Airway inflammation in Michigan pleasure horses: prevalence and risk factors

Reasons for performing study: Although subclinical airway inflammation is thought to be common in horses, there is little information on its prevalence and none on risk factors. Objective: To determine the prevalence and risk factors for an increased number of inflammatory cells and for mucus accumulation in the trachea of pleasure horses. Methods: Horses (n = 266) in stables (n = 21) in Michigan were examined endoscopically, once in winter and once in summer 2004. Visible tracheal mucoid secretions were graded 0-5 and inflammatory cell numbers counted in a tracheal lavage sample. Information collected about each horse included age, gender, presence of cough, percent time indoors and source of roughage. The repeated measures were analysed by generalised estimating equations and linear mixed models. Results: Horses eating hay, especially from round bales, had the most neutrophils, whereas horses feeding from pasture had the fewest. Being female and being outdoors in winter were associated with increased numbers of inflammatory cells. Older horses had fewer macrophages than young horses. More than 70% of horses had > 20% neutrophils in tracheal lavage. Twenty percent of horses had a mucus accumulation score > 1; 17% had both a mucus score > 1 and > 20% neutrophils. The significant risk factors for mucus accumulation > 1 were age > 15 years, feeding on hay as compared to pasture, and being outdoors for more than 80% time in winter. Even though mucus accumulation score > 1 was a risk factor for cough, only half of such horses coughed. Cough and mucus accumulation were associated with increased number of neutrophils. Conclusions: In comparison to pasture feeding, hay feeding, particularly from round bales, was associated with an increased number of neutrophils in the airway. Being outdoors in winter was associated with increased numbers of inflammatory cells and with mucus accumulation. Because 70% of horses have > 20% neutrophils, this value should not be used as the sole indicator of airway inflammation. Potential relevance: The study reinforces the importance of hay feeding and older age as risk factors for inflammatory airway disease. Horses that do not have 'heaves' may be best kept indoors when winters are cold.