Equine Asthma- To treat or retire?

[She_s_Pure_Gold]

Forgive me, this is as much a vent as it is a question. The TL;DR version is has treatment for your horse’s asthma been successful and/or when did you decide to just retire rather than treat?

My horse was diagnosed with equine asthma this past summer and I’m at a bit of a crossroads, to either treat it and hope for improvement, or retire him (multiple vets have confirmed that if he is retired, intensive treatment is not necessary for his comfort and wellbeing).

A bit of background: my horse is 20yo but otherwise sound, healthy, and prior to this year still had plenty of get up and go. We event locally at the lower levels (BN/N) though have had lots of ups and dow s over the years health-wise.

Treatment would include purchasing a nebulizer ($$$) and giving him treatments 2-3x/day, every day. Medications would run about $100-150/month, on top of cost for nebulizer. Not an unsurmountable expense, but not cheap. I’ve already spent $1300 on a hay steamer for him and am steaming all of his hay every day.

I keep him at home on our small farm, work full time, have a 5yo son, and do 95% of all farm chores myself, with occasional help from my husband. The vet specialist who did a complete workup on my horse thinks that even with treatment, it is extremely unlikely that he would be able to event again. He has high mast cell counts, and I guess horses with high mast cell counts tend not to respond as well to treatment as others.

So, I’m just wondering what experiences others have had with treating their horses with asthma and any benefits they’ve seen. I’m leaning towards just retiring him. I’m just not sure that the cost both in money and time is worth what little benefit we may get. Buying another event horse right now is not on the table, but my husband would be open to me finding something to free lease- I’ve been thinking about maybe finding something quiet/beg-friendly that my son and I could share.

How have others navigated this? How do you decide? I’m waiting for my regular vet to call so I can discuss further with her but I’m pretty bummed about the whole thing. He’s my first and so far only horse- it finally hit me and I broke down this morning realizing I will likely never be able to soar over jumps on his back again.

[IPEsq]

My horse has “mild equine asthma” (with severe asthma being RAO/heaves) that is mast cell rich. He’s 9 this year. When he lived in more humid environments, it was not noticeable. After I bought him, I moved him to a dry, high altitude place with a banner year for wildfires, which is when the issues started. Took a lot of time to diagnose. Had the opportunity to move to the southeast for a bit, and the vets said not to treat, just see how he did there. He had very mild spring allergies in the form of grass glands, and on those days, the warmup was slower, but otherwise, he really had no issues.

Had to come back west, and he immediately started coughing at the beginning of rides. Bought a nebulizer and treated with saline only. That helped until the smoke from a lot of fires farther west rolled in and sat on top of us along with high temperatures, little moisture, and high ozone pollution. The small particulate and ozone pollution really set off his asthma. After consulting with the internal medicine specialist, she suggested keeping on with the saline nebulization and adding Zyrtec 2x a day. She also wanted him kept in at least light work. That did help quite a lot but I could not do much on the “unhealthy for sensitive groups” AQI days, but I did try to keep him moving, mostly walking, some trot. On better AQI days, he can work fine, but if there have been several bad days in a row, then the first good day means a pretty rough warmup till he can actually clear his lungs, and he will be very muscle sore. The muscle soreness can take a bit to go away but bodywork and Robaxin support that. The airway is usually fine after that one rough warmup day.

Getting into fall, it’s been very dry and dusty, and so standing out in the paddock he’ll have swollen glands (meaning he has some inflammation and likely some mucous in the guttural pouches), and so I will keep up this protocol until that goes away, and then I will keep the saline but try dropping the Zyrtec this winter. The vets say that mast cells indicate more of an allergy trigger, and his allergy triggers appear to be linked to the type of air pollutants that predominate out west. For example, we had abundant pine pollen last spring on the east coast and he was fine. His allergies out west were also much worse in the fall (though there was also a TON of smoke) and ok in the spring–he didn’t really start showing symptoms till the unusually hot and dry summer.

This horse is a h/j horse, and with the right conditions and management, he has been able to continue jumping. I am trying to figure out a situation where we could move to a different climate permanently. I don’t think steroids and bronchodilators would be the right move for this horse unless absolutely necessary–so we have avoided them so far, and while the results could be better, I have to ask, should I be trying to work him on bad air days anyway, asthma or no? I think not, and so I don’t want to give meds that I think will be riskier for him just to try to horse show more in the summer when neither of us should be breathing hard outside ideally anyway. I bought more KN95 masks for myself not just because of COVID but I also had days where I had headaches, sore throat, etc. just being outside, and I’ve needed more allergy meds myself. The local CDC put out an advisory to be careful because wildfire smoke exposure and COVID can have a lot of the same symptoms.

Anyway, from my experience, it is possible to control it depending on what the triggers are and how the horse responds to the therapies. You may have to make environmental adjustments, which you can do if yours lives at home to the extent that triggers might include bedding type, whether it’s worse in the barn or outside, etc. For me, basically all the environmental triggers are beyond my control absent moving elsewhere, and so I’m trying to figure out how to do that with my career (also because I don’t enjoy the environment as it is now either).

