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Intradermal Allergy Testing -- (northern) Virginia/nearby/east coast -- cost/where?

Horse Care
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#1

Sorry for yet another allergy thread, but none of them seem to answer my very specific question:

If you’ve had intradermal allergy testing for your horse, in northern Virginia (or MD/nearby, or really anywhere for comparison), where did you get it done and how much did it cost (in what year)?

Background: Horse (elderly but with a lot of life left) has been on daily ventipulmin for about forever which is working OK to manage his symptoms but I’m starting to wonder if other allergy treatment would be a better option. Our vet is coming this week for spring shots and I will discuss with them, but I like to get background information first.

(Inspired by the other recent allergy testing thread, in which someone from Canada named a low price. I am pretty sure now that Canadian horses also have subsidized medical care, because I don’t think anything here could be that cheap.)

#2

Further background, for those who like every detail–otherwise feel free to skip this post: He’s rising 29, but still in light work: 30-60 minute trail rides 3-4 times a week (as weather allows), main goal is fitness and enjoyment, lots of trotting and a decent amount canter. Only other health problem is arthritis, managed with Novox and Adequan, and as long as that continues working there’s every likely-hood that he can continue in work into his mid/late thirties. Cost is sadly a factor (although ventipulmin isn’t exactly cheap either), but I’m willing to spend a little more if it results in a healthier horse.

He receives ventipulmin in his food twice a day, between 1cc and 5cc per dose (so 2-10cc per day), adjusted slowly in reaction to how bad his symptoms are (as in, “he seems like his breath is a little heavier, time to start giving him a bit more” or “I think the pollen is going down, maybe we can try giving him a bit less”). We could keep him on the highest does full time, but 1) we are worried about him developing a tolerance to the ventipulmin and then needing an even higher does, 2) worried about side effects, and 3) this stuff isn’t cheap, hate to have him on 5x the dose he actually needs.

His primary allergy symptom is wheezing breath, like someone suffering from a mild asthma attack–we try to keep his medication adjusted so that you can’t hear any wheeze even if you put your ear up to his nose. Sometimes (not too often) we miss adjusting when we need to and he has an audible wheeze when ridden–it does not seem to upset him, but if it gets to that point then the shortness of breath does impede his performance. He also has a quick coughing session during our first trot but it is an over and done thing, doesn’t continue into the rest of the ride.

His primary problematic allergies seem to be seasonal, probably pollen based. He is outside 24/7 with a run-in stall. His breathing is generally worst during summer/fall (3-5cc 2x/day), moderate during the winter (1-2cc 2x/day), and oddly best during spring (1cc 2x/day)–but that does change, and it’s especially difficult to tell when he needs less ventipulmin.

Hay is rinsed off, which helps a lot during the heavy hay months. Grain is the same all year.

Other allergy symptoms: He can sometimes be itchy, but I’ve been able to manage this pretty well using a combination of insect repellent and vacuum cleaning–he still rubs, but in a more relaxed/habitual way, and doesn’t damage his fur or rub out his mane.

He is probably allergic to tick bites, he develops a good lump for any tick bite (no matter how minor), but I am able to keep the ticks off of him by aggressively applying repellent starting in early spring–we probably have 1 or 2 bites for an entire season, and keeping ticks off has been a big factor in his not itching.

He had hives once–I think in reaction to a new roll on fly repellent that I used, I threw out the bottle immediately and he never had hives again, so it’s inconclusive what caused it. Otherwise, he does not seem to react to most products.

#3

So I never got a solid quote from the internist for the skin test. I ended up going with the blood test because at least they gave me a number over the phone. $450 for the full panel (no option for a partial, but it is apparently regional), not counting barn call, blood drawn by Haymarket and they use ACTT as the lab. Scan of the test results in my inbox within a few days, ordered the serum (it has been less than a week so still waiting for that). Test results seemed to line up surprisingly well with what I’ve observed, he seems to be allergic to very specific things but enough variety between them to give him problems most of the warmer months.

The interesting ones were beets (I’d been considering giving him beet pulp, so that’s a NOPE) and fire ants (I was ready to quibble over this, they’re not common here no matter what the fact sheet says, but it was one out of sixteen so I just gave in).

150 is border line, 175 is significant (recommend treatment), 200 is positive, and 400 is “strong positive”. I’m posting the actual results separately as I’m pretty sure my phone will mangle it.

#4

Here are the full results.

