Every rider, trainer and owner that cares about not damaging their horse needs to see the highly anticipated follow up to Equitopia's first "Biomechanics of Engagement" video featuring Veterinarian/Trainer Karin Leibbrandt, DVM, Joanna Robson, DVM, and Jeroen Duenk, Equine Bodyworker.

Part one of this video explores the physiological consequences of riding "behind the vertical" (hyperflexion) as well as anatomical damage as a result of riding with a hollow back.

Part two demonstrates how to start to bring a horse into a relaxed self carriage by teaching the horse to be in both vertical and horizontal balance.

Read more: The Biomechanics of Engagement :The Essential Components of Self Carriage (18:19)

Read more: Julie Goodnight: Don't wear a bike helmet for horseback riding-- here's why.... (0:30)

Read more: Julie Goodnight: Quick Tip to Stay out of Horse's Kick Zone, CHA (0:29)

Equestrian World travelled to a remote part of the island more than 100 km from Reykjavik to meet Gunnar Sturluson, an Icelandic Horse breeder and President of FEIF, the International Federation of Icelandic Horse Associations, at his 'Hrísdalur' farm. We also visit Guðmar Þór Pétursson at his farm Hestaland, offering riding tours and instruction all year round.

Read more: The Uniqueness of Icelandic horses, Part 2 (7:15)

By Kentucky Equine Research Staff

Hay produces dust particles that contain mold, endotoxins, mites, and other microscopic antigens. Inhaling those respirable dust particles is the most significant exacerbator of severe equine asthma (SEA). While studies show that hay soaking decreases the production of dust particles, only one study performed to date demonstrates that hay soaking improves lung function.*

In that study, 10 horses with SEA belonging to the Equine Asthma Research Laboratory at the University of Montreal, Canada, were recruited. All horses were in exacerbation at the start of the six-week study. Horses were split into two groups and fed either soaked alfalfa pellets in a feeder or hay that had been soaked in cold water for 45 minutes before feeding at ground level. At baseline and again at the end of the study, airway inflammation was measured via bronchoalveolar lavage (BAL, a “lung wash”), and tracheal mucous scoring was performed. On weeks 0, 2, 4, and 6, researchers assigned respiratory clinical scores based on nasal flare and abdominal effort while breathing. They also measured lung function, as determined by lung resistance/obstruction, during those weeks.

“Clinical respiratory scores and pulmonary function improved significantly during the study in both groups of horses,” explained Ashley Fowler, Ph.D., a Kentucky Equine Research nutritionist.

No significant improvement, however, was noted in airway inflammation in the soaked hay group based on BAL findings of “pulmonary neutrophilia.” This means that a specific type of white blood cell, called neutrophils, persisted in the BAL fluid throughout the treatment period.

“Pulmonary neutrophilia is known to occur when respirable dust exists in the horse’s breathing zone—the two-foot sphere around the nose,” Fowler said.

Despite effectively reducing respirable particles, hay soaking is perceived as cumbersome by many owners, resulting in poor compliance. Further, alternatives to hay soaking such as expensive pellets, oil-mixed hay, and haylage/silage also have limitations. Nonetheless, methods that decrease respirable particles are essential for decreasing the clinical signs of SEA, including labored breathing, coughing, and increased mucus production.

“Because SEA is characterized by inflammation, current recommendations include adding marine-derived anti-inflammatory omega-3 fatty acids to the diet.** Kentucky Equine Research offers EO-3 and ReSolvin EQ, both of which contain EPA and DHA in a palatable formula,” Fowler said.

Owners are also encouraged to decrease dust in the horse’s environment through ventilation and other management practices like turnout and low-dust bedding.

Read more: Beyond Dust Reduction: Soaking Hay Improves Lung Function in Asthmatic Horses

Dr. Janet Beeler-Marfisi

There’s nothing like hearing a horse cough to set people scurrying around the barn to identify the culprit. After all, that cough could mean choke, or a respiratory virus has found its way into the barn. It could also indicate equine asthma. Yes, even those “everyday coughs” that we sometimes dismiss as “summer cough” or “hay cough” are a wake-up call to the potential for severe equine asthma.

