Understanding a horse's cough and acting correctly

A single cough when trotting off, occasional coughing in the stable or short coughing fits - such signs alert many horse owners. And that's a good thing, because early observation gives you the opportunity to react in good time: A horse's cough can range from a harmless irritation to a chronic respiratory disease, which can often be treated well with targeted care.

The challenge is to correctly assess the cough and react appropriately. A persistent or worsening cough often indicates serious problems. Modern diagnostic procedures such as endoscopy and bronchoalveolar lavage - a lavage of the deep airways for cell analysis - now enable precise diagnosis. Innovative therapeutic approaches also offer new hope for chronically ill horses. This article shows you how to correctly classify coughs in horses, which examinations are useful and when which treatment is required.

Physiology of the horse's lungs: Why horses are susceptible to respiratory problems

The horse's lungs are a high-performance organ. With a lung volume of around 42 liters and a gas exchange surface area equivalent to the size of ten tennis courts, they are perfectly adapted to the requirements of a running and flight animal. At the same time, this enormous capacity also makes the respiratory system susceptible to impairment.

At rest, horses breathe around 8-16 times per minute, moving around 60 liters of air. Under maximum stress, the breathing rate can increase to over 120 breaths per minute, with up to 1,800 liters of air flowing through the lungs per minute. These enormous volumes of air inevitably also transport dust, spores, allergens and pathogens into the respiratory tract.

The cough reflex is an important protective mechanism. When foreign bodies, mucus or irritants enter the airways, receptors in the windpipe and bronchial tubes trigger a cough. Air is expelled at high speed to clear the airways. A horse with a cough therefore first tries to keep its airways clear.

Harmless versus serious cough: the important distinguishing features

Harmless cough

A short, occasional cough is usually harmless if:

• no nasal discharge occurs,
• Breathing and general behavior remain normal (no fever, no drop in performance),
• the cough disappears within a few days,
• the horse reacts to dust or temperature changes, for example.

This cough is usually dry, occurs only occasionally and the horse otherwise shows no signs of illness. The horse remains willing to perform and the cough disappears by itself after a few minutes.

Cough of concern

If the horse coughs and shows additional symptoms, you should take notice:

• Frequent coughing
• Coughing during or after exercise
• Moist, rattling cough
• Nasal discharge (especially if yellowish or greenish)
• Increased breathing rate at rest (over 20 breaths/minute)
• Drop in performance or rapid fatigue
• Fever (over 38.5°C)
• Loss of appetite

A horse with this type of cough requires a veterinary examination. The earlier the cause is identified, the better the chances of treatment. Are you unsure whether your horse's cough needs treatment? Contact our specialists for a professional assessment.

The most common causes of coughing in horses

Infectious respiratory diseases

Viral infections such as influenza or herpes can trigger acute coughing. The horse initially coughs dryly, but later often coughs up mucus. This is usually accompanied by fever, nasal discharge, and swollen lymph nodes. Bacterial infections can occur as primary or secondary infections and often exacerbate an original viral infection.

Chronic obstructive bronchitis: Equine asthma (COB/COPD)

This disease, also known as "dampness", is the most common chronic respiratory disease in horses. Coughing occurs mainly during exercise, later also at rest. The prolonged exhalation phase with visible abdominal pressure is typical. The disease often develops gradually over years.

Allergic asthma

More and more horses are developing allergic reactions to environmental allergens such as hay dust, mold spores or pollen. Coughing in horses often occurs seasonally or in certain situations. The symptoms are similar to COB, but are usually less severe and can disappear completely if the allergen is avoided.

Lungworms

Lungworms can cause coughing, especially in grazing horses that are kept together with donkeys. The cough is often persistent and does not respond to the usual treatments. A fecal examination for lungworm larvae provides clarity.

Modern diagnostics: from clinical examination to endoscopy

The clinical examination

The basic diagnosis begins with a thorough general examination. The vet listens to the lungs, checks the respiratory rate and depth and examines the upper airways. An exercise test can show whether the horse is coughing and how quickly it recovers after exertion.