Category Allergen Score
Weeds English Plantain 210
Weeds Nettle 207
Weeds Cocklebur 201
Weeds Mustard Pollen 174
Weeds Alfalfa Pollen 172
Weeds Dandelion 171
Weeds Pigweed 168
Weeds Ragweed Mix 166
Weeds Dock Mix/Sheep Sorrel 158
Weeds Kochia 157
Weeds Marsh Elder, rough/true 156
Weeds Russian Thistle 156
Weeds Lambsquarters 147
Weeds Mugwort, Common 134
Weeds Goldenrod 131
Weeds Clover 128
Tree Privet/Olive Mix 193
Tree Oak Mix 180
Tree Birch Mix 166
Tree Box Elder/Maple Mix 165
Tree Sycamore 162
Tree Cedar Mix (Juniper) 161
Tree Walnut, Black 161
Tree Pecan/Hicory Mix 154
Tree Elm Mix 149
Tree Pine Mix 146
Tree Willow, Black 143
Tree Mulberry 142
Tree Cottonwood 141
Tree Alder 140
Tree Hazelnut Pollen 133
Tree Ash Mix 118
Other Mouse Epithelia 191
Other D. farinae 175
Other D. pteronyssinus 175
Other Pyrethrum 171
Other Cat Epithelia 160
Other Grain Mill Dust 154
Other Sheep Epithelia (Wool) 144
Molds Grass Smut Mix 206
Molds Aspergillus fumigatus 161
Molds Rhizopus nigricans 157
Molds Epicoccum 154
Molds Penicillium Mix 150
Molds Cephalosporium 147
Molds Botrytis cinera 140
Molds Aspergillus Mix 132
Molds Cladosporium 132
Molds Mucor 125
Molds Candida 123
Molds Alternaria tenuis 100
Insects Horse Fly 387
Insects Culicoides 216
Insects Deer Fly 206
Insects Blomia/Lepido Mix 199
Insects Ant, Fire 190
Insects Acarus siro 176
Insects Cockroach Mix 172
Insects Hornet, Wasp 169
Insects T. putrescentiae 165
Insects Mosqiuto 157
Insects Caddisfly 154
Insects House Fly 146
Insects Ant, Black 119
Grass Timothy Grass 185
Grass Bahia Grass 169
Grass Johnson Grass 166
Grass Bluegrass (Junegrass) 159
Grass Rye/Fescue Mix 154
Grass Bermuda Grass 146
Grass Orchard Grass 143
Food Beets 210
Food Barley 173
Food Rice 164
Food Apple 154
Food Corn 154
Food Carrot 148
Food Oats 142
Food Soy Beans 123
Food Wheat 114

#5

I just had mine done by Clarke Equine, 648 for overnight stay, intradermal allergy serum testing, farm call for first dose and for all his immunotherapy vials. We tested 30 allergens and it was well worth it! I contacted Morven and was not impressed as they only offered blood test and expected the horse to be off any steroids for 8-10 weeks…not realistic and also produces a less accurate list of allergens.

#6

[QUOTE=egrubbs;8869425]
I just had mine done by Clarke Equine, 648 for overnight stay, intradermal allergy serum testing, farm call for first dose and for all his immunotherapy vials. We tested 30 allergens and it was well worth it! I contacted Morven and was not impressed as they only offered blood test and expected the horse to be off any steroids for 8-10 weeks…not realistic and also produces a less accurate list of allergens.[/QUOTE]

Interesting, their website doesn’t even mention that they offer this! I’m playing with the idea for my 3-year-old so that’s good to know.

Long Green advertises equine intradermal testing for $295 plus an $85/hr travel fee to your barn/vet’s. There is also a first appointment fee of $180.

Gamma: That’s a ton of information they gave you! What do you do with it all? Other than the feed allergies, some of those environmental factors are very hard to control. Will you be giving allergy shots?

#7

I am planning to start the shots, I ordered them so just waiting for them to come in.

I think knowing what I’m up against is really helpful. The plantain all blooms at once so we can be really diligent about mowing right before it bloom, or even mowing twice to catch stragglers. Oak is everywhere here so that’s hard, but we can increase his ventipulmin as soon as it starts and we know to try tapering off after it ends. (Knowing when to taper off has been a struggle before now.) Grass smut is going to be a really hard one, it seems like a fall thing so hopefully by next year the shots will kick in.

He already gets a lot of fly control stuff which makes a big difference for the insect allergies. Only has the sweet itch if a poorly timed rain storm washes the Equispot off right after I apply it, but maybe the shots will help there, too… It would be nice to do Equispot every three weeks for ticks instead of every two for gnats.

#8

OK, so it’s been about 9 months since starting the shots. We also at the same time made some other changes, big thing was switching from timothy to alfalfa since timothy pollen is one of his sensitivities (he doesn’t get that much hay, though, only in the winter time). Also added vitamin e and MSM for a while, but they seemed to have no effect so stopped when I ran out and no real changes from stopping, either.

So far I finished the first set of vials (building up to full strength) and a good way through the second set (full strength for almost every shot). The shots are not difficult to give (especially now that he’s in summer coat, it was a bit harder in the winter). He’s not really a fan of them, but he gets that they are not optional and puts up with it. He’s never had a particular reaction, maybe a little itchy spot like a fly bite but since he is very dramatic about even mild itches I don’t worry about it too much.

