Treating coughs in horses correctly

What is a cough in horses?

Coughing in horses is primarily a reaction to irritation of the airways. If there are foreign bodies or increased amounts of mucus in the airways, the body tries to get rid of them by coughing them out. Coughing is a protective reflex to keep the airways free of harmful substances that could hinder breathing.

Healthy, clear airways are essential for the horse's survival as a flight animal. The horse can only breathe through its nose, whereby it can pump up to 100,000 liters of air through its lungs under heavy exertion. However, if the respiratory tract is irritated and thus increasingly mucoused, its volume narrows and the horse does not get enough air and oxygen, causing its performance to drop. The horse will therefore cough in an attempt to clear the mucus from the airways before it becomes trapped in the bronchial tubes.

A horse's cough is a serious alarm signal, the cause of which must be remedied promptly.

A distinction is made between acute and chronic coughs. Acute respiratory problems in horses are often caused by viruses and bacteria as well as foreign bodies. This is known as acute bronchitis. If this is not treated, it settles in the alveoli and develops into chronic bronchitis. In this case, we speak of equine asthma, COPD, RAO or, colloquially, dampness as the highest stage of chronic bronchitis.

Horse cough - one symptom, many causes

As with many equine diseases, it is often difficult to identify the trigger for a horse's cough. Horses cough, but not every horse has the same trigger. There are many causes for the one symptom.

If the horse suddenly starts coughing, for example when eating, foreign bodies such as food residue or dust may have entered the windpipe. The horse then tries to expel these as quickly as possible by coughing and choking. Once this has been removed, the horse calms down again.

However, if the horse coughs several times, more frequently and possibly in the same situations, then something is wrong. Let's take a brief look at how equine respiration works:

When inhaling, the horse draws in air through the nostrils and nasal passages. The larynx opens and clears the way into the lungs. The air continues to flow into the two lungs, where the bronchi and fine alveoli carry out the gas exchange and convert the oxygen into carbon dioxide. During this process, the diaphragm and rib muscles expand to create sufficient space in the chest for the air.

When you exhale, these muscles relax, the chest constricts and pushes the air with the carbon dioxide back out through the nostrils. You can find further explanations in the article: Breathing in horses explained - recognizing and treating respiratory problems.

The horse's movement plays an important role in cleansing the lungs. This is because breathing is directly linked to movement. It is therefore important that the running animal horse has free movement every day, which is necessary to keep the lungs healthy and clean.

If the horse can breathe freely, it takes 8 to 16 breaths per minute at rest, and up to 150 breaths and 1,500 liters of air per minute under heavy stress. Remarkable! How quickly breathing calms down again after exertion depends on the horse's level of training.

If the horse takes 20 breaths per minute at rest, this may already be a cause for concern and indicate problems.

Viruses and bacteria can cause the immune system to kick in and produce more mucus in the airways to fight off the invaders. Coughing is then the necessary reaction to expel this mucus.

The causes of horse cough can therefore be divided into infectious and non-infectious :

• Viral infections (influenza and herpes)
• bacterial infections
• Parasite infestation (lungworms)
• Mechanical problems, as with laryngeal pipes
• Heart problems, here left heart failure 
• Tumors and abscesses
• Poor air conditions (ammonia, little fresh air supply, high dust levels, mold spores)
• High humidity and resulting mold growth
• Allergic reaction to pollen, hay and straw dust
• Too little movement and therefore insufficient air exchange in the lungs
• Untrained, weakened immune system: inadequate detoxification, excessive demands on the liver and kidneys, unbalanced intestinal flora
• Genetic predisposition
• Blocked diaphragm
• Pulmonary edema/water accumulation in the lungs, which ultimately leads to suffocation of the horse

In the case of horse cough, it is possible that several triggering factors come together. In addition to viruses and bacteria, poor housing conditions are common triggers for coughing. Sensitive horses with a weakened immune system are particularly susceptible to bronchitis or an allergic cough. Horses suffering from sweet itch should be mentioned here in particular.

Symptoms and course of cough in horses

The symptoms and course of the disease differ between the acute and chronic variants.

