Managing heaves/asthma--sudden onset

[blob99]

My mare will be 13 this year. I’ve had her since she was 3 and most of that time she’s had summer skin allergies (hives and itching). This has mostly been managed that last few years with a sweet itch blanket that keeps her covered from the offending bugs. But other than hives and itching from bugs she’s never shown any other type of allergic response to anything.

A couple weeks ago she started coughing a couple times at the beginning of my ride. This is unusual for her, but it was 2-3 coughs and that was it. The vet was out for someone else, so I had her take a look. She said lungs sounded normal and so were all vitals. So she suspected it was allergies. Well, since then things have gotten worse. She is now coughing quite a bit and breathing heavily even at rest. We tried zyrtec, first just once a day, and then upped to 10 pill 2x a day (horse is approx. 1100lbs). At first this seemed to make some difference not enough. I was worried about such a prolonged period of difficulty breathing, so we started her on oral dex (5ml every every 4 days for 2 weeks) to get things under control. Her breathing has improved greatly, she is still coughing.

She was allergy tested last year and the vet thinks it’s unlikely that anything has changed dramatically and doesn’t think it’s worth redoing the test. I’ve looked up ways to manage heaves/asthma and a lot of them are already in play–she’s outside most of the time (14 hrs a day), she is fed hay from the ground via a slow feeder, her grain is wet. We also had a stretch of rainy days during this period and that did not improve symptoms like I hoped it might.

I am hoping the dex will at least give some time for her airways to rest and inflammation/irritation to come down/heal. But I am starting to look beyond to how I can manage this over the long term. I’m in the southern US, so for us ‘summer’ is most of the year, so i’m not sure learning this is just seasonal offers much relief. So, curious to hear what others have done/found successful in managing heaves in their horses.

She is a performance horse and ideally I would like to be able to get her back into real work, but of course I am not going to work a horse who is having trouble breathing.

[PaddockWood]

What type of slow feeder? And are you wetting the hay?

[blob99]

The slow feeder fits an entire bale of hay and has a slow feeder net over it. The bale is not actually resting on the ground, but it is ground level.

I was wetting hay for a few days but it did not make much difference, so we didn’t continue as I was afraid the hay in the bale in the slow feeder would get moldy if wet too much.

[TXPiaffe]

We have a mare that was diagnosed with equine asthma (heaves) last year. Right now she is on 10 pills 1 x day of zyrtec, bioflax, and MSM. She seems to be doing pretty well on this combo. The flax is for omega 3 &6 and the MSM helps with inflamation.

[sascha]

FWIW, (probably not much, but maybe something to keep in mind), I struggled for over a year trying to find meds and management that would work for my mare. Inhalers were a disaster with the bronchodilator making her cough and the steroids doing zip. Cetirizine helped the most, but I still spent last summer going nowhere and riding pretty much only at a walk. She had been scoped and lung washed and dynamic scoped, etc. before all that and pronounced “mildly asthmatic.” Basically try some drugs, try some more management changes - the usual.

Then she got actually sick with (more) elevated breathing and a fair bit of snot, a day of fever and no other symptoms - no swellings, not off feed, etc… And we did the $$ swab that’ll make your eyes water just watching how far up that thing goes. It came back somewhat disturbing so we put her on a couple of antibiotics and went 3 rounds before she cleared up. Once she cleared up, her original asthma symptoms gradually disappeared. This past fall she had another snot attack with reduced exercise tolerance so we threw the abx at her again. She is now better than ever (AND I AM KNOCKING ON EVERY PIECE OF WOOD BETWEEN HERE AND TIMBUKTU!) and her exercise tolerance is great.

That said, the hot, humid summer months are not here yet …

[GoodTimes]

What type of allergy testing did you do? Blood or intradermal? Did you try allergy shots?

Is a hay steamer or nebulizer in your budget?

[PaddockWood]

As a mother of a heaves horse, I forgot to say I’m sorry first. This is a frustrating situation that I know all too well. What I’m convinced are my girl’s triggers are decomposed organic material. We did a skin test and she had high marks for several categories too.

You have to go “Columbo” mode and my first idea for you would be to ensure there is NO decomposed organic material in your hay feeder AND to move it away from it’s current site. It’s a way to start the detective work. i.e., does that eliminate her symptoms?

Also, if she’s in a stall for any time, you have to start lifting mats etc and look for mold/organic material
and get it out. Trapped under anything - mats, corners.

Just some ideas.

[blob99]

@sascha oh goodness what a saga. I’m glad you have gotten some resolution! We have not had any snot yet, so vet did not think it was an infection, but I guess that could be brewing.

@GoodTimes it was a blood test. We have not tried allergy shots. Current vet is not really a believer in them. But I would be willing to try for sure. I’m not sure a hay steamer is practical in my boarding situation. But I could spring for a nebulizer

@PaddockWood thank you, yes. I am moving barns (not because of this but it was already in the plan) in 4 weeks, so that might also change the circumstances. At that new situation, she will be out more or less 24/7.

[PaddockWood]

That’s really good to move. I did that that a few years ago and all symptoms stopped. I have my girl at home now but really good you are doing that. I hope her issues go away just with that move.

[ThatBayHorse]

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. We are back to riding WT and trails and I’m confident i’ll be able to do more when the weather gets cooler.

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.

