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Topic:Respiratory Disease

Respiratory disease in horses encompasses a range of conditions affecting the respiratory system, including the upper and lower airways. These diseases can result from various etiologies such as infectious agents, environmental factors, or genetic predispositions. Common respiratory conditions in horses include equine asthma, equine influenza, and strangles. Clinical signs often associated with respiratory disease in horses include coughing, nasal discharge, and labored breathing. Diagnostic approaches may involve endoscopy, imaging, and laboratory tests to assess the function and health of the respiratory tract. This page compiles peer-reviewed research studies and scholarly articles that explore the pathophysiology, diagnosis, and management of respiratory diseases in equine populations.
Thoracic electrical impedance tomography using a two-plane electrode configuration in horses.
Equine veterinary journal    May 28, 2026   doi: 10.1002/evj.70188
Studer N, Byrne D, Raisis A, Adler A, Cheong J, Secombe C, Schramel JP, Mosing M.Traditional one-plane (oneP) electrical impedance tomography (EIT) electrode configurations limit evaluation to a convex lens-shaped lung slice, prone to overrepresentation of central areas. Two-plane (twoP) EIT is expected to refine this technique and result in more representative lung imaging. Objective: To compare ventilation distribution using single slice reconstructions, obtained with twoP or oneP. Methods: Computational modelling and in vivo exploratory randomised experimental trial. Methods: A finite element simulation model of oneP and twoP was calculated to estimate captured lung fie...
The effect of romifidine on endoscopic grading of laryngeal function in horses.
The Veterinary record    May 22, 2026   doi: 10.1002/vetr.70804
Murphy C, Baglioni M, Lepage OM, Schumacher J, Kelleher L, Burke J, Gangl M.To our knowledge, the effect of sedation with romifidine on the grading of laryngeal function in horses has not been studied. Our objective was to examine the effects of romifidine on the grading of laryngeal function and the cross-sectional area of the rima glottis (CSARG). Methods: Ten horses underwent three endoscopic examinations of the larynx: once while unsedated (group R1), once after being sedated with romifidine (0.04 mg/kg intravenously; group R2) and once again, while still sedated, after receiving a repeat dose of romifidine (0.08 mg/kg intravenously, total dose; group R3). The r...
Bronchoalveolar lavage changes the ultrasonographic and radiographic appearances of lungs in adult horses.
Journal of the American Veterinary Medical Association    May 20, 2026   1-8 doi: 10.2460/javma.26.03.0161
Hepworth-Warren KL, Harbor K, Nelson NC, Kurihara M, Qu Y.To describe the effect of bronchoalveolar lavage (BAL) on the ultrasonographic and radiographic appearances of lungs of horses being evaluated for equine asthma syndrome (EAS). Unassigned: Prospective observational study enrolling 32 adult horses evaluated for EAS. Ultrasonographic and radiographic examinations of the thorax were performed before and within 3 hours following BAL and scored using previously validated systems. The differences in scores between groups (normal, mild EAS, moderate/severe EAS) were evaluated through the Kruskal-Wallis test, and the differences in scores before and f...
Air pollution exposure during training impairs performance in Thoroughbred racehorses.
Equine veterinary journal    May 10, 2026   doi: 10.1002/evj.70186
Scott D, Seabaugh K, Kim L, Magzamen S, Duncan C.Ambient air pollution contributes substantially to human morbidity and mortality, and athletes are recognised as a particularly vulnerable group. However, little is known about the impact of air pollution on equine athletes. Objective: To explore the relationship between air pollution exposure during the pre-competition training period and race day performance among Thoroughbred racehorses that competed on California racetracks. Methods: A retrospective longitudinal study. Methods: For each winning horse, pollutant exposure during the 21-day pre-competition training period was assigned using d...
Retrospective assessment of equine herpesvirus type 1 (EHV-1) genotype-associated clinical disease in Ontario.
The Canadian veterinary journal = La revue veterinaire canadienne    May 1, 2026   Volume 67, Issue 5 499-503 
Espinosa MA, Lack A, Kenney D, Arroyo LG.Equine herpesvirus type 1 (EHV-1) is an important viral pathogen in horses, associated with diverse clinical manifestations including fever, upper and lower respiratory disease, neurological signs, ocular disease, and abortion. Currently, EHV-1 variants (genotypes) are classified based on a single nucleotide polymorphism mutation of the open reading frame 30 (ORF30). Unassigned: The aim of this retrospective study was to evaluate the EHV-1 genotypes present in horses with various clinical presentations, including respiratory disease, abortion, and neurological disease, at a referral center in ...
