Persistent Cough: Underlying Cause Key To Determining Appropriate Treatment by Paulick Report Staff|08.16.2022|7:48am Though coughing isn't out of the ordinary for horses that might be exposed to viruses, bacteria, or allergens, a persistent cough that interferes with training or a horse's daily life can be a concern, Dr. Matthew Mackay-Smith tells EQUUS magazine. Horses are often put on antibiotics when they cough. While this can aid in the reduction of coughing, the best way to determine what is causing the persistent tickle is to have a veterinarian scope the horse. A scope shows exactly which structures are affected and helps to determine what is causing the horse to cough. A scope might show areas in the horse's throat that are enlarged and inflamed. Horses don't have tonsils like humans, but they do have small areas of lymphoid tissue throughout their throat. The swelling of this area is called lymphoid hyperplasia (also called pharyngeal lymphoid hyperplasia or follicular hyperplasia). This condition is characterized by upper respiratory tract inflammation; it may also be associated with the same issues in the lungs. Lymphoid hyperplasia is classified by grades depending on the severity: grade I is the least severe, with grades III and IV being more severe. The condition often causes nasal discharge, exercise intolerance, and unusual respiratory noises during work. There are a multitude of treatments for the condition, but none has been successful in treating every case. The number one method to assist the horse in feeling better is to determine what is causing the coughing and eliminate it, if possible. The horse must then be allowed to rest while the inflammation subsides; this may take up to eight weeks in some cases. Other treatments for these areas of swollen tissue can include topical or systemic anti-inflammatories, antibiotics, cryotherapy, and frequent administration of influenza and herpesvirus vaccinations, among other things. The treating veterinarian will determine the best course of action based on the horse's medical history, exam results, and diagnostic testing. Read more at EQUUS magazine.