5 yo with inflamed airway disease / heaves / allergies

[rezaroo]

I’m at my wit’s end with this and feeling pretty helpless and just need some advice.

After being at the same barn for 2 years, my horse began coughing on and off after fall shots in 2019 (when he was 4). I was away at college and he was working with my trainer. It started with a few coughs at the beginning of the ride and these symptoms be on and off. Sometimes he wouldn’t cough for a month and sometimes he would have a fit. Before I got back from college in March 2020 (COVID) he was having some coughing fits with my trainer she gave him breaks when he would have fits. But then COVID hit and I came home but didn’t ride him until May. He would go a couple weeks without coughing then get bad again for a couple weeks. This would be coughing at the beginning and sometimes increased coughing with exercise.

He didn’t improve by June and I was very concerned and had the vet out. We put him on Tri-Hist, an anti-histamine which I think helped, but it was a pain to feed (he wouldn’t eat it and the texture would clog a syringe) so we stopped after a couple of weeks. The cough came back and he was on 12 mg of dexamethasone tapering for 10 days which helped, but the cough came back right after. Then I decided to get an allergy panel done, and he’s allergic to a bunch of things.

My BO grows hay, and we put him on the first cutting of grass which has the least clover. It is beautiful and green and not dusty. The barn uses straw, but we switched him to wood shavings. We are considering trying the wet wood pellets. I am also considering soaking his hay, but my BO is a bit opposed to this.

I decided to try a new vet who diagnosed him with inflammatory airway disease and put him on Ventipulmin Syrup and a longer taper of Dexemethesone 20 mg tapering over a month. That month he didn’t cough at all, until the taper from 4 mg to 2 mg. Right after the taper ended, it got extremely cold, and he started coughing again. His symptoms on a bad day are coughing at least once a circle starting with the trot. He sort of holds his coughs in at the canter then coughs a lot once we stop. When we free-lunge, sometimes he is very fresh and over-exerts himself then stops and coughs, struggling to catch his breath (I stopped letting him do this after the first time it happened). It’s still very cold in the Midwest and I am not riding him when he is not feeling well. It’s just hard because this has gone on for so long and I’ve tried so many things and don’t know what is causing it.

It’s also odd because three other horses in the 24 horse barn began struggling with heaves, not all at the same time, but something seems to be going on. I talked to my BO and we are going to turn him out 24/7 when the weather gets better if he doesn’t improve. I’ve reached out to another vet who is a nutritionist and maybe they can help me. He doesn’t get any fresh grass and is on a dry lot, so I’m thinking he might have a deficiency in his diet. He has been on SmartBreathe and another herbal supplement from Smartpak but neither helped significantly.

If anyone has advice or experience with this, please leave a reply.

[Highflyer1]

I would find a way to turn him out 24/7 now if you can, preferably somewhere else. As long as he has shelter and blankets he should be fine.The fact that multiple horses are having issues is very concerning and definitely points to a management issue.

[Amy3996]

I agree - multiple horses developing symptoms around the same time is a huge red flag for management problems. Straw bedding is a well known trigger for respiratory issues because of all the dust. Switching him to a different bedding was a good call, but if everyone else in the barn is still bedded on straw, it may not be enough to lessen the irritants. 24/7 turnout ASAP would be my first recommendation.

High dose cetirizine (Zyrtec) worked well for my gelding who had heaves. He’d get 150mg (15 tabs) twice a day. He was 16.3h and almost 1300lbs, though, so your dosage may vary. I bought the generic version in bulk on Amazon and it wasn’t terribly expensive. He got his feed soaked to mash so we were able to drop the tablets right into his bucket and he ate them no problem. Alternatively, they’re easily shoved into an oatmeal pie, fig Newton or other similar treat.

[4horses]

I would try turnout starting as soon as possible except during bad weather. My mare was diagnosed with inflammatory airways. One vet wrote it off as heaves (and basically acted like he didn’t care and she wasn’t worth his time.) Second vet started her on dexamethasone tapered over 3 months and she hasn’t had a problem since. It started with a bad batch of hay.

My barn had very dusty stalls. I put in mats and eliminated beddding. Bare stall mats that get mucked and swept daily. I use chicken feed to absorb the wet spots during cleaning. They aren’t stalled for long but best to keep the dust down.

Hay should be soaked or wetted. If that doesn’t help, then switch to a pelleted feed.

If it’s severe, you can do allergy shots.

[RedHorses]

There are other antihistamines. My horse is affected most in summer, worse when it’s hot and humid. I have him on Hydroxyzine capsules from late spring to early fall. Some horses will eat them, but they also dissolve easily in a syringe with 10-15cc of warm water (administer while still warm as the capsule itself congeals as it cools). Apparently it also comes in a powder.

Is there any mucus in his cough? I’ve found that Omega Alpha’s RespiFree helps loosen my horse’s mucus. Combined with exercise and then a snack fed at ground level can prompt some pretty dramatic draining.