At first there wasn’t much change, the first vials start off with a very low dose. I also have a human pincushion around who has done allergy shots before (and is doing them again, when he can get to the doctor’s office during their open hours–benefit of the horse, you just go out and stab him on your own schedule). Anyway, bf says the effects build up pretty slowly and it can take 3-5 YEARS to reach maximum effectiveness for humans. (On the other hand, with his previous medicine he was requiring a stronger dose every year just to achieve the same results, so the idea that continuing to use the shots over time can actually “cure” the allergies is nice!)

We left him on the ventipulmin until we ran out sometime in late January/early February. Previous winter we tried stopping the ventipulmin since he’s usually much better in the winter, but had to start it again since he was still coughing/wheezing too much. With the shots we were able to stop the ventipulmin and he was fine (and it was a mild winter, with a lot of stuff still growing).

Vet came at the end of February for spring vacs and listened to his breathing and it wasn’t perfect but was improved compared to the same time last year (when he was on the ventipulmin). So shots+alfalfa are at least replacing the ventipulmin over the winter, and the shots are comparably priced (works out to about 80-90$ per month for either shots or ventipulmin) and the alfalfa is better for him for a bunch of reasons anyway.

I did add an antihistamine (CostCo “compare to Zyrtec”) around mid-March. With the antihistamine his breathing is pretty much perfect. I took him off it recently for a week trial and breathing was back to “just OK”–but comparable to ventipulmin only. I like perfect so he’s staying on antihistamines for a while. I think I’ll be able to take him off it sometime in the fall and maybe leave him off entirely next year.

On top of the breathing, I can maybe see some other benefits from the current medicines. Eye goop seems to be less, and overall itchiness maybe slightly less (but, still itchy, all over). He hasn’t had any bad reactions to gnats this year (yet) but it’s a bit early to get excited about that. Have been using Equispot about every 3 weeks.

The other weird thing was that he started shedding out much, much earlier. Usually when the vet comes in February he hasn’t even started–they have tested for Cushings several times and now have a note specifically about him being a late shedder (who does shed fully once he gets going)…but this year he had already blown out a good portion of coat, when our neighbor’s horses were just starting. Last year he finished spring shedding right at the solstice, this year he finished weeks and weeks before. On the other hand, the summer shed this year seems to be lasting fur-ev-er, not that he’s not shedding out, but he seems to keep finding more fur to drop. Anyway, the vet was happy to see him shedding on time/early.

Otherwise, well, he is 30, seems pretty happy and spry, and finds new ways to torment me all the time.

2 Likes
#9

Fall update. Kept up with the antihistimines full time since his breathing is SO GOOD with them. I took him off for a week at one point and breathing was OK, but not SO GOOD. Took him off for another week before his fall vet visit, since I wanted the vet to hear him at “worst”. Vet agrees with me that it is a definite improvement over where he was same time last year, when she listened to him while he was ON his old meds, so that is awesome!

He did have one major “legs being chewed on by insects and getting oozy and gross and needing the whole arsenal applied to them” disaster, but it’s hard to compare to anything since our gnat/fly seasons are so inconsistent, so that is worse than some years and better than others and who knows. Improvement in fly allergies was only on my “nice to have”, not mandatory list, I don’t mind keeping him in EquiSpot as long as his breathing is better.

The other big thing… So, over the past few years, my horse has slowly had trouble keeping on weight. Basically every year, we add a little more “grain” (textured senior feed), and then the next year there are just too many ribs, so we add a little more grain… It’s not even like he’s getting a crazy amount, but he was such an easy keeper when he was young so he started with only a token amount of grain and worked up to what a normal horse would get. Up until now I basically decided that it was a sign of aging, maybe his digestion is a little less efficient, maybe his chewing is less efficient (teeth are OK, but he is 30), maybe he is just eating less grass… Coat always shiny, always has plenty of energy, no real problems eating, good appetite, does dribble a little grain, but over his bucket where he just eats it again (I have known sloppy eaters with perfect teeth who wasted more than he does), no problems chowing down grass if he is hand grazed. And adding a half pound or so of grain has always made the ribs go away.

Yeah, so this year he started packing on the fat again. I like to have a couple ribs on the surface, he doesn’t need extra weight on his arthritic joints, and now you have trouble even finding them with poking. It is also now one more thing on my vet’s checklist of “he MUST have Cushings”. I have the normal blood panel done anyway, because of daily NSAID (Rimadyl/Novox), so let them draw some extra blood, if anything came back abnormal on the normal blood panel then we could use it to test directly for Cushings (for the 4th time). Nothing abnormal at all on the plain blood panel, so skipped the Cushings test. And honestly, he doesn’t look like he is putting on fat weirdly… He is basically the same couch-shape as he was if he gained weight in his younger days, with maybe a little sway to the back. He just looks like he needs less grain now.

