COPD medications

[cnd8]

I’ve owned this horse for a year, he has always had clear bi-lateral nasal discharge and my local vets have said not to worry about it. He is also a scoped and diagnosed “mild bleeder” (barrel horse). I put him on SmartBreathe Ultra to help him and it lessened the mucus. He’s at an 1800 acre stable surrounded in large part by farm land, so dust is likely the cause.

Fast forward–My horse decided to stop sweating in July (and I am in South Georgia so this is a big deal here), and had been struggling to catch his breath in workouts, so I took him to a specialist. He diagnosed him with COPD and prescribed Ventipulmin to “get through the last hot months of summer.” I also, of course, started the tedious process of seeing what anhidrosis supplements would work. He has improved in sweating and we made management changes. Nasal discharge stopped and when he did have some still it was within very normal amounts. The vet started us on a dose twice a day, then once a day, and gradually weaned him down to nothing over the course of a month.

Ventipulmin is supposed to be stopped after 30 days because I’ve read it is not a long-term med. Mucus amounts are back up to being back to where we were when we started.

Is there a long-term allergy/respiratory med/supplement that can take the place of Ventipulmin? The Smartpak one is clearly not enough.

[Renn_aissance]

Two thoughts.

Herbal bronchodilators can be useful when you’re not in crisis mode. We had a decent response to OmegaAlpha’s Respi-Free, which is mostly eucalyptus. A product I’ve found to work just as well as ventipulmin for my horse is Ramard’s Total Respiratory… but at $13 a day, I usually go back to the ventipulmin!

If he really needs something pharmaceutical, an albuterol inhaler might be something to discuss with your vet as a longer term option than ventipulmin. Inhaler itself from Walgreens, equine adapter from Airohippus.

[IPEsq]

Ventipulmin is a bronchodilator. You may need steroids to also control the inflammation part of the disease. You might be able to do that seasonally depending on the triggers. I don’t think anyone has found a causal link between non-sweating and types of equine asthma, but they do seem to occur together a lot, from my experience and also my vet who spent time practicing at UGA.

[cnd8]

Thanks. Yes, this specialist did seem to think the two conditions often worked in conjunction.

[Renn_aissance]

Horses cool themselves through sweating and respiration. If one mechanism shuts off, it overloads the other. If the horse already can’t breathe, and all of a sudden he needs to breathe a lot harder, that stresses the respiratory system, and all of a sudden that system is more symptomatic. That’s how I understand the relationship, anyway.

[cnd8]

Exactly what he said. I mentioned how my vet believed in that connection in one of the anhidrosis groups and was pounced on because that exact relationship hasn’t been pursued in research yet. But, I think we can mostly agree that anhidrosis hasn’t really been figured out all that much yet, despite all the research. It’s a crap shoot at what treatments will or wont work.

[Bonnie2]

Nothing works as well as Ventipulmin. People do find nebulizers help if the horse will tolerate it. Some people also find acupuncture to help bleeders, COPD and sweating. It hasn’t helped my horses. Steroids help but have their own risks, particularly for long term use. I have a foxhunter that I give Ventipulmin the night before and morning of a hunt and that helps him tremendously. Be sure to check your association’s drug rules if you are competing.

[cnd8]

I’ve tried the acupuncture route and that hasn’t made any noticeable improvements so far for breathing/mucus or the sweating.

[cayuse]

I used beclomethasone and albuterol inhalers via an AeroHippus chamber for my pony. Worked great along with Zyrtec to control his allergies. He also did not sweat well, I was lucky that One AC and salt gets it started for him.

[jvanrens]

A cheap option that helped my dearly departed Moe with his breathing was spirulina. I bought mine from MadBarn. He was on outdoor board, but bringing him into the barn for a grooming went from less than 5 minutes to a coughing fit to maybe one small cough in 20 minutes. Sorry no suggestions for the non-sweating other than the old Guinness. Maybe the two mixed in a beatpulp mash will help.

[Ghazzu]

If you’re not already doing so, soaking the hay will help reduce the dust and other allergens.

[RedHorses]

My senior is on Prednisolone and Hydroxyzine and Omega Alpha’s RespiFree daily for his seasonal allergy induced heaves. His season started on March 22 this year. Last year’s season ended in October. At one time it was May-September.

Ventipulmin is his emergency drug. I think we went through 3-4 bottles in season three or four years ago. The unopened bottle I got last July has expired.

In season I have been checking his breath rate daily for about six years now, and listening to his lungs for the last four. Each year his lowest resting breath rate went up by two breaths per minute. In 2021 it was 20, with a starting rate frequently in the 30s (starting meaning pre all the things I could do to help him breathe more easily that day). Yesterday his starting breath rate was 10 mid morning. Today it was 8 late afternoon - the starting breath rate before all the things I can do. A couple of weeks ago I realized I was getting worried when his starting breath rate was 18.

