Heaves (RAO) induced by exercise? Management? Advice?

[beau159]

I’m heading into unknown territory --> Heaves.
I’m sorry, this is a novel!

I have a 7-year-old quarter horse mare, Lilly. This will be my 3rd year with her. All of a sudden this week, she seems to have an episode of heaves. I have 3 horses and they are outside 24/7. I feed round bales in the winter with a HayChix net on it. In the warmer months, they graze. This is my set up and I’ve done it for years.

I bought Lilly in April of 2021. No issues at all the first year, no coughing, no breathing issues, etc. The only thing I can perhaps say is she did have trouble catching her breath one time after a barrel race in mid-September 2020. It was a 3-day barrel race and it was the first night. She never has any trouble catching her breath after a run but she did that night. I thought it was because I tried Red Cell on her for the first time (with the okay from my vet). That was our first race since I added that and I obviously stopped it after that because I thought it made her heart race or something dumb like that.

The only other thing notable about 2021 was that we had a severe drought year. So everything everywhere was dusty and dry. All 3 of my horses were coughing a little bit here and there, nothing extreme, but we were in a severe drought. So I don’t know if that matters or not, but I guess it’s part of the history.

Last year 2022, I bought a nebulizer (FlexiNeb). I didn’t really have a certain NEED for it, but I actually bought it with my other horse in mind. But I figured it’s not going to hurt her to be on it too. All 3 of my horses still had that little bit of a cough over the winter that carried on from the prior fall due to the horrible drought. With the nebulizer, the coughs cleared up very quickly. I did also start 2 of my 3 horses on CEP Daily Lung at the same time as starting the nebulizer, so I guess I can’t fully say it was the nebulizer. I didn’t feel it made any difference whatsoever for my other horse during the year, nor for Lilly (who didn’t have any issues), so I actually sold my nebulizer last fall. If something doesn’t seem to be working for my program, then I ditch it.

But throughout 2022, I probably did about 45 days of the CEP daily lung that spring, then I discontinued it when I ran out. But continued with the nebulizer, roughly once a week. Maybe twice a week if we were going to a race. One day, I was at a playday type show where they had numerous events. I can’t remember exactly but Lilly would have probably done 2 or 3 events prior, but she suddenly had trouble catching her breathe. It took her a while to recover, but she did. The arena was dusty that day. At the time, I didn’t really think about the other event the fall prior, because I had seriously thought the Red Cell did it. But now that I am thinking back, is it connected?

We’ve had a horrible, horrible winter this winter. Blizzard after blizzard after blizzard. I had noticed that she has been coughing a little bit over the winter, but it didn’t start right away. My other 2 horses haven’t really been coughing at all. I didn’t think much of it for Lilly since she got a little coughy last winter too. So I just started her back on the CEP Daily Lung about a month ago. And her cough has improved and is nearly gone.
We’ve very slowly started getting back in shape again, because I’ve had nowhere to ride with mountains of snow everywhere.

On Sunday 4-9-23, I took my horses to an indoor riding arena for a private lesson with a nationally-known trained. I did a 2 hour session on her in the morning, and a session on my other horse in the afternoon. It is a heated arena (although not that warm) and she did get very sweaty inside, as I expected. I wouldn’t say she was worked super hard. We did some trotting circle exercises, and then the trainer rode her for a bit, working on neck reining. We didn’t do any loping at all. But she still got a workout, and she was breathing hard. She stood tied at the trailer outside while I rode my other horse, and she was fine and we went home.

Monday night 4-10-23, when I went outside after I got home from work, she was breathing heavy, like she was having trouble catching her breath, just standing there. I thought maybe she was hot. It was about 70 degrees, which was literally a heat wave for us in North Dakota (seriously, we had another blizzard just 5 days prior - not joking). So this was a huge temperature swing. I almost texted my vet but I though I would give it a day. Well, the next day Tuesday when I checked her after work, same thing. Still breathing hard and kinda struggling. So I consulted with my vet. With my work schedule this week, there is just no way I could get her to my vet (who is 2 hours away), and I’m unfortunately getting on a plane Tuesday to be out of town for a week for work, so this is just horrible timing. (Husband is non-horsey so little help from him.) Vet and I decided to get her on a course of dexamethasone IM. I picked it up from a local supply store on Wednesday and gave her the first dose when I got home.

