Horse Recurrent Airway Obstruction Management

Recurrent airway obstruction (RAO, formerly heaves) is a common inflammatory airway disease in horses that causes chronic breathing difficulty requiring environmental and medical management.

Key Facts

RAO affects approximately 14% of horses in temperate regions
It is triggered by allergens in hay, bedding, and stable dust causing inflammatory airway narrowing
Affected horses show exercise intolerance, coughing, nasal discharge, and increased respiratory effort
Managing hay by soaking or steaming and using dust-free bedding dramatically reduces allergen exposure
Corticosteroids and bronchodilators provide symptomatic relief during acute episodes

Welfare Considerations

Horses with RAO experience chronic breathing difficulty that impairs exercise capacity and reduces quality of life. During acute exacerbations, horses may show obvious respiratory distress with pronounced abdominal movement during breathing. The chronic nature of the condition means horses may suffer for years if environmental management is inadequate. Turning horses out to pasture and managing hay quality and bedding are the most effective long-term welfare interventions.

What You Can Do

Soak or steam hay before feeding horses with RAO to reduce spore and allergen load
Use dust-free bedding alternatives such as rubber matting, paper, or cardboard
Maximise turnout on pasture where possible for horses with stable-associated RAO
Seek veterinary treatment during acute exacerbations for bronchodilator and steroid therapy
Consider respiratory specialist referral for horses with severe or poorly responsive disease