Ventipulmin? Other treatments for heaves flare?

[Amy3996]

My horse is a bit of a hot mess right now, so please bear with me. One week of stall rest after he gashed his coronary band on Jan 25th turned into 3 weeks because he busted the staples. He’s back on small paddock turnout now and we started riding again a couple of days ago. I’ve noticed since we started riding again that the coughing from his heaves has escalated. Prior to his injury it was well-controlled with minimal intervention. Now he can barely manage a few strides of trot without coughing almost constantly.

His symptoms were bad in the summer, managed with night turnout and a taper course of dexamethasone. My best guess is that the extended stall rest over the last few weeks triggered a flare. He was in at night and outside during the day prior to his injury, and that along with feeding his hay in a PortaGrazer to contain the dust and keep him from burying his nose in it had been enough to manage what the vet described as a “mild” case of heaves.

The vet gave me a bottle of dex to keep on hand, so i gave him four pills tonight (the same as his first day of the taper course over the summer), and started him back on generic Zyrtec. I’m going to call the vet in the morning to talk things over with her, but in the meantime…

What medications/ OTC supplements/ products have helped if you’ve had a horse with heaves? Ventipulmin? HorseTech Respire? Something else?

I tried SmartBreathe Ultra, Air Power, Cough-Free, and Anihist this past summer with no real improvement.

[2DogsFarm]

None of the OTC remedies helped my horse when he developed SAD with rales I could hear without a stethoscope along with the beginnings of a heave-line.
Coughing worsened with exertion/riding.

A 3mo course of Ventipulmin(Clenbuterol) cleared him up so well that prescribing vet told me he would never have guessed it was the same horse.

Caveat:
In my case, it turned out to be sensitivity to the corncob bedding I had switched to around 6mos prior.
Google told me dairy cattle bedded on the stuff sometimes developed respiratory problems from bacteria in the cobs.
In that first month of treatment I switched back to shavings.
My other horse was never bothered & both were turned out 24/7 with access to stalls.

[Amy3996]

@2DogsFarm

A 3mo course of Ventipulmin(Clenbuterol) cleared him up so well that prescribing vet told me he would never have guessed it was the same horse.

Thank you! How often did you dose with the Ventipulmin over the 3 months, and what dosage?

[2DogsFarm]

@Amy3996

Thank you! How often did you dose with the Ventipulmin over the 3 months, and what dosage?

This was over 10yrs ago.
I wish I could answer you truthfully, but as best I recall I dosed twice a day & syringe was not large - maybe 30cc? - and not filled all the way.
IIRC, I dosed for a month, then had him off for a week (or more?) & when symptoms reoccurred he went back on for another month.
Wash, Rinse, Repeat & 3rd month - along with replacing bedding - was the charm.
Sorry.

[CanteringCarrot]

I have a horse with IAD/allergies and management is important. I do not feed any dry hay, especially if he is having a flare up of sorts. His bedding is dust free, and he has 24/7 paddock access off of his stall.

If I don’t keep him in that set up, any other treatment is useless as it just puts a bandaid on the issue.

If he still has problems (dust, pollen, whatever in the air) then I treat him. For 2-3 weeks with a brochodilator and steroid via nebulizer (Flexineb). Feed through stuff works ok, but I feel that the nebulizer delivers the medication more directly. It’s also safer to administer Dex via inhalation due to a decreased risk of laminitis. Horse is of the type/easy keeper status that could be more prone to laminitis.

Then I give him an herbal syrup to soothe the airway. So for me, there are 3 points; open the airway, reduce inflammation, and soothe irritation. This combination works for him and usually a 2-3 week treatment. It can vary as I cannot control pollen, dust when the weather is dry, or some other weather factors. I’ve considered Zyrtec as we do have it here, but have not tried it.

I think if you slowly increase exercise, that will help as fitness is usually beneficial to heaves horses.

If inhalation treatments are not possible, I’d go for the same effect (reduce inflammation and open airways) via feed through. I am not familiar with other supplements available in America, so I cannot comment on that. I also feed MSM, I don’t know if it does anything, but it’s cheap enough.

[TMares]

Wet hay, no dry hay.

