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.
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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