Equine veterinary journal2026; doi: 10.1002/evj.70355

Managing equine asthma: Owner adherence, practical constraints and environmental protocol evaluation.

Stucki, L
·
Schüpbach, G
·
Ramseyer, A
·
Herholz, C
·
Gerber, V

Abstract: Adherence to recommendations for environmental management is central to equine asthma (EA) treatment. Reasons for non-adherence warrant further investigation. Objective: To: (1) evaluate adherence to recommendations for environmental changes, identify reasons for incomplete implementation, assess changes in clinical signs and medication use; (2) evaluate owner acceptability, practicality and perceived usefulness of a structured stable-side protocol. Methods: (1) Retrospective online survey and (2) prospective onsite testing with owners of EA-affected horses. Methods: (1) Online survey on implementation of standardised recommendations, clinical progression and medication use; and (2) environmental protocol evaluation during stable visits. Results: Seventeen of 40 horses still received dry hay and 13/40 were bedded on straw. Reasons for non-implementation included time, financial and infrastructural constraints, boarding stable restrictions, group housing, weather dependence, use of self-produced roughage, perceived ineffectiveness and individual horse preferences. Owners reported that overall clinical impression had improved and the proportion of coughing horses decreased from 88% to 55% (p < 0.001, OR = 0.07, 95% CI 0.002-0.47, n = 40). The other clinical outcomes did not reach the Bonferroni-adjusted significance threshold. Twenty-two horses were still coughing, and 7/40 had received medication within the previous 3 months. All interviewed owners found the environmental protocol helpful, 11 reviewed it again and 5 used it for discussion with others. Conclusions: Use of small convenience samples, lack of a control group and potential selection and recall bias. Conclusions: Owner non-adherence arose from diverse and often structural constraints. The environmental protocol was well accepted by owners and helped to structure discussions on risk factors.

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Publication Date: 2026-11-03 PubMed ID: 42975133DOI: 10.1002/evj.70355Google Scholar: Lookup

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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Overview

This study investigated how horse owners adhere to environmental management recommendations to control equine asthma and evaluated a structured protocol designed to assist owners in managing the condition more effectively.
It also explored the reasons why owners might not fully implement these recommendations, the impact on clinical symptoms, and the acceptability and utility of a stable-side environmental protocol.

Introduction and Objectives

Equine asthma (EA) requires strict environmental management to reduce exposure to dust and allergens that exacerbate symptoms.
Owner adherence to environmental recommendations is crucial but often incomplete.
The aims were to:
- Evaluate how well owners follow environmental management recommendations.
- Identify reasons for incomplete adherence.
- Assess changes in clinical signs and medication use following management.
- Test the practicality and usefulness of a structured environmental management protocol during stable visits.

Methods

The study was conducted in two phases:
- (1) A retrospective online survey with owners of EA-affected horses, asking about their implementation of recommended environmental changes, clinical progression, and medication usage.
- (2) A prospective onsite evaluation where researchers used a structured environmental protocol during stable visits to assess practicality and owner acceptance.

Key Findings: Owner Adherence and Constraints

Many horses still received potentially problematic environmental exposures:
- 17 out of 40 horses were fed dry hay, which can produce dust that aggravates equine asthma.
- 13 out of 40 were bedded on straw, another known environmental trigger.
Reasons for incomplete adoption of recommendations included:
- Time and workload constraints limiting owners’ ability to change routines.
- Financial limitations affecting the ability to buy alternative feed or bedding.
- Stable infrastructure or boarding stable policies restricting management changes.
- Group housing situations making individualized management difficult.
- Weather dependence influencing the feasibility of some changes.
- Use of self-produced roughage, limiting feed options.
- Owner perceptions that some changes had little benefit or were ineffective.
- Individual horse preferences and behaviors influencing management choices.

Clinical Outcomes and Medication Use

Owners reported an overall improvement in clinical impressions of their horses post-management changes.
The proportion of coughing horses decreased significantly from 88% to 55%, showing a positive response (statistically significant with p < 0.001).
Other measured clinical outcomes (not detailed here) did not meet stringent significance thresholds after statistical correction.
Despite improvements, 22 horses continued to cough and 7 horses had been treated with medication in the past 3 months, indicating persistent or partially controlled disease in some cases.

