Inflammatory Airway Disease (IAD) worse with bronchodilator and other questions

[CanteringCarrot]

I have a horse that had a respiratory infection, was treated with antibiotics and VentiPlus. The very low grade fever went away quickly and coughing receded. There was never a crazy amount of mucus, just some clear and/or white nasal discharge while exercising. As soon as the VentiPlus (brochodialator I guess) stopped, the occasional cough came back. I pursued an endoscopy and bronchial lavage. No sign of infection or mucus. Just some slight inflammation left in the airway.

I was then told to complete 15 days of Dex and Atrovent via nebulizer. He’s been on a low dose of Dex for 3 days, and I haven’t noticed anything negative, he hasn’t coughed at all, and was doing alright.

I then introduced the Atrovent (a type of asthma med) today and I could hear him breathing the entire time during our ride. Even at a casual walk. He kept trying to paw at his nose, which can be a thing for him at the end of a ride, but not the beginning. He didn’t seem into exercising and was short of breath easily. So, could the Atrovent actually make this worse? I used the nebulizer before our ride.

The only thing I could think of is that maybe it made his lungs/airway too sensitive and that created short breaths? Kind of like when you use a really strong nasal spray and try to take a deep breath.

So has anyone with a horse that has IAD (Inflammatory Airway Disease) seen them get worse with a bronchodilator? Part of me just wants to give the Dex tomorrow and skip the Atrovent to see how it goes.

Btw, this is what Atrovent is (not sure if it is given in America):

Atrovent (ipratropium) is a bronchodilator that relaxes muscles in the airways and increases air flow to the lungs.

Atrovent is used to prevent bronchospasm, or narrowing airways in the lungs, in people with bronchitis, emphysema, or COPD (chronic obstructive pulmonary disease).

Fortunately, I am not super familiar with respiratory diseases, this is my first. I will consult the vet again, but I am also interested in what COTH may have experienced.

[VFT]

I’m curious what type of solution you are using in your nebulizer?

This is my IAD experience:

I have a horse that has suffered from severe IAD, diagnosed by having his lungs and upper airway scoped and doing a lung wash. He never had any sort of bacterial infection with it. He first took prednisone orally for a few weeks I forget the exact length, which helped alleviate the symptoms for the time he was on it. His symptoms at the time was only that he would cough while eating, not during exercise. He was eating soaked mash, or a carrot and coughing so it was not a dusty hay making him cough trigger. When he was first diagnosed I began steaming his hay and switched to dust free bedding.

The cough returned when he was off the pred and was working. We took another trip to the hospital to have his upper airway scoped, and it did look a lot better, but since he was still having issues he went on 2 different types of steroid inhaler ( human inhalers) . The inhalers helped his breathing so I don’t have any advice to offer on your question of inhalers causing further problems, but each horses circumstance are different. We used the inhalers for a few month before each time I worked him. And began using a colloidal silver nebulizer solution in a nebulizer the night before he worked, and sometimes right after. I noticed that using the nebulizer right before work makes him more fussy with his nose, he does the same rubbing his nose on his leg thing your horse does. You might want to try using the nebulizer a few hours at least before work if that’s possible?

I have noticed for my horse that anytime he takes any type of steroids he gets an abscess in one of his hoofs 1.5 - 2.5 months later. After taking the inhalers for a few months he started getting several small abscesses. My vet did not agree with my analysis of the steroids causing the abscesses but it is an obvious pattern to me whenever he has had oral or inhaled steroids. So I took him off the steroids all together and did what I could to make him comfortable, which for a long time meant not working. His problems are aggravated by seasonal allergies ( allergy meds did not help) and exercise and he does need to be managed year round. Right now I am using the nebulizer still with the colloidal silver solution about 5 days a week, always the night before I work him.the following morning. I also still steam his hay, use dust free bedding, and have had huge success with two supplements from springtime inc. The breather powder and the DMG, which he gets daily.

This has been an issue for us for 2 years now. It has been very disheartening for me but I have managed to find a maintenance routine that works for us. I have had him in regular work since November now, and so far even with allergy season kicking up he has been doing good.

One last tip to add, I have to do a very slow and tedious warm up with him to get his lungs warmed up slowly. Like several laps of slow walking, then a bit of faster walking, back to slow walking, a half circle of a really pokey lazy trot, back to walking a few laps, then a full circle of lazy trot… you get the idea. Once he is warmed up and his lungs have been slowly acclimated for work he shifts into a different mode and is good to go.

[CanteringCarrot]

Saline solution, Dexamethason, and Atrovent is what he currently inhales. I figured before work would be best, but I could try to ride first and see what the difference is. I cannot do it hours before I ride. He does not cough, and hasn’t for a week or two (stopped just before the dex). No problems eating, no problems with sawdust bedding. He just “puffs” while working. I can hear him make quick, short, exhales repeatedly. When I stop, his sides aren’t “heaving” that hard. Just these shallow quick breaths it seems.
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He actually rubbed all of the hair off of his nose at the beginning of his infection. I think it became itchy once he started irritating the skin with the rubbing, but I think it was because he had a runny nose. He doesn’t like the wetness. He’s even fussy sometimes when he gets really foamy at the mouth during a ride. He’s a queen. The hair is coming back, but I still feel like he sneezes more than the average horse at work. I was partially convinced it was pollen related since this is his first spring here, but the vet didn’t think so and no evidence of an allergy was found in the airway or tests (took blood too).

I slowly warm him up every ride. It’s just odd because he was fine for our lesson on Friday. Good on a long hilly hack Saturday, great ride on Sunday, free longe on Monday, and then not good yesterday for riding. Starting the Atrovent could have been a coincidence, but it’s the only thing that changed. I did not see if he was fine before inhalation yesterday though. Only post inhalation.