We currently have a pony at university hospital who went in in critical condition 2 days ago and has stabilized.
We’re not sure what caused this particular episode but he was full of mucous and couldn’t catch a breath. He was on prednisolone and clenbuterol which has always worked to keep his breathing issues under control.
We’ve tried all of the supplements but vet has confirmed what we suspected…his case is past supplements.
Next step is inhalers…we tried a nebulizer but he was too critical by that point and the vet has also said nebulizer is not enough.
We are not past putting him down but if there’s a chance he can still have a good life while being on inhalers, we want to try. He is only 14 and a winning pony when his breathing is under control (which it has been up til this week) and he has been showing and winning all season.
This is a new problem to us so looking for info on inhalers…how they work, cost, how to do it and what to expect. Also, anyone who has a severe case like this one…do you also treat with supplements or medications?
I have a pony on beclomethasone inhaler as needed. It works but is pricey. Last time I bought it it was just about $200 per inhaler. There are 120 doses or “puffs” per inhaler and my pony at his worst was getting 6 puffs a day until we got him sorted out. Now that I know the pony well, I can catch the subtle changes in his breathing before the problem escalates and 2 puffs a day hold him until whatever triggers his episode has passed (usually bad air quality and humidity). IDK if it would be an option on not for your guy. Sounds like his condition is more advanced than my pony.
The inhaler itself connects to a chamber with a cup on the end that goes over the ponys nostril and that is how the med is delivered. I believe it is called an Aeohippus chamber.
Please ignore any misspelling and grammatical errors, my hands hurt. Not typing well.
Pony weighs 500 pounds for reference.
Good luck with your pony. I hope that you can find a solution.
ETA: did you do allergy testing to see what his triggers might be?
Cayuse, There is a lower cost beclomethasone inhaler source which I use for my own needs as I have asthma. I don’t know if it would work for your pony, but if you want to check it out, take a look at the offering of a Canadian company called Global Pharmacy Plus. You would need a medical professional to provide the Rx to purchase, but the price is more like $40 rather than $200 for 200 doses. The product goes by the name Qvar/
I would be interested in the experience of anyone here who has used beclomethasone inhalers for their horse/pony. I know the product suppresses the immune system in the respiratory system and I have been worried that this could lead to a significant risk of infection of the gutteral pouch in a horse which could be a very serious problem. Has anyone used such an inhaler for long enough to see if such a problem arises? Do you have any system to watch for such a development?
When not critical, nebulizer may still be useful with 0.9% saline (normal saline) to reduce mucus, or albuterol to open the airways. I personally have not used a nebulizer on my heaves horse due to cost (the Flexineb sounds awesome, but I’ve enough money in meds/supplements/vet bills for this horse before adding $1000 just for equipment). I am going to try to fashion my own nebulizer mask and get a cheap compressor unit for humans and see if it helps.
I do use inhalers. I question the deposition to the airway due to the long, long trachea of the horse (same question with nebulizer), as well as my horse’s shallow, quick breaths that are now pretty standard. But, I have seen her respiratory rate and wheezing decrease when I use albuterol. She is a 1100 lb ish appendix, and gets 10 puffs (though I have given up to 20). I can get three 200 puff inhalers for $35 via ordering from Canadian Pharmacy World. I have also given generic Advair (Seroflo) which is fluticasone 250mcg (steroid) and salmeterol 25mcg (LABA). Fluticasone 220mcg (Flovent) was more expensive. Beclomethasone 80mcg (QVAR) was also more expensive, and now comes as a breath-actuated inhaler, which is great for humans, but useless for horses. We use the Aerohippus for delivery; there are Aerochambers with masks available for cheaper, but I personally prefer the Aerohippus as the mask is easier to seal to the nostril without having to press hard to the face. Seal is important for medication delivery.
If you are using a steroid inhaler, it needs to be used every day (or at minimum, every other day) as it is a maintenance medication. It doesn’t matter if there are symptoms or not, steroids help control and prevent any exacerbations. Unfortunately this is cost prohibitive for me.
