Determining the cause of your horse's respiratory problem starts with an examination by your veterinarian.
To determine the source of his breathing problem, I would start with a good general physical examination by your veterinarian, including a good respiratory examination with a rebreathing bag.
The next thing I would do would be perform an upper respiratory endoscopic examination to rule out any abnormalities of the nasal passages, pharynx or larynx. With the endoscope, the trachea can also be examined for evidence of mucus, which could signify inflammatory airway disease.
If your veterinarian has not performed a bronchoalveolar lavage, I would recommend having that diagnostic test performed on your horse. The test results will let you know if your horse has inflammatory airway disease or small airway disease (or heaves).
If your horse does have an inflammatory or small airway disease, there are certainly ways to manage the condition. Usually, some form of corticosteroid therapy (either systemic or inhalant) is necessary to relieve the inflammation and allow for easier breathing. Bronchodilators (systemic Ventipulmin or inhalant Albuterol) are also helpful, but often are combined with the corticosteroid therapy. Systemic MSM can also be helpful for some horses. Cough Ease is a natural product that can help some horses that cough.
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If your horse has inflammatory or small airway disease, environmental management is often one of the most important aspects of treatment. If the hay is dusty, it is helpful to wet the hay down at each feeding. The other feeding alternative to try is a complete pelleted diet or cubes, which will decrease the amount of dust, hay pollens and endotoxins your horse inhales. If the horse is kept in a barn, make sure that it is well ventilated and not dusty. Ideally, it is best to house these horses outside on pasture, although some horses with inflammatory or small airway disease are worse on pasture and do better in a non-dusty dry lot, stall or run. If the arena where you ride your horse is dusty, it is beneficial to wet down the ground before riding.
As far as building up endurance, I would first start with trying to determine what condition your horse has and get that under control first. Once you can decrease the inflammation in the airways, you will be able to ride longer and build his endurance over time.
Dr. Tanya Balaam-Morgan
American Association of Equine Practitioners