Evaluation of the Structured Environmental Protocol

All interviewed owners found the environmental management protocol helpful during stable visits.
Eleven owners reviewed the protocol again after the visit, indicating ongoing engagement.
Five owners used the protocol as a communication tool with other caretakers or veterinarians, suggesting it facilitated clearer discussions about environmental risk factors.

Limitations

The study used a small convenience sample (only 40 horses), which may limit the generalizability of findings.
No control group was included to compare the effects of management changes, limiting causal conclusions.
Potential biases such as selection bias (owners motivated to respond) and recall bias (self-reported data) may have influenced results.

Conclusions and Implications

Non-adherence to environmental recommendations is common and mainly driven by practical, financial, and structural constraints rather than a lack of willingness.
The structured environmental protocol was well accepted and useful for guiding owners through risk factor assessment and management discussions.
Supporting owners with practical tools and acknowledging real-world constraints may improve long-term adherence and health outcomes for horses with equine asthma.

Cite This Article

APA

Stucki L, Schüpbach G, Ramseyer A, Herholz C, Gerber V. (2026). Managing equine asthma: Owner adherence, practical constraints and environmental protocol evaluation. Equine Vet J. https://doi.org/10.1002/evj.70355

Publication

Equine veterinary journal

ISSN: 2042-3306

NlmUniqueID: 0173320

Country: United States

Language: English

Researcher Affiliations

Stucki, Lea

Swiss Institute of Equine Medicine (ISME), Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, University of Bern, Avenches, Switzerland.

Schüpbach, Gertraud

Department of Clinical Research and Veterinary Public Health, Vetsuisse-Faculty, University of Bern, Bern, Switzerland.

Ramseyer, Alessandra

Swiss Institute of Equine Medicine (ISME), Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, University of Bern, Avenches, Switzerland.

Herholz, Conny

School of Agricultural, Forest and Food Sciences HAFL, Bern University of Applied Sciences, Zollikofen, Switzerland.

Gerber, Vinzenz

Swiss Institute of Equine Medicine (ISME), Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, University of Bern, Avenches, Switzerland.

