Managing heaves/asthma--sudden onset

[stb]

I have a 13 year old gelding that was diagnosed with equine asthma last August. He also has reactions to bug bites (gets granulomatous lesions that last forever). He was initially treated with Dex and Clebuteral but steroids scare me, so I am working really hard to figure out a better way to handle things this year. I live in the Southeast, so heat and humidity are my enemies.

Here is what I have figured out so far:

1. Staying entirely out of the barn gives dramatic relief. Even coming in for a short time seems to flare his symptoms - I suspect it is dust and mold. I have moved him to a run in shed in my dry lot. The shed has no bedding - just rubber mats. This probably makes the biggest difference of anything I have done. This horse doesn’t even really like a barn, so he just tended to eat inside and stay out the rest of the time, but even a little bit of barn exposure sets him back.

2. Wetting hay definitely makes a difference. However, hay sours quickly in the hot summer months, so this is difficult. I have ordered him a hay steamer and am waiting impatiently for delivery. If you are considering one you should know that wait times are very long right now and you have to pay in advance - both of which are painful. I ordered mine on December 17 and I may get it in April. Fingers crossed.

3. I use an antihistamine for all but the winter months. Currently on Hydroxyzine. Have also used Zyrtec. I can’t tell much difference between the two and I don’t see a huge difference with either, but it’s a reasonable first step and one that I feel should be continued.

4. I am using a DHA supplement, both for his lungs and his reactive skin.

5. Last year I let the grass get too long at the end of the summer. My vet has cautioned me about keeping grass on the shorter side so that my horse isn’t burying his nose in it and also so that it doesn’t seed out. I have bahia grass and my horse tested mildly positive to bahia grass on serum allergy tests.

Recently my horse had a big flare. My husband gave me a new barn aisle for my Christmas present. My old aisle was rubber mats over dirt (was like this when we bought the place). The dirt in the aisle had to be excavated to place the gravel bed for the pavers. I let my gelding in to eat his supper in the evening after the excavation took place and all work was finished for the day. Big mistake. In retrospect I suspect there was lots of mold in the dirt under the mats. The next morning he was in bad shape. So, no more barn time for him AT ALL.

Tomorrow I am starting a 21 day hindgut health program from Stride Animal Health. I am usually skeptical of supplements but have had this program recommended to me from a couple of different sources. I am going to give it a try. I also plan to use the Aservo inhaler if needed during the coming season. I will probably also not even try to ride in July and August (actually this doesn’t hurt my feelings much because I don’t enjoy riding at that time of year anyway). No point in stressing him more than needed during the hottest months of the year.

Sorry for the novel, and I’m sorry that you and your horse are dealing with this. It’s a beast to manage. I hope some of this is helpful. I have been researching everything I possibly can in an attempt to manage symptoms and stay away from steroid treatments.

[blob99]

@stb thank you for the novel! I’m trying to learn as much as I can about what has worked for others. I too am in the southeast, which is certainly not the easiest climate for this.

[RedHorses]

I use exercise, antihistamines (hydroxyzine), RespiFree, and hay in small hole nets as base heaves management. Oh - I suppose living out full time should be mentioned. It’s not heaves management as such though, just how I like to keep my horses, and for this one it’s also PSSM management. Ventipulmin is my emergency drug.

Exercise is by far the best tool I have. I found RespiFree helps loosen/thin the mucus in his sinuses but add exercise and then get his nose to the ground and it’s draining like crazy. Antihistamines help limit the mucus build up in the summer allergy season.

Exercise naturally triggers the dialation of the airways, as well as getting mucus moving and the effects last. I discovered this entirely by accident (because PSSM requires regular exercise) and rely on exercise to keep my horse’s breathing in reasonable territory. It is hard to ride when he’s wheezing, but I have seen the positive results so many times now I can make myself do it - even if I’m apologizing to him constantly.

Exercise is not a “regular schooling” but is as much physical effort as he is capable of doing. The limit increases during the ride and I let him tell me how he’s doing, and sometimes have to slow him down when he’s thinking he can go faster than he can breathe. I stay out of dusty rings and do most of the breathing rides on the trails.

While many vets recommend exercise as part of heaves management it is with the idea of getting/keeping the horse as fit as possible so that everyday activity requires less effort. I have discussed my experience with exercise as heaves management with quite a few vets (between scribing duties at endurance rides) and all were surprised at how effective it’s been as a direct “bad breathing day” treatment. I’m not just imagining things - I have been tracking my horse’s breaths per minute before exercise, immediately following, post recovery, and 8-12 hours later. Most of the time the breath rate 8-12 hours later is still lower than the pre ride rate.