[Foxglove]

My fellow with heaves was given Prednosone twice a month for three months --Ventipulmin as needed before riding --recommended 3 hours before exertion and as needed during (never did need it during). He was able to continue as a first flight fox hunter . However, no cause for his sudden onset of heaves was ever discovered. After a year he was completely symptom free despite being told by two vets “he’d never be any better, the damage was done [to his lungs].” In the meantime I bought a second fox hunter. So weather it was the treatment, the interval, or the lighter work load —my incurable fellow is now 100% sound. He was 19 when he got the sudden onset of heaves --he’s now 21. He has 24/7 turn out but always has. I use sand bedding (dust free) and wet my hay when I haul him. If I remember.

[enterata]

I had wonderful results with Smartpak’s Spirulina pellets.

[spacehorse]

I have my heavey horse on spirulina, jiaogulan, msm, flax, and a varying amount of zyrtec (right now he is just on 6 tabs 2x day since it is winter). I still have no idea what triggered him, but it started over the summer. We did a steroid course and ventipulmin. I soak hay, changed over to shavings and his stall is on the end so he gets lots of air flow. Curious to see what happens once spring rolls around…

[RedHorses]

Do you have a stethoscope? And do you/have you listened to his lungs?

If this trouble started after the stall rest I would be concerned about potential mucus build up. He may need an expectorant along with a bronchodialator to clear things up.

My horse had two bad flare ups last fall one of which had the vet concerned about pneumonia (I caught it early enough). That one required Ventipulmin and Sputolysin along with his regular antihistamines. The second cleared with Ventipulmin and antihistamines (caught earlier and was from hay which was changed).

I started taking pulse rate last summer using my stethoscope and that naturally extended into listening to his lungs. I was already checking respiration rate every day (multiple times). I learned what his lungs sounded like during allergy season, before exercise, after exercise, after returning to resting rate, when on Ventipulmin, when mucus-y, when constricted, and so on. This obsession is what caught the pre pneumonia flare up.

After last summer and fall’s flare ups I have a vet prescribed Ventipulmin treatment plan for use in flare ups and know when I need to have a vet listen to him.

​​​​​​The late fall, hay induced flare up had Ventipulmin for 14 days at 16cc 2Xday, then 7 days at 8cc 2Xday, then 7 days at 8cc once a day. This tapering dosage is typical for Ventipulmin use.

Please consult your vet and listen to your horse’s lungs before messing with Ventipulmin on your own.

For daily support I use Omega Alpha’s RespiFree. It helps loosen the mucus and with exercise helps him clear his upper airways. Depending on various factors I give him 30-60cc a day. In the summer heat it’s 45cc every morning with his antihistamines. He may get another 30–45cc before I ride. The bottle says you can give 30-90cc up to 3Xday.

I also use exercise to help him breathe easier - especially in the summer heat. I have gotten his resting breath rate from 32/min down to 18/min with exercise alone.

[AKB]

We did a couple of days of dexamethasone and occasional Ventipulmin, as needed. Our guy was very hay allergic, so Dengie helped a lot.

[Palm_Beach]

@Amy3996 - you will probably have to do a combo of drugs and environmental modification. Whatever in the environment that triggered him is still triggering him, and you need to remove it so that the drugs can give him some relief. He probably has some significant inflammation, and coughing exacerbates it. Leave him turned out, and rinse his hay good to get rid of any dust. Being out of the barn will help a lot. You may have to stop riding until the coughing is under control and the inflammation goes away. Otherwise you may just get stuck in a cycle of coughing/inflammation/more coughing/more inflammation.

[Amy3996]

Thank you, everyone! We’ve seen a significant improvement in just a couple of days on the Dex and Zyrtec. Vet wants to give it a week or so before we consider other treatments, since he’s not coughing at rest and it’s been markedly reduced under saddle with the meds. Fingers crossed that he continues to improve!

Thanks, @Palm Beach We’ll definitely be rinsing his hay. Unfortunately, the injury is not completely healed yet so extended or 24/7 turnout isn’t really an option currently. It’s also a last-resort otherwise, because this horse absolutely will not tolerate it. We’ve tried the whole tough-love “leave him out and let him figure it out” approach for upwards of a month and he was miserable. It didn’t matter if we turned him out with friends, individually but with other horses in adjacent fields. Fed him outside. No dice. Even my vet agreed that despite 24/7 turnout being “best practice” for heaves horses, it just wasn’t worth the stress it caused him.

