My older horse has developed severe wheezing from what we believe are allergies. We tried Banamine, Zyrtec and cough syrup per our vet and it got a little better for a few days, but is back with a vengeance. I am now trying the Aservo inhaler. He had his first dose tonight. This seemed to start with a new shipment of hay from my usual supplier. I put him back on his old hay and may remove him from hay all together and put him on hay replacement. He cannot have oral steroids as he is an IR/Cushing’s horse to boot. Would love any advice or experience with the Aservo. Thanks!
I have not tried it yet, but I did get the placebo inhaler from my vet so that I could see if my horse would tolerate it. He did, fortunately, but right about that time I kicked him out of the barn entirely and he has had dramatic improvement in his symptoms.
Please let us know how it works for your horse. I hope he gets good (and lasting) relief from the inhaler. Along with now living outside, I am wetting all of my horse’s hay before feeding it to him. I’m hoping not to have to go to hay replacement but will do it if I have to.
My horse’s symptoms also came at the same time as a new shipment of hay. Could have been a coincidence, but I do wonder if it contributed.
Hmmm…that is interesting! I am glad your guy is doing better. I did the inhaler a few hours ago and no improvement yet, but my vet said it might take a few doses. He cannot have any grass, so he is dry lotted but his barn door does open to the dry lot. I thought of leaving it open overnight so he can go in or out. He has two big windows in his stall too. I have to think it has to do with the hay delivery. It was almost immediate. Luckily his heart rate remains normal (on the low side of normal) and vet stopped by today to check his lungs and there is no sign of pneumonia. His wheezing just sounds awful 
Next step would be clinic for a scope and xray of head/nose area.
My barn is very airy and well ventilated. I also keep it very clean. My stalls are always open to the dry lot, so my guys are never locked inside. This is one reason I wasn’t quicker to lock my gelding out of the barn, as I figured he really never spent much time inside anyway. However, he does have a habit of hanging his head inside the stall of his friend, who likes to hang out inside.
Anyway, I moved my horse to a small pen with shelter. The run in has mats but no bedding. Improvement in breathing was dramatic and happened overnight. I suspect it is the dust and mold which is present in every barn that was causing a lot of the issues. YMMV, of course.
I am also careful to feed hay outside, and from the ground. I wet it as well.
I had an allergic horse. He was the canary in the coal mine for dusty or moldy hay…so check your hay.
10 mg Azium (dexamethazone) powder plus Ventipulmin got him to breathe. We never got to needing inhalers/nebulizers
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That’s the problem for those of us that have horses that have had laminitis or have IR issues. We can’t take the risk of systemic steroids. Believe me, if we could we would because it’s cheaper than inhaled meds!
Talk to your vet. The steroid question is not a simple black/white question…the answer is “it depends.”
My horse had Cushings and had had laminitic episodes. I understand the danger of systemic steroids and potential for laminitis, but it depends heavily on the dosage. The vet and you can weigh the risk/benefits of a potential laminitic episode vs the harm of a respiratory distress episode. A small dosage of dex can help with respiratory issues without incurring effects on the laminae.
Ventipulmin is a bronchodilator, not a steroid.
If hay started this problem I would wonder if it would be wiser to invest in a hay steamer than an inhaler. But then I do not know the cost of an inhaler and hay steamers are pretty expensive.
My girl used the Aservo inhaler last December. Saw an improvement at about day 3 or 4, but proper placement of the contraption is an art and it took a few days to get it right. By day 7 she was breathing normally. Finished the course at day 10 but two days after that we ended up back in a hole again. I’m not saying the Aservo doesn’t work, because it did, and I would use it again, but what I now know is it takes a whole lot of things to keep an asthmatic horse on track. My vet mentioned that some vets are playing with the the spacing of the dosing to see if there’s another way to maximize the effectiveness in more severely affected horses. It’s not been available in the US all that long and it’s so doggone pricey that it’s tough to get a lot of feedback.
Like your horse, mine also has PPID so oral steroids are out so she takes Aleira daily. I reduce the dose in spring and summer when her asthma isn’t problematic and resume the regular dosage starting Aug 1 before the ragweed.
@WanderingHorse96 this is my concern with the Aservo inhaler. It’s pretty expensive for a short term treatment.
I would love to have a hay steamer but wow are they expensive. The very smallest one isn’t too, too bad but then I wonder if I wouldn’t be sorry that I didn’t buy the next size up. If I am steaming for one horse I should probably steam for both of mine, which means almost double the price of the steamer.