It should be obvious that just as heaves has many causes and many treatment options the sort of exercise I use may not be effective for every horse with heaves. But it is an option so often overlooked because we see our horse struggling to breathe and we don’t want to add to their strain.

[blob99]

@RedHorses that’s interesting about the exercise. My horse was in very consistent and fairly heavy work until this suddenly started. I haven’t been riding her now, because one trot circle has her huffing and puffing.

She started all this in very good shape, but now has had about 3 weeks off. Should I still be riding her or should I wait for this flare to go down? She’s still struggling at rest… Even with the dex

[RedHorses]

You can try it. Each year I figure out what my horse’s base respiration rate is during his heaves season. Normal rate for horses is 8-10/minute. My horse in season is usually around 18. If his rate goes higher then I know he needs the exercise. If his body has a jerk at the end of the in or out breath then he needs the exercise. If I hear a wheeze at his nostrils, or from any distance, he needs the exercise. If his breathing is shallow he needs the exercise. I use my stethoscope to monitor lung sounds - groans, wheezes, squeaks and crackles mean exercise.

This degree of breathing impairment does affect how much work he can do. We start with walk. At my last barn we had several short trail sections with decent slopes and I used them to increase demand without going to trot. When we do trot it’s very short distances determined by how he feels. Little trots interspersed with walking until he gets his breath back.

Those little trots get longer and we may try a short canter if he’s willing. I ask him “Would you like to canter?” and he will say “Yes! Faster!” or “Yes!” or “Okay” or “Not really” - you need to be paying careful attention to your horse to pick up on their capabilities in that moment. I want to slow down before he gets into anaerobic exercise, before the lack of oxygen makes his muscles weaken, before he has a coughing fit (one or two coughs are acceptable and often necessary to help shift mucus).

I don’t ask him to come up into a dressage outline because closing the angle at his throatlatch triggers coughing. I encourage a longer, show hunter type of outline. I also use a hackamore because I read that horses are meant to have sealed mouths for optimum breathing during exertion - this is a case of giving him every possible advantage I can.

Some examples for you:

One day my horse had a breath rate of 32. I took him out for 30-40 min and when we got back his breath rate was 43. I cold hosed, let him have a drink, and some hay cubes. Twenty minutes later his breath rate was 26. Half an hour after that it was 18, and I suddenly realized I had forgotten to give him his medication! THAT is what exercise can do for my horse. And yes, I gave him his meds right away.

Last year was a harder year for allergy induced heaves and there were days I could hear my horse wheezing from several metres away. The walk initially made the wheeze louder, but after a bit it was gone. Trot made the wheeze return - that made it easy to monitor his breathing. I felt like a huge meanie making him go for a ride. Even knowing that it would really help I found it difficult to do.

If you’re going to try exercise, give yourself some hard evidence to monitor its effect. Count your horse’s breaths per minute (count 15 seconds and multiply by 4) before riding, immediately after you get back, and 30-40 minutes later. You can do a count at 15-20 minutes post ride as well if you want. I put the back of my hand on my horse’s flank in front of his stifle find the extreme ends of in and out breaths, then count “one in, one out, two in, two out…” and use a 15s timer on my phone.

I suggest you start by walking for 15-20 minutes (in hand or under saddle). Keep a steady, forward march at the pace your horse can do on that day, in that moment. If you have short slopes/hills available increase the effort required by walking up the slope. Stop and let your horse catch their breath if necessary at any point. Even this short bit of exercise should give you an idea of whether exercise will be helpful. In the first few minutes it might appear to be making things worse, but the stress is needed to trigger the airway dialation. Don’t give up too quickly.

[blob99]

latest dilemma is that the vet can come do the allergy testing this Friday, but that means starting today she needs to be off her zyrtec, dex, cough free, etc.

I’m torn because part of me thinks she needs the dex for now until we can get this further under control to prevent damage and the other part of me thinks the sooner I can get some feedback on triggers the better I can properly address it. It would be a blood allergy test, so also not the most conclusive option.

[GoodTimes]

@ThatBayHorse when you say that the Flexineb made things worse for your horse, can I ask in what way? More coughing? Increased respirations? Were you just using saline? or medications?

I just ordered one and I’m still picking people’s brains about them.