Endoscopy of the airways

Endoscopy enables a direct assessment of the upper and sometimes also the lower respiratory tract. Using a flexible camera, the vet can detect inflammation, mucus accumulations or anatomical changes. In a horse with a cough, endoscopy often reveals mucus in the windpipe or reddened, swollen mucous membranes.

Bronchoalveolar lavage (BAL)

In BAL, sterile saline solution is flushed into a section of the lung and then sucked out again. The fluid obtained is examined in the laboratory. The cell composition provides information about the type of disease—elevated neutrophil granulocytes indicate a bacterial infection, while many eosinophil granulocytes indicate an allergic component.

Further diagnostic procedures

X-rays of the lungs can reveal structural changes. Arterial blood gas analyses provide information about lung function. If infection is suspected, swab samples for bacteriological testing and antibiograms are useful for selecting the right antibiotic.

Your horse has a persistent cough and you would like a thorough diagnosis? Find a specialized clinic near you here with state-of-the-art equipment.

The decisive factor: posture and respiratory health

Optimize barn climate

Housing conditions have an enormous influence on whether a horse coughs or remains healthy. Optimal are:

• Permanent fresh air supply without draughts
• Humidity between 60-80%
• Dust minimization
• Avoidance of ammonia pollution through regular mucking out

Many stables are too warm and poorly ventilated. The often well-intentioned "warmth" does more harm than good. Horses tolerate cold much better than stuffy air.

Feeding management

Hay is the main source of dust in the stable. If a horse coughs, the roughage should be adjusted:

• Water or steam hay before feeding
• Haylage as an alternative for highly allergic horses
• Moisten concentrated feed
• Feeding from the floor instead of from hay racks at head height

Soaking hay reduces the dust load by up to 95%. Vaporized hay has the additional advantage of killing mould spores.

Movement and training

Regular exercise is essential for lung health. It promotes self-cleaning of the airways and improves the ventilation of all parts of the lungs. A horse with a cough often benefits from adapted training - not too intensive, but regular. Open stabling or all-day grazing are ideal for horses with respiratory problems.

Modern inhalation therapies: Medication directly at the site of action

Advantages of inhalation

Inhalation therapy delivers medication directly to the site of the problem and is often the treatment of choice when a horse is coughing.

Various inhalation systems

Ultrasonic nebulizers produce very fine droplets that reach deep into the lungs. They are particularly suitable for treating the lower respiratory tract. Compressor nebulizers are more robust and suitable for daily use in the stable. Mobile inhalers enable treatment directly in the pasture or during transportation.

Inhalation solutions

Saline solution moistens the airways and liquefies thick mucus. Bronchodilators widen constricted airways. Corticosteroids have an anti-inflammatory effect on allergic coughs. Secretolytics loosen stuck mucus. The choice of inhalation solution depends on the cause of the horse's cough.

Practical implementation

Most horses accept inhalation well after a short period of familiarization. It is important to provide a calm environment and positive reinforcement, for example with treats after the treatment. Inhalation should last 15-20 minutes and be carried out 1-2 times a day, depending on the severity.

Drug therapy: When are antibiotics really necessary?

Antibiotics - only for bacterial infections

Antibiotics are not a universal solution when a horse has a cough. They only work against bacteria, not viruses or allergies. Anyone who uses antibiotics without a clear need risks resistance and damage to the body's own microflora

Antibiotics are used for:

• Proven bacterial infection (swab sample)
• Purulent nasal discharge
• Fever over several days
• Deterioration despite symptomatic therapy

An antibiogram should guide therapy to identify the most effective antibiotic.

Expectorants and bronchodilators

Acetylcysteine and dembrexin dissolve thick mucus and make it easier to cough up. Clenbuterol dilates the bronchi and facilitates breathing. These drugs are often the first choice for a horse with a cough without bacterial involvement.

Anti-inflammatory

Corticosteroids are highly effective for allergic and chronic coughs. They reduce inflammation and mucus production. However, they should be used selectively and under veterinary supervision. Non-steroidal anti-inflammatory drugs can alleviate the symptoms of acute infections.

