And what can be done about it
What is a chronic cough and how does it develop?
Chronic respiratory diseases are unfortunately on the increase. There are many reasons for this, which is why different treatment approaches are often necessary for what appears to be the same symptom.
From the nostrils to the alveoli
The horse’s airways do not begin in the lungs, but with the nostrils. This is where the air flows in and is first warmed, moistened and filtered of dust. A spongy bone called the ethmoid is responsible for this, which extends into the nasal passages at eye level. The air also passes through various sinuses, especially the frontal and maxillary sinuses. In this way, pathogens are filtered out of the air we breathe and stick to the mucous membranes. This is well designed by evolution, because mucus and pus can drain more easily from here than from the lungs. The air we breathe passes through the larynx, trachea, bronchi and lungs and into the small air sacs, where the oxygen exchange takes place.
Many illnesses that cause coughing as a symptom occur in the upper respiratory tract (paranasal sinuses, ethmoid bone and larynx). Persistent pathogens or a weak immune system can lead to permanently inflamed respiratory mucosa. If dusts are inhaled, e.g. from hay, this triggers a coughing reflex, which in turn contributes to inflammation.
When the boxes and stable aisles are being cleaned, there should be no horses in the stable. The dust and ammonia levels in the air are too high for sensitive respiratory tracts.
Causes of chronic cough
Many owners believe that if their horse coughs chronically, it has a lung problem. However, most horses have problems in the upper respiratory tract, i.e. the paranasal sinuses, ethmoid bone or larynx. Pathogens can take hold here and – as in humans – lead to chronic infections. These cause constant irritation and inflammation of the respiratory mucosa, which means that new pathogens can easily take hold in these affected mucous membranes.
Hay dust allergy is usually not the cause
Even if the vet has diagnosed an inflamed and reddened larynx and a hay dust allergy is therefore suspected, this is not necessarily the case. Very few horses are allergic to hay dust; in most cases, hay dust is just the trigger for a cough that has a completely different cause.
Chronically inflamed sinuses
An inflamed larynx can be the result of chronically inflamed and/or infected sinuses. In such cases, mucus does not flow out of the nose or need to be coughed up. The chronic infection must be treated first. In addition to a veterinarian, a craniosacral therapist or a horse kinesiologist may be able to help you, because unfortunately antibiotics and rinses often do not work well enough for these types of infections.
Unhealthy breathing air
Another important factor is the air we breathe. The horse is a native of the steppes and its airways are correspondingly sensitive. Humid air, enriched with dust particles and ammonia, is toxic to horses’ respiratory tracts! Therefore, in the case of closed stabling, attention must always be paid to excellent ventilation and dust reduction. And even if you don’t mind the stable air, just sit in a box that has not yet been mucked out. You will notice how quickly your own respiratory system reacts to dust and ammonia. Mouldy hay or straw while sweeping the stable yard can also create dust. Therefore, if the stable is being swept or the bedding changed, the horses should be outside.
Too many proteins
Ammonia levels can be reduced by lowering the protein content of the feed. Most horses receive far too much protein with their concentrated feed, which the body cannot convert into muscle mass at all but has to laboriously excrete as urea through the kidneys. In the soil, microorganisms are happy to gain energy from the urea and produce ammonia as waste. If you regularly spray the stable and especially the box floors with EM-A 1, these ammonia producers will slowly be replaced by the EM-A and the air in the stable will noticeably improve. You will notice that your horse’s faeces smell less acidic and of ammonia when the protein content in the feed is reduced.
Your horse’s ancestors were steppe inhabitants. Provide them with dry and clean breathing air!
Left-sided heart insufficiency
The heart is also connected to breathing: if a horse has left-sided heart insufficiency – a common problem in older horses – blood pools in the lungs and blood pressure in the alveoli rises. This causes fluid to leak out of the bloodstream into the alveoli, which can cause what is known as a ‘heart cough’. By strengthening the heart muscle, you can provide therapeutic support for affected horses and reduce the coughing.