Formerly known as heaves, broken wind, emphysema, chronic obstructive pulmonary disease (COPD), or recurrent airway obstruction (RAO), this respiratory condition is now called severe equine asthma (sEA). These names reflect how our scientific and medical understanding of this debilitating disease has changed over the years. We now consider heaves to be most comparable to severe asthma in people.

But what if your horse only coughs during or after exercise? This type of cough can mean that they have upper airway irritation (think throat and windpipe) or lower airway inflammation (think lungs) meaning inflammatory airway disease (IAD) – which is now known as mild-to-moderate equine asthma (mEA). This airway disease is similar to childhood asthma, including that it can go away on its own. However, it is still very important to call your veterinarian out to diagnose mEA. This disease causes reduced athletic performance and there are different subtypes of mEA that benefit from specific medical therapies. In some cases, mEA progresses to sEA.

What has Equine Asthma got to do with Air Quality?

A lot, it turns out. Poor air quality, or air pollution, includes the barn dusts – the allergens and molds in hay and the ground up bacteria in manure – as well as arena dusts and ammonia from urine. Also, very importantly for both people and horses, air pollution can be from gas and diesel-powered equipment. This includes equipment being driven through the barn, the truck left idling by a stall window, or the smog from even a small city that drifts nearly invisibly over the surrounding farmland. Recently, forest-fire smoke is another serious contributor to air pollution.

Smog causes the lung inflammation associated with mEA. Therefore, it is also likely that air pollution from engines and from forest fires will also trigger asthma attacks in horses with sEA. Smog and smoke contain many harmful particulates and gasses, but very importantly they also contain fine particulate matter, known as PM2.5. The 2.5 refers to the diameter of the particle being 2.5 microns. That’s roughly 30 times smaller than the diameter of a human hair. Because it is so small, this fine particulate is inhaled deeply into the lungs where it crosses over into the blood stream. So, not only does PM2.5 cause lung disease, but it also causes inflammation elsewhere in the body including the heart. Worldwide, even short-term exposure is associated with an increased risk of premature death from heart disease, stroke, and lung cancer. This PM2.5 stuff is not trivial!

In horses, we know that PM2.5 causes mEA, so it’s logical that smog and forest-fire smoke exposure should cause exacerbation of asthma in horses, but we don’t know about heart disease or risk of premature death.

Symptoms, Diagnostic Tests, and Treatments

Equine asthma manifests with a spectrum of symptoms that vary in severity and degree of debilitation they cause. Just like in people with asthma, the airways of horses with mEA and sEA are “hyperreactive”. This means that the asthmatic horse’s airways are extra sensitive to barn dusts that another horse’s lungs would just “ignore”. The asthmatic horse’s airways constrict, or become narrower, in response to these dusts. This narrowing means it’s harder to get air in and out of the lungs. Think about drinking through a straw. You can drink faster with a wider straw than a skinnier one. It’s the same with air and the airways. In horses with mEA the narrowing is mild. In horses with sEA the constriction is extreme and is the reason why they develop the “heaves line” – they have to use their abdominal muscles to help squeeze their lungs to force the air back out of their narrow airways. They also develop flaring of their nostrils at rest to make their upper airway wider to get more air in. Horses with mEA do not develop a heaves line, but the airway narrowing and inflammation do cause reduced athletic ability.

The major signs of mEA are coughing during or just after exercise that has been going on for at least a month, and decreased athletic performance. In some cases, there may also be white or watery nasal discharge particularly after exercise. Often, the signs of mEA are subtle and require a very astute owner, trainer, groom, or rider to recognize them.

Another very obvious feature of horses with sEA is their persistent hacking cough, which worsens in dusty conditions. Hello dusty hay, arena, and track! The cough develops because of airway hyper-reactivity and because of inflammation and excess mucus in the airways. Mucus is the normal response of the lung to the presence of inhaled tiny particles or other irritants. Mucus traps these noxious substances so they can be coughed out, which protects the lung. But if an asthma-prone horse is constantly exposed to a dusty environment it leads to chronic inflammation and mucus accumulation, and the development or worsening of asthma – along with that characteristic cough.

