Feedback on Aservo inhaler? Update! It wasn't allergies or asthma! Long road, but he is doing better :)

[ThatBayHorse]

I post the same thing to everyone. 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. 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!

[PaddockWood]

I’ve got a PPID horse w allergies including past emerg call attacks AND finding HorseTech’s Respire works for her. I syringe her two scoops mixed w water and she loves the stuff. Also administer if I see any labored breathing, i.e. the very beginning of being bothered. Have needed 10x in the past couple months.

Just one idea.

I’m trying to avoid using the Dex and Vent for all the reasons stated above.

[Gardenhorse]

@stb

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.

I’m in Maryland, which is relatively hot and humid. My mare was getting her hay in a slow feeder, but the barn was not great about cleaning out any old hay from her feeder before putting in the fresh steamed hay and in the middle of summer it would get a bit yucky at the bottom of the feeder. So we switched to just feeding her on the ground in the humid summer months when she’s not stalled that long anyway, but will go back to the slow feeder in the winter. But if you were good about cleaning out the old hay every day, I think it would probably be fine. Or at least better than soaked hay.

[Dutchmare433]

@stb

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

I fed steamed hay to my guys for a while. I’m in New England, so not extreme heat but very humid. We were able to steam a bale at PM feed and use it the next day no problem. Longer than that it would start to get gross and/or moldy. I fed in slow feed nets so no issues with a slow feeder getting icky.

[IPEsq]

I bought my steamer when I was spending the winter in Aiken. So, very wet climate and starting to get hot towards the end of my stay. I live out west where it is very hot in the summer but not humid. Soaked hay will still go rancid out here. I haven’t been able to use my steamer much since coming home due to boarding barn restrictions.

In Aiken, my horse didn’t really eat much hay except when stalled overnight. He got an alfalfa flake at lunch but otherwise preferred the pasture at least by the time my steamer arrived. He’d still only eat a flake or two outside when the rye grass was dying off before the summer grass came in.

I bought the starter pack which comes with a timer that you can set up to 2x a day. I would prep the hay nets and water tank early, usually the night before, then not worry about it. I’d time it to steam so it would be somewhat cooled down by the time I wanted to throw evening hay. Only when I had to steam for multiple horses would I steam some earlier, like around lunch.

Because the hay stays much drier when steamed, I don’t think it got funky. Plus, the heat kills off a lot of bacteria. My horse definitely started to object when the temps rose if I made up his soaked beet pulp too early, but he never objected to the hay.

Haygain does recommend you feed it within 24 hours.

[Amordoro]

Ugh I am not getting notifications, keeps happening no matter what I do…

Anyway to answer some questions. First re the Aservo: for one of my horses, I did all three consecutively. For the other, I did 2 consecutively, then about a 2 week break, then the third.

Note that for the first horse the BAL was clear after the second inhaler, but because I felt that he still didn’t feel quite right, after discussion with the vet we decided to try a third, on the theory that a single BAL sample is not always representative. (It was covered by his insurance so cost didn’t enter into the decision.) In retrospect, I’m not sure he needed the third one, as there turned out to be other issues that might have accounted for what I was feeling.

The other horse too had no symptoms after the second inhaler, but because it took until the very end of that inhaler for his symptoms to resolve, and because he didn’t get a confirming BAL, again we decided to be extra certain with a third inhaler.

In both cases, then, two might have been enough.

Another thing to mention: Leesburg charged $310 for the Aservo, but my local vet charged $423!!! I asked them (local vet) about the discrepancy, and they confirmed that that was their price. I still don’t understand this.

I still have a feeling that oral dex works the best. But my horse who had asthma 11 years ago switched to low dose dex after the fluticosone got too expensive, and while on it, he received 2 coffin joint injections from an extremely reputable vet that both went septic. The chances of this happening randomly are very slight, and in the years since then, as the vet and I replayed possibilities over and over, one that came up was the possibility of immunosupression from the dex. There was no proof of this whatsoever; it’s just a possibility. And I’ve had many horses who have received IV shots of dex for various reasons since then. But I admit it made me a bit gun-shy about longer term oral dex!

A few other things… I am in Maryland, northwest of DC (quite a bit). It is very humid, but we have had no issue with steamed hay keeping for up to 2 days; never had mold or any other problems.

In my case, switching to steamed hay was not by itself sufficient to resolve the horses’ issues. Maybe it would have been eventually? But the steroid more quickly helps ease the inflammation in the lungs (depending on what’s causing it; my understanding is that mast cells respond less well than neutrophils, but I am very far from an expert!!), and after that the environmental changes help keep it from recurring. The worst possible thing, my vet at Leesburg said, is to get to a point that’s so bad that scar tissue forms in the lungs; inflammation can be addressed, but physiological changes to the lungs are not reversible. So initially addressing the problem rapidly with steroids was the approach that most appealed to me.

One more thing worth mentioning: both my horses had been (and still are) taking fish oil -enough to give them a very ample dose of DHA, far more than in most supplements - and MSM for years. These are some of the main ingredients in respiratory supplements, but they were not enough to prevent asthma from developing. I’ve since put one of them on Aleira - the other is a picky eater at the best of times and would never eat it.

One thing I’ve taken from this experience - I find this condition frustrating and confusing!!

[stb]

Thanks for this information. It’s very helpful.

Which fish oil supplement are you using? I have had my gelding on Aleira, but would like to find something more economical if possible.