She has been slowly improving. Last night (Thursday) she was breathing better, but still not back to normal. Today (Friday) again a little bit better but I could still see her breathing hard once in a while.

I was able to do a PEMF session on her Wednesday and again today.

Of course, I was a googling fiend on Wednesday night and I ordered a good omega-3 supplement from Total Health Equine and also ordered MVP Air-Way EQ. Those both arrived today and I gave them to her, along with her usual CEP Daily Lung. (The MVP and the CEP does double up on a couple ingredients, but they are more natural ones and I know you can feed double the dose of the CEP daily lung without problem.) I like that the MVP has MSM and Spirulina.

Hopefully she continues to get back to normal over the next few days before I have to fly out. She’ll get 7 days of dex treatment.

If you’ve read through my novel of details, thank you.

My big question is that I feel like there has been an exercise event each time. The first was a barrel run. The second was a speed event (can’t remember if it was barrels or poles or which event, but it was one of them). And third we had the session with the trainer where she got very sweaty and out of breath. (although not a cardiovascular exercise like running a speed event)

She was not eating from a round bale during the first two. I know that round bales are bad for RAO but also in my case, I do have a net on it so she isn’t burying her head inside and it literally gets snow on it. A lot. I know that’s not the same as wetting down hay, but I would think it speaks for something.

And I had her on a nebulizer for the second event.

So I am just trying to rack my brain on what is going on here and what the trigger may be. Maybe it helps to type it all out and have others give their two cents.

Obviously, when I am able, a vet visit is in order for other diagnostics but… if she’s got Heaves, it may or may not change the treatment outcomes.

If I made a mistake by selling my nebulizer, thinking it was not helping, I obviously can buy another. But I’m just not so sure. I’d like to give the omega-3 and the MVP supplements a chance to work.

The snow is melting and they are already going out to graze more, and eating less from the round bale. So I think that will be helpful. But I seriously have no idea what I will do if she can’t be managed somehow on the round bale. I don’t have a barn. We’ve only been on our place since 2020 so there are still lots of things in progress. I don’t know how I would keep her separate from the other two horses in the winter. I’ve only got one shelter they all share and I certainly cannot afford to put up a second one this year.

I know all horses are individuals and they will all respond differently to different treatments.
So I guess, thank for reading and welcome your suggestions.
I’ve never had a horse with a breathing issue before so this is new to me. (and I don’t like it one bit!!)

Last but not least, she is a stunning girl and an absolute sweetheart.

[IPEsq]

If she is struggling now, I would scope her at this point. Look in the airway and do a BAL. The BAL can distinguish between mild and severe (heaves) asthma and also see what type of cells are dominant as well as any other junk that might be in there including if she’s a bleeder. It would give you some direction on the triggers.

For example, my horse has mast cell dominant mild asthma. That indicates that allergens are a trigger. He seems to be mostly susceptible to particulates and pollution in the air versus pollen. Dust (as it id part of poor air particulates) is also a problem. Allergy control supplements and meds seem to help him more than the lung or cough type supplements or bronchodilators, and some days he is just less tolerant of exercise.

Because your horse is having a flare up standing around, that is a heaves response, and the dex is appropriate. But maybe also antibiotics or a change in management to bring the more acute attack down—was taking care of a horse that we put on a slow feed net who shortly thereafter had a similar issue and we took the net away thinking it must have contributed and we split up his dinner into dinner and night check ration though I would have liked to slow his hay eating down further. He also showed signs of sinus infection at the same time (hence reference to antibiotics).

[beau159]

@IPEsq

If she is struggling now, I would scope her at this point. Look in the airway and do a BAL. The BAL can distinguish between mild and severe (heaves) asthma and also see what type of cells are dominant as well as any other junk that might be in there including if she’s a bleeder. It would give you some direction on the triggers.

At some point, I am sure a BAL is going to be in order. I just could not get her there with my work schedule right now; plus my vet didn’t have any openings anyway. She is amazing but she is busy. I see patients myself and I know there are times when you just cannot squeeze in another patient.

My plan is to communicate with her on Monday, based on how she’s doing, and come up with a game plan.

