Most horse owners hear “asthma” and think of an inhaler and a lifetime of management. For decades, that’s mostly been true: environmental changes, corticosteroids, bronchodilators, and a lot of watching the hay for dust. But a growing body of clinical research is pointing to a non-drug option that many owners don’t know about yet: shock wave therapy. 

What Is Equine Asthma? 

Equine asthma is a chronic inflammatory disease of a horse’s lower airways that causes coughing, mucus buildup, and labored breathing, especially during exercise. It is the most common non-infectious respiratory condition in adult horses, and it can range from mild to severe. 

Equine asthma is far more common than most owners realize. It affects up to 15% of horses, most commonly in horses over the age of seven, making it one of the more prevalent respiratory conditions in mature performance and pleasure horses alike. Inflammation narrows the airways and increases mucus production, which over time can limit a horse’s ability to breathe efficiently, especially under exertion. 

If you’ve heard this condition called “heaves,” “RAO” (recurrent airway obstruction), or “COPD” (Chronic Obstructive Pulmonary Disease) – that’s the same diagnosis under an older name. According to the Merck Veterinary Manual, “equine asthma” is now the preferred clinical term, covering the full spectrum from mild inflammatory airway disease (IAD) to the more severe presentation once known as heaves. 

Equine Asthma Symptoms: Signs Your Horse May Have Asthma 

Equine asthma doesn’t always look dramatic, and that’s part of why it’s underdiagnosed. Veterinary experts at the University of Florida IFAS Extension point to these signs: 

• Coughing, especially after exercise or first thing in the morning 

• Nasal discharge 

• Reduced performance or stamina that doesn’t have an obvious cause 

• Increased respiratory effort, including flared nostrils or a visible “heave line” along the abdomen in more advanced cases 

Any one of these on its own might seem minor. Together, especially in a horse whose performance has quietly declined, they’re worth a conversation with your veterinarian. 

Equine Asthma Treatment Options: The Standard Approach 

The conventional playbook for equine asthma starts with environmental management: soaking or steaming hay, improving barn ventilation, and reducing dust exposure. When that’s not enough, vets often add medication on top of those changes, usually a steroid to calm the inflammation and/or a bronchodilator to help your horse breathe easier in the moment. In practice, this can mean daily inhaler treatments, ongoing monitoring, and a management routine that never fully turns off. 

These treatments work, but they come with real tradeoffs. Long-term steroid use carries side effects, and many competition organizations have rules around medication timing before horses can compete. For owners managing a working or competing horse, that can mean choosing between symptom control and competition eligibility, a tradeoff that shapes both the treatment plan and the show calendar. 

A Drug-Free Alternative: Shock Wave Therapy for Equine Asthma 

This is where newer research is changing the conversation. Electrohydraulic extracorporeal shock wave therapy (ESWT), delivered using the PulseVet® shock wave device, is emerging as a non-invasive, drug-free option for managing equine asthma. 

The clearest evidence comes from Dr. Beau Whitaker, DVM, of Brazos Valley Equine Hospital. In a study of horses treated for mild to moderate asthma, Dr. Whitaker observed measurable reductions in respiratory effort, cough frequency, and overall clinical signs following treatment, with no adverse events reported. In an earlier, separate study looking at a different condition, exercise-induced pulmonary hemorrhage (EIPH, sometimes called “bleeders”) in barrel racing horses, researchers noticed something unexpected: every horse in that study also showed some degree of underlying equine asthma. That’s a meaningful clue that the two conditions may be more connected than previously understood. 

If you want to dig into the full clinical data behind these findings, including the specific research numbers, read our in-depth look at PulseVet shock wave for equine pulmonary conditions. 

While shock wave therapy is not a replacement for veterinary diagnosis or a cure, it has become a promising, evidence-backed option that can reduce reliance on medication, particularly for horses where drug-free management matters most. 

The Ongoing Research: Zomedica’s Equine Asthma Clinical Registry 

Because this is still an emerging application, Zomedica has launched an Equine Asthma Clinical Registry to keep building the clinical case with real-world data. Vets across the country are enrolling horses in a structured treatment and evaluation protocol, adding to a growing body of evidence on how shock wave therapy performs for asthma in everyday practice, not just in a controlled study. 

What to Expect During Treatment 

If you’ve never seen shock wave therapy in action, the idea of “treating” a respiratory condition with sound waves can sound more complicated than it actually is. A PulseVet shock wave treatment session is quick, lasting around six minutes, and horses tolerate it well. Watch this video to see a PulseVet therapy session for equine asthma in action. 

For orthopedic conditions, PulseVet therapy treatments are usually spaced a few weeks apart, with most horses needing only a handful of sessions to see results. Shock wave therapy for equine asthma is a newer application, so your veterinarian will determine the right number of sessions and spacing based on your horse’s individual case. PulseVet therapy stands alone as the only shock wave technology with an approved indication for equine asthma. 

That’s exactly why this is a conversation to have with your vet rather than something to try to figure out on your own. They can walk you through what a treatment plan would realistically look like for your horse, how it might fit alongside any current medications or environmental management you’re already doing, and what kind of timeline is reasonable to expect improvement. 

PulseVet® Shock Wave Therapy: Talk to Your Vet 

This is one of those options worth knowing about before your horse’s next coughing fit turns into a bigger conversation. If your horse has been coughing more than usual, seems to tire faster than they used to, or has already been diagnosed, ask your veterinarian whether PulseVet shock wave therapy could fit into their management plan, and whether your horse might be a candidate. 

Find a vet that offers PulseVet therapy near you. 

Have questions before you talk to your vet? Contact us to learn more. 

©2026 Zomedica Inc. All rights reserved.  PulseVet is a registered trademark of Zomedica Inc.   

 Disclaimer: The information provided on this blog is for general informational and educational purposes only. It is not intended as medical advice and should not be used as a substitute for professional medical guidance. Always consult a qualified healthcare provider before making any health‑related decisions. 

Disclosure: Dr. Beau Whitaker was compensated by Zomedica for his role as an investigator in the EIPH study referenced above.