I have used Dex twice with my horse, but it sure makes me nervous. I am trying to get my ducks in a row over the winter and spring so that I can be more proactive next late summer/early fall, which is when my horse got sick. Management of “summer heaves” is different than normal heaves that generally occur in the winter months, and there doesn’t seem to be as much of a consensus as to environmental management either.

I do think we had a perfect storm last year, in that the weather was extremely wet and hot - even more than our usual. My grass was also more lush and long than in past years, and was seeded out at the time that my horse got sick. Turns out he is allergic to Bahia, which is what was blooming all over my farm. Keeping the grass cut shorter and not allowing it to seed out will apparently be important in the future.

[Amordoro]

One of mine got sick in summer as well - early August - but I’m not convinced it was summer heaves in his case. He didn’t cough any more in the pasture than he did in his stall, and discomfort outside is usually a characteristic of pasture-associated asthma. Still, the timing of the onset was a bit mysterious, and I keep wondering about it. It’s true he had very little grass in his paddock by August and was receiving supplemental hay. And his stall had been situated for a few years near where the hay for the barn was forked into wheelbarrows for dispensing. But still, why then?

I do keep coming back to the fact that air quality in our area had been very poor because of the western wildfires. I read a study that these fires cause major asthma problems in the east because of the fine particulates from the smoke, which we often don’t even notice here. This was certainly a problem in August. But I guess I might never know why he started coughing at that moment. Maybe the problem had been building up and that’s when it crossed a threshold and became serious enough to make him cough? Who knows??? I wish I did!

Anyway - to answer your question, my horses are all (even the ones without asthma!) on Wellpride fish oil for horses. I’ve used this for many years. I don’t know whether it actually helps anything, but I started it for an old horse, now gone, in hopes it might offer some slight incremental help with arthritis pain - not a substitute for medication or treatment, but a supplement. It isn’t particularly cheap, but the level of omega 3s is far higher than in any standard equine omega 3 supplement - most of which contain flax, which is an ALA and therefore less ideal than the DHA and EPAs in fish oil anyway.

Aleira does contain DHAs, though from algae not fish oil. One serving of Aleira contains 1.5g DHAs. One serving of Wellpride fish oil contains double that - 3g DHAs - plus also 4.5g EPAs. 30 servings of Wellpride costs $50 (there is the potential for discounts if you buy more than one, and they often have sales); 90 servings of Aleira costs $170. But I suppose if you just wanted to match the DHA level in Aleira, you’d only need to feed a half serving of Wellpride, in which case it would definitely be more economical. (Of course, Aleira also has MSM (5000mg) - though that is cheap - and a proprietary “mushroom matrix”!)

[stb]

Thanks for the additional information. I hadn’t heard of Wellpride before. It looks like a good alternative to the Aleira.

[mlb722]

This is really interesting. My mare had a respiratory infection at the end of July when wildfire smoke was bad in the northeast. It was not secondary to a viral infection. We thought perhaps some moldy hay got things started…we had so much rain and humidity hay was spoiling even when stored correctly. It took months for the cough to clear. I’ve heard that respiratory issues in horses have been plentiful this year.

[tpup]

Hi everyone! Finally have a moment to update my original post on my horse with the suspected allergies. First of all Merry Christmas!! So it wasn’t allergies at all. A few days after my post, he got worse, and we scoped his upper airway to find a raging voicebox infection - and arytenoid chondritis. He needed an emergency traecheotomy and it provided immediate relief. His entire voicebox area was blocking his airway, causing the wheezing, which turned severe the morning I took him to the clinic. A metal temporary traech “apparatus” was placed in his neck inside the traech hole, and he was put on SMZ’s and a throat “spray”. I brought home a relieved, well-breathing pony - through the traech of course.

Fast forward to 9 weeks later - 2 additional scopings, stronger antibiotics after we saw no progress after the first 3 weeks, we anticipate that his scoping next week will reveal that his temp traech “jewelry” can come out and we can let the hole close. After 3 weeks on the new, double and “super” antibiotics, we saw significant improvement, including proof he is breathing through his nose calmly when the vet covered his traech breathing hole for 5 minutes.

It’s been a long road but if you didn’t notice the hole in his neck as soon as he could breathe again through the traech, we had our normal pony back. It’s been LONG and tough on me (cleaning it daily - I have NO words… ) but he’s worth it!

Vet said this infection had been brewing quietly for months. It can start with a scratch or minor abrasion to the throat or larynx area and it grew from there. We had no idea, and were treating him for allergies for quite a while. I hope my story can help others! And fingers crossed we can let his traech hole close and he can be back to normal soon! (Worse case, we are looking at surgery on his arytenoids OR a permanent traech)

[LazyA1]

I am curious – what part of the country do you live in? In some parts of Texas (east of Austin), horses have been getting a nasal cicatrix that the vets do not know the cause of. Other than that it occurs with pastured horses.

[tpup]

Hi! We live in Northern VA. It’s quite possible that this long-brewing infection caused nerve damage in the moving parts of his larynx area. In the last scoping, one of his adenoids (?) wasn’t moving as much as the other. The next scoping will consist of blocking his traech hole and videotaping his throat as he breathes through his nose only. I also learned that this condition can take a long time to resolve. He definitely needed the much stronger antibiotics. We are hopeful he won’t need surgery. If he would need a permanent traech, the temp hole sometimes cannot be used So it could involve a different traech hole (and the current one would close up and heal)

[LazyA1]

Thank you for the info! The nasal cicatrix around here is a mystery, that’s for sure.