Changes

==Diagnosis==

==Diagnosis==

Diagnosis is usually based on the characteristic and seasonal appearance of clinical signs combined with a history of exposure to pasture during late spring or summer. Endoscopy may be used in order to evaluate the airways and to examine the presence of inflammation or mucus. Alternatively a sample of mucous may be obtained via bronchioalveolar lavage which often yields copious mucupurulent material. Cytology usually reveals >25% non-degenerate neutrophils confirming the presence of lower airway inflammation. Curschmann's spirals may also be observed, representing inspissated mucus in the obstucted lower airways.  

Diagnosis is usually based on the characteristic and seasonal appearance of clinical signs combined with a history of exposure to pasture during late spring or summer. Endoscopy may be used in order to examine the airways for the presence of inflammation or mucus. A sample of mucus may be obtained via bronchioalveolar lavage which often yields copious mucupurulent material. Cytology usually reveals >25% non-degenerate neutrophils confirming the presence of lower airway inflammation. Curschmann's spirals may also be observed, representing inspissated mucus in the obstructed lower airways.  

Thoracic radiology is not commonly performed but may reveal an increased bronchointerstitial pattern.

Thoracic radiology is not commonly performed but may reveal an increased bronchointerstitial pattern.

==Treatment and management==

==Treatment and management==

Affected horses should only be allowed access to pasture during late autumn, winter and early spring. They should ideally be kept stabled in a dust-free environment such as a stable with rubber matting and no bedding. If hay appears to act as a trigger to the horse, a complete pelleted diet may be fed or alternatively hay should be soaked. Alfalfa has been previously associated with less respiratory problems than grass hay and may be preferable.  

Control of environmental exposure is essential in horses affected by SPA-RAO. Affected horses should only be allowed access to pasture during late autumn, winter and early spring. They should ideally be kept stabled in a dust-free environment such as a stable with rubber matting and no bedding. If hay appears to act as a trigger to the horse, a complete pelleted diet may be fed or alternatively hay should be soaked. Alfalfa has been previously associated with less respiratory problems than grass hay and may be preferable.

 

In some cases, the response to environmental management may be significant and drug treatment may not be required. In other cases, drug therapy may be required to suffiently manage the clinical signs. Corticosteroids may be administered via nebuslisation using an inhaler in order to allow the maximum concentration of the drug in the respiratory tract, with minimal systemic side effects. This can be combined with a bronchodilator such as clenbuterol. Antibiotics may be required if seconday bacterial infection is present.

In some cases, the response to environmental management may be significant and drug treatment may not be required. In other cases, drug therapy may be required to suffiently manage the clinical signs. Corticosteroids may be administered via nebuslisation using an inhaler in order to allow the maximum concentration of the drug in the respiratory tract, with minimal systemic side effects. This can be combined with a bronchodilator such as clenbuterol. Antibiotics may be required if seconday bacterial infection is present.

 

 

==References==

==References==

*McGorum, B. C., Edward Robinson, N., Dixon, P. M., Schumacher, J. (2007) '''Equine respiratory medicine and surgery''' ''Elsevier Health Sciences''   

*McGorum, B. C., Edward Robinson, N., Dixon, P. M., Schumacher, J. (2007) '''Equine respiratory medicine and surgery''' ''Elsevier Health Sciences''