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RAO in Horses: Chronic Obstructive Pulmonary Disease

Updated: Jan 16


Hempqualizer in RAO case studies:

  1. In collaboration with Ms. Magdalena Żak, we implemented regular supplementation in two of her charges for a period of 30 days. You can read the description of both cases, the course of supplementation, and its effects HERE

  2. Faraon case study HERE 

  3. John Doe case study HERE

  4. Playboy case study HERE

  5. Bufflo case study HERE

  6. Kasia case study HERE

  7. Berenika case study HERE


RAO, or Recurrent Airway Obstruction, is a serious condition affecting horses, often compared to human asthma. This disease is most common in horses kept in stables or those exposed to high concentrations of pollen, mold, or other particles in pastures. RAO is characterized by chronic and troublesome episodes of respiratory difficulty, significantly limiting the animal's sporting and functional capabilities.

Ten Facts You Need to Know About RAO::

  1. RAO is marked by distinct episodes of breathing difficulties, during which the horse exhibits "heaving" sides, struggling to breathe.

  2. Common symptoms include chronic cough, nasal discharge, exercise intolerance, and breathing problems. A characteristic symptom is the so-called "heave line" along the lower edge of the ribs, caused by the enlargement of the abdominal muscles due to excessive respiratory effort.

  3. There are two types of RAO: stable-associated and summer pasture-associated obstructive pulmonary disease (SPARAO).

  4. The average age of onset is 9-12 years, with a genetic predisposition noted in some horse populations.

  5. Diagnosis of RAO is based on history, housing conditions, and clinical symptoms, supported by additional diagnostic tests such as bronchoalveolar lavage (BAL), lung function tests, chest radiography in selected cases, and blood tests (haptoglobin and SAA).

  6. Horses with stable-associated RAO should be kept on pasture, with their diet based on fresh grass and supplemented with pelleted feed.

  7. Horses with pasture-associated RAO should not be housed in the same building as a covered arena and should have a low-dust stable environment.

  8. Complete feed can replace dried forages, but hay cubes are a good low-allergen alternative.

  9. RAO is a chronic disease requiring lifelong management, including environmental and dietary changes, and in severe cases, pharmacological treatment, which often has minimal effects.

  10. Severe or prolonged cases of RAO may require the use of bronchodilators and corticosteroids, which must be prescribed by a veterinarian.

Inflammation in RAO

Studies show that RAO in horses is not just a respiratory system disorder. Research indicates that RAO may be associated with a systemic inflammatory state that can contribute to the development of other pathologies or exacerbate existing ones. It's been found that acute phase proteins (SAA) are increased in the peripheral blood of horses with RAO. Particularly, haptoglobin levels in serum are higher in horses in every clinical phase of the disease. Unlike C-reactive protein (CRP), which is not a good marker of chronic respiratory inflammation in horses, elevated haptoglobin levels may indicate the presence of RAO even during disease remission.

In summary, RAO is associated with increased levels of acute phase proteins, such as haptoglobin and SAA (serum amyloid A). This clearly confirms that RAO involves inflammatory changes in both the remission and exacerbation phases.


Coexisting Systemic Inflammation in Horses with RAO May Have Several Implications::

  • Immune System: Chronic inflammation can lead to dysregulation of the immune response, making the body more susceptible to infections. Chronic inflammation may also contribute to the development of autoimmune diseases.

  • Circulatory System: Systemic inflammation can affect the circulatory system, increasing the risk of clot formation and other circulatory disorders, potentially leading to serious complications like deep vein thrombosis or pulmonary embolism.

  • Metabolism: Chronic inflammation can impact metabolism, potentially leading to difficulties in maintaining proper body weight and being a risk factor in the development of insulin resistance.

  • Digestive System: Prolonged inflammation can disrupt the normal function of the gastrointestinal tract, leading to problems with nutrient absorption and digestion, affecting overall nutrition and health.

  • Musculoskeletal System: Inflammation can contribute to the development of joint diseases like osteoarthritis, particularly relevant in sport horses where any deterioration in mobility can mean the end of a career.

  • Mental State: Chronic pain and discomfort can affect a horse's behavior, leading to changes in behavior, depression, or aggression.

Coexisting Inflammatory Disorders

In the context of RAO, there are several disorders that can develop concurrently or be exacerbated by chronic inflammation:

  • Skin Diseases: Inflammation can exacerbate existing skin diseases or contribute to their development, as the skin is directly linked to the immune system.

  • Gastrointestinal Diseases: Such as stomach ulcers or colic, which can be a result of or exacerbated by oxidative stress and gut microbiota imbalance caused by chronic inflammation.

  • Metabolic Disorders: Such as equine metabolic syndrome, which can be linked to chronic inflammation and lead to serious complications, including laminitis (inflammation of the hoof lamina).

Managing Inflammation

Managing inflammation in RAO involves both treating the underlying respiratory disease and supporting overall health:

  • Environmental Changes: Ensuring a low-dust environment can help reduce systemic inflammation.

  • Supplementation: Anti-inflammatory supplements like omega-3 fatty acids, vitamin E, and other antioxidants can support overall health and help manage inflammation.

  • Pharmacological Treatment: The use of anti-inflammatory medications, such as corticosteroids, may be necessary in severe cases but should always be under veterinary supervision.

  • Balanced Diet: A diet rich in natural antioxidants can help regulate inflammatory states.

Managing RAO and coexisting inflammatory conditions requires a comprehensive approach and often collaboration between a veterinarian, equine nutritionist, and caretaker.


Hempqualizer and RAO

Considering the effective anti-inflammatory, antioxidant, calming, and anti-allergic properties of Hempqualizer ingredients, we decided to use them in horses suffering from RAO. Below are the links to the case studies, which we will systematically update with additional cases:

  1. In collaboration with Ms. Magdalena Żak, we implemented regular supplementation in two of her charges for a period of 30 days. You can read the description of both cases, the course of supplementation, and its effects HERE

  2. In collaboration with Ms. Gabriela Adamaczewska, we implemented regular supplementation for her horse Faraon for a period of 30 days. You can read the description of the supplementation process and its effects HERE

  3. John Doe case study HERE

  4. Playboy case study HERE

  5. Bufflo case study HERE

  6. Kasia case study HERE

  7. Berenika case study HERE




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