b'YOUR GUIDE TO THE 2017 AAEP CONVENTION SPONSORED BYMelissa Mazan, DVM, Dipl. ACVIM, a professor at Tufts University Cummings School of Veterinary Medicines Hospital for Large Animals, in North Grafton, Mas-sachusetts, reviewed how veterinarians can best treat and manage equine asthma.Treatment goals for RAO and IAD are similar, Mazan said, with a few key differ-ences. Goals for RAO should include:Relieving bronchospasm that causes coughing and labored breathing; Reducing lower airway inflammation;Preventing acute episodes in the long term by controlling lower airway in-flammation and obstruction; andReturning the horse to athletic function.Treatment goals for IAD should include:Eliminating bronchospasm;Reducing mucous production and airway obstruction; ISTOCK.COM Reducing airway reactivity; and If your horse has asthma, take steps to keep his environment as low-dust as possible. Preventing recurrences.Treatment of these diseases entails achoose to begin treatment with systemicsteam it and feed from the ground. team approach and an acceptance thatmedications or with a combination ofAvoid storing hay above stalls, or place this may be a lifelong problem that maysystemic and inhaled aerosolized medica- a tarp beneath it to reduce downstairs be modified, but that is unlikely to gotions, said Mazan. With a chronic casedust and allergen exposure.away, she said. One of the most impor- the vet might opt for aerosolized delivery. If your grains and concentrates are tant aspects to successful treatment is theThe decision as to which deliverydusty, wet or soak them prior to feeding.establishment of a reasonable definitionmethod is preferable may be influencedUse wood shavings and other low-dust of return to athletic use, she added.by a number of factors, including finan- beddings rather than straw.While a young IAD horse might returncial, given that aerosolized drugs andDampen aisleways before sweeping, to full function, an older RAO one mighttheir delivery devices are quite expensive. and avoid using leaf-blowers.only be suitable for light pleasure riding.BronchodilatorsVeterinarians often useRemove horses from the barn before Its also important for veterinarians toaerosolized bronchodilators because theyperforming chores.consider the horses history (Is the condi- produce fewer side effects, Mazan said,Keep barns and stalls free of cobwebs tion seasonal? Worse indoors than out?)but systemic options are also available.and other materials that collect dust.before implementing a treatment andThe two types of bronchodilators includeLeave barn doors and windows open management plan, Mazan said.-2 agonists (e.g., albuterol, clenbuterol)when possible for air movement.Regardless, veterinarians have a fewand parasympatholytics (e.g., ipratro- Use low-dust footing in arenas, or pharmacological therapy options: pium, hyoscine butylbromide). reduce current footings dust by adding CorticosteroidsMazan called theseA very important caveat is that usinga humectant or hygroscopic agent.drugs the cornerstone of successful treat- corticosteroids (and bronchodilators)Medical treatment and environmental ment for both IAD and RAO. Researcherswithout remediating the environment ismanagement go hand-in-hand when car-have shown that systemic oral or inject- like using hand sanitizer without wash- ing for horses with asthma. Mazan encour-able corticosteroids work well for treatinging your hands, Mazan said. Its betteraged practitioners to monitor treatment horses with heaves, but they appear lessthan nothing, but much less effective thanoutcomes to ensure horses are improving. effective in IAD horses. Veterinarians useremoving the actual problem. Lack of improvement could suggest an prednisolone and dexamethasone mostThe root problem might be within yourinfectious disease and the need for addi-frequently. They can also administervery own barn. The barn environment istional diagnostics and treatment. hinhaled corticosteroids. Vets commonlyreplete with organic particulate matter, prescribe the aerosolized drugs flutica- respirable endotoxins, molds, and volatile sone and beclomethasone for owners togases such as ammonia, Mazan said. She administer via a metered-dose inhaler,offered tips for improving RAO and IADesuch as the Aerohippus or EquineHaler,horses environments: Visit TheHorse.com/AAEP2017she said. Hay is notoriously dusty. If possible, Depending on how severe a horsesswitch to pelleted hay, complete feed, Evaluating Horse Airways: At Rest, During Exer-clinical signs are, a veterinarian mightor silage. If you must use hay, soak orcise, or Both? TheHorse.com/40199A52 TheHorse.com/AAEP2017 AAEP Wrap-Up THE HORSEMarch 2018'