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Recurrent Airway Obstruction (view source)
Revision as of 13:03, 26 August 2010
, 13:03, 26 August 2010→Treatment
==Treatment==
==Treatment==
The single most important treatment is environmental management to reduce allergen exposure. Medication will alleviate clinical signs of disease; however, respiratory disease will return after medication is discontinued if the horse remains in the allergen-challenged environment. The most common culprits are organic dusts present in hay, which need not appear overtly musty to precipitate an episode in a sensitive horse. Horses should be maintained at pasture with fresh grass as the source of roughage, supplemented with pelleted feed. Round bale hay is particularly allergenic and a common cause of treatment failure for horses on pasture. Horses that remain stalled should be maintained in a clean, controlled environment. Complete commerial feeds eliminate the need for roughage. Hay cubes and hay silage are acceptable, low-allergen alternative sources of roughage and may be preferred by horses over the complete feeds. Soaking hay with water prior to feeding may control clinical signs in mildly affected horses but is unacceptable for highly sensitive horses. Horses maintained in a stall should not be housed in the same building as an indoor arena, hay should not be stored overhead, and straw bedding should be avoided. Horses with summer pasture-associated obstructive pulmonary disease should be maintained in a dust-free, stable environment.
The mainstays of treatment
and prevention of RAO are
and prevention of RAO are
environmental control, the
environmental control, the
bronchodilation, due to the mucus accumulation and
bronchodilation, due to the mucus accumulation and
inflammatory changes in the airway wall. It is important
inflammatory changes in the airway wall. It is important
to understand that bronchodilators do not treat the underlying
to understand that bronchodilators do not treat the underlying inflammation.
inflammation.
Medical treatment consists of a combination of bronchodilating agents (to provide relief of airway obstruction) and corticosteroid preparations (to reduce pulmonary inflammation). Bronchodilator therapy will provide immediate relief of airway obstruction until clincal signs of disease are controlled by corticosteroids. Severely affected horses are ideally controlled with aerosolized bronchodilators and systemic corticosteroids. Horses with mild to moderate airway inflammation can be treated with aerosolized corticosteroids and bronchodilators. It is inappropriate to treat RAO with bronchodilators as the sole therapy. NSAID, antihistamines, and leukotriene-receptor antagonists have failed to demonstrate therapeutic benefit.
Corticosteroids
Corticosteroids
Many horses benefit from corticosteroid administration
Many horses benefit from corticosteroid administration