So I was doing some internet doctoring, and Ventipulmin/Clenbuterol is popular with some people for…wait for it…losing weight. (Summary: he has been on Clenbuterol or Albuterol for something like 10 years continuously, low dosage, for his breathing, but finally came off it over the winter when the allergy shots were helping and I switched to antihistimine instead.)

(And, it can possibly also raise ACTH maybe possibly causing…wait for it again…not shedding.)

So, pony is getting his grain trimmed back slightly, and we will see what happens with the combination of that and winter, and maybe cut back again in the spring.

#10

Canadian subsidized medical care for horses would be false lol! We are as poor as every other horse owner.

Following because I’m trying to get personal information on allergies too.

#11

Spring update a little late…

He had a relatively small (and yet expensive) corenal ulcer (unrelated to anything, pasture accident of some kind) back in the fall. Banamine, topical antibiotic, topical anti fungal, and soothing eye wash. Vet said it was fine to give him anti-histimines and his allergy shots with all of that on his normal schedule (although he did go off of his Rimadyl because he was getting Banamine).

Went off anti-histimines over the winter, before Thanksgiving, all the way through the end of February. Breathing was fairly good during this time, but towards mid February it was clearly getting scratchy again, but I left him off so the vet could hear his breathing during spring shots. The vet said his breathing then, with no anti-histimines or anything, was an improvement over what it was before he started the allergy shots when he was getting ventipulmin, so that’s fantastic! After going back on anti-histimines it’s back to pretty much perfect. Definitely got a questioning look at CostCo checkout when I bought 9 “one year supply” bottles of CostCo brand “compare to Zyrtec” a-h (at least the price was reasonable, not tooooo heart stopping).

Only other detail is the first allergy shot I gave him after he stopped a-h, he got a nice big itchy reaction…so after that I gave him 5 “compare to Zyrtec” when I gave him his shots, which eliminated any visible reaction (still a little bit itchy on his neck/shoulders, but he really is itchy all over so it’s hard to say if it’s more or less)…

He also had a big hematoma from a tick bite, after he was back on the a-h, so nothing is doing anything for that allergy, but since I don’t want ticks anywhere near him and use topical repellent for that during the season, I’m not too bothered.

Otherwise allergy shots still on a steady every two weeks schedule (with ramp ups every time we get new vials). Not sure what set of vials we’re even on any more, but lots.

Giving the allergy shots with winter fur was not the most fun… If anyone has any tips…

Shedding started even earlier this year, he started having the first few hairs loose right at the solstice, and was in full on buckets-of-fur by early February. Actually we had a warm February, so he was probably happier just then, but then March was miserably colder than normal and they’re whispering the s-n-o-w word for this weekend, so he may be having second thoughts… Anyway, I think the ventipulmin was 100% responsible for the change in shedding.

Weight is still a little heavier than I would like ideally, but not terrible. Don’t want to start dieting him yet with it still unpredictably cold. Definitely in his old age he doesn’t go out and exercise himself as much, more content to just sit around the barn and hoover up alfalfa (although he started getting a little sassy towards me, so I’ve been working him rather more than I was in the fall, and he’s been enjoying it and digging in, so that’s another yay!).

Still on straight alfalfa during the winter for hay, since the only other thing really available here is Timothy which is one of his allergies. His spring bloodwork came back with high calcium, which I hope is just a result of this plus Triple Crown Senior (which is also high calcium). I’m going to start a separate thread about that. Otherwise bloodwork normal, if anything tending towards the middle of values that had been slightly low or high. Grass trying to come in, if it ever stops having cold spells, and once it’s really in the hay will go away anyway.

1 Like
#12

Gamma,

I really appreciate your detailed posts. They contain so much information. How many of the Costo “Zyrtec” do you give on a daily basis? Like your horse, mine is on allergy shots and her breathing is greatly improved, though not yet perfect. I’m thinking antihistamines might be good for her.

Thanks.

#13

He gets 10 of the 10mg pills (normal size pills) per day, this was the dose recommended by my vet. Elsewhere I have read that it should be about 10mg per 100lbs of horse, which is fairly close to the same dosage, but definitely check if your horse is particularly small or large.

His gets split up into two feedings (am & pm), 5 pills fit into a piece of fig bar and drop it in his food or feed by hand–no problems eating it.

It works out to about 40 cents/day for the pills, and 20 cents/day for the fig bars I like best, at CostCo prices.

Btw, glad someone likes my wall-of-text posts. :slight_smile: I like to write everything down because my memory is terrible, so I can come back to this and remember what happened when!

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