Symptoms of an acute cough are

• Swollen lymph nodes on the neck and head
• Difficult breathing
• Fever from 39°C
• Fatigue
• Lack of appetite
• Large amounts of nasal discharge, mainly mucous, cloudy, yellow to green
• Mucousy cough / cough with sputum that dries up after a few days

If the horse suffers from acute bronchitis, many other symptoms such as fever, fatigue and loss of appetite are also present. All in all, the horse is suffering from an infection that is accompanied by a cough.

The infection causes swelling of the airways and increased mucus production. This constricts the airways and makes it more difficult for the horse to breathe. If medication, inhalation etc. is not used to help reduce the swelling of the airways, the mucus becomes trapped in the bronchial tubes of the lungs. This in turn forms a breeding ground for bacteria and can lead to a secondary bacterial infection. The bacteria further weaken the horse's immune system.

If the acute cough does not go away after one to two weeks and the mucus production continues for longer than two weeks, it will become protracted. Eventually, chronic bronchitis develops, although this is accompanied by other symptoms:

• Dry cough
• Increased respiratory rate, even at rest
• Shortness of breath
• Power reduction
• Steam channel

Symptoms such as fever, loss of appetite or nasal discharge, as is the case with an acute cough, are absent in the chronic variant. Instead, the horse finds it increasingly difficult to breathe, even at rest without exertion. Chronic bronchitis in horses is also referred to as dampness, equine asthma, COB, IAD or RAO. The self-cleaning effect of the lungs is severely restricted, which worsens the horse's state of health. The vet should not be called in only then, but already on the third day that the horse coughs as a result.

Equine asthma or dampness in horses

Dampness in horses is the absolute final stage of chronic bronchitis. The airways are so severely constricted and restricted that the horse can no longer breathe passively. It has to actively use its rib muscles to circulate air - recognizable by the tense abdominal muscles, which can be seen as a so-called "steam channel". Dampness is accompanied by weight loss and emphysema. This means that the alveoli rupture and the lung tissue is damaged - resulting in partial death of the lung tissue.

Once the horse has reached this stage of respiratory disease, it can no longer be cured. The only way to alleviate the symptoms is to keep the horse dust-free and have the vet prescribe lung-expanding medication. However, the horse will struggle permanently with bouts of the disease after symptom-free intervals.

It is alarming that around 10% of our horses suffer from dampness and respiratory distress. This is preceded by a long course of the disease, which could be prevented with the right treatment. Therefore, consult your vet as soon as your horse starts coughing. Because the earlier the better!

You can find more information on equine asthma in the article: Equine asthma, when the horse can't breathe - cause, diagnosis and treatment.

Diagnosis by the vet

If the horse coughs for three days in a row, the vet should examine the horse. The vet will first take a medical history in the stable. He will take the temperature, listen to the lungs for coughing noises and examine any nasal discharge. However, listening to the lungs is not always informative, as some horse breeds are difficult to listen to. The vet can therefore carry out a blood gas analysis to examine the oxygen saturation in the blood, which provides information about the functionality of the lungs.

If nothing helps, a bronchoscopy can be performed in addition to an X-ray of the lungs. A camera is inserted into the airways and a mucus sample is also taken. This is examined in the laboratory for bacteria, viruses and fungi in order to select the best possible treatment.

‍Treatment of horse cough

There are various treatment options for acute equine cough, primarily with medication. These are prescribed by the vet and should be administered promptly to prevent the mucus from becoming trapped in the bronchial tubes. The following treatments are possible for acute coughs in horses:

• Mucolytics: In particular, the administration of sputolysin. Mucolytics liquefy the mucus so that it can be coughed up more easily and disease particles can leave the horse's system more easily.
• Antispasmodics and bronchodilators: Bronchospasmolytics relax the respiratory muscles so that more volume is achieved in the airways and the performance of the lungs is improved. Bronchodilators are mainly used for allergic coughs.‍
• Anti-inflammatories: Cortisone in particular, which reduces the inflammation and thus the swelling of the mucous membrane. This increases the volume of the airways so that the horse can breathe more freely and cough more easily.‍
• Lung lavage: In severe cases, the lungs must be flushed by the vet. This is the case when the lungs can no longer clean themselves. However, lung lavage must be carried out in the veterinary clinic, as the horse must be monitored afterwards.‍
• Antibiotics: Antibiotics are only used in the case of a secondary bacterial infection to prevent the growth and spread of the bacteria that have settled in the mucus and to kill them.‍
• Inhalation: Accompanying therapy can be inhaled with a saline solution or medication prescribed by the vet. This provides relief for the horse by moistening the airways and liquefying the mucus. The vet will then advise the horse to inhale two to three times a day. There are special inhalers for horses that finely atomize the solution so that the medication can penetrate deep into the airways.
  Important: The equipment must be thoroughly cleaned with hot water after each use and then dried completely before it is used again. Otherwise bacteria can form in the inhaler and be inhaled by the horse.

