Upper respiratory causes of exercise intolerance

The respiratory system is a frequent cause of exercise intolerance in performance horses. Labored breathing, fatigue during performance, and prolonged recovery after exercise are common complaints. Inadequate fitness level and diseases of the cardiovascular system are differential diagnoses that share these complaints and should be ruled out. Generation of increased airway noise is a clinical sign that implicates the upper respiratory system. A careful history from the owner and endoscopy of the upper airway are the most useful diagnostic tools. Endoscopy during exercise on a treadmill is indicated when the airway lesion is not apparent with endoscopy at rest. Treatment of the respiratory obstruction may differ with the level of performance required.