@IPEsq

Because your horse is having a flare up standing around, that is a heaves response, and the dex is appropriate. But maybe also antibiotics or a change in management to bring the more acute attack down—was taking care of a horse that we put on a slow feed net who shortly thereafter had a similar issue and we took the net away thinking it must have contributed and we split up his dinner into dinner and night check ration though I would have liked to slow his hay eating down further. He also showed signs of sinus infection at the same time (hence reference to antibiotics).

We chose no antibiotics for right now, based on her symptoms (no fever, no running nose, etc), and went with just the dex.

I am also hoping that since the snow is finally melting, and the grass will be growing again, that they can get out grazing again, and that’ll help her too.

I’ve been around horses for 30 years and I’ve never had one with a heaves episode before! I feel like a total newb with something I know very little about.

[beau159]

Lilly is doing better, but not back to normal yet. The last 2 days she looks a lot more comfortable but watching her closely, she is still taking a little deeper breaths than is normal. I have to watch her tummy specifically to notice, but I can still notice it. Yesterday was her 4th dose of the dex.

On a good note, I did not see her cough at all yesterday and they were tied to the trailer for about 2 hours while I did everyone’s PEMF treatments so that’s good.

Maybe I’m nuts, but her breathing seems more improved after her PEMF treatment.

[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 last 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. She is now rideable and mostly symptom free.

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!

For what its worth, I spent $5000 on testing at LSU Vet School. Not one of the tests resulted in me getting any information that was helpful for the treatment. They told me to get a $1200/MONTH (yes month) drug and I laughed in their face. Best thing for me was knowing what she was allergic to and making feed/environmental decisions

Edit: round bales are almost always a trigger for allergy horses- switch if you can once you figure out what she’s allergic to

[Ghazzu]

Soak the hay.
Don’t just wet it, immerse it for 5-10".
Especially round bales.

[SusanO]

Spend the money on diagnostics with a vet, not on supplements. You need to know if her lungs are affected, if it is the bronchial tubes, infection, allergies, etc. This will give you a much better idea of her prognosis for what you want her to do and how to treat the problem. Just throwing random supplements,“cures”, whatever at her is only going to drain your pocketbook. I would try to take her somewhere that they can scope her and do a full workup. The best way to fix the problem is to know what you are dealing with.

[ladipus]

@beau159 I have 2 horses with Asthma/allergies /respiratory issues & exercise intolerance…what I can tell you is even if you’re not feeding a round bale currently is that it can take up to 3 months for a flare up to subside ….so first thing would be no more round bales …second and the most important factor is to Steam your hay …this is the GameChanger -mine don’t require any meds since I invested in the steamer …next is no shavings, sawdust, wood pellets, or traditional straw bedding (I use cardboard) …and what helps mine the most is giving Spirulina, Jiagulon,flax and msm …or you could give an all in one supplement such as Smartbreathe Ultra or Uckele Lung Eq as well as KER EO3 oil (I tried the Arenus product Aliera -it’s very expensive and didn’t do much.

I also do allergy immunotherapy shots.

**Also be very careful with steroids as they can cause laminitis **

I took my mare to a University Vet Hospital for a work up …she had a physical exam, ridden exam, they tested her heart , did a BAL, and upper airway scope …she has mild asthma…I had all the proper management already in place

[erinmeri]

I have a horse with asthma/EIPH.

I have had success with steaming hay. Prior to steaming, soaking (like @Ghazzu says, fully immersed) in a hay net in a clean muck tub for an hour worked well. We don’t use round bales, but even our nice hay in small bales that seems to be dust- and mold-free can trigger, so all hay gets steamed (or soaked).

I know your horses live out, and that you cannot control drought, but in case it helps… Minimizing dust and other airborne particles is key, so other helpful management tips include: maximizing turnout, absolutely no sweeping or blowing when horse is in, in a shedrow when stalled, avoiding indoor immediately after dragging (exhaust fumes, dust), etc. We ride in an indoor 4-5 months of the year, and I try and leave the door open when weather and fellow riders allow.

I haven’t tried supplements, but my horse also seemed to improve on Zyrtec, which was given for an unrelated issue, so we continued it. (Unrelated, but also seems to help with fecal water syndrome & loose poops).