[ThatBayHorse]

It made her cough really wet and much more severe. I had albuterol and a steroid that I was using. She couldn’t get a deep breath. Issues resolved when I stopped. Once I stopped feeding her stuff she was allergic to, it fixed everything. Now I have a barely used flexineb rotting jn my tackroom lol

[GoodTimes]

@ThatBayHorse

It made her cough really wet and much more severe. I had albuterol and a steroid that I was using. She couldn’t get a deep breath. Issues resolved when I stopped. Once I stopped feeding her stuff she was allergic to, it fixed everything. Now I have a barely used flexineb rotting jn my tackroom lol

Interesting, thanks for the feedback.

[blob99]

@ThatBayHorse I bet you could find someone who would gladly buy a used flexineb off of you. I might even be that person!

Just wanted to share the update that we had a couple of better days and i was optimistic that something was finally starting to make a difference, but then had increased breathing again today. Not as bad as before, but not great. She’s on day 5 of consecutive days of dex.

I have gone ahead and ordered the respi-free to see if it makes a difference and I have 2 different vet appointments scheduled–my usual vet to come back out and another vet I’ve used before to get a second opinion on treatment ideas/approaches.

[blob99]

I mentioned this in another thread on apoquel specifically. But I wanted to share it here as well…
But we started my horse on apoquel this past weekend. She’s on day 6 out of 7 for her loading dose period (5 pills daily) and seems to have really turned a corner.

The apoquel is making more of a difference than the dex did in terms of immediate symptoms. It is expensive and I’m not sure how expensive it really will be as I have yet to figure out what her accurate dosing will be. But wanted to share it as an option for folks who are not having a ton of success with dex and/or antihistamines. It is still too early to tell whether the apoquel will be good enough to get her back into proper work. But right now normal breathing at rest is a victory.

[blob99]

Well, we got our allergy tests back. They are blood, not skin because she’s not in a place right now where she can be off meds long enough for a skin test. But figured blood test was likely better than nothing. According to the test she is allergic to pretty much every grass that grows in this part of the country–most severely to bermuda (ugh)–and some weeds (clover, dandelion, and sorrel).

Currently she’s on a very grassy pasture and coastal/bermuda hay, so that has to change, of course. We’re moving barns soon (for unrelated reasons), so am working with new barn manager to find a solution for her. Thankfully the new barn only feeds alfalfa and an alfa/orchard mix, so that should help.

[Wyndwolfe]

Another OTC treatment that worked well for my gelding was Spirulina. He ate the powder, just mixed into his feed, but you can also find it in more palatable wafers. Antihistimines worked, but made him groggy, which he hated.

[blob99]

@Wyndwolfe where did/do you get your Spirulina powder? I’ve used the smartpak version (pellets) but I’m guessing the direct source is probably more affordable and it’s worth trying if my mare will eat the powder!

[Wyndwolfe]

I buy it from Horsetech. You can find it under Basic Ingredients. I

[sascha]

@blob99

where did/do you get your Spirulina powder?

Mad Barn has it. It is not super palatable according to my fussy creature, but she did get used to it once I backed off to a half dose for a few days and then gradually built back up to a full dose.

[GoodTimes]

We had to put my gelding back on dex last week. When we did his allergy testing last year it came back very positive for mould. With the melting snow and rain I suspect there’s mould all over.
The shots do seem to be working for his skin issues though, so that’s a win.

I started him on spirulina and jiaogulan from Madbarn, relatively cheap so worth a try. He also gets EO-3, it has higher EPA/DHA levels than any other Omega 3 supplement that I could find.

We tried out our flexineb for the first time last night. He didn’t mind it. I imagine we’ll always be battling respiratory issues to some degree, he’s only 13 and I don’t ever plan on selling, so it’s nice to have a versatile way of administering different meds.

In a perfect world I would be steaming his hay. But he’s on outdoor board with 4 other horses so it just isn’t possible right now.

[pony_baloney]

Your horse’s issues are much more serious than my pony’s new mild asthma. I’ve been giving him Hilton Herb’s Freeway Gold liquid and in two weeks his cough has disappeared and he’s not winded after just walking. I read many reviews on this supplement and it’s been helpful for horses with more serious symptoms. Just putting this out there if you would like to add something else to your arsenal.

[moonlitoaksranch]

Related question: Shipping a horse with periodic allergies? She’s not in a flare up, so that helps. She going to a boarding stable until I can pick her up in two weeks. I’m planning on giving her Zyrtec daily leading up to shipping and sending Zyrtec and Dex with her, but I really don’t want the Dex to be used unless she gets really bad because of the shipping stress and lowering her immunity.

[blob99]

How long is the trip? I think the biggest thing would be keeping her calm and relaxed so neither heart rate nor respiration has reason to go up.