asthma attack, systemic corticosteroids in combination with systemic or inhaled bronchodilators are most effective, while inhaled corticosteroid treatment in horses with controlled severe equine asthma offers the lowest risk of side effects.