During flares, I have had success with the Aeservo, though I needed either two courses or one course followed by a course of Pred and a week of a bronchodilator. If going the Pred route, I wouldn’t too dress feed, but would dissolve in water and syringe orally. Horse tells us that the pills are nasty. Will probably invest in a Flexibeb soon so can get ahead of a flare at first signs/symptoms to minimize downtime.

Also during a flare, we give several days off (5-7ish) when first medicating, followed by a slow and gentle return to work over the course of about a week or two. It’s important for the lungs to heal. Also to make sure that flare is over. That’s part of why I want to get a Flexibeb - so we can treat at first cough and not allow a full-blown flare to erupt.

That said, with management changes, it was nearly 1.5 years between flares, and horse was in steady work with no issues between. Latest bout was triggered by something that had all but two horses in barn coughing, but no fever. We think either something in the hay or something environmental on property. So, the asthma doesn’t really affect mine on a normal basis.

ETA: I was interested in allergy testing (skin, not blood), but supply chain issues precluded it. I may go that route in future and do the shots - vet has had success with them in horses with respiratory issues. Also, the inhalers (Aeservo) carry less laminitis risk from what I understand, but this most recent flare we went the oral Pred route and monitored for laminitis after the initial round of the Aeservo. The Aeservo is pricey and single use - another reason I am considering the Flexineb.

[candyappy]

@beau159

Lilly is doing better, but not back to normal yet. The last 2 days she looks a lot more comfortable but watching her closely, she is still taking a little deeper breaths than is normal. I have to watch her tummy specifically to notice, but I can still notice it. Yesterday was her 4th dose of the dex.

On a good note, I did not see her cough at all yesterday and they were tied to the trailer for about 2 hours while I did everyone’s PEMF treatments so that’s good.

Maybe I’m nuts, but her breathing seems more improved after her PEMF treatment.

My daughters mare started out with occasional coughing under saddle late one Fall. It continued about the same until one day after lunging ( before a ride) she could not catch her breath. I took her saddle off and could hear a slight wheeze to her breathing. Called the vet who came out immediately and had us do oral Dex treatments as well as soaking hay etc…

I am happy to say that it has been 3 years and she has never had another breathing episode, no wheeze and has no management to control it. She has never been stalled, I don’t soak the hay but I always feed off the ground and the hay is off a round bale which has a bale sleeve/ bag applied immediately after baling but we feed by hand daily.

We feel hers was allergy induced ( vet agrees) and that year something must have been crazy in bloom that just caused her to react. Hopefully you will be as lucky. I do have a bottle of Dex on hand, just in case. We have had her for 13 years now.

[beau159]

@Amberley

Drought and dried up field dust always makes me think of fungal infection or just spores starting an inflammatory/ allergy type process. Ask your vet if its an issue where you are.

This last year (2022) was not a drought. We had good rain. It was the year before (2021).

@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.

No she hasn’t been allergy tested (haven’t had a need until last week!) but I am sure that will be on the vet’s agenda when I get her down there.

@Ghazzu

Soak the hay.
Don’t just wet it, immerse it for 5-10".
Especially round bales.

Easier said that done in my climate.
When it’s -20 * F outside, wet hay freezes pretty fast. And she doesn’t eat fast.
I’m not sure what I am going to do over winter.
I do not have a barn or anywhere inside to put her, but I wouldn’t want to anyway because I think outside fresh air is best.

Who has suggestions or advice on soaking hay in a cold winter climate? (North Dakota)

They don’t get hay in the spring, summer or fall. Just the winter.

@SusanO

Spend the money on diagnostics with a vet, not on supplements. You need to know if her lungs are affected, if it is the bronchial tubes, infection, allergies, etc. This will give you a much better idea of her prognosis for what you want her to do and how to treat the problem. Just throwing random supplements,“cures”, whatever at her is only going to drain your pocketbook. I would try to take her somewhere that they can scope her and do a full workup. The best way to fix the problem is to know what you are dealing with.

I know my first post was very long, but I said a vet visit will be in order. I am getting on a plane this afternoon and not back until Sunday so I just could not get her there immediately.

@erinmeri

I know your horses live out, and that you cannot control drought, but in case it helps… Minimizing dust and other airborne particles is key, so other helpful management tips include: maximizing turnout, absolutely no sweeping or blowing when horse is in, in a shedrow when stalled, avoiding indoor immediately after dragging (exhaust fumes, dust), etc. We ride in an indoor 4-5 months of the year, and I try and leave the door open when weather and fellow riders allow.

