Any disorder impairing a performance horse's ability to ventilate its lungs and exchange oxygen compromises exercise performance in any discipline. Since bronchoalveolar lavage was described in horses in the early 1980s, laboratory evaluation of respiratory fluids, along with clinical and functional assessment of the respiratory system, has become a relevant step in the diagnosis of respiratory disease affecting performance. The aim of this review is to provide objective information to assist clinicians in interpreting laboratory findings by (1) summarising published cytological references values in both clinically healthy horses and those with various airway diseases, (2) assessing the influence of physiological circumstances, such as exercise, on the cytological evaluation, (3) discussing the relationship between cytological and microbiological analyses, clinical signs and respiratory function, and (4) suggesting how this latter relationship may affect performance.
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