Immunomodulators

Modern immunomodulators such as interferon or special bacterial lysates can strengthen the immune system and reduce susceptibility to infection. They are a particularly interesting therapy option for chronically coughing horses.

Your horse continues to cough despite treatment? Our experts will advise you on alternative therapeutic approaches.

Naturopathic support

Proven medicinal plants

Thyme has antibacterial and expectorant properties. Ribwort plantain soothes irritated mucous membranes. Marshmallow forms a protective film on the respiratory tract. Echinacea strengthens the immune system. These herbs can be used as a supportive measure in the form of tea, feed supplements, or inhalation when the horse is coughing.

Acupuncture and homeopathy

Acupuncture can have a particularly supportive effect on chronic coughs. Certain points promote lung function and the coughing up of phlegm. Homeopathic remedies such as Drosera or Ipecacuanha are selected individually according to the symptoms.

Brine inhalation

The inhalation of brine (salt solution) has an expectorant and anti-inflammatory effect. Brine chambers, in which horses can breathe freely, are becoming increasingly popular. The salty air cleanses the airways and promotes the regeneration of the mucous membranes.

Prognosis and long-term management

The prognosis depends heavily on the underlying disease. Acute infections usually heal without consequences if treated promptly. Chronic diseases such as COB require lifelong management measures, but can be well controlled.

A horse with a cough due to chronic respiratory problems needs:

• Optimal housing conditions with plenty of fresh air
• Low-dust feeding
• Regular, adapted exercise
• Consistent drug therapy if required
• Regular veterinary checks

With consistent management, even chronically ill horses can often live for years with a good quality of life. It is important to take early warning signs seriously and act in good time.

Prophylaxis: Preventing coughs in horses

Prevention is the best protection against respiratory diseases:

Vaccinations against influenza and herpes reduce the risk of infection. The basic immunization should be carried out correctly and refreshed regularly.

Quarantine for new horses prevents the introduction of diseases. New stable residents should be kept separately for at least two weeks.

Reducing stress strengthens the immune system. Excessive demands, frequent transportation or social conflicts make you susceptible to infections.

Continuously improve air quality through regular mucking out, dust minimization and good ventilation. Investing in a good barn climate pays off in the long term.

When is a cough an emergency?

In certain situations you should not hesitate and call the vet immediately:

• Severe respiratory distress with mouth breathing
• Bluish mucous membranes (lack of oxygen)
• Highly increased respiratory rate (over 40/minute at rest)
• High fever (over 40°C)
• Apathy (apathy, lack of liveliness and lack of reaction to environmental stimuli) and unwillingness to eat
• Bloody nasal discharge

These symptoms indicate a life-threatening situation in which rapid action is required.

Conclusion

Coughing in horses is a symptom that should be taken seriously. Distinguishing between harmless and serious coughing requires attention and experience. While occasional coughing may be harmless, persistent or worsening coughing indicates a condition that requires treatment.

Today, modern diagnostics make it possible to find the exact cause. Endoscopy, BAL and other examinations help to make the correct diagnosis. Treatment depends on the underlying disease - from targeted antibiotics for bacterial infections to inhalation therapies and comprehensive postural management for chronic diseases.

The most important factor for respiratory health is and remains husbandry. Fresh air, low-dust feed and sufficient exercise are the cornerstones of prevention. A horse with a cough often benefits more from optimized husbandry conditions than from medication alone.

The prognosis for coughing horses has improved significantly in recent years. Innovative therapies, a better understanding of the disease mechanisms and modern husbandry concepts enable even chronically ill horses to lead a life worth living. It is crucial to recognize early warning signs and act consistently. Because the earlier a respiratory disease is recognized and treated, the better the chances of recovery.

Do you have questions about diagnostics or treatment if your horse has a cough? Our clinics are at your disposal with state-of-the-art equipment and expertise.

For better readability, we predominantly use the generic masculine in our texts. It goes without saying that all personal designations refer equally to all genders. The abbreviated form of language is used solely to improve comprehensibility and is to be understood in an unbiased manner.