In addition to medication, light exercise is also necessary in the treatment of horse cough. Adapt the exercise to your horse's state of health. Exercise stimulates the metabolism and breathing and therefore helps to make it easier to cough up loose mucus.

Home remedies for coughs in horses - cough teas and cough herbs for horses

Cough teas and cough herbs can be given to your horse to accompany therapy or prevent coughs. Especially in the case of upper respiratory tract disease. Herbs are a useful addition in the treatment of coughs, as they have an anti-inflammatory, mucous membrane-soothing, decongestant and antispasmodic effect.

If you want to give your horse herbs for an acute cough, don't buy a ready-made tea mixture, but make up the herbal mixture yourself. Pay attention to the quality and purity of the herbs so that no harmful substances hinder the healing process. You should also change the manufacturer from time to time to avoid exposure to harmful substances.

Cough herbs can be fed to your horse as a lukewarm infusion or in dry, solid form mixed into the feed. Cough herbs for horses are:

• Aniseed
• Caraway seeds
• Fennel
• Camomile
• Eucalyptus
• Peppermint
• Sage
• Thyme
• Ribwort plantain
• Fenugreek
• Icelandic moss
• Black cumin

As with humans, giving horses homemade cough syrup can also provide relief. Mix chopped onion with honey and leave to rest overnight. The juice that comes out has a soothing effect on the mucous membranes.

Preventing coughs in horses

The following measures can not only prevent coughs in horses, but should also be at the top of the priority list when treating acute coughs. Horses with a chronic cough must be kept in an environment that is as dust-free as possible with plenty of free movement. The horse is by nature a running animal that needs a high level of free movement, light and fresh air to keep itself and its respiratory tract healthy. Coughs can only be prevented in the long term if these basic needs are met.

Feed quality

A matter of course and yet a frequent cause of respiratory diseases in horses: feed quality. To prevent coughing in horses, the roughage should be free of mold, fungi and (dried) poisonous plants. Contamination that causes a high dust load should also be avoided at all costs. To keep dust to a minimum, it is best to distribute the hay when the horses are not in the stable. Horses with existing respiratory problems can be fed moistened hay.

‍Keep dust exposure to a minimum

The fine dust particles can often be trapped well in the horse's upper airways. However, if the dust load is too high, the particles penetrate the lower airways, irritate them and cause increased mucus production. To prevent this, the (stable) environment should be kept as dust-free as possible. This means that mucking out, sweeping and bedding should be done when the horses are not in the stable. After the stable work has been completed, the horses should only be allowed back into the stable after at least two hours when the dust has settled.

Shavings and other highly absorbent, chopped bedding are a sensible alternative to straw to minimize dust exposure.

Chronically ill horses are usually also given watered (at least 30 minutes) or steamed (at least 10 minutes) hay to reduce dust in the feed. However, the problem with steamed and watered hay is that the minerals are flushed out of the feed. It is therefore important to ensure a high-quality mineral supply in order to maintain the immune system. Alternatively, soaked hay cobs can also be fed.

Horses should never be moved on dusty surfaces such as indoor arenas or riding arenas. If possible, water the ground before work.

Fresh air supply

Respiratory diseases in horses often occur in closed stables where no attention is paid to air exchange. Dust, high humidity and ammonia irritate the horse's mucous membranes. Good ventilation (no draughts!) should therefore be ensured, especially in stable aisles. The stable must be mucked out daily to reduce the formation of ammonia. Here too, the horses should not remain in the stable during mucking out, but should only be brought back into the stable after at least two hours.

