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How To Manage Equine Heaves

Updated: Feb 8

Horse with heaves labored breathing

As winter arrives, it's all about warm clothes, spending hours inside, and warm coffee or hot chocolate. We’re also gearing up to protect ourselves from viruses and other diseases that usually spread during this time. Flu, cough, and other respiratory diseases are very common in the winter months. Horses are also at risk for respiratory diseases.

In the winter, horse owners start stressing about the season changes and aim to protect their horses from the cold weather. So, they stable the horses inside the barn for the cold nights and cover them with blankets. But little do they know that all the closed stall windows and doors can cause problems for ventilation. The air quality deteriorates, and the horse becomes exposed to allergens and toxins, resulting in a respiratory condition known as heaves.

In this article, we will discuss heaves and how to manage it. We’ll also expose how it develops, its signs and symptoms, how vets diagnose it, and the treatment options.

What are heaves?

Heaves, also known as Recurrent Airway Obstruction, is a common respiratory disease in horses like asthma is in humans. It is referred under the category of chronic obstructive pulmonary disease (COPD). It is characterised by cough, nasal discharge, difficulty breathing, and performance limitation. It occurs due to hypersensitivity of the lungs and often causes lung damage in severe cases.

There are two types of heaves:

  • Summer pasture-associated heaves: usually occurs in summer and is caused due to exposure to allergens from trees and grasses.

  • Classic heaves: usually occurs in winter due to cold. The main allergens involved are barn dust, spores, and mold.

How do horses develop heaves?

It develops due to allergic reactions to pollen, dust, mold, and foreign inhaled particles. The lungs become more hypersensitive to such particles than usual. It is also possible that heaves develop due to a genetic component.

Some microorganisms, like bacteria and fungi, are also responsible for such conditions. These organisms include Faenia rectivirgula, Aspergillus fumigatus, and Thermoactinomyces Vulgaris.

Whenever a foreign object is present in the hay or even in the surrounding area, the horse's lungs are triggered and respond in reaction. It causes bronchoconstriction, which means the narrowing of the airways. In response, breathing is difficult, and the equine starts coughing to eliminate those inhaled particles. Constant irritation to the lungs makes the lung tissue inflamed and thickened. Hypersensitivity also causes mucus accumulation and generates pus.

equine bronchial tube comparison of a healthy tube and heaves tube
Comparison of bronchial tubes. Right side shows bronchoconstriction and mucus/pus accumulation. Photo credit: Doctor Ramey

Heaves Signs and Symptoms

Here are some signs and symptoms you may notice in a horse suffering from heaves

  • Frequent coughing

  • Wheezing

  • Increased respiratory rate

  • Difficulty in breathing

  • Flared nostrils

  • Functional limitation

  • Abnormal lung sounds

  • Nasal discharge

These are mild symptoms that appear in the beginning. The cough only occurs during exercise or eating. However, as the disease progresses, the symptoms also become severe. The cough frequency increases, and it is present even during rest.

In severe cases, the heave line develops. As the equine puts more effort into breathing, there is more stress on the breathing muscles. The frequent use of the muscle and unusual stress cause muscle hypertrophy. It also leaves a visible line on the abdominal muscle known as the heave line.

horse with heaves has a heave line on the abdomen
Heave line seen on the lower portion of ribs. Photo credit: Horse Journals

How to Check if Your Horse is Suffering from Heaves

You should always call your veterinarian if you suspect any changes in your horse. They will be able to preform diagnostics or exams that can determine what is going on with your horse. If you suspect heaves, you should list the symptoms you notice to your vet. The vet will make a diagnosis based on physical examination and history.

Physical Exam

He will check for flared nostrils, episodes of coughing, fever, the intensity of the performance, and weight loss. The most noticeable physical sign in chronic cases will be the heave line.


He may auscultate the lungs to check the lung field and listen to breathing sounds. The breathing sounds may be lacking in areas with restricted airflow. He may also be able to hear crackles and wheezes because airflow turbulence increases due to constriction of the alveolar walls.

Diagnostics Used to Diagnose Heaves

Horse trachea shows inflammation from heaves
Inflammation can be seen in the trachea with the endoscope. Photo credit: Anoka Equine
  • Complete blood count - may be advised to check blood cell count for inflammation.

  • Chest X-ray - is advised to rule out complications and other respiratory diseases, including pneumonia, pleurisy, and lung damage.

  • Ultrasound - can also rule out inflammation of the pleura.

  • Endoscopy - the vet can use a small flexible tube with an attached camera to see the trachea and bronchioles to check for mucus buildup and inflammation. Finding these things would indicate infection, heaves, or other respiratory diseases.

  • Bronchoalveolar lavage - is the most reliable method to confirm the diagnosis of heaves in severe cases. It is performed by taking a fluid sample from the lungs to check the presence of inflammatory cells. The secretions are then observed under a microscope to check the number and type of cells present. Primarily, there are macrophages and neutrophils.