From Horses to Zebras, an Update in Small Animal Respiratory Medicine.
The Veterinary clinics of North America. Small animal practice    April 8, 2026   S0195-5616(26)00023-9 doi: 10.1016/j.cvsm.2026.03.002
Dear JD.No abstract available
Mucosal T cell activation pathways are upregulated by equine herpesvirus type 1 infection.
Veterinary research    April 6, 2026   doi: 10.1186/s13567-026-01741-x
Holmes CM, Babasyan S, Wagner B.Equine herpesvirus type 1 (EHV-1) is a high morbidity and mortality virus that impacts horse populations worldwide. As a respiratory virus, it enters through the upper respiratory tract (URT), where mucosal immunity plays a crucial role in preventing severe disease. In this study, flow cytometry was used to characterize the nasal leukocyte population during EHV-1 infection, and RNA sequencing of nasal secretions was employed to assess transcriptional markers of the mucosal immune response. Horses with distinct immune statuses were compared at four stages: pre-infection, early (day 1 and 3 post...
Malignant Ovarian Teratoma in a Lusitano Filly: Diagnostic Challenges and Clinical Significance.
Journal of equine veterinary science    April 3, 2026   105883 doi: 10.1016/j.jevs.2026.105883
Campilho R, Saraiva S, Chaves S, Quaresma M, Silva F, Pires I.An 8-month-old Lusitano filly (a young female horse) was referred with a five-day history of abdominal distension, respiratory distress, and hyporexia. Clinical and ultrasonographic examinations revealed ventral edema, anemia, leukocytosis, hypoalbuminemia, and bilateral pleural effusion. The filly subsequently developed progressive clinical deterioration, including persistent hyporexia, scant fecal output, and acute colic with nasogastric reflux, followed by sudden respiratory decompensation, collapse, and death. Post-mortem examination revealed a large, multilobulated abdominal mass involvin...
The transition from winter to spring has an impact on the airway metabolome profile of asthmatic horses.
PloS one    April 3, 2026   Volume 21, Issue 4 e0346250 doi: 10.1371/journal.pone.0346250
Drespling J, Heelemann S, Strathmeyer S, Kühn H, Schwarz B, Mundhenk L.Equine asthma is a chronic, non-infectious inflammatory disease of the lower airways in horses, classified as mild to moderate (MEA) or severe (SEA). Its pathogenesis is not fully understood and is influenced by environmental and seasonal factors. In this cross-sectional study, seasonal effects on the bronchoalveolar lavage fluid (BALF) metabolome were investigated in asthmatic and non-asthmatic horses. The metabolome of 230 BALF samples from horses across different seasons, classified as cytologically unremarkable (CUA), MEA, or SEA, was analyzed using proton nuclear magnetic resonance spectr...
Nitric oxide and its role in the management of hypoxaemia in the anaesthetised horse-a narrative review.
Veterinary anaesthesia and analgesia    April 1, 2026   Volume 53, Issue 4 101227 doi: 10.1016/j.vaa.2026.101227
Auckburally A, Grubb TL, Perchiazzi G, Högman M, Nyman G.To outline historical aspects of nitric oxide, including its discovery and biological effects, to describe the current use of inhaled nitric oxide (iNO) in human healthcare, and to review the available evidence on the use of pulsed iNO (PiNO) for the management of hypoxaemia in anaesthetised horses. Methods: Google Scholar and PubMed databases were searched using the search terms nitric oxide, PiNO, environment, discovery, acute respiratory distress syndrome, COVID-19, SARS-CoV-2, horse, pony, hypoxaemia, and anaesthesia. Conclusions: Inhaled NO is licensed in the management of hypoxic respira...
Relationship between prevalence and severity of exercise-induced pulmonary hemorrhage and environmental factors.
