Be very careful with steroids-not only can they cause laminitis but they will also further compromise her immune system. I would stop working her all together if it’s at all very hot/humid …not sure if you saw my other comments but steaming her hay will be the best thing you can do for her as well as giving her Jiagulon, Spirulina, flax& msm , EO3 oil…Smartbreathe Ultra
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Given that she’s just recovering from a serious illness on top of the respiratory issues, I’d back way the hell off in terms of competing.
Give the poor mare time to recover.
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Per my recent responses, the BAL has already been done as of last week. (It took me a month to get in!! 
) My vet uses the scope to do the BAL so she is scoping airways at the same time. There were some “bumps” which indicate an allergy response and mucus discharge but nothing else noted as far as abnormalities.
Got final results back from the lab on the BAL and there isn’t actually a fungal component (thank goodness!), and the only thing slightly elevated was eosinophils (which can happen “normally” in a young horse so my vet wasn’t real worried about that) but she did have some RBCs which indicates she has bled at some point. Not shocking to me as that’s quite common in barrel horses, especially with respiratory issues. Although I myself have never had an official bleeder diagnosed before so this will be new territory for me. Likely will have to run her on LASIX which I am not a fan of but we’ll wait and see what my vet tells me when we get to the point where we are ready to make a run again.
Still waiting for final results on the allergy testing, which was also done last week.
Yes, vet offered the allergy shots, pending when we get the allergy results.
Next step is we are going to try Alpha-2 in the nebulizer, so I’m set up next week for a blood draw so we can get that spun up.
I know things get old but yes I see you did comment earlier on my thread (even though I did not respond directly) and the hay steaming “discussion” is also earlier in the thread. 
Yes, of course, steroids have side effects but they also have their place. I’ve only given her the IM when she has absolutely needed it and I’ve been giving it in the nebulizer per my vet’s instructions.
She is on pasture 24/7 right now. The only hay she’s gotten in the last 5 months is when she’s tied at the trailer at a show/race. And the bag I use for her, she can’t bury her face or nose in it. She won’t eat it if it’s wet (tried that).
She is already on MVP Air-Way EQ (which does have spirulina in it) along with CEP Daily Lung and a daily omega-3 supplement (that has flax in it).
Also added a Forco digestive pellet after the tummy issues. I just think she should be on something digestive for a bit right now. Not to mention my vet has me doing antibiotics again (for 7 days) since we now know she’s a bleeder.
I’m going to refrain from responding as I don’t need your negatively to return to the thread a second time.
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Then I’ll just toss this out there in the hopes that it may reach someone else–
your horse doesn’t care about winning a barrel race or any other gymkhana event.
(or a jmper class, or a hunter round or a dressage test or cross-country course, etc.)
That’s your ego.
If you place your ego above the needs of your horse, you are not a horseman.
And it will eventually end badly for either you, your horse, or the both of you.
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Have you ever tried the nasal strips during exercise?
My ego?
Thanks for bringing a smile to my face in light of your egotistical attitude.
Have a good day belitting others.
I haven’t for her. I did use them on my gelding a few years ago (didn’t seem to make a difference for him).
They were kind of tricky to get to stick, and also quite spendy.
I would like to look into the nose clips that you can get that accomplish the same thing and are re-usable. I don’t remember who makes them or what they are called. I need to ask around and look into it.
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May not do anything for the heaves part of it but could help with the EIPH.
Dh was positive for the
this is so true. my own best and favorite gelding struggles with RAO and I wouldn’t dream of working him hard in pursuit of a trail ride much less a competition.
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be super mindful of overdoing the dex.
I feel for you- managing these horses is a full time job. Where I am, the air is filthy due to a lack of rain and we’re having uncharacteristically dry weather (typically humidity is above 85%, it’s been sitting at 40 for a few weeks. So yeah it’s nice that the air is dry so there’s no mold and mildew on the ground and grass… instead it’s just airborn dirt and crud blowing around.
have you considered the silva-dene for the nebulizer? I have used it some as a ‘lung health’ thing between episodes but I can’t say I’m fully bought in to its usefulness.
Got the allergy results back the other day
and… already made a bunch of changes to the grain I give her. 
I’m thankful she’s not allergic to any grasses around here (pretty sure we do not have Johnson Grass up here) but goodness we have ragweed everywhere. Definately will be doing the allergy shot program because there is no way I could totally eliminate ragweed. I can spray/maintain in my own pastures but it’s still going to be in the neighbors pasture 40 feet across the road with the wind blowing the seeds into mine.
The little omega-3 cookie I have been feeding her has flax in it. So stopped that and already have a different fish oil omega-3 on the way (KER EO-3) for her. I take a high quality fish oil for myself so I suppose it would make sense it would be useful for an animal as well.
