Recurrent airway obstruction in horses is a common, painful, and largely preventable condition caused by stable dust and mould spores that requires environmental management alongside medical treatment.
RAO is a welfare problem that illustrates the direct link between management decisions and respiratory health. A horse kept in a poorly ventilated stable on dusty hay and straw bedding is continuously inhaling the allergens that drive airway inflammation — every breath contributes to a condition that causes chronic discomfort and progressive lung damage. The welfare-positive response is environmental: maximising turnout, improving stable ventilation, switching to soaked hay or haylage, and changing to dust-extracted or paper bedding. These changes can dramatically reduce clinical signs and the need for medication. Medical management provides symptomatic relief but cannot compensate for ongoing allergen exposure. Environmental management is both the most effective and most humane approach to RAO.