Journal of veterinary internal medicine    March 29, 2026   Volume 40, Issue 2 aalag052 doi: 10.1093/jvimsj/aalag052
Pinnell E, Shoemaker S, Wang Y, Tang Y, Sellon D, Leguillette R, Gold J, Sanz M, Bayly WM.Environmental risk factors could contribute to the development of exercise-induced pulmonary hemorrhage (EIPH) in racing Thoroughbreds. Objective: To identify environmental risk factors that might contribute to differences in EIPH prevalence and severity across 12 Thoroughbred racetracks in the United States. Methods: Eight hundred fifteen 2-year-old and 122 >2-year-old Thoroughbred racehorses. Methods: Prospective blinded observational study. Videoendoscopy was performed 30-60 min post-race. Three observers independently assigned an EIPH grade to each videorecording, and prevalence and se...
Interstitial pneumonia associated with equid gammaherpesvirus 5 infection in 2 neonatal foals, and a retrospective study in Hokkaido, Japan. Ochi A, Takechi M, Fujii S, Ohno O, Kishi D, Ueno T.Various bacterial and viral pathogens have been identified in cases of interstitial pneumonia in foals within the first month of life. A potential association has been suggested between equid gammaherpesvirus 5 (EqGHV5, equine herpesvirus 5; family , taxon species ) and interstitial pneumonia in foals; however, direct histologic evidence has been limited. We examined 2 neonates-12-d- and 24-d-old-with acute respiratory distress and poor response to treatment. Postmortem examination revealed interstitial pneumonia with diffuse alveolar damage and intranuclear inclusion bodies in alveolar macrop...
Tracheal wash culture is not associated with bronchial infection, remodelling or inflammation in horses with asthma.
Equine veterinary journal    March 17, 2026   doi: 10.1002/evj.70157
Leduc L, St-Jean G, Lavoie JP.Antimicrobials are commonly prescribed for the treatment of equine asthma, despite limited evidence supporting their use. Tracheal wash (TW) bacterial culture results are known to influence antimicrobial prescription decisions. Objective: To determine whether a positive TW bacterial culture in horses with asthma is associated with bronchial infection or colonisation, increased bronchial remodelling and airway inflammation by evaluating the presence of bacteria and airway remodelling in endobronchial biopsies, as well as bronchoalveolar lavage fluid (BALF) cytology and tracheal mucus scores. Me...
Differences in Redox Biomarkers in Bronchoalveolar Lavage Fluid of Leisure Horses With and Without Severe Equine Asthma: Preliminary Results.
Animals : an open access journal from MDPI    March 12, 2026   Volume 16, Issue 6 882 doi: 10.3390/ani16060882
Bindi F, Vitale V, Cingottini D, Pasquini A, Longini M, Tagliaferri G, Bonelli F, Nocera I, Sgorbini M.Equine asthma is a common chronic respiratory disease characterized by airway inflammation and oxidative imbalance, particularly in its severe form. The aim of this study was to evaluate pro-oxidative substances, oxidative products, and antioxidant defense biomarkers in bronchoalveolar lavage fluid (BALF) from horses with and without a history of severe equine asthma (SEA). This prospective observational study included 21 leisure horses classified as SEA or non-SEA based on clinical history and BALF cytology. Bronchoalveolar lavage fluid was analyzed for derivatives of reactive oxygen metaboli...
A randomized, masked, crossover, clinical trial of the efficacy and safety of nebulized albuterol sulfate and dexamethasone sodium phosphate in asthmatic horses.
Journal of veterinary internal medicine    March 6, 2026   Volume 40, Issue 2 aalag030 doi: 10.1093/jvimsj/aalag030
Tyson KN, Couetil LL, Ivester KM, Murray L, Mukhopadhyay A, Marmolejo JF, Jannasch A.Nebulization of injectable dexamethasone sodium phosphate (DSP; 0.01 mg/kg) to horses with severe equine asthma (SEA) was previously found to be ineffective. Horses with SEA have marked bronchoconstriction that decreases peripheral lung deposition of nebulized drugs. Administration of a bronchodilator immediately before nebulizing dexamethasone may improve efficacy. Objective: Evaluate the therapeutic effects and optimal dose of nebulized DSP after nebulized albuterol in horses with SEA. Methods: Seven horses with SEA from a research herd. Methods: In this masked randomized crossover trial, h...
Analysis of lipid mediator profiles in the blood of horses with equine asthma using UPLC-MS/MS.