The Purina Outlast and the alfalfa pellets I have been giving her are safe, but not the Purina Outlast cookies (which are oddly different than the bag) or the Purina Ultium Gastric Support, which is a bummer because she gobbles that stuff up and I use it to top dress her supplements and alfalfa pellets.
She really doesn’t like eating the alfalfa pellets plain but she has been eating them painstakingly slowly. (She’s probably wondering WTH is her Ultium …) I’m hoping she’ll like the fish oil supplement I ordered and as least that I can pour over the alfalfa pellets, if she doesn’t mind it. We’ll see. She does NOT like her pellets moist or wet. She won’t eat them. I don’t like feeding them dry but it’s the only way she does eat them.
Her CEP and MVP and Forco supplements are good so we’ll continue those.
It might. I listened to a really, really good podcast a few weeks ago from a very well-respected vet from Littleton Equine and the bottom line is there really is no way to prevent the bleeding because it’s just how the blood volume of a horse is and the amount of pressure/exertion they create during the bursts of speed or running (like also in racehorses), it’s going to pop those tiny capillaries deep inside the lungs. I suppose she very much is an advocate for LASIX but in terms of how it’s really the only thing that can prevent the bleeding at an anatomic level, just because of how the horse’s body is designed. It was a really good conversation.
But like we horse owners do, we try lots of other things anyway! Flair strips, supplements, nebulizers, etc etc etc.
Honestly, my vet is kinda against any of those silva things for the nebulizers. I think mainly because there are so many unregulated products out there and you have to be really careful that you are putting STERILE things into the lungs via the nebulizer. Yes, I understand that silver is supposed to be anti-microbial but I don’t think the research takes a stance one way or the other specifically on the true effects. And I think it just mainly lacks the science background and that’s probably the main reason why she doesn’t like it.
I know people that use it and say it works. I’m going to go the Alpha-2 route with my vet first and we’ll see how she responds to that.
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Yeah me too. Would kill for those kinds of numbers for my asthma horse!
Ugh I think I’m getting ready to embark on the asthma adventure and not looking forward to it. I’ve been following this thread since it got updated and have no idea what’s going on, as I’ve never dealt with asthma before. I fear what future allergy test results will look like……
It’s much better to have the knowledge than not, if that is your horse’s issue. Before I had gathered enough information, my horse was basically unrideable despite being previously very supple and amateur friendly, he was miserable, spooky, muscle sore all over, and not sweating. This year has been tackling the itching, hives, and sweet itch component. But he is sweating like a champ and I’ve hardly used the nebulizer since winter!!
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It’s very helpful to know that oats are an allergen, for example. I have chip mostly well managed, though I was overwhelmed at first.
I’ll be coming here for advice when we do get things narrowed down, for sure. We thought he had a bug of sorts, then thought allergies, then a huge fever after trailering assumed it was in fact viral or bacterial, but test results indicate no such thing. So back to thinking it’s allergies/asthma. Will have the vet out very shortly to open that can of worms. The horse was born with pneumonia so I’m assuming he has some damage that predisposes him to lung problems 
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Oh I agree that her allergy results really were not that bad. She could have come back a lot worse with a lot more allergies. I am glad I can control most of them (except that ragweed…)
I’m also secretly hoping that maybe she’s been a silent bleeder all along and THAT’S the issue … which then the LASIX should manage well.
Headed to the vet on Thursday to get the Alpha-2 spun up for her nebulizer, and pick up the LASIX and have another discussion with my vet.
Or there may be heaves and EIPH. And the heaves may not be the allergy phenotype.
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My mind is simplistic and hopeful, but I know in reality that just doesn’t fly. 
Two of her episodes this year, had nothing to do with a barrel run, exertion, or (in my opinion) EIPH. The first one we had taken a riding lesson in an indoor arena for 2 hours. She was fine the rest of the day, but the next day had the first heaves episode. We loped some circles for the lesson but most of the work was actually trotting or working on spins. So in that particular case, there wasn’t any chance she could have bled because we hadn’t even made a barrel run at all for the year.
So something is triggering her. The struggle is figuring out how to stop the trigger.
Obviously the prescence of the RBCs in her lungs has not been helping matters.
Interesting article. Her blood work was all normal with the exception of the high eosinophils. Obviously doesn’t mean there isn’t a problem. I guess I was happy her mast cells weren’t elevated b/c I know some people that struggled with that.
My horse had significant mast cells in his BAL (5%, compared to <1% eosinophils), and the internist said that was more indicative of mild equine asthma, allergen type. The only thing that makes it better is that with “mild” asthma, they don’t have elevated respiration at rest associated with heaves/severe asthma. I think the article said that high eosinophils seemed to be more like late-onset severe equine asthma. In which case, it sounds like steroids (maybe switching from dex to fluticasone) as well as avoiding dust (not for the allergy component but general inflammatory effect, not so easy with horses) are the recommended treatments.
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