I do wonder, though, if the hay steamer wouldn’t be the cheapest treatment option in the end. A couple of years of vet visits and inhalers and nebulizers is going to add up quick.
[quote=“pluvinel, post:7, topic:765666”]
Talk to your vet. The steroid question is not a simple black/white question…the answer is “it depends.”
My horse had Cushings and had had laminitic episodes. I understand the danger of systemic steroids and potential for laminitis, but it depends heavily on the dosage. The vet and you can weigh the risk/benefits of a potential laminitic episode vs the harm of a respiratory distress episode. A small dosage of dex can help with respiratory issues without incurring effects on the laminae.
Ventipulmin is a bronchodilator, not a steroid
Right, we’ve made decisions to avoid systemic steroids without talking to our vets, and our specialists at the University hospital. A “small” dose for some could be lights out for others. The safest route for at risk horses is to avoid if at all possible. There is not enough research yet for any vet to confidently weigh the risk assessment. Inhaled steroids, otoh, have been shown to be pretty darn safe for at risk horses. It’s just too bad they don’t work quite as well and are more expensive than systemic steroids.
For many of us that damn near lost our horses to laminitis, there is no systemic steroid risk worth taking. You may be ok with that risk. Many of us are not. Do not tell us we are idiots for weighing pros and cons and coming up with a more cautious decision than yours. Dex, for many of us is absolutely NOT a choice.
Where did anyone say that ventipulmin was a steroid? I will say it’s not magic though and doesn’t work at all for some horses.
I’m also currently researching hay steamers and $1000-$1700 is insane. I’m looking at companies in the UK who ship to the US b/c even with shipping it’s still cheaper than the version available here. There seems to be more manufacturers there. Plus the brand available here is on 5-8 week backorder. If I owned the barn, I’d DIY it for sure.
I bought a Flexibeb for mine but the goal was to avoid steroids entirely if possible (though he is not wheezing at rest so different situation). It is quite expensive, but I use it with saline almost daily. You have the option of adding albuterol and/or Flovent (which I believe is the same steroid that’s in your inhaler IIRC) if needed.
I also have a hay steamer, although current boarding barn won’t let me use it. Thankfully for my horse, the barn environment is lower on the list of triggers versus outside environment. I did also use it on another horse I was caring for last winter who had some kind of big mystery respiratory flare up, which seemed to coincide with us trying him on a slow feeder for his hay because he was a blimp. Switched back to feeding more small meals on the ground, adding steamed.
I got the smallest one because it’s more portable, and if there’s a place to set it up/plug in at shows, I plan to do that. For two horses, you do probably want the next size up.
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My horse has PPID and I manage her allergies with Zyrtec, ventipulmin and a hay steamer. My husband made me a steamer for about $100. Steaming has helped the most. My vet wasn’t impressed with the longer term effects of aservo, given cost.
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I am a bit late to this party, but I’ve used the Aservo for 2 horses this year, and there is a third in my barn using it now, all with success.
Before I go further: Both of the horses in question are upper level dressage horses who get 15 hours t/o per day, year round, and have stalls with 2 large windows always open when they’re in them, One, who is 19 and has been at this barn for 11 years, was diagnosed (via tracheal wash, BAL, etc) for the first time in March. He generally gets steamed hay during his 9 hours in the barn, but for various reasons had not been this past winter (I bought one of the first HayGains when they came out around 2010). I changed him back to it as soon as he was diagnosed, and hay roll season ended soon thereafter as well, all of which probably contributed to his improvement.
The other horse had never been on steamed hay. He was diagnosed in August, so not hay roll season - but he is on private t/o in a smaller paddock and so by August often has to have supplemental hay while out. I also wondered if it might have had to do with poor air quality from wildfires out west (I am in Maryland), because my vet said she had seen many asthma cases this year. But after diagnosis, I put him on steamed hay for his hours in the barn (can’t steam enough for his t/o hay too) and moved his stall further away from where the hay bales are dispensed.
Back to the Aservo: it is much trickier to use correctly than the instructions make it seem, and I wasted a bit of my first inhaler figuring it out. Also they sometimes stop working correctly if the bottom part is jostled and have to be fixed, sort of “re-primed,” in that case - you have to pay attention and notice that the sound is wrong and no mist is coming out. I’ve heard that some horses spook at the sound, but both my horses that used it tolerated it very well - though one never stopped making a flehmen face!