Horses with lung disease should consider switching from a stable to an open stable.

‍Stall temperature

The hutch temperature should be based on the outside temperature. Excessive temperature differences between inside and outside damage the immune system and also provide a good breeding ground for mold and fungal spores in the environment.

‍Free, relaxed movement

Horses need a lot of free movement to get their breathing going and to stimulate self-cleaning of the lungs. Ideally, the horse should be able to move freely for several hours a day in a run and open stable. You can also work the horse loosely or take it for a walk. Make sure that there are no stressful peak loads during exercise, which would overload the lungs. In this case, not enough air enters the airways as the breathing rate is too high and shallow. Instead, work your horse loosely and appropriately for its level of health and training.

‍Strengthening the immune system

The best protection against infections and coughs is your horse's own immune system. Especially in the wet and cold season, it is important to ensure that your horse is supplied with vitamin C. Rosehips are real vitamin C bombs, which you can feed your horse in fresh, dried or powdered form. The herbs mentioned above also help to strengthen the horse's immune system and make it less susceptible to infections.

A healthy horse's immune system also includes healthy intestinal flora, as this is where many immune cells are produced. When the seasons change, the change in feed causes many horses to have watery stools and diarrhea. Fecal water disrupts the absorption of minerals and unbalances the intestinal flora. You can find more information on causes, treatments and differences in our article: Fecal water & diarrhea in horses.
If the intestinal flora is out of balance, intestinal rehabilitation with probiotics can be useful. A healthy intestinal flora provides good protection against coughing.

Detoxify

It is not uncommon for coughs associated with a damaged liver to be referred to as liver cough. The liver and kidneys are the body's detoxification organs, which therefore also play a decisive role in the prevention of horse cough. If the horse's immune system is no longer able to combat the harmful substances, the liver and kidneys must take care of detoxifying and excreting the harmful substances in the body. Support them by feeding dehydrating herbs such as birch or metabolism-stimulating herbs such as hawthorn.

‍Vaccinations

A common cause of acute coughing in horses is a viral infection. In addition to strengthening the immune system, you can protect the horse with regular influenza vaccinations. Although these do not rule out infection with influenza viruses, they greatly minimize the risk.

Further information on how to prevent a herpes infection can be found in the article: Equine herpes virus - causes, symptoms, treatment and prevention in horses.

FAQ - Frequently asked questions about coughing in horses

How long does a horse's cough last?

An acute cough in horses should subside or disappear after a maximum of two weeks of treatment. If the cough and thus the mucus formation persists for longer than two weeks, bacteria can settle and multiply in the airways. This leads to a secondary bacterial infection, which further worsens the horse's state of health. After four weeks of regular coughing, it is already possible to speak of chronic bronchitis.

‍Is coughing contagious for other horses?

Whether a horse's cough is contagious depends on the cause. A horse's cough is often caused by a viral infection. As with humans, viruses and bacteria can be transmitted from horse to horse. Whether the other horse becomes infected depends on its immune system and the infection pressure. To prevent coughing during the infection period, it is therefore important to invest in the horse's defenses with vitamins.

If the cough is caused by allergies, heart failure or other non-infectious causes, the cough is not contagious.

‍When should the vet be called to a coughing horse?

In principle, a horse's cough should be taken very seriously, but it is not always an alarm signal for which the vet must be called immediately. For example, if the horse chokes while eating. However, if food residue comes out of the nose when gagging and coughing, it is a case of throat obstruction and the vet must be called immediately.

If your horse has been coughing for longer than 3 days and has other accompanying symptoms such as fever, exhaustion, etc., you should urgently call the vet. This will not only allow him to treat the symptom of the cough, but also to get to the bottom of the cause at an early stage. It is better to call the vet too early than too late.

‍How much should a horse with a cough be moved?

The horse's respiratory muscles are closely linked to the horse's locomotor muscles. Therefore, light exercise can contribute to the horse's recovery from both acute and chronic coughs. This is because exercise promotes blood flow, circulation and metabolism and dilates the bronchial tubes. This in turn makes it easier for the horse to loosen stuck mucus and cough it up. However, it is important that the exercise is adapted to the horse's condition. It is best to discuss the amount of exercise with the vet treating the horse.