I rarely ride in an indoor arena; I don’t have one.
I also do not have barn or anywhere indoors to put her, so no stalls and no sweeping!

@erinmeri

During flares, I have had success with the Aeservo, though I needed either two courses or one course followed by a course of Pred and a week of a bronchodilator. If going the Pred route, I wouldn’t too dress feed, but would dissolve in water and syringe orally. Horse tells us that the pills are nasty. Will probably invest in a Flexibeb soon so can get ahead of a flare at first signs/symptoms to minimize downtime.

I had a Flexineb last year but I sold it. I just wasn’t sure it was making a difference or doing anything. I can’t say I noticed a difference in either of my horses??

@candyappy

We feel hers was allergy induced ( vet agrees) and that year something must have been crazy in bloom that just caused her to react. Hopefully you will be as lucky. I do have a bottle of Dex on hand, just in case. We have had her for 13 years now.

Yes, I will be keeping a bottle of Dex on hand now, just in case and maybe even bring it with when I must travel and stall her (not often).

[Ghazzu]

@beau159

When it’s -20 * F outside, wet hay freezes pretty fast. And she doesn’t eat fast.
I’m not sure what I am going to do over winter.

Bring a container of hot water to dump on the hay.
Once it’s been wet down/soaked briefly, it doesn’t have to stay submerged while the horse eats it.
Drain it and you’re good to go.

[beau159]

@Ghazzu

Bring a container of hot water to dump on the hay.
Once it’s been wet down/soaked briefly, it doesn’t have to stay submerged while the horse eats it.
Drain it and you’re good to go.

Not opposed to working hard for my horses, but to carry hot water from the house to the horses is about 400 yards. If we happen to have really bad weather (40 mph winds) obviously it is going to be a challenging feat. And walking through 2-3 foot drifts to get out there. Winter isn’t always horrible but this year was especially horrible.

I also would need to be mindful of where I drain the water as it’s going to create an ice hazard all winter, wherever I dump it.

Realistically, why does it have to be hot water? It’s going to cool and freeze no matter what. I do have a frost free hydrant next to my horse’s run in shelter which would be a lot easier than carrying buckets all the way from the house. That would make more sense and be more realistic.

New question. What if the hay is already covered in snow? Obviously might not be “wet” but would it still accomplish the same thing of reducing dust?

This is what I could be dealing with throughout winter:

[Ghazzu]

Why hot? Because you were talking about how effing cold it was.
I’ll refrain from attempting to offer you any more basic management advice in the future, since it is apparently ill-received.

[Bonnie2]

I don’t look at this picture and think heaves. Heart issues can sometimes present as breathing problems. Or the dry cold air could be irritating her airways plus or minus fungal/bacterial/viral issues. Definitely needs a diagnosis as soon as practical. I would not wet a round bale. It will freeze in the cold or rot in the warm. Hope you get this figured out soon!

[Ghazzu]

@Bonnie2

I would not wet a round bale. It will freeze in the cold or rot in the warm.

Who said anything about dousing the entire bale?

[Argo]

@Ghazzu

Soak the hay.
Don’t just wet it, immerse it for 5-10".
Especially round bales.

You did?

[Ghazzu]

No, I recommended soaking the hay fed to the horse with the respiratory issue.
I believe I used the term “submerged”.
Please explain how on earth one would submerge an entire round bale.
I suppose a large stock tank and a tractor with bale spears might suffice, but it doesn’t sound very practical.

[candyappy]

@Ghazzu

Bring a container of hot water to dump on the hay.
Once it’s been wet down/soaked briefly, it doesn’t have to stay submerged while the horse eats it.
Drain it and you’re good to go.

If it is cold enough once the hay is wet it will freeze ( without being submerged) even using hot water. I stopped soaking hay when it got that cold because no horse would eat it . Maybe by then @beau159 won’t need to soak it.

[Ghazzu]

Mine don’t mind it being frozen.
In that case, I’d be inclined to take the horse off hay entirely and substitute pellets or cubed roughage, but I suspect that wouldn’t work for the OP either.