Did her allergy test results show any food allergies?

[blob99]

@ThatBayHorse

Did her allergy test results show any food allergies?

they did not! but I also know blood testing is not always that conclusive. She has been on the same hay for many years now and there was no new shipment at the onset of these symptoms. I know allergies can kick in over time, but it’s just so sudden. The grasses have started to grow back in more in pasture the last few weeks, so that is more of a change than hay. But she does not seem better necessarily if she’s stalled. Though I haven’t kept her stalled for multiple days to really put it to a harder test.

[erinmeri]

My asthmatic horse is also prone to hives. She does well with really soaked hay… not just rinsed… and living in a shedrow rather than the barn, never being around sweeping aisles, and getting as much turnout as possible (as much as she will tolerate anyways). I got multiple slow feeder nets so one can soak in a clean much tub while the other hangs and no mold will form on the floor. When she has flare ups, she gets the Aservo inhaler, I want to do the skin testing as had read and vet agreed blood testing isn’t as useful, but vet is having trouble getting the antigens right now. She has said she has had a lot of success with the shots and so we will continue to pursue - more for the asthma than for the hives.

Edited - she does well with the Aservo Equihaler. Considering flexineb in future.

[moonlitoaksranch]

I have a horse with allergies as well. She is exposed to an extreme amount dust and mold right now because we live in Florida and she’s dry lotted. We’re moving to the Midwest in a month where she will be on 24/7 turnout in a medium sized paddock. I’m curious if change of location will help (her allergies coincide with early cedar pollen and summer everything, lol). I’m also curious if full turnout will alleviate some of the issues. I have tried minimizing dust in our barn, but it’s a challenge. For those with a run in shed for their allergy horses, what do you use for bedding?

[GoodTimes]

I purchased my now 13 yo gelding as a yearling. Over the years he’s had the odd few days where he coughed a little, or produced some mucous. Nothing alarming. In hind sight it always happened in the fall. Little to no skin issues as a young horse.

Sometime in 2017 he started needing to snort at the beginning of a ride, not coughing, but needed to clear his airway. Due to lack of turnout I moved him and it went away.

During the fall of 2019 and 2020 he developed stubborn scratches that required a couple months of creams and a couple rounds of antibiotics to clear up.

During the fall of 2020 he also started coughing during exercise and at rest. He had several “asthma attack” type flareups that required dex to resolve.

Spring 2021 I took him for intradermal allergy testing. Mildly allergic to some pollens and weeds, very allergic to a couple different molds, sheeps wool, yeast, some flies, and severely reactive to staph bacteria. Started him on allergy shots. We haven’t had any skin issues since starting the immunotherapy. No respiratory flare ups, but still the occasional cough.
Since we do a fair bit of showing I plan on purchasing a flexineb. I’d like to be able to nebulize saline during show season (he’s doesn’t have many symptoms during show season anyway), and then nebulize medications through the remainder of the year when needed.

In a perfect world I would steam his hay, but like the OP he’s boarded most of the time with my trainer and it just isn’t realistic, especially in the winter. Out 24/7 in a herd.

[GoodTimes]

Here’s a picture of the intradermal reading at 30 minutes and at 4 hours.

Here’s a chart for oral allergy syndrome. Since my horse reacted to birch pollen I was advised to avoid feeding apples and carrots during the spring. I also noticed that quite a few “respiratory” supplements contain anise and fennel which are in the chart as well.

And here is a list of common equine allergens and their cross reactions.
Allergens _ Cross Reactions Handout.pdf (920.3 KB)

These were all provided by the veterinary dermatologist who did the intradermal testing and provides the immunotherapy shots.

[blob99]

@GoodTimes wow, thank you for sharing that is all very very helpful.

I have decided to go ahead and get another blood test even if the vet does not think it’ll be much different from last year. But it sounds like the better route to go is the intradermal test. I think i will likely have to go to a specialist/vet university for that.

[GoodTimes]

Yes I had to take my horse to a specialist for it. It took most of the day since they have to wait 4 hours for the second interpretation.

Before testing we couldn’t administer any medications (dex, cetirizine, etc) in the preceding four weeks. And no Omega 3 supplementation for two weeks prior.

I do keep my gelding on a high dose of omega 3’s, I’ve used both the Madbarn and KER EO-3 instead of flax, to get more EPA and DHA. I figure it won’t hurt, and he can show on it.

[candyappy]

My oldest mare has allergy related heaves and we treated it initially with oral Dex, wetting the hay fed at ground level and that seemed to do the trick for her.

In several years she has never had another episode, thankfully. She isn’t stalled so that helps. I do bed the run in but it doesn’t seem to bother her.

She also has allergy related Uveitis flare ups that we treat with both a dose or 2 of oral Dex and eye ointment.

[blob99]

@candyappy that is helpful to know. How long did you have to treat with dex for original flare up and was it daily dex or every few days?

[candyappy]

@blob99

@candyappy that is helpful to know. How long did you have to treat with dex for original flare up and was it daily dex or every few days?

It was 3 weeks from start to finish. 5cc orally daily for 7 days and then 5cc orally every other day to equal 3 weeks total. I eventually stopped wetting the hay as well and have never had to do that again. Once colder temps came nobody wanted to eat wet, frozen hay( they all eat together) .

Can’t say I blame them!