Prostaglandins, leukotrienes, and essential fatty acids    March 5, 2026   Volume 209 102735 doi: 10.1016/j.plefa.2026.102735
Dörsam K, Nischang V, Büttner K, Fey K, Werz O, Jordan PM.Equine asthma (EA) is a chronic inflammatory disease of the lower respiratory tract in horses, which is mainly triggered by dusty hay. EA is becoming increasingly acknowledged as a valuable animal model for studying human asthma. Research on the pathogenesis of EA has primarily focused on the associated cells and cytokines involved. However, the role of inflammation-related lipid mediators (LM) in the development and progression of equine asthma remains elusive. LMs are categorized into pro-inflammatory arachidonic acid (AA)-derived leukotrienes (LTs) and prostaglandins (PGs), as well as infla...
An in-hospital clinical trial assessing nebulized lidocaine compared to saline for treatment of asthma in horses.
Journal of veterinary internal medicine    February 26, 2026   Volume 40, Issue 1 aalaf053 doi: 10.1093/jvimsj/aalaf053
Mahalingam-Dhingra A, Bedenice D, South A, Minuto J, Robins TJ, Trautwein V, Larkin M, Wagner B, Mazan MR.Corticosteroids are the main pharmacologic treatment for equine asthma (EA) but may have adverse effects in metabolically unstable horses. Recent pilot studies support the use of nebulized lidocaine as an alternative treatment option. Objective: Nebulized lidocaine will improve EA-associated clinical variables and airway inflammation. Methods: Twenty client-owned horses diagnosed with EA. Methods: Randomized, blinded, in-hospital study comparing 1 mg/kg preservative-free 4% lidocaine (n = 10) nebulized via Flexineb (twice daily for 7 doses) to 0.9% saline control (n = 10). Clinical examin...
Clinical Manifestations and Behaviors Associated with Equine Head and Neck Disorders.
The Veterinary clinics of North America. Equine practice    February 26, 2026   S0749-0739(26)00002-7 doi: 10.1016/j.cveq.2026.01.002
Nout-Lomas YS, Story MR.Equine head and neck disorders can present with a wide range of clinical manifestations, depending on the structures involved and disease process. Important components of the gastrointestinal, respiratory, ophthalmological, neurological, and musculoskeletal systems are contained within the head and neck, and clinical signs of disorders will result in expected clinical signs. However, clinical manifestations of disease are sometimes subtle, and when not recognized can lead to behavioral changes including undesired behaviors and poor sleep. Recognizing behavioral phenotypes of horses with proble...
Pulmonary fibrosis in horses associated with spontaneous Crotalaria juncea intoxication.
Toxicon : official journal of the International Society on Toxinology    February 23, 2026   Volume 274 109037 doi: 10.1016/j.toxicon.2026.109037
Andrade AC, Fonseca SMC, Silva Filho GB, Melo ET, Santos JRP, Frota MLSL, Duarte JMBS, Evêncio-Neto J, Brito LB, Lima TS, Wicpolt NS, Riet-Correa F....We report an outbreak of Crotalaria juncea intoxication in horses exhibiting progressive weight loss and respiratory distress in northeastern Brazil. Necropsy revealed firm, non-collapsed lungs with extensive interstitial fibrosis, bronchiolar epithelial hyperplasia with club cells proliferation, and marked pulmonary arterial remodeling. Hepatic lesions consisted primarily of centrilobular necrosis, probably resulting from hypoxic injury related to anemia and prolonged agonic death. Pasture inspection identified significant invasion by shrubs of C. juncea in various phenological stages.
[Equine laryngeal dysplasia – overview of variable clinical presentation based on 6 cases].
Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere    February 13, 2026   Volume 54, Issue 1 60-67 doi: 10.1055/a-2751-7292
Werner CA, Wimmer-Scherr CM, Schwarz BC.Equine laryngeal dysplasia (ELD) is the umbrella term for various malformations of laryngeal structures that arise from the 4th and 6th branchial arches during embryogenesis. The disease is rare and may be subclinical. In symptomatic patients with clinical signs, the clinical presentation is highly variable and is the result of functional limitations of the larynx as well as of the esophageal sphincter. The spectrum of signs may range from respiratory changes such as abnormal respiratory noise, coughing, and at times dyspnea all the way to poor performance, dysphagia, aerophagia, and colic. Th...