Accurately Diagnosing Equine Asthma

Dr Janet Beeler-Marfisi listening to a horse's lungs assisted by a "rebreathing" bag Veterinarians use a combination of the information you tell them, their observation of the horse and the barn, and a careful physical and respiratory examination that often involves “rebreathing”. This is a technique where a bag is briefly placed over the horse’s nose causing them to breathe more frequently and more deeply to make their lung sounds louder. This helps your veterinarian hear subtle changes in air movement through the lungs and amplifies the wheezes and crackles that characterize a horse experiencing a severe asthma attack. Wheezes indicate air “whistling” through constricted airways, and crackles mean airway fluid buildup. The fluid accumulation is caused by airway inflammation and contributes to the challenge of getting air into the lung.

Other tests your veterinarian might use are endoscopy, bronchoalveolar lavage, and in the specialist setting, pulmonary function testing. They will also perform a complete blood count and biochemical profile assay to help rule out the presence of an infectious disease.

Endoscopy allows your veterinarian to see the mucus in the trachea and large airways of the lung. It also lets them see whether there are physical changes to the shape of the airways, which can be seen in horses with sEA.

Bronchoalveolar lavage, or “lung wash” is how your veterinarian assesses whether there is an accumulation of mucus and inflammatory cells in the smallest airways that are too deep in the lung to be seen using the endoscope. Examining lung wash fluid is a very important way to differentiate between the different types of mEA, between sEA in remission and an active asthma attack, and conditions like pneumonia or a viral lung infection.

Finally, if your veterinarian is from a specialty practice or a veterinary teaching hospital, they might also perform pulmonary function testing. This allows your veterinarian to determine if your horse’s lungs have hyper-reactive airways (the hallmark of asthma), lung stiffening, and a reduced ability to breathe properly.

Results from these tests are crucial to understanding the severity and prognosis of the condition. As noted earlier, mEA can go away on its own but medical intervention may speed healing and return to athletic performance. With sEA, remission from an asthmatic flare is the best we can achieve. As the disease gets worse over time, eventually the affected horse may need to be euthanized.

Management, Treatment, and Most Importantly – Prevention

Successful treatment of mEA and sEA flares, as well as long-term management, requires a multi-pronged approach and strict adherence to your veterinarian’s recommendations.

Rest is important because forcing your horse to exercise when they are in an asthma attack further damages the lung and impedes healing. To help avoid lung damage when smog or forest-fire smoke is high, a very useful tool is your local, online, air quality index (just search on the name of your closest city or town and “AQI”). In Canada click here. There is also a visual map of conditions across North America.

Available worldwide, the AQI gives advice on how much activity is appropriate for people with lung and heart conditions, which are easily applied to your horse. For example, if your horse has sEA and if the AQI guidelines say that asthmatic people should limit their activity, then do the same for your horse. If the AQI says that the air quality is bad enough that even healthy people should avoid physical activity, then do the same for you AND your horse. During times of poor air quality (Image 2), it is recommended to monitor the AQI forecast and plan to bring horses into the barn when the AQI is high and to turn them out once the AQI has improved.

Prevent dusty air. Think of running your finger along your tack box – whatever comes away on your finger is what your horse is breathing in. Reducing dust is critical to preventing the development of mEA and sEA, and for managing the horse in an asthmatic flare. Logical daily practices to help reduce dust exposure include:

• turning out all horses before stall cleaning
• wetting down the aisle prior to sweeping
• never sweeping debris into your horse’s stall
• using low-dust bedding like wood shavings or dust-extracted straw products – which should also be dampened down with water
• reducing arena, paddock, and track dust with watering and maintenance
• when selecting footing substrate, consider low dust materials.
• steaming (per the machine’s instructions) or soaking hay (15-30 minutes and then draining, but never storing steamed or soaked hay!)
• feeding hay from the ground or using hay feeders that sit on the ground
• feeding other low-dust feeds
• avoiding hay feeding systems that allow the horse to put their nose into the middle of dry hay – this creates a “nosebag” of dust

