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Recurrent Airway Obstruction (RAO) is the preferred term by veterinarians for what is commonly referred to as “heaves.” In the past, it has also been referred to as COPD or Chronic Obstructive Pulmonary Disease but experts now recognize that this respiratory condition in humans is not the same as the one in horses.
RAO is defined as episodes of obstructive lower airway disease in horses triggered by exposure to hay and bedding and characterized by: difficulty breathing, severe airway inflammation, a large number of neutrophils (white blood cells), airway hyper-reactivity, and reversibility with bronchodilator treatment. Signs include:
“Heaves” can usually be diagnosed based on the horse’s medical history and a physical examination. However, additional tests to rule out other conditions or monitor the horse’s response to treatment may be needed. These include:
Corticosteroids—which reduce airway inflammation—include dexamethasone and prednisolone or the newer beclomethasone and fluticasone. The most common bronchodilators—which relieve airway obstruction--are in the beta-adrenergic agonist family and include clenbuterol and albuterol.
There is good evidence that some herbal supplements may be beneficial to horses with “heaves.” Because the condition may place them under additional oxidative stress, antioxidants are recommended. Vitamin C in particular is being investigated for its role in neutralizing the free radicals associated with “heaves.”