Out during the day/in at night during the winter or in during the day/out at night during the summer is the best we can do for now. Obviously if his symptoms become unmanageable we’ll have to figure something else out. Immediately prior to the injury and stall rest he was nearly symptom-free, so hopefully if we can get him over this flare, we’ll be back on track.

[Laurierace]

@2DogsFarm

This was over 10yrs ago.
I wish I could answer you truthfully, but as best I recall I dosed twice a day & syringe was not large - maybe 30cc? - and not filled all the way.
IIRC, I dosed for a month, then had him off for a week (or more?) & when symptoms reoccurred he went back on for another month.
Wash, Rinse, Repeat & 3rd month - along with replacing bedding - was the charm.
Sorry.

30ccs is a massive amount. The normal dose is usually 5-10ccs

[Gamma]

I’ve written at length about my horse’s allergies, allergy testing, and allergy shots (and he was previously on ventipulmin and before that albuterol for like 10 years)… https://www.chronofhorse.com/forum/forum/discussion-forums/horse-care/322054-intradermal-allergy-testing-northern-virginia-nearby-east-coast-cost-where

Once you’ve got a strong suspicion of allergies (which it sounds like you already have), I highly recommend getting the allergy testing done. The blood test is reasonably priced for horse care, and you can decide what other management steps to take based on the results…either focus on just a management strategy with removing triggers, adding antihistamines during certain times, or the allergy shots, or combination of all of the above.

There’s also an inhaler mask, my neighbor uses it on her horse and really likes it.

(By the way, ventipulmin/clenbuterol has an effect on the metabolism…my horse was on a very low dose for a long, long time with no serious problems, but he did suddenly gain a ton of weight when he went off of it.)

[2DogsFarm]

@Laurierace

30ccs is a massive amount. The normal dose is usually 5-10ccs

Blame my feeble, aging memory.
As best I recall syringe size was ~30cc or thereabouts.
Like I said, it was nowhere near full, just easier for me to dose from a larger syringe.
Lucky for me, horse was very cooperative with getting dosed.
Him: 17h+
Me: 5’4"
If he’d wanted to avoid it…

[Buglet]

My show hunter had severe heaves. Had to basically stop riding for a while. We treated with dex and ventipulmin initially to get it under control. Now we just manage his environment as much as possible and he hasn’t had to have any meds in a year. He only gets dust free bagged shavings. He gets steamed hay which he eats off the ground. His stall is the closest to the barn door to allow for extra air flow. The hay steamer was expensive but I noticed a huge difference in steamed hay versus soaked/wet hay.

[PaddockWood]

How are you all keeping your hay wet that is fed outdoors? My mare had her first heaves attack (BAD) on Dec 7th and I can’t get her off the drugs (Dex and Ventipulmin). They hay dries out that is fed outside when they are out all day and the grass is dead. She’s been moved to an outdoor stall and the hay fed at night is soaked and stays wet until eaten. Very worried about not being able to get her off the drugs. Would buy a steamer but barn owner isn’t keen on steamer.

[CanteringCarrot]

@PaddockWood

How are you all keeping your hay wet that is fed outdoors? My mare had her first heaves attack (BAD) on Dec 7th and I can’t get her off the drugs (Dex and Ventipulmin). They hay dries out that is fed outside when they are out all day and the grass is dead. She’s been moved to an outdoor stall and the hay fed at night is soaked and stays wet until eaten. Very worried about not being able to get her off the drugs. Would buy a steamer but barn owner isn’t keen on steamer.

My guys hay normally stays wet or he gets Haylage and that works fine for him too, but I know that’s not really fed in America IME. However, I did see someone at another stable get a large water trough and fill it with soaked hay with some water still in the trough. Her horse seemed to eat this fine.

Why isn’t the BO keen on a steamer?

[PaddockWood]

The outdoor hay isn’t being soaked, nor can we go the steaming route because there are two other horses turned out with her and the BO feels it will all be too heavy - she has a bad back. And I know that until all hay is soaked/steamed that we’re not doing all we can. It’s a bummer. They’ll come off the hay outside all together in a month or so when the grass kicks in. Meeting with vet soon. Possible I need to move her to another barn.