My mare had allergy testing and is allergic to pretty much everything, so despite being out of the dust/mold from a barn 24/7, she deals with being out amongst the grass and trees she is also allergic to. The warm humid weather is extremely hard on her. She still eats hay, but I’m going to trial her on hay cubes and no hay when a private turnout becomes available. Biggest thing you can do for horses with respiratory issues is remove sources of dust and mold, aka get out of the barn and stop giving hay. I don’t care how great quality the hay is, every single hay will have some dust or mold. When my mare was taken off round bale hay and placed on higher quality small squares, she improved significantly. Other steps prior to switching to cubes or pellets would be soaking (need to feed wet, basically still in water for this to be effective) or steaming the hay.
Beyond dealing with heaves/COPD/RAO/asthma with this horse for two years, I am also a registered respiratory therapist, which is where my info on medications comes from, I promise I’m not pulling it out of my butt
I’ve used a steroid inhaler on my mare for over 6 months with no related issues. Systemic steroids controlled her condition well, but also immune suppressed her so significantly that she developed a severe skin infection resulting in her losing almost all of her body hair. She only goes on systemic when nothing else is working, now.
The beauty of a steroid inhaler is that you don’t have the systemic effects, it is localized to the lungs. This results in a lower risk of infection. Provided the horse’s general immune system is adequate, inhaled steroids will be very unlikely to cause infection, including guttural pouch.
I have a Flexineb nebulizer for my horse with IAD/allergies. It is so convenient and simple to use. I usually put in Dex, Pulmicort, or Atrovent. I have used a combination of the steroid with the Atrovent (brochodilator) mixed with saline solution to reduce inflammation and open the airways.
That being said about 2-3 months after buying the Flexineb, he no longer uses it. He may have to again next winter when it becomes more dry and dusty here, but even in the spring with the pollen, grasses, dust, and mold he is allergic to, he did really well without the nebulizer. Basically symptom free.
However, I did make management changes. He is in a stall with flax straw (or wood shavings), eats wet hay or haylage, and his stall opens up to a paddock. Since the paddock has good footing, this ensures that he can be out all year. He does go out to the field about 12 hours a day too. He cannot be in an enclosed barn, especially with straw. The hay storage in his barn is away from his stall in another open area. So he is really exposed to minimal dust in his current set up. His neighbor has Heaves, and she is managed the same way and does quite ok without much medical intervention. She was worse when kept in a stall in a more enclosed stable.
I also think that keeping a good level of fitness helps with these horses.
So I’d do the best to make sure he is in a proper environment and give the inhalor or nebulizer with an anti-inflammatory and brochodilator a try. I think it’d be worth it as he isn’t very old and I personally rather give it a shot than not. Of course I don’t want the animal to suffer, but some do ok with proper management. I don’t personally know your pony, so I’m not sure how severe he is or will continue to be. The medication will help, but I cannot stress enough the management in respect to living and feeding.
I’ve not dabbled much in feed through stuffs, I just have my guy on a higher dose of MSM and flax. I’d feed him these things regardless of his respiratory issues though.
I have a really nice young horse who has some pretty bad allergies this time of year, resulting in some respiratory issues. In years past, we’d wet his hay, give him the regular supplements, and kind of just manage through the “bad season.” (In his case, it really just restricted his ability to work under saddle and did not cause the kinds of challenges you are facing.)
This year, on the advice of my new trainer, we tried him on a hay steamer. It has been truly amazing to see how much it has helped him. He never liked wet hay but he loooooooves the steamed hay. The texture is fluffy rather than wet - but it has made a huge difference in his symptoms, which have now pretty much disappeared. He can work normally under saddle again without any of the supplements he previously required and is so much happier. Probably not the total answer for a more symptomatic horse but I’m sharing anyway since it made such a huge difference for mine. Apparently he was really triggered by the (high quality, $$$ hay) he was eating. The steamer removes mold, spores, bacteria and dust and it has been kind of a miracle for us. Good luck.
I have one with breathing issues. My vet prescribed albuterol pills. They work pretty well, I slip one or two under her tongue. Not saying they are the answer for your horse right now, but possibly later, when you hopefully get him past this. The pills are very portable, and handy for those times when a breathing issue catches you off guard.
I wish you and your pony luck. I know how helpless something like this can make a person feel.