The role of the large intestine
The connection between the large intestine and the respiratory tract is less well known. Traditional Chinese medicine teaches that the lungs and large intestine belong to the same functional circuit: disorders in the large intestine lead to disorders in the respiratory tract over time. This is also reflected physiologically, because if the horse’s large intestine is disturbed, the intestinal mucosa becomes inflamed and the liver is overloaded. This deprives the metabolism of sulphur, which means that the body can no longer produce sufficient cysteine. However, this is needed for the formation of mucus in the respiratory tract. A deficiency therefore leads to dry mucous membranes, in which germs and sometimes purulent mucus can then accumulate. These horses usually respond to the administration of ACC (acetylcysteine), especially via the inhaler, when they cough.
Incorrect intestinal fermentation also leads to an increased content of volatile fatty acids (propionic, butyric and acetic acid), which are absorbed into the bloodstream and largely exhaled. This correlation shows that chronically coughing horses should not be given haylage either, as this disturbs the gut in the long term to such an extent that the problem in the respiratory tract is likely to be exacerbated. The horses do not cough because there is no dust stimulus, but they often develop heaves or asthma after a few years.
What can be done about chronic coughing?
The first thing to do is to improve the breathing air, which is why many chronically coughing horses are moved to open stables or outside stables. Small changes in stable routines, such as spraying with EM-A, not shaking hay, feeding wet or steamed hay, moistening the stable floor with a watering can before sweeping and keeping the horses out during mucking out and applying fresh bedding, are possible in almost every stable and significantly improve the air in the stable.
No straw
Horses that cough chronically or are prone to coughing should not be kept on straw bedding, as this is often infested with mould. Dust-free shavings are a good alternative.
Optimise feeding
Once the external conditions have been optimised, it is essential to improve feeding and to restore the intestinal flora in order to rule out the possibility that the respiratory problems are being maintained by hidden problems in the digestive tract. Please change the feed slowly over a period of two weeks and then carry out an intestinal restoration. You can find more information on this in the ‘Intestinal Restoration’ information sheet.
Test for Kryptopyrrolurie
In a second step, you should have your horse tested for Kryptopyrroluria (KPU). This metabolic disorder is not infrequently the underlying cause of the visible symptom of ‘chronic cough’. You can find more information about this in our information sheet on KPU. If the KPU values are positive, please contact us, as this disorder must be treated before the therapies can work effectively.
Promote regeneration of mucous membranes
After that, support your horse’s airways with a three-week course of OKAPI Liquorice Extract. This has an anti-inflammatory effect on the mucous membranes and also stimulates the formation of new mucous membranes. At the same time, give OKAPI Sekretosan for a period of 6 weeks. This is a herbal mixture that has been specially developed for the respiratory tracts of horses that suffer from chronic coughing. It has a lasting soothing effect on inflammations. OKAPI Cough Herbs have been formulated for horses that suffer from acute coughing and are therefore more suitable for ‘cold coughs’, which can occur as an additional complication in chronically coughing horses during the winter months. In such cases, you can give OKAPI Sekretosan and OKAPI Cough Herbs in weekly alternation over a longer period of time. Inhalation with a 7% saline solution helps to drain any mucus that may be present.
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Support the immune system
In any case, give OKAPI Immuno Herbs for 6 weeks to support the immune system during the therapy. OKAPI Zinc Chelate for 2–3 months also supports the immune system and mucosal regeneration, and chronic inflammation can heal sustainably.
Strengthen heart muscle
In some horses, a weak heart can cause chronic coughing. Conversely, chronic coughing and especially chronic coughing that causes breathing to become laboured can put undue strain on the heart. Affected horses, as well as older horses that cough, can benefit from OKAPI L-Carnitine to strengthen the heart muscle. Treat with OKAPI L-Carnitine for 4–6 weeks, with 3–4 week breaks in between.
Optimise mineral supply
Make sure that all chronically coughing horses have an optimal mineral supply. Depending on the quality of your soil, you can give one of our mineral feeds, alternating with OKAPI Seaweed, which has a positive effect on mucosal regeneration.
🇬🇧 We are an experienced team of therapists specializing in feed consultation and integrated therapies for horses. With extensive experience in treating metabolic issues, we focus on natural, species-appropriate feeding and proven naturopathic remedies to enhance your horse's health. Benefit from our expertise to ensure the well-being of your horse.
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