Can heaves be cured?

No, heaves cannot be cured but it can be managed. You can reduce the signs of inflammation and other symptoms. This can be done by improving the horse's environment, medication and taking preventive measures to make him less exposed to allergens. The air quality must be monitored and improved with proper ventilation to provide the best environment for your horse.

6 Ways to Manage Heaves in Horses

Although Heaves is not curable, some precautions can reduce or even eliminate the signs and symptoms. Below are a couple ways to manage heaves.

Avoid Exposure to Dust and Allergens

Horse eating a round bale of hay develops heaves
Is this your horse? She could be at risk for developing heaves. Photo credit: Horse Canada

The best management is to keep your horse away from exposure to allergens and dust. Keep your horse outside in the fresh air rather than in a barn. Allow him daily access to fresh pasture land instead of feeding hay and round bales. If you're feeding him hay, maintain the quality and avoid round hay bales. Round bales should only be used if the pasture is not providing enough for the horse(s). Hay huts are extremely dusty and put the horse at risk of breathing particles each time he goes in to pull hay out.

In case the horse is stalled or rests indoors, ensure proper ventilation. Below are some ideas you can implement if your horse stays indoors.

  • Choose a stall location where the airflow is good

  • Avoid fine shavings for bedding

  • Provide a solid stall floor instead of dirt/sand/earth. Adding floor mats or concrete stall floors will prevent dirt particles from flying around when the horse moves.

  • Always provide good quality hay

Nutritional Management for Heaves

alfalfa pellets for horses with heaves

Stop feeding traditional hay and try hay replacements like alfalfa, hay pellets, or forage. Make sure the vitamin and mineral needs are maintained. Adding supplements to the diet can help the horse maintain health naturally. Vitamins will boost immunity and act as an anti-inflammatory. Omega-3 fatty acids are also essential for anti-inflammatory properties.

Herbal supplements and essential oils may also be good options for your horse. Essential oils can help reduce inflammation, are antispasmodic, and will support the immune system. Be sure to talk with your vet about the best nutritional options for your horse at their stage of the disease.

Check the Quality of Hay and Ensure Some Moisture

hay steamer for horses with heaves
Photo credit: Farm Vet

It is essential to feed your horse with good quality hay that is appropriately farmed and cleaned. Even if the hay quality is excellent, there are chances of mold and spores to be present. You can reduce the risk of flying particles by steaming or wetting the hay.

Steaming hay is a great option for any equine respiratory disease. Steaming hay allows you to continue to provide hay but eliminating most of the dust and foreign flying particles. Hay steamers also get hot enough to kill fungal spores and living organisms like mites. However, steamers can be very expensive to buy.

Feed at Chest Height During Heaves Flare-ups

Feeding at ground level is undoubtedly best for horse digestion, but it may be problematic for horses with heaves. After you soak the hay, you can feed in hay mangers at chest height and use hay nets to raise the hay up. Lifting the hay up will avoid the dust and allergens present on the ground.

Horses with full time access to pasture are believed to be safe, but if they have access to round bales, they could develop heaves.

Medical Management for Heaves

Corticosteroids are the advised medication in case of heaves. Bronchodilators and antihistamines can also help to reduce allergic response and cough. The veterinarian himself can only do medical management. Never give any medication to your horse without consulting the vet.

horse inhaler used for horses with heaves
Photo credit: University of Saskatchewan

There are also equine inhalers that are FDA-approved devices for horses with heaves. Inhalers offer a way to directly administer medication to the respiratory tract. This is usually an expensive option, but effective.

You can discuss the best medical management option with your vet.

Acupressure Therapy

Acupressure sessions are great as complementary care for your horse. However, this is not a quick fix option. Acupressure works to bring balance back to the animal. Since heaves presents as an imbalanced disorder, it may take many sessions to see improvement. This is why acupressure works best as a preventative care option.

Acupoints are gently pressed to reduce the allergic response. Below are some benefits that acupressure provides.

acupressure work on a horse can prevent heaves
  • Improves breathing function by relaxing the hypertrophied muscle.

  • Stimulates release of anti-inflammatory cytokines by activating the immune system.

  • Prevention of recurrent episodes of heaves.

  • Clears the nose and nasal cavity from obstructions.

  • Relaxes the body and encourages calmness.

  • Great for any respiratory imbalance (colds, coughing, sneezing, etc)

Adding acupressure to your horses care plan will greatly benefit his immune system. Poll to Pastern offers acupressure sessions and clinics! Schedule your horse routine acupressure sessions today!

During a clinic, you can learn about acupressure, how to find the points, what to look for, pressure techniques, and more! We travel for our clinics cross-country. If you would like to host a clinic, reach out to us today!

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