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Inhalation therapy is a proven and effective treatment option for respiratory diseases such as COB, equine asthma, and chronic cough. Many horse owners ask themselves: When and why should a horse be given inhalation therapy? This article provides all the important information on the subject of inhalation in horses and highlights the benefits, options, and factors that are crucial for alleviating symptoms and supporting the respiratory tract.

Saline solution (0.9%) and brine solutions with salt contents between 1.4 and 6% are used for this purpose, which specifically moisturize the airways and loosen mucus. Ultrasonic nebulizers, which generate a particle size of 1–5 micrometers and reach deep into the lower airways, are suitable for optimal effect. The inhalation time is usually 20–40 minutes per day. Getting used to the inhalation mask should be done gradually and without stress. A consultation with a veterinarian is essential in order to make the correct diagnosis and develop a suitable treatment strategy.

Causes of respiratory problems in horses

Respiratory problems in horses are often caused by a combination of various factors that put strain on the sensitive respiratory tract. The most important causes include high dust levels in the stable, inadequate stable hygiene, lack of exercise, and bacterial or viral infections. Dust from hay, straw, or bedding can cause horses to cough and irritate the mucous membranes, which increases the risk of chronic respiratory diseases such as COB or equine asthma. Poor stable hygiene promotes the accumulation of germs and pollutants, which can put additional strain on the respiratory tract and lead to inflammation. Lack of exercise also has a negative effect on lung function, as the natural self-cleaning of the respiratory tract is restricted in horses at rest. Infections caused by bacteria or viruses are another common cause of acute or chronic respiratory problems in horses. Horse owners should therefore ensure a clean, well-ventilated environment, provide regular exercise, and consult a veterinarian at the first signs of coughing or other symptoms. Targeted measures such as low-dust bedding, consistent stable hygiene, and early veterinary checks can prevent or treat many respiratory diseases in horses at an early stage.

Why should my horse inhale?

Due to their anatomy, horses' respiratory tracts are particularly sensitive, especially in stable conditions with high levels of dust and allergens. Coughing in horses is a symptom of various respiratory diseases and should be taken seriously. Coughing in horses is often caused by inflammation of the bronchi and mucous membranes. Coughing is initially a natural protective reflex, with coughing up being an important measure for removing mucus from the respiratory tract. However, if it becomes chronic or occurs frequently, this may indicate bronchitis or a respiratory tract infection as the cause of chronic respiratory diseases. Typical diseases such as equine asthma (formerly COPD), COB, or heaves require targeted treatment. Early consultation with a veterinarian is crucial for alleviating symptoms and preventing further problems. Inhalation supports natural mucus clearance and helps loosen stuck mucus—especially in winter, during box rest, or in dusty conditions. The benefits of inhalation lie in the targeted support of the horse's lungs and the alleviation of respiratory problems. Overall, inhalation offers an effective way to improve respiratory health in horses.

If your horse shows signs of respiratory problems, it should be examined by a veterinarian at an early stage. Specialized equine clinics can provide targeted diagnostics and individualized treatments that can have a positive impact on the long-term prognosis.Find an Altano clinic near you now!

How does inhalation therapy work in horses?

The effect is based on osmosis: saline solutions thin out thick mucus, moisturize dry mucous membranes, and promote self-cleaning through the cilia. Inhalation primarily affects the deep airways and bronchi, where the mucous membrane is specifically targeted. Inhalers have been specially developed to effectively nebulize saline solutions and Dead Sea salt solutions and transport the solution to the mucus in the bronchi. Dead Sea salt brine has a particularly mucolytic effect compared to conventional saline solutions. The right solution is crucial for removing mucus from the respiratory tract and thus helping to relieve symptoms. Medications can thus reach the site of action in a targeted manner and without systemic stress. A fully grown horse weighing 500 kg has a lung capacity of around 40 liters and breathes around 60 liters of air with approximately 12 breaths per minute. Horses therefore require special inhalation devices.

Which inhalation agents are suitable for horses?

Depending on the clinical picture and veterinary recommendation, various inhalation solutions are used. Saline solutions are the most commonly used inhalation agents. Isotonic saline solution with 0.9% salt content is suitable for mild humidification and is particularly well tolerated, which is why it is recommended for everyday use and preventive applications. Dead Sea salt brine offers an advantage over conventional saline solutions in that its special mineral content can have additional positive effects on the mucous membranes and respiratory tract. Hypertonic brine solutions with a salt content of 1.4–6% have a stronger mucolytic effect, but should only be used as a course of treatment, as they can have a drying effect if used for longer periods. It is important to ensure that the solutions are prepared and used correctly, as improper use can lead to risks such as irritation or infection. An inhalation solution tailored to the individual horse offers the advantage of specifically addressing the respective symptoms and needs. Medicinal solutions such as corticosteroids, bronchodilators, or mucolytics should only be used on veterinary prescription.

Which inhaler is right for my horse?