Grant Funding

33-890 / University of Bern

References

This article includes 39 references

Simões J, Sales Luís JP, Tilley P. Owner compliance to an environmental management protocol for severe equine asthma syndrome.. J Equine Vet Sci 2020;87:102937.
doi: 10.1016/j.jevs.2020.102937google scholar: lookup
Boivin R, Pilon F, Lavoie JP, Leclere M. Adherence to treatment recommendations and short‐term outcome of pleasure and sport horses with equine asthma.. Can Vet J 2018;59(12):1293–1298.
Barton AK, Gehrke R, Gehlen H. Diagnosis and therapy of severe equine asthma in Berlin‐Brandenburg—a questionnaire study.. Pferdeheilkunde 2022;38(1):39–44.
doi: 10.21836/pem20220106google scholar: lookup
Lehmann B, Merle R, Klier J, Gehlen H. Besitzerbefragung zur chronisch‐obstruktiven bronchitis bei Warmblütern unter Verwendung eines online‐Fragebogens [Survey of horse owners on chronic obstructive bronchitis in warmblood horses through the use of an online questionnaire].. Pferdeheilkunde 2016;32:357–366.
doi: 10.21836/pem20160408google scholar: lookup
Diez de Castro E, Fernandez‐Molina JM. Environmental management of equine asthma.. Animals (Basel) 2024;14(3):446.
doi: 10.3390/ani14030446google scholar: lookup
Ivester KM, Couëtil LL, Zimmerman NJ. Investigating the link between particulate exposure and airway inflammation in the horse.. J Vet Intern Med 2014;28:1653–1665.
doi: 10.1111/jvim.12458google scholar: lookup
Holcombe SJ, Jackson C, Gerber V, Jefcoat A, Berney C, Eberhardt S. Stabling is associated with airway inflammation in young Arabian horses.. Equine Vet J 2001;33(3):244–249.
doi: 10.2746/042516401776249606google scholar: lookup
Couëtil LL, Cardwell JM, Gerber V, Lavoie JP, Léguillette R, Richard EA. Inflammatory airway disease of horses‐revised consensus statement.. J Vet Intern Med 2016;30(2):503–515.
doi: 10.1111/jvim.13824google scholar: lookup
Ramseyer A, Gaillard C, Burger D, Straub R, Jost U, Boog C. Effects of genetic and environmental factors on chronic lower airway disease in horses.. J Vet Intern Med 2007;21(1):149–156.
doi: 10.1111/j.1939-1676.2007.tb02941.xgoogle scholar: lookup
Wyler M, Sage SE, Marti E, White S, Gerber V. Protein microarray allergen profiling in bronchoalveolar lavage fluid and serum of horses with asthma.. J Vet Intern Med 2023;37(1):328–337.
doi: 10.1111/jvim.16600google scholar: lookup
Greim E, Naef J, Mainguy‐Seers S, Lavoie JP, Sage S, Dolf G. Breath characteristics and adventitious lung sounds in healthy and asthmatic horses.. J Vet Intern Med 2024;38(1):495–504.
doi: 10.1111/jvim.16980google scholar: lookup
Bouverat VMA, Naef J, Dolf G, Lamon I, Sage SE, Gerber V. Minimising feeding behaviour interference: a hay‐shaker device to assess dust exposure in horses.. Equine Vet J 2025;57(6):1666–1676.
doi: 10.1111/evj.14492google scholar: lookup
Röschmann J, Naef J, Doras C, Gerber V. Respiratory rate recovery after submaximal lunging exercise is delayed in asthmatic horses with neutrophilic airway inflammation.. Animals 2025;15(5):713.
doi: 10.3390/ani15050713google scholar: lookup
Bullone M, Lavoie JP. Science‐in‐brief: equine asthma diagnosis: beyond bronchoalveolar lavage cytology.. Equine Vet J 2017;49(3):263–265.
doi: 10.1111/evj.12679google scholar: lookup
Olave CJ, Ivester KM, Couetil LL, Burgess JH, Park JH, Mukhopadhyay A. Effects of low‐dust forages on dust exposure, airway cytology, and plasma omega‐3 concentrations in thoroughbred racehorses: a randomized clinical trial.. J Vet Intern Med 2023;37(1):338–348.
doi: 10.1111/jvim.16598google scholar: lookup
Symoens A, Westerfeld R, Vives BM, André V, Moulon L, Collomb M. Steamed hay and alfalfa pellets for the management of severe equine asthma. Equine Vet J 2025;57(3):756–765.
doi: 10.1111/evj.14209google scholar: lookup
Westerfeld R, Payette F, Dubuc V, Manguin E, Picotte K, Beauchamp G. Effects of soaked hay on lung function and airway inflammation in horses with severe asthma. J Vet Intern Med 2024;38(1):469–476.
doi: 10.1111/jvim.16919google scholar: lookup
Clements JM, Pirie RS. Respirable dust concentrations in equine stables. Part 2: the benefits of soaking hay and optimising the environment in a neighbouring stable. Res Vet Sci 2007;83(2):263–268.
doi: 10.1016/j.rvsc.2006.12.003google scholar: lookup
McGorum BC, Ellison J, Cullen RT. Total and respirable airborne dust endotoxin concentrations in three equine management systems. Equine Vet J 1998;30(5):430–434.
doi: 10.1111/j.2042-3306.1998.tb04514.xgoogle scholar: lookup