The first horse stopped coughing before the end of the first inhaler, and after the second inhaler his BAL was normal, but after discussion with the vet (at Leesburg), we put him on one final inhaler (total of 3), at which point I felt he was fully back to normal in his upper level work. No recurrences so far, but I will say that I basically stopped riding him and sought treatment the second day I heard even one cough.
The second horse never coughed as much, though his BAL results were worse. He did not completely stop coughing until midway through the second inhaler. I waited two weeks, then gave him a third inhaler. He has had no recurrences either, but he has not had a repeat BAL (different treating vet, didn’t think he needed it).
There is another horse in my barn who was coughing horribly over the past month or two - barely able to trot 3 steps, much worse than either of mine. Her owner took her for a full workup. She showed significant improvement soon after starting her first Equihaler and is now in the middle of her second - last I checked, which was last week, she still had some mild coughing when asked to trot, so she is improved but not resolved.
I had another horse with asthma 11 years ago, and with him I used the face mask and inhaled fluticosone (sp?). As I recall, that was more expensive, and I had to do it for longer to see results. I am sure the Aservos won’t work for every horse - actually I imagine oral Dex is probably the easiest and cheapest and most effective treatment of all in most cases! - but I have had good luck with them, and I would (and have) recommended them.
There are many owners of coughing horses who aren’t willing to take them to get fully checked out with BALs, lung ultrasounds, etc., and aren’t willing to deal with asthma masks, much less nebulizers. I’ve seen vets give them cough syrup with albuterol, or Ventipulmin (when available!), but the effectiveness is limited. If they are willing to spend a few hundred dollars, one Aservo is a relatively easy way to give those horses a little relief. I’ve actually seen that happen, and that’s one of the reasons I am happy it exists. It will be better when the vets get more experience showing people how to use it though!
Sorry for the long-winded reply!
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@Amordoro this is helpful information. Thanks for posting. I am disappointed to hear that 3 courses of the inhaler were used. I haven’t been quoted an exact price on the inhaler yet but my understanding is that it will be in the $300.00 range.
Did you give the courses consecutively or did you wait a bit between treatments?
I am also considering a hay steamer, but yikes are they expensive. Still, I have seen many people swear that the hay steamer alone was enough to keep their horse healthy. If that really is the case then it’s probably cheaper than multiple vet visits and inhalers.
FWIW, if you get a nebulizer and go the Flovent route, those inhalers are a similar price point (also had a vet with asthma and was researching switching from oral steroids to inhaler since I had a mask thing for her for an albuterol inhaler).
Also my asthma horse rarely coughs but his condition was confirmed on BAL. Has predominantly different symptoms, mostly performance related.
The hay steamer has worked really well for my horse. No coughing since we started steaming her hay. I never tried an inhaler, but we tried soaking her hay and Albuterol with pretty much no impact on her coughing. However, I should note my horse’s condition was never very severe - she would just cough at the beginning of rides and a few times an hour in the barn. Never any wheezing or exercise intolerance.
Unfortunately, I believe the Haygain steamers are currently taking about 6-8 weeks to be delivered. I know some people on here have made their own steamers but my barn wouldn’t allow that. I have the smallest size Haygain steamer and it is fine for one horse. I also started steaming hay for a friend’s horse this summer, and it has been okay, we just run it twice in a row to get two batches of hay. But they’re out on pasture 16 hours a day in the summer so weren’t eating that much hay. Now that we’ve switched to night turnout and they’re in the barn 16 hours a day and eating more hay, I am not sure if it will be big enough for two horses all winter.
I do think that if you buy a Haygain steamer and it doesn’t work for your horse, you’ll probably be able to resell it pretty easily. The few used ones I have seen for sale tend to go pretty quickly.
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I tried to buy my steamer last winter on holiday sales and it took a couple of months to arrive.
I definitely recommend buying their haynets if you buy the less than full bale sized steamer. (Does not shrink, no metal parts). Much easier / less mess to transport from hay storage to steamer to stall.
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Thanks for the info on the Haygain steamer y’all. It’s very helpful. I think I heard that they do a sale somewhere around Black Friday, so I may order one at that time. Fortunately my horse seems to be doing really well right now with me wetting the hay, but his worse time of year is late summer/early fall. I’m trying to get my ducks in a row before next year.
Do either of you live in a hot and humid climate? If I wet my hay in the hot months it goes sour pretty quickly. I am hoping the Haygain would keep the hay fresher for longer. In the summer I have to wet the hay and feed it immediately and even then the remnants in the bottom of the hay feeder are sour smelling by morning. Yuck.