The choice of device depends on lung volume, type of therapy, frequency of use, and budget. There are various devices and inhalers available for horses, including ultrasonic nebulizers, compressor nebulizers, mesh nebulizers, and salt chambers. Choosing the right inhaler is a crucial factor in the success of the therapy. Ultrasonic nebulizers offer high performance and short treatment times of 20 to 30 minutes. They are weatherproof but expensive (approx. $500–1,500) and require a lot of maintenance. Compressor nebulizers are more robust and cheaper (approx. $350–$600), but work more slowly, often taking longer than 40 minutes, and are louder. Mesh nebulizers are quiet, mobile, and battery-powered—ideal for sensitive horses, but with smaller filling capacities. Each inhaler offers specific advantages: Ultrasonic nebulizers are particularly efficient, compressor nebulizers are characterized by their robustness, and mesh nebulizers are particularly quiet and flexible. An alternative for horses that are intolerant to masks is the salt chamber, which is less efficient but allows several horses to be treated at the same time.

If you are unsure which form of therapy is suitable,our equine clinics will advise you individually.

Step by step: Getting your horse used to inhalation

During the first week, the switched-off device should be placed in a visible location so that the horse can explore it. The mask can be put on briefly, with any positive reaction being rewarded. In the second week, the device is used for the first time. The mask is gradually combined with the running nebulizer. From the third week onwards, regular inhalations lasting 20 to 40 minutes are possible, ideally at fixed times of the day in a quiet environment. The course of therapy should be documented.

Optimal timing: When should my horse inhale?

Inhalation before exercise mobilizes mucus and improves breathing during exertion. After exercise, medications are particularly effective and the mucous membranes can regenerate. In acute phases, daily or even twice-daily use is recommended. For chronic conditions, regular long-term therapy is recommended. Inhalation can be used preventively 2–3 times per week.

Hygiene and maintenance of inhalation devices

After each use, all parts that have come into contact with the solution should be rinsed with warm water, dried thoroughly, and stored separately. It is important to be aware of the risks of improper cleaning and maintenance of the equipment, as this can lead to problems such as germ formation, which can endanger the horse's respiratory tract and bronchial tubes. Weekly disinfection with veterinary-approved agents is necessary. Consumable parts such as filters, seals, and hoses must be replaced regularly in accordance with the manufacturer's instructions.

Horse inhalation and training: What should be considered?

The combination of horse inhalation and training can specifically support respiratory health, but requires careful planning. Before starting treatment, you should always consult with your veterinarian to determine the optimal dosage and timing of inhalation. During training, it is important not to overwork the horse, as excessive strain can further irritate the respiratory tract. A gradual training program helps the horse slowly get used to the demands and strengthens the lungs. Especially after training, inhalation with appropriate medication can be useful to calm the respiratory tract and promote regeneration. Make sure to allow the horse sufficient rest after inhalation and training so that the respiratory tract can recover. Close cooperation with the veterinarian and individual adjustment of inhalation and training can effectively treat respiratory problems in horses and improve your horse's quality of life in the long term.

Supporting measures

In addition to inhalation therapy, stable hygiene should be optimized: low-dust bedding such as shavings, steamed hay, and regular mucking out improve the air quality. Supportive measures are an important part of therapy to promote your horse's respiratory health. In addition to inhalation, feeding and exercise, among other things, play an important role in recovery. Good air quality with adequate ventilation, optimal humidity (60–80%), and the avoidance of ammonia are crucial. Above all, a combination of different measures brings the greatest success in the treatment of respiratory diseases. Regular exercise, taking the disease into account, and an adapted diet with vitamin C, omega-3 fatty acids, and herbal support (e.g., thyme) promote recovery. A stress-free daily routine and social contact have a positive effect on respiratory health.

Take advantage of the experience of ourAltano equine clinics to ensure the long-term health of your horse.

Costs of inhalation therapy

Depending on the device, the purchase price ranges between €300 and €2,000. The running costs for inhalation agents are around €10 for 20 ampoules of saline solution and approx. €50 for 30 ampoules of brine. Medication costs vary depending on the active ingredient. Rental devices, used models with a warranty, or shared use in the barn can reduce costs. With consistent use, the need for emergency treatment and medication is reduced in the long term.

Limitations of inhalation therapy

Inhalation alone cannot cure structural defects, primary allergies, or severe infections. It does not work miracles, but merely serves as a supportive measure in the treatment of respiratory diseases. Sudden shortness of breath, fever, cyanosis, or worsening symptoms despite ongoing therapy require immediate veterinary attention. Chronic respiratory diseases often require multimodal therapy with medication, environmental adjustments, exercise, and diet.

Conclusion

Inhalation therapy is a proven method of supporting the respiratory tract in horses and helps with both acute and chronic conditions such as COB or equine asthma. It specifically moisturizes the respiratory tract and liquefies stuck mucus, promoting natural cleansing of the lungs.

The success of the treatment depends on correct application: this includes choosing the right inhalation device, the correct concentration of saline solution or Dead Sea salt brine, and consistent hygiene. It is also important to patiently accustom the horse to the inhalation mask.
However, inhalation alone cannot cure respiratory diseases. It works best in combination with improved stable hygiene, low-dust feed, sufficient exercise, and optimized husbandry. Regular inhalation can thus improve the quality of life and respiratory health of horses in the long term.