[Pigmentation disorders in the nasal vestibule of horses with nasal discharge].
Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere    February 13, 2026   Volume 54, Issue 1 38-46 doi: 10.1055/a-2710-4022
Kremer H, Bartling B.The nasal vestibule of numerous horses is pigmented. In the ventral part of the nasal vestibule, this pigmentation is often disturbed resulting in a clearly depigmented area. As nasal discharge passes this area, our study aimed at the practical quantification of the depigmented area in the nasal vestibule of horses and the analysis of its relation to nasal discharge and other parameters.This study included 74 horses (59 warmblood horses, 15 ponies) with pigmented nasal vestibule. When a depigmentation was found to be present in the ventral part, this area was photographed and quantified by use...
Comparison of two doses of lidocaine constant rate infusion on cardiopulmonary function and recovery in isoflurane-anesthetized horses.
Veterinary anaesthesia and analgesia    February 11, 2026   Volume 53, Issue 3 101202 doi: 10.1016/j.vaa.2026.101202
Henderson AR, Valverde A, Côté N, Sanchez A, Arroyo LG, Gu Y, Johnson R.To compare cardiopulmonary variables and recovery scores in isoflurane-anesthetized horses undergoing arthroscopy using two different intravenous (IV) lidocaine constant rate infusions (CRIs; 50 or 100 μg kg minute) under intermittent positive pressure ventilation (IPPV) or spontaneous ventilation (SV). Methods: Prospective, randomized, clinical study. Methods: A group of 30 client-owned horses, 8-156 months old (range), with body masses of 280-550 kg. Methods: Anesthesia protocol consisted of xylazine, ketamine and diazepam, and maintenance with isoflurane and a CRI of dexmedetomidine. All g...
Disorders of the Equine Head and Neck: Larynx and Pharynx.
The Veterinary clinics of North America. Equine practice    February 6, 2026   Volume 42, Issue 1 61-78 doi: 10.1016/j.cveq.2025.12.002
Luedke LK.This comprehensive review outlines the anatomy, diagnostic methods, pathophysiology, treatment, and prognosis of common equine upper airway disorders. It discusses the structure and function of the larynx and pharynx, and details diagnostic tools such as endoscopy and ultrasound. Major conditions-recurrent laryngeal neuropathy, arytenoid chondropathy, epiglottic entrapment, dorsal displacement of the soft palate, and nasopharyngeal collapse-are described with emphasis on their etiology, clinical signs, and management options for optimizing performance outcomes.
Interstitial pneumonias of undetermined etiology in foals in California, 1990-2020. Asin J, Carvallo F, Gonzales-Viera OA, Macías-Rioseco M, Streitenberger N, Abdelrazek S, Crossley B, Pesavento PA, Uzal FA.Interstitial and bronchointerstitial pneumonias of undetermined etiology in young foals are relatively common in autopsy services with an equine focus. Unknown viruses, toxins, hyperthermia, surfactant or alveolar macrophage function deficiency, certain antibiotics, and aberrant responses to or other bacteria have been proposed as causes. We performed a retrospective study of autopsies on foals with a diagnosis of interstitial or bronchointerstitial pneumonia with an unidentified etiology. Forty-one foals (median age: 3-mo-old) were included. Most were received in summer ( = 28) and sprin...
Occurrence, antibiotic susceptibility and genetic variation of Streptococcus zooepidemicus in Finnish weanling horses with and without respiratory infection.
Acta veterinaria Scandinavica    January 27, 2026   Volume 68, Issue 1 7 doi: 10.1186/s13028-025-00839-0
Junkkari R, Mykkänen A, Sulku P, Rantala M, Pohjanvirta T, Eklund M, Pelkonen S, Grönthal T. subsp. (), an opportunistic pathogen often found in the stable environment and upper respiratory tract of young horses, can cause severe pneumonias in Equidae. In this study we investigated the occurrence, genetic variation and antimicrobial susceptibility of isolates from 63 weanling horses kept in loose housing or conventional stables. The bacterial isolates were typed by using pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST). The possible associating factors (stable type, age, breed and clinical signs) for positive finding were analysed using logistic regre...
The trajectories of relative concentrations of antirhodococcal immunoglobulin A differ from those of immunoglobulin G subisotypes in bronchoalveolar lavage fluid but not serum of foals.