[beowulf]

What climate are you in – and is this horse stalled? Controlling/managing the environmental triggers and whether or not it is even feasible to control these triggers would weigh into my decision on whether or not to retire.

[She_s_Pure_Gold]

I’m in MA near Boston. My horse essentially has 24/7 turnout, with the option to go in the barn at night or in inclement weather and high heat. He’s on grass most days from May-Sept and gets free choice hay when not out on grass. I only lock them in during severe weather, ie nor’easters and tropical storms. I’ve already discussed management with both vets to determine what could be changed, so the question is more about whether to try adding meds to the situation or not.

[ThatBayHorse]

Have you had your horse allergy tested? If you don’t know what they are allergic to, you can’t make environmental or diet management decisions to improve their symptoms.

My horse was retired/unrideable this spring because I was feeding her hay with grasses she was allergic to and she was having symptoms even with steroids and antihistamines etc. Flexineb made everything 10x worse. I switched her to timothy hay (one of the 2 grasses she was not allergic to) and her symptoms improved 99%. She stopped coughing and got off steroids completely. We are back to riding WT and trails and I’m confident i’ll be able to do more when the weather gets cooler.

i will note that the allergy shots did not work for my horse, but using the results to make feed decisions did majorly improve her symtoms. If you are feeding your horse something they are allergic to (even if you are steaming the hay etc) they will still have symptoms unless it is specifically the mold/dust they are allergic and not the grass species itself. Good luck!

Edited to add: I am in Louisiana, my mare is a 12 yo ottb mare that is out 24/7. I had a full $1000+ workup done by LSU. They recommended flexineb + insane treatment (which ultimately did not work so I am out $1200), a drug that cost $1200/month (haha you read that right) or oral steroids. The one thing that my regular vet recommended (that ultimately worked EXCEEDINGLY well beyond my wildest expectations) was the diet switch!

[She_s_Pure_Gold]

I have not done allergy testing, but did just discuss with my vet. She didn’t say not to do it, but seems like it’s a fairly involved process. I don’t think it is the hay, I think this is an issue that has been getting worse over time. We did a BAL test (twice!) and he does have asthma, not just allergies. Neither vet has mentioned a diet being part of the equation, and it’s been going on for years with various sources and mixes of hay. Symptoms just got worse this year, beyond thinking it was just allergies, prompting me to have more diagnostic work done on him.

[ThatBayHorse]

It’s $300 and a bloodtest- not that involved. Out of the thousands of dollars I spent treating this, it was my single best expenditure.

And LSU didn’t tell me to consider diet either. I also did BAL, etc. All I know is it is the one thing that worked and got her off steroids. When I tell you she stopped coughing that DAY- it was that big of a difference. While on the old hay she could barely walk from the paddock to the barn without extreme coughing.

[She_s_Pure_Gold]

Thanks- will look more into it.

[TXPiaffe]

Bay Horse, Where did your vet send the BW to for testing? We have a POA mare that has mild asthma and I would like to go into the vet’s with as much info on allergy testing as I can. Thanks!

[ThatBayHorse]

Heska labs

[4horses]

My vet recommends allergy desensitization shots but you have to get them tested with the skin prick tests to find out what they are allergic to. I would not retire your horse. In my experience, untreated asthma gets worse and can lead to euthanasia. I would absolutely want to treat it. If thet means allergy shots, then do it!

[WildGooseChase]

I had an RAO/Heaves horse. The best thing is turn out in a dust free environment, soaking hay and grain, low stress exercise and steroids if needed. Untreated/unmanaged breathing issues almost always lead to an early euthanasia. Treat it, and continue to work with your horse. All the RAO/Heaves horses I’ve seen get retired early has nothing but problems.

[GoodTimes]

Definitely look into allergy testing, fwiw the intradermal testing is considered the gold standard. The specialist that I used doesn’t trust the blood tests at all.

My horse is 12. When he was an 8yo and stalled I noticed some coughing at the beginning of rides, threw him out 24/7 and the coughing stopped. The last couple years he developed rain rot and scratches no matter what I did.
Last fall he started having asthma attacks (respiratory rate of 40-60 breaths per minute at rest) that required dex. The snow came and the asthma attacks went away, but the coughing at beginning of rides started.

I had intradermal testing done in the spring. Mildly allergic to some tree pollen, moderately allergic to some weeds and flies, severely allergic to staph bacteria and mold. We started allergy shots and he only coughs on very dusty days and knock on wood hasn’t had any attacks this fall. Tiny bit of rain rot, but no scratches so far.
We do a lot of showing (A circuit hunters), so most medications aren’t allowed. A nebulizer with saline would be our next step.
I’m giving him this winter off to keep him out of the dusty indoor, I need to focus on my 4yo mare anyway.
I’ll see how he is next year and reevaluate, we’ll know for sure how well the allergy shots are working by then.

