Breathing difficulties

[Sail_away]

So about two weeks after Paddy was back to full fitness from the last injury and was just ready to start competing... his breathing increased dramatically. As in, it’s usually 10-12, and it had jumped to 30. That was almost two weeks ago. We had the vet out on the day it started, he thought it was just gas (the horses had just moved field and the grass was very lush) and to ride him gently. I put him on one of the small paddocks without much grass but he was still breathing fast after a few days and he wasn’t coping with exercise very well - he is pretty fit but was breathing hard and almost blowing after a couple laps of canter in the arena. I’ve never heard him breathe that hard and he has often done long xc sessions and gallops training - so it’s not his fitness. The vets came out a couple more times and now think it’s an odd case of equine asthma; the odd thing being his lungs are completely clear to listen to and there’s no unusual nasal discharge. He’s been on Ventipulmin for almost a week but it doesn’t seem to be making much of a difference, his breathing rate this afternoon was between 27-30ish. The breaths aren’t particularly laboured but they are shallow and uneven.
He is otherwise very cheerful and shows no other signs of distress, he is eating well, not tense or sweaty, and is sound. No digital pulses in his feet, legs and hooves aren’t at all warm. He is on soaked hay and comes in at night, he’s on rubber mats and a thick shavings bed. He’s fed from the ground so no haynet to stuff his nose in either.
He’s having scopes done on Friday, but has anyone experienced something like this? Did it turn out to be asthma or something else? And if it is asthma and he’s not responding to the ventipulmin then where do we go from there? The vet has mentioned steroids but we haven’t spoken in much detail about that.

 

[Pearlsacarolsinger]

We had a mare who needed steroids for her breathing - she had problems with elderflower pollen originally. The vet told us that the risk of laminitis had been found to not be so high as used to be thought. We found that the breathing problem was probably one of her Cushings symptoms. We had the ACTH test a few times and each time it came back 'within normal limits'. Then we had the TRH Stim test, which came back at 8 times the normal limit. We immediately put her onto Prascend and didn't have to use the steroids again. Sadly we didn't manage to keep her until the next pollen season.

 

[Mule]

Mine has recently been diagnosed with copd and the ventipulmin isn't doing much for him either. The next thing for him is getting a sample of the mucus in his lungs to see what's going on in there. From what I understand steroids are good when ventipulmin doesn't do the trick.

He has had steroids before for treatment of what was thought to be a dust allergy. When that became severe it progressed to sinusitis that lead to headshaking. Steroids did the trick for that so hopefully if he's prescribed them now it will do the same again. It's annoying because he lives out and doesn't have hay. Hopefully they will work for you too. It's a right pain isn't it

 

[paddi22]

I had a similar one two weeks ago. did they take bloods or a nasal swab? that might be your best bet.

mine sounded ok when they listened to chest but the nasal probe scope thing spotted the mucus. he went on antibiotics for six days, plus ventepulmin, and he sounds a lot better now.

I've been lashing breathing supplements into his food as well.vet is due back out but I rode him lightly today (as that was when he coughed really) and he didn't cough or have any discharge so he does seem to be headed the right way now.

 

[Sail_away]

Okay thank you everyone - it’s good to here that the steroids have worked for some - I was worried about the laminitis risk too so again it’s helpful to know the risk isn’t very high.
paddi22 they haven’t taken bloods or a nasal swab - I’ll ask them about that when they come on Friday for the scopes. The odd thing is that he’s not had any cough or mucus at any point, perhaps that’s why they didn’t check?

 

[Ownedby4horses]

Do you have any fields of oil seed rape? I had issues with two horses in the UK, one elderly diagnosed with COPD, the other, a mini diagnosed with asthma. Ventipulmin did absolutely nothing apart from drain my bank balance. Ended up with inhalers and used vaseline inside the nostrils for four years (i have allergic asthma and vaseline is thought to catch pollen etc). Anyway, we moved house after 4 years and symptoms disappeared in both equines within 24hrs. We had oil seed rape in fields up to a mile away.

 

[southerncomfort]

As someone with asthma, I have to take antihistamines all spring and summer otherwise all the various types of pollen trigger my symptoms. I forgot to take one yesterday and was coughing and wheezing all day.

Has your vet mentioned if pollen might be the cause or suggested trying antihistamines?

 

[Yeomans]

Hi Lillian, I have a Connemara who developed a cough early in March, went on Dilaterol and oral steriods for 3 weeks. Then scoped him and he was found to have a bacterial infection in his lungs and fungal/spore allergy. So back on Dilaterol and antibiotics for another 2 weeks, no improvement and his breathing is varying from high 30s to early 40s every day. He has his hay soaked, change bedding to Aubioise and is out until 10pm at night. Coughing came back again, scoped again and mucus found in lungs and sample taken again. He now has a secondary infection to the original one and this one is strep zoodemicus so now having invested in a nebuliser he has steriods twice a day and 3 week course of Marbonor antibiotics twice