The therapeutic goals for treating IAD include: 1) immediate relief of the bronchospasm that causes cough and bronchoconstriction that impairs, 2) reduction of lower airway inflammation, mucus production and airway plugging, and 3) long-term prevention of worsening of IAD by control of lower airway inflammation and airway obstruction.
For treatment to be successful, the practitioner must develop a treatment strategy with recognizable and achievable goals in place that is approved by both the attending veterinarian and the owner or trainer. Owners should also recognize that this may be a chronic problem that may require management of some kind for the life of the horse. Clear expectations of what the outcome of successful treatment will be should also be set in place. It is entirely reasonable, for instance, to expect that a young racehorse would be able to return to racing after a short, targeted period of treatment. The owner of the older horse with heaves, however, must recognize that a much more modest return to light pleasure riding is a reasonable goal.