If I can take advantage of the post winter ice/mud footing pre summer heat period to increase his cardio fitness that’s all the medication/supplement he needs. I have missed that window the last two years and put him on Prednisolone for the summer/fall.

I count his breath rate every day when the season arrives. I listen to his lungs as well (stethoscope). I use exercise to naturally dilate the airways and keep him fit so that he doesn’t have to work as hard to get oxygen during a flare up. I keep Ventipulmin on hand for any flare ups. The longer inflammation continues the more scarring occurs in the lung tissue and that reduces lung capacity permanently. He’s had one or two serious flares a year for the last few years and quick, aggressive response has kept his lung capacity pretty much 100%. I have caught pneumonia before it got serious when his breathing did not improve with the usual treatment.

It sounds like it’s time to ask your vet about other options.

[luvmyhackney]

I could write a novel on this topic, was dealing with it for years and now have a good management plan in place.

Zyrtec - 3-4 a day
Steamed hay - soaking didn’t work for mine as it didn’t kill the spores. If you can’t steam, soak and use a hay bag to keep them from burying their nose in it. No round bales!!
Damp feed with crushed Zyrtec
Outside 99% of the time
Keep him fit, like really fit, sometimes you have to let them gallop and get the mucus crap out.
Nose net if trail riding

Mine is allergic to pine so bedding is a challenge , he has been fine on standard shaving that are damp. I’m moving to flax bedding for him eventually.

I smear vicks on his nose to help open airways and tree oil/ peppermint steams with him if he has a slight flare. Plus use Sudafed you get behind the pharmacy counter. The good stuff the meth dealers want.

Last resort is Albuterol and Ventipulman since he foundered on dex. So far we haven’t had a flare in 2ish years.

I tried a bunch of the supplements with minimal results and now just use a high dose of MSM to fight inflammation. Keeping him fit has been key and worked better than anything else.

[Equkelly]

I’m also dealing with this now with my 4YO mare. We live in Colorado and were very close to the fires. Ever since she’s been having airway issues.

Does anyone know how accurate those allergy panels are? I’d totally spend the money on it but I worry they’re not super accurate.

[Foxglove]

Seems to me OP you are doing everything right. I can only offer a glimmer of hope. My 18 year old rock-solid-never-sick gelding began to cough in January of 2018. Got worse to the point where I had to pull him out of the hunt field. Three vets later, one a specialist in pulmonology, and the three agreed (independently) that horse would be useable with dex and Vetripulman before riding, but would never be sound.

Meanwhile, I did everything under the sun --power washed barn, removed all (all) hay and bedding, re did stalls with clay and sand, bought new hay --oh, horse has always been out 24/7 on 20 acres of pasture --just comes in to eat --but I had to try something and cleaning the barn was all I could think of to do.

Finally, I accepted that my old friend wasn’t ever going to be able to do mad gallops after the hounds, and I bought a young horse.

It had been 5 months since the diagnosis. My thought was even if my old horse got better, he’d still be 19 and maybe it was time to look to a younger horse.

Young fellow worked out great --wonderful horse. Occasionally, I’d take the old guy out for some Mounted Archery practice (90 m canter ten times or so, nothing hard). At some point I realized I had not heard him cough.

Took him to the hunt and hilltopped a couple of times that fall. No cough.

It has now been 4 years since the diagnosis. The same three vets have all seen the horse again, and all three said --SOUND --no heaves. One said that if he didn’t know the horse’s history, he would not have believed he’d been so sick.

This year, I have started riding my now 22 year old horse back on the hunt field. My friend takes the young fellow to improve his jumping.

My point is that “it ain’t over til it’s over.” What cured my fellow? No idea --but then, we never knew what caused his heaves in the first place.

[Gardenhorse]

I found that steamed hay and cetirizine made the biggest difference for my horse. Soaking hay didn’t help much.

[rezaroo]

@RedHorses

Is there any mucus in his cough? I’ve found that Omega Alpha’s RespiFree helps loosen my horse’s mucus. Combined with exercise and then a snack fed at ground level can prompt some pretty dramatic draining.

Yes, he coughs out white, foamy mucus after a few upper respiratory sounding coughs. Then the mucus stops and he starts to have bigger coughs. I believe he was on Hydroxyzine as well, I’ll talk to my vet about another anti-histamine.

[rezaroo]

That makes a lot of sense. He wasn’t coughing very much in the summer because he was so fit. I’ve been giving him breaks when he’s been coughing so he’s lost fitness but the cough seems to have gotten worse too. The cold weather also triggers his cough so it’s tough. I will start working him again. As for the hay net, I read that it might not let the mucus drain as well to have them eat from higher up. How high do you put the haynet? I think I’ll give it a try. I’m also going to talk to my vet about Zyrtec.

[rezaroo]

Which hay steamer do you have? Haygain?

