Clinical variability of equine asthma phenotypes and analysis of diagnostic steps in phenotype differentiation

Table 1 Anamnestic and clinical scoring system used to evaluate asthma severity in the study horse population

Clinical sign or symptom reported	Score	Comment
Nasal discharge	0	None or light serous discharge
Nasal discharge	1	Yes (e.g., mucous, purulent)
Cough and history of coughing	0	None
	1	Not at examination but single coughs noticed by owners the past weeks
	2	Not at examination but single coughs regularly daily or always at start of exercise noticed by owners the past weeks
	3	Cough spontaneously at examination or cough attacks noticed by the owner the past weeks
Dyspnoea at rest	0	No dyspnoea (costo-abdominal breathing pattern)
	1	Slightly elevated abdominal lift at end of expiration
	2	Moderate abdominal lift without other signs of elevated breathing effort
	3	Severe abdominal breathing pattern, inspiratory flared nostrils
	4	Severe dyspnoea with pendular body movement, nostril flaring, signs of general discomfort
Auscultation	0	Physiological (soft inspiratory respiratory noise)
	1	Mildly forced inspiratory respiratory noise
	2	Moderately forced inspiratory and mild expiratory vesicular noises
	3	Severely forced in- und expiratory respiratory noises and/or tracheal rattling noises
	4	Rhonchus or rattling noises
Individual score (max. 12)

Medical history was included as part of the cough score, since cough was considered an objective symptom to be noticed reliably by the owners, if horses are regularly supervised. All horses were observed on a daily basis by their owners or caretakers in this study. The scoring system aimed at objectifying clinical examination results and history of cough for further analysis. The anamnestic and clinical score is in the following referred to as ‘clinical score’

ISSN: 1751-0147