In 2021 he was getting 300mg/day of Prednisolone with 2 Hydroxyzine capsules. On bad days he’d get a second dose of 150mg Prednisolone and another 1-2 Hydroxyzine capsules. Plus Ventipulmin if needed. Until this week he’s been getting 240mg/day Prednisolone and 1 Hydroxyzine. I bumped his Hydroxyzine to 2 capsules this week as ragweed pollen is high, and last year I figured out he’s probably allergic to ragweed.

So those are the hard, non-subjective numbers showing the improvement after using a Bemer on him 4-6 times per week since March 22, 2022. Subjectively his lungs sounds have improved substantially. Now I’m calling this subjective, but I don’t think anyone would accuse me of imagining improvement when I’m going from recording various crackles, groans, and wheezes to barely audible air movement.

I took a Hail Mary on a Bemer because I was hoping to get a couple more years with my then 24 year old horse. At the rate things were progressing I was expecting to be seriously considering euthanasia early this spring (I will not wait until he’s not able to breathe in the summer heat). Now I’m thinking something other than his breathing will bring his end.

[Bogey2]

I have had two with COPD in the past…both had to live outside and I am unclear if your horse does? I also found that when needed only the Prednisone, hydroxide and if needed ventipulmin worked. We dropped all the supplements (one of the horses came with 5 meds/supplements she got daily and when I moved her outside with a three sided run-in within a year she was off all the daily stuff. She did occasionally start to heave (usually humid weather) and then I would start the meds.
I hope you find a good balance for your horse!

[BayMoose]

What managment changes? If he’s a mild bleeder (diagnosed on BAL?), does he also run on lasix?

[cnd8]

Yes, he’s normally pasture boarded with no hay needed May through November. However, with this non-sweating, he has been in the barn for about 6 hours per day. I do not notice a noticeable difference in his condition being in the barn, however.

[cnd8]

Yes, he runs on lasix and it was diagnosed via BAL at a barrel race years ago. Management changes for anhidrosis so far have been riding in cool hours of morning, if at all (he stopped sweating at fourth of July so it has been incredibly hot since then), bringing him into the stall with fans from 10-4 each day, hosing as needed, guiness beer, oneAC, Mega Sweat, and now Platinum Refresh. There really haven’t been any management changes for the breathing/discharge because he is pasture boarded and no hay from May through November (we have large lush pastures). The discharge is the same all year long, but maybe worsens a tad with windy dry weather.

[Leather]

@jvanrens

A cheap option that helped my dearly departed Moe with his breathing was spirulina.

I used spirulina 15 years ago with my gelding that had RAO. If he was having a bad flare I’d use Ventipulmin, but I wanted something to supplement that. It did seem to help - he really never had as bad of flares when on it. I think the mechanism is that spirulina has some anti-histamine properties.

He lived outside his whole life (pasture board) and really only had symptoms in the spring/summer, so he likely had what is now called SPARAO (Summer Pasture Associated Recurrent Airway Obstruction). It would get bad during wet springs/summer so he likely had a sensitivity to some sort of mold.

It sounds like you are well educated, but thought I’d pass along the Tufts Respiratory Health website in case you hadn’t found it. It’s changed over the years but was a great resource for me back in the day with my gelding. Tufts Respiratory Health

[cnd8]

Thank you for sharing!
The SmartBreathe Ultra has the spirulina in it (along with MSM for inflammation and I feed extra MSM to get him a heavy dose each day), but I could look at feeding it straight instead.

[pony_baloney]

I had my mild COPD pony on Uckele’s Lung EQ, which contains spirulina, msm and Jiaogulan and flax. And it’s pelleted!! Just started autoship with Chewy and it’s a bit cheaper that way.

[pompeiii]

We do the Aservo EquiHaler (which is being/has been discontinued grr) for my mini but will be switching to a normal inhaler (to be honest, I have 6 half used albuterol inhalers that are about to expire in the next couple of months that could be donated to his cause and I’m due for a refill… lol) and chamber once this runs out. We do use it off label and only when we have flare ups (he obviously does not need the full sized equine dose and as a result, my vet has advised that I can find the minimum dose that works and try to make it last). He’s actually much worse with humid weather than the drier air.

Soaked feed and hay definitely help though soaked hay has been a hard one. It’s taken several failed attempts and tough love for it to finally worked.

I’ve added spirulina though I don’t know if this has helped at all. Plus zyrtec.

We cannot do steroids due to metabolic issues. I suspect we’ll add ventipulmin if necessary. I used it years ago with my late gelding and it helped a lot. He finished that bottle during a previous flare.