American journal of veterinary research    January 27, 2026   1-8 doi: 10.2460/ajvr.25.11.0402
Aucoin AA, Zhidkov V, Legere RM, Borba KER, Landrock KK, Parker LE, Bray JM, Bordin AI, Cohen ND.To characterize age-related trajectories of the relative concentrations of anti-virulence-associated protein A (VapA) immunoglobulin (Ig)-G1, IgG3/5, IgG4/7, and IgA in serum and bronchoalveolar lavage fluid (BALF) as indicators of systemic and intrapulmonary immune responses in foals naturally exposed to Rhodococcus equi. Unassigned: Blood and BALF samples were collected at ages 4, 14, 28, and 56 days from healthy Quarter Horse foals (n = 19) naturally exposed to R equi. Samples were tested via ELISA for relative concentration of IgG1, IgG3/5, IgG4/7, and IgA recognizing the VapA of R equi. D...
Barrel racing horses demonstrate a high incidence of nonclinical postrace airway disorders.
Journal of the American Veterinary Medical Association    January 23, 2026   1-10 doi: 10.2460/javma.25.10.0712
Williams MR, Silverstone A, Burba DJ, McCarrel T, Schoonover MJ, Rudra P.To describe the prevalence of postrace airway abnormalities in a population of barrel racing horses competing in Oklahoma. Unassigned: A descriptive field study was conducted at a single event. Horses underwent resting endoscopy within 60 minutes of competition. Recordings were evaluated and numerical and/or binary scores assigned for pharyngeal lymphoid hyperplasia, recurrent laryngeal neuropathy, dorsal displacement of the soft palate, epiglottic entrapment, and exercise-induced pulmonary hemorrhage. Clients completed a questionnaire detailing the horse's medical history and run time. A line...
Evidence linking ambient air pollution to domestic animal health outcomes: a scoping review.
Journal of the American Veterinary Medical Association    January 14, 2026   1-10 doi: 10.2460/javma.25.10.0666
Kern-Allely C, Scott D, Magzamen S, Duncan C.Air pollution is a major global health threat that is expected to worsen, yet its effects on domestic animals remain poorly understood. The objective of this scoping review was to synthesize existing evidence on associations between ambient air pollutants and health outcomes in domestic animals and to identify gaps to guide future research. Unassigned: A scoping review was conducted following the Arksey and O'Malley framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines with 2 search databases (PubMed and Web of Science) using ...
Antibiotics prescribing patterns and association with system-specific pathologies in equine veterinary practice: Insights from a 12-year study at a veterinary teaching hospital.
Journal of equine veterinary science    January 7, 2026   Volume 157 105779 doi: 10.1016/j.jevs.2026.105779
Vernaccini M, de Marchi L, Bindi F, Meucci V, Sala G, Cingottini D, Sgorbini M.Antibiotics are essential in veterinary medicine, enhancing animal health and welfare. However, widespread use contributes to resistance, increasing the risk of treatment failure and the transmission to humans. Objective: Analyze antibiotic prescribing practices in an equine internal medicine unit, focusing on factors influencing use, particularly Highest Priority Critically Important Antimicrobials (HPCIAs). Methods: 1315 adult equids, including horses, donkeys and mules, presented for different diseases to the Veterinary Teaching Hospital (VTH) of the University of Pisa from 2011 to 2023. Re...
Successful Treatment of Acute Respiratory Distress Syndrome in an 8-Day-Old Standardbred Foal With Intratracheal Oxygen Therapy via Temporary Tracheostomy.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    December 23, 2025   Volume 36, Issue 1 138-144 doi: 10.1111/vec.70066
Palmisano MG, Tukdarian CR, Hopster K, Nolen-Walston RD.This report describes an 8-day-old foal diagnosed with acute respiratory distress syndrome (ARDS) successfully managed using a novel approach of intratracheal oxygen delivery. Methods: An 8-day-old Standardbred filly presented for an acute onset of respiratory distress. Given the acute onset, known risk factors, bilateral diffuse infiltrate on thoracic radiographs, and low PaO:FiO ratio of 170.5, the foal was diagnosed with acute respiratory distress syndrome. Initial treatment consisted of antimicrobial therapy (minocycline and metronidazole), nonsteroidal anti-inflammatories (flunixin meglum...