[rezaroo]

I’ve heard that the skin allergy panels are more accurate than the blood ones. I learned this after getting a blood one though. Both vets told me that allergy shots only help around 25% of horses.

[rezaroo]

Did you give your horse those 5 months off?

[rezaroo]

I agree. However, the cold triggers his cough and it’s been -12º at night here. He’s never been out 24/7 and I’m worried about stressing him out too much because he has coliced in new environments. I am planning on having him go out 24/7 after this bad weather passes. Most of the other barns in the area get their hay from my BO, so I don’t know how much of a difference switching barns would make. I’ll definitely clean the shelter and switch the bedding to shavings though.

[Foxglove]

@rezaroo -i gave my horse FOUR YEARS off --after I got the young horse, I was totally involved in getting to know him and learning a new discipline with him (Mounted Archery). The old fellow just hung out in the pastures with a couple of retired horses (I thought of him as retired too). Occasionally I’d take him out --maybe 4 times a year? Just for a walk around. This fall a friend asked to hunt with me --I put her on my old guy to ride with hilltoppers --at some point she was swept into first flight --next thing I know my old horse is blasting over 3’ walls --no cough.

After seeing that twice, I gave her my young fellow to hunt (he jumps poorly, never having jumped much in his life as a cutting/sorting horse). She has the young fellow going well, and I am back riding my old fellow second flight --could go first but prefer the people in second.

I know most folks can’t give a horse 4 years off --but it worked for mine. But remember, we never knew what caused his Heaves in the first place.

[rezaroo]

Okay that makes sense. It’s an option for me to give him a couple years off because I could just have him go out 24/7 while I finish undergrad and save some money on training and a stall. Or I am also considering transferring schools and shipping him to Seattle with me and seeing if it improves. Many of the barns there have open air stalls or I’m looking at pasture board and a good rain sheet. However there are fires over there and the smoke might be an issue. My only worry with giving him time off is stunting his training, which wasn’t an issue with your older horse.

[Foxglove]

@rezaroo -you make valid points you will have to consider. My old fellow was, I considered, “done” --he’d had continual training until he was 14 --by then, in my opinion, a horse is what he is in the sense that I think it would be unfair to ask a dressage horse to learn to rope after he’s 14-15 years old. Of course one can continue to improve the horse . . .but after 15, we have always gone to “maintain what is there” mode and saved our training dollars for younger horses. At 5 your horse is too young to stop training --but delaying your training might well depend on your discipline. We never jumped the horses until they were 7 --but my cutting/sorting (now fox hunter) was showing in his discipline successfully at 3!!

If your horse is a driving horse, then a year or two off would be fine --many not if he’s a race horse.

You seem to be an intelligent, caring horse-owner. The right solution is out there. I wanted you to know that there is hope

[Jackie_Cochran]

I used to ride a very elderly Arabian mare at my lesson stable (30 minutes at a time, walk and trot, sand ring.) She started coughing several years ago, deep racking coughs, and she just went on getting worse in spite of veterinarian prescribed medicine. Winters were the worst as far as the coughing went. Eventually my riding teacher retired her.

This winter the mare has been put into the super elderly retiree group. This group only gets hay from regular bales, versus her previous mare group which ate off a round bale.

She has yet to cough this winter. My riding teacher now thinks that something in the round bales (mold?) had been triggering this mare’s extreme coughing.

My riding teacher actually has been thinking about returning this mare to limited riding duties at age 34 or 35 after two years or so off (limited riding duties means me riding her mostly at the walk for 30 minutes a week and maybe a regular lesson with the beginning kids if that goes well.)

She is a grand old mare. My riding teacher and I feared that she would just die the last two or three winters but at 35 this mare is not quite ready to kick the bucket. She REALLY likes the fact that she can have a boyfriend now she no longer lives in the mare herd, and I guess that her boyfriend gives her something to live for.

My riding teacher has not heard her cough AT ALL this year. Removing her from the dusty and possibly somewhat moldy round bale was all it took to get these good results.

[LCDR]

The allergy panel is a good start. One of my hunt horses developed recurrent airway obstruction at age 8 and we went through all the usual treatments and avoiding known allergens, with only short-term success. I swear he learned by positive reinforcement that if he coughed whenever he saw me in hunt clothes, I would take my other horse hunting instead. The barn manager would report later “he was perfectly fine as soon as you left.”

After much experimentation with dexamethasone doses and regimens his older experienced vet and I decided on dexamethasone for life, much to the chagrin of many younger vets. The next 22 years he was on dexamethasone 8 mg IM every other day, with dosage and frequency increased during grass, ragweed, and tree pollen seasons, up to 40 mg to keep him free of signs of RAO. And, he reliably hunted all that time, until we both finally used up all the jumps that God gave us both.

BTW, I do not know if it’s still possible, but dexamethasone could be ordered in 500 ml containers, by the case of 6, from Canada without a prescription.