Other critical factors include ensuring that the temperature, humidity and ventilation of your barn are seasonally optimized. Horses prefer a temperature between 10-24 ºC (50-75 ºF), ideal barn humidity is between 60-70%. Optimal air exchange in summer is 142 L/s (300 cubic feet/minute). For those regions that experience winter, air exchange of 12-19 L/s (25-40 cubic feet/minute) is ideal. In winter, needing to strip down to a single layer to do chores implies that your barn is not adequately ventilated for your horse’s optimal health. Comfortable for people is often too hot and too musty for your horse!

Medical interventions for controlling asthma are numerous. If your veterinarian chooses to perform a lung wash, they will tailor the drug therapy of your asthmatic horse to the results of the wash fluid examination. Most veterinarians will prescribe bronchodilators to alleviate airway constriction. They will also recommend aerosolized, nebulized, or systemic drugs (usually a corticosteroid, an immunomodulatory drug like interferon-α, or a mast cell stabilizer like cromolyn sodium) to manage the underlying inflammation. They may also suggest nebulizing with sterile saline to help loosen airway mucus and may suggest feed additives like omega 3 fatty acids, which may have beneficial effects on airway inflammation.

New Research and Future Directions

Ongoing research is paramount to expanding our knowledge of what causes equine asthma and exploring innovative medical solutions. Scientists are actively investigating the effects of smog and barn dusts on the lungs of horses. They are also working to identify new targeted therapies, immunotherapies, and other treatment modalities to improve outcomes for affected horses.

Read more: Air Quality and Air Pollution’s Impact on Your Horse’s Lungs

By Juliet M. Getty, Ph.D.

Driving through Kentucky, I passed breathtaking farms - acres and acres of meticulously manicured pastures, lined with black Kentucky-style four board fences that seemed to travel for miles. What struck me, however, was their barrenness.

Where are all the horses?

Placed high on mounds in the distance were spectacular barns, "horse hotels," where horses reside - some just during the day, some for most of the time.

While this may be convenient for the horse owner, standing in a small area for hours on end (even if part of it is outdoors) takes its toll on your horses' mental and physical health, to such a great extent, that it dramatically diminishes his quality, and length, of life.

Horses need to move.

Ever tried staying in a small room for most of the day? Likely, very uncomfortable; and we like cozy places! But horses most definitely do not! Their very survival depends on their ability to flee at a moment's notice from dangers, real or perceived. Trapped, they eventually succumb to their fate, appearing as though they are accepting and perhaps even appreciating their solitude. But the stress takes its toll on their immune system and hormonal responses, leading to a vast variety of health issues.

All body systems, including cardiovascular, respiratory, digestive, reproductive, neuromuscular, and skeletal systems depend on exercise to remain sound. If the horse cannot be ridden every day, many will benefit from simply being lunged or worked in a round pen for a short period of time to provide an opportunity to get the blood flowing. Be aware that running around in circles for prolonged periods of time is unnatural and can be detrimental physically and mentally, causing frustration and inducing a stress response. Allowing for more natural forms of movement such as free exercise by walking around in a large pasture (or dry lot with hay available) is the best way to provide needed exercise.

Consider these potential problems

Obesity. The reason is obvious -- too little activity, combined with too many calories. Reducing calories can be accomplished by minimizing or even removing concentrates from the diet, but forage must never be restricted. Doing so starts a hormonal cascade that actually keeps the horse overweight.[i]

Porous bones. Skeletal bones are made of living, dynamic tissue that is constantly being subjected to changes in mineral and protein content. The horse's large size helps him build bone mass simply by moving. Inactivity can make horses' bones porous, potentially leading to fractures when only a slight demand is placed on them.

Poor feet and hair coat. Inadequate blood circulation reduces the flow of nutrients and oxygen to the extremities and hair follicles. Don't be fooled by the shiny coat that results from added dietary fat - that is simply a result of more oil secretion from the skin's sebaceous glands. Truly healthy hair and hooves require exercise to delivery necessary nutrients.

