A crusty nasal discharge from both nostrils may indicate a respiratory problem coming from the lungs, trachea or the laryngeal area including pneumonia, allergic bronchitis or strangles. Disease in the head region usually discharges from one nostril and is more fresh in moisture. However in some horses with allergic bronchitis, the discharge can be predominately from one nostril but there is usually an associated cough reflex as it passes from the lungs through the cough center in the throat.

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