Tanner MK, Swinker AM, Beard ML, Cosma GN, Traub‐Dargatz JL, Martinez AB. Effect of phone book paper versus sawdust and straw bedding on the presence of airborne gram‐negative bacteria, fungi and endotoxin in horse stalls. J Equine Vet Sci 1998;18(7):457–461.
doi: 10.1016/s0737-0806(98)80038-5google scholar: lookup
Samadi S, Van Eerdenburg FJCM, Jamshidifard AR, Otten GP, Droppert M, Heederik DJJ. The influence of bedding materials on bio‐aerosol exposure in dairy barns. J Expo Sci Environ Epidemiol 2012;22(4):361–368.
doi: 10.1038/jes.2012.25google scholar: lookup
Whittaker AG, Hughes KJ, Parkin TDH, Love S. Concentrations of dust and endotoxin in equine stabling. Vet Rec 2009;165(10):293–295.
doi: 10.1136/vr.165.10.293google scholar: lookup
Fleming K, Hessel EF, Van den Weghe HFA. Generation of airborne particles from different bedding materials used for horse keeping. J Equine Vet Sci 2008;28(7):408–418.
doi: 10.1016/j.jevs.2008.05.004google scholar: lookup
Mönki J, Saastamoinen M, Karikoski N, Norring M, Rajamäki M, Mykkänen A. Effects of bedding material on equine lower airway inflammation: a comparison of two peat beddings, wood pellet, and straw pellet. Front Vet Sci 2021;8:799645.
doi: 10.3389/fvets.2021.799645google scholar: lookup
Auger EJ, Moore‐Colyer MJS. The effect of management regime on airborne respirable dust concentrations in two different types of horse stable design. J Equine Vet Sci 2017;51(2):105–109.
doi: 10.1016/j.jevs.2016.12.007google scholar: lookup
Elfman L, Riihimäki M, Pringle J, Wålinder R. Influence of horse stable environment on human airways. J Occup Med Toxicol 2009;4(1):10.
doi: 10.1186/1745-6673-4-10google scholar: lookup
Ivester KM, Couëtil LL, Moore GE, Zimmerman NJ, Raskin RE. Environmental exposures and airway inflammation in young thoroughbred horses. J Vet Intern Med 2014;28(3):918–924.
doi: 10.1111/jvim.12333google scholar: lookup
Herholz C, Kocher J, Küng P, Barren A. Digital monitoring of dust release in a horse stable, depending on ventilation opening area and bedding type. Pferdeheilkunde 2020;36(4):316–324.
doi: 10.21836/pem20200405google scholar: lookup
Mostafa E, Szabo E, Gates RS, Buescher W. Identification of airborne particles and fungus spores concentrations within horses stables. Atmos Pollut Res 2021;12(2):93–103.
doi: 10.1016/j.apr.2020.10.012google scholar: lookup
Romolo A, Costa G, Sica B, Memoli G, Ardit M, di Benedetto F. Exposure to respirable silica contributes to lower airway inflammation in asthmatic horses. J Vet Intern Med 2024;38(6):3315–3326.
doi: 10.1111/jvim.17160google scholar: lookup
Claußen G, Hessel EF. Particulate matter in equestrian stables and riding arenas.. J Equine Vet Sci 2017;55:60–70.
doi: 10.1016/j.jevs.2017.04.004google scholar: lookup
Jackson CA, Berney C, Jefcoat AM, Robinson NE. Environment and prednisone interactions in the treatment of recurrent airway obstruction (heaves).. Equine Vet J 2000;32(5):432–438.
doi: 10.2746/042516400777591165google scholar: lookup
Couetil L, Cardwell JM, Leguillette R, Mazan M, Richard E, Bienzle D. Equine asthma: current understanding and future directions.. Front Vet Sci 2020;7:450.
doi: 10.3389/fvets.2020.00450google scholar: lookup
Séguin V, Garon D, Lemauviel‐Lavenant S, Lanier C, Bouchart V, Gallard Y. How to improve the hygienic quality of forages for horse feeding.. J Sci Food Agric 2012;92(4):975–986.
doi: 10.1002/jsfa.4680google scholar: lookup
Cameron A, Harris P, Longland A, Horseman S, Hockenhull J. UK horse carers' experiences of restricting grazing when aiming to prevent health issues in their horses.. J Equine Vet Sci 2021;104:103685.
doi: 10.1016/j.jevs.2021.103685google scholar: lookup
Furtado T, Perkins E, Pinchbeck G, McGowan C, Watkins F, Christley R. Exploring horse owners' understanding of obese body condition and weight management in UK leisure horses.. Equine Vet J 2021;53(4):752–762.
doi: 10.1111/evj.13360google scholar: lookup
Ross M, Proudfoot K, Nishimura EC, Campbell Nishimura E, Morabito E, Merkies K. ‘It's more emotionally based’: Prince Edward Island horse owner perspectives of horse weight management.. Anim Welf 2024;33:e14.
doi: 10.1017/awf.2024.9google scholar: lookup
Bullone M, Lavoie JP. The equine asthma model of airway remodeling: from a veterinary to a human perspective.. Cell Tissue Res 2020;380(2):223–236.
doi: 10.1007/s00441-019-03117-4google scholar: lookup
Abood SK. Increasing adherence in practice: making your clients partners in Care.. Vet Clin North Am Small Anim Pract 2007;37(1):151–164.
doi: 10.1016/j.cvsm.2006.09.011google scholar: lookup