Digestive disorders. Horses allowed to graze on pasture 24/7 rarely develop ulcers. Stall confinement is a significant cause of this painful condition, especially when forage is not available 'round the clock. In addition, digestive tract muscles suffer from lack of activity. A steady, consistent supply of forage will help exercise these muscles.

Physical activity increases blood circulation and stimulates gastrointestinal motility, keeping the entire digestive tract in good shape, lessening the chance of torsions, impactions, and intussusceptions that lead to colic. Fiber digestion is also improved.

What is so disheartening is that within two weeks of changes to stall confinement (such as experienced by horses transported to training facilities), the vast majority of horses will develop ulcers and more than half of them will develop colon/cecal impactions.[ii]

Mental well-being. The stress of stall confinement and isolation often leads to unattractive behaviors, consistent with trapping any animal -- weaving, stall-walking and circling, pawing, wall-kicking, chewing, head-bobbing, self-biting, and even cribbing (which is more than just a bad habit - it is generally done to alleviate the pain of an ulcer). Horses are social animals, requiring time with each other in a herd environment to provide protection, comfort, and mutual grooming.

Metabolic impacts. Sedentary horses lose muscle mass and can become insulin resistant. Muscle uses a large amount of glucose for energy; the more muscle mass your horse has, the more glucose transporters are produced, leading to beneficial insulin sensitivity. Therefore, exercise not only burns calories, but reduces insulin resistance. Exercise also helps reduce leptin resistance.

Fitness decline. Reduced exercise results in loss of muscle and bone mass which significantly impacts the horse's fitness level and performance ability. Researchers at Virginia Intermont College[iii] found that horses on stall rest for 14 weeks lost fitness and even more interestingly, pastured horses were able to maintain the same fitness level as horses who were stalled and exercised five days per week.

Growth retardation. A growing horse requires exercise for cartilage and overall bone and joint development. Restricting exercise can result in injury, under-conditioned joints, contracted tendons, deformed legs, and osteopathic disorders.

Accelerated aging. When the immune system is suppressed, the horse becomes more susceptible to catching infections from other horses, developing insect-borne diseases, and exhibiting allergic responses to the environment. Weariness from confinement increases oxidative stress, resulting in free radicals that damage healthy tissues, inhibit repair, and alter DNA. What we once thought as age-related conditions such as degenerative arthritis, and PPID, now appear in horses at far younger ages.

Possible solutions

We need to think "out-of-the-box" (pun intended). We need to find ways to offer our horses a safe environment that encourages movement and grazing time, as well as respects their innate physiological need for forage flowing through the digestive tract at all times.

One innovative approach is to transform an area into a "Paddock Paradise"[iv] where horses seek out new batches of hay while walking from place to place. This concept is quite versatile, allowing for even small sizes of land.

Relaxing standards that require keeping a horse stalled so he will stay clean and well-groomed, in favor of having a happier, more naturally kept horse will cut back on maintenance requirements and allow more time for enjoying your horse. Think of creative ways to let your horse outside to be with other horses.

If some stall time is unavoidable, be sure to provide at least two places where hay is always provided. If your horse tends to eat very quickly, start by providing hay free-choice. Once he gets the message that he will not run out of hay, he will start to slow down his eating and be more relaxed. Commercially available "slow feeders" are a good option for many horses, if they are introduced gradually, to avoid frustration.[v]

Shelter from harsh weather is a must. This can best be accomplished by offering your horse the option to make choices. Barn stalls with open gates that can be entered at will, allow your horse to decide what is most comfortable.

Bottom line

Confining a horse to a stall or small outdoor area without the ability to exercise leads to an animal who is mentally stressed and physically limited. Exercise, walking, grazing, socializing, and freedom to flee from perceived dangers are essential parts of what makes your horse, a horse.

This article originally appeared on Getty Equine Nutrition and is published here with permission.

Find more informative articles in our section on Health & Education, Bedding & Feed or Supplements.

Read more: Empty Fields Everywhere Why Movement is So Important