Severe equine asthma is a chronic respiratory disease of adult horses, occurring when genetically susceptible individuals are exposed to environmental aeroallergens. This results in airway inflammation, mucus accumulation and bronchial constriction. Although several studies aimed at evaluating the genetic and immune pathways associated with the disease, the results reported are inconsistent. Furthermore, the complexity and heterogeneity of this disease bears great similarity to what is described for human asthma. Currently available studies identified two chromosome regions (ECA13 and ECA15) and several genes associated with the disease. The inflammatory response appears to be mediated by T helper cells (Th1, Th2, Th17) and neutrophilic inflammation significantly contributes to the persistence of airway inflammatory status. This review evaluates the reported findings pertaining to the genetical and immunological background of severe equine asthma and reflects on their implications in the pathophysiology of the disease whilst discussing further areas of research interest aiming at advancing treatment and prognosis of affected individuals.

Decision making consists of gathering quality data in order to correctly assess a situation and determine the best course of action. This process is a fundamental part of medicine and is what enables practitioners to accurately diagnose diseases and select appropriate treatment protocols. Despite severe equine asthma (SEA) being a highly prevalent lower respiratory disease amongst equids, clinicians still struggle with the optimization of routine diagnostic procedures. The use of several ancillary diagnostic tests has been reported for disease identification and monitoring, but many are only suitable for research purposes or lack practicality for everyday use. The aim of this paper is to assist the equine veterinarian in the process of decision making associated with managing SEA-affected patients. This review will focus on disease diagnosis and monitoring, while also presenting a flow-chart which includes the basic data that the clinician must obtain in order to accurately identify severely asthmatic horses in their everyday routine practice. It is important to note that European and American board-certified specialists on equine internal medicine can provide assistance in the diagnosis and treatment plan of SEA-affected horses.

The purpose of this study was to investigate stressful responses during a 6-week training protocol in young Lusitano horses used for dressage. The hypothesis was that the proposed training protocol would improve fitness and ensure the welfare of the animals by reducing stress predictors. Nine 4-year-old horses were evaluated before (M1) and six weeks after (M2) beginning a training protocol. The training program was performed six times per week and included 40–80 min of individually intensity-adjusted preparatory exercises for dressage. For both moments, the horses were examined before (T0) and after (T1) dressage simulation tests (DST), and at 30 (T2) and 240 min (T3) during the recovery period. Blood samples were taken to determine the horses’ cortisol levels, total WBC, and neutrophil and lymphocyte counts. All variables were analyzed by one-way ANOVA and Tukey tests, with p ≤ 0.05. After training, there was a significant reduction in cortisol (p = 0.0133), HR (p = 0.0283), total WBC (p < 0.0001), and neutrophil (p < 0.0001) and lymphocyte (p = 0.0341) counts. Other findings included an increase in HRV parameters related to a cardiac vagal modulation. In conclusion, the chosen training protocol led to better fitness as the horses worked more intensively with lower cardiovascular requirements, and they showed blunted cortisol responses at M2. Such data can be used to evaluate performance, but also to predict the welfare of athletic horses.

From previous studies, the International Society for Equitation Science has advised that further research be conducted on the physiological/psychological effects of less-exacerbated poll flexion angles. We aimed to evaluate the effects of two riding poll flexion positions with a difference of only 15° on the respiratory systems and behaviour of horses through an evaluation of dynamic airway collapse via over-ground endoscopy, the pharyngeal diameter, pleural pressure, arterial oxygenation and lactate, HR/RR, and the occurrence of conflict behaviours. Twenty high-level dressage and twenty show-jumping horses underwent a 40 min ridden test at a ground angle of 85°; 3 weeks later, they underwent a ridden test at a 100° ground angle (the angle between the ground and the line from the forehead to the muzzle) and in a cross-over design. Using a mixed model for repeated measures, Wilcoxon/Friedman tests were carried out according to the experimental design and/or error normality. For both groups, at 100°, conflict behaviours and upper airway tract abnormalities were significantly more frequent, and the pleural pressure was higher, and the pharyngeal diameter was lower. At 85°, relaxation behaviours were significantly more frequent. Lactate was significantly higher at 100° only in the dressage horses. Compared to the first test at 85°, the HR/RR were significantly lower at the beginning of the second test (at 100°) but higher at the end. The significant differences identified in these dressage and show-jumping horses support the idea that an increase of just 15° in riding poll flexion can have negative effects on the respiratory system and behaviour of a horse and therefore on its welfare.