He’s a good example of a horse whose environment is nearly impossible to “fix”. He has too many outside triggers.

[Djones]

I finally did allergy testing on my now 17 year old gelding. Wish I’d done it long ago. Pull blood, send it off, get 6 vials of stuff, give him lots of subcu shots to build his system, and he’s so much better and we’re still in the building resistance phase. He’s allergic to everything, so soaking hay helped a TON, but I can’t soak the pine trees in our pasture, right?

He’s off all supplements and eats dry hay, and is right as rain.

Get him tested.

[stb]

I have a gelding who was recently diagnosed with summer heaves. Since summer weather is pretty much endless here, that is a real problem. I am going to get him allergy tested. My vet told me that they recently had a horse that tested positive to flax - which the owner was feeding heavily in response to the immune problems (as I am). I would hate to be feeding something that I could easily eliminate, so this is where I am going to start.

Oral steroids scare me. I am considering trying the new BI Aservo inhaler with him. It’s pricey, though. Apparently some horses gets months of relief from it, others a very short time. Might be worth trying once.

I have also started my horse on antihistamines. Started with hydroxyzine but have recently moved to Zyrtec and it seems a bit more effective.

[ThatBayHorse]

Just because I’ve fought this fight, thought I would tell you what my vet said Horses can be on oral steroids for periods of time, but it isn’t great to be on full time. For instance, my horse was on them for August and most of Sept due to the high humidity, everything blooming, etc, but I was able to take her off at the end of September and she currently has no symptoms. We use predisolone instead of dex - while more expensive, it has fewer side effects (way less chance of founder, etc). I noticed no ill effects from using it for those months AND she readily ate the powder. I also started with hydroxyzine last summer, but switched to zyrtec. I did not see any improvement with hydroxyzine, she did not like the powder and it’s expensive compared to zyrtec. She is on zyrtec year-round and I get the 360 pill bottles on amazon (appx $15/month).

[IPEsq]

Oh I forgot to mention I also put mine on DHA per the vet. She recommended a plant based (marine) DHA supplement. Unfortunately it smells like bad fish. But horse would eat HorseTech’s Profile supplement which has that mixed with flax, chia and fenugreek flavor, so I’ve now mixed my own (to use up the plain DHA flakes that are too stinky) using bulk ground fenugreek.

There is one that has MSM and other stuff in it (Aleira?) but I don’t love this horse’s response to MSM. If that is something that might work for your horse there’s that DHA based supplement or also HorseTech’s Respire (which would be a tastier way to get spirulina into the diet).

If the asthma for my horse becomes too hard to manage again the next steps would be a repeat BAL (hopefully at a time with less smoke exposure for more of a baseline) and allergy testing. I think there is a specialist in my general area who does the skin test. But I have a feeling the things he would respond to are beyond my reasonable control (not food related). He did get grass glands a bit in the spring when I had pasture access, but other than having a little more mucous to clear from his upper airway to get started, he didn’t really have any other asthma symptoms, including the fact that he could clear the junk out pretty readily versus spending the whole ride feeling like he wanted to sneeze but not and getting frustrated.

[stb]

I will say that my horse is currently on Aleira and is eating it readily. He is a picky eater too, so this surprised me. It is expensive, though. I am currently looking for other palatable options for marine based DHA supplement with an easier to swallow price tag.

[quietann]

Adding my mare to the Aservo club soon. Benadryl, soaked hay and an open window in her stall didn’t make things much better. She has a little bit of a heave line starting on her right side, which is scary.

My vet will start her at a lower dose because she isn’t severely impaired, and she’s a bit smaller than the average horse.

She is out about 7 hours a day, but not so much right now because of the weather. It has been very cold, we had a big snowfall, then an ice storm last Friday and every paddock had an inch or more of solid ice on it. She has been in at least 2 days a week for the last 5 weeks or so. The horses were in last Friday and Saturday, out Sunday and Monday, and turned out late today. (Bless our barn workers for putting down sand on all walkways, in paddocks near the gates, etc.)

This is the worst winter for horses we’ve had since Snowmageddon in 2015.

If she’s still there by the spring, the barn is left completely open, all stalls have open dutch doors etc. from sometime in April through late October/early November. (And yes, 24/7 turnout would be better. But no, I don’t have access to that any place I’d be comfortable boarding her. A bunch of places are out of the question because she’s IR and the horses are out on grass all the time.)

[erinmeri]

My horse with asthma (13 year old jumper) has done well with a change in management (shedrow to minimize dust, as much turnout as she can handle, and soaked hay) and the Aservo inhaler for flare ups. She does seem to have issues with allergens in hay, but we haven’t had her allergy tested. We did scope her and do a BAL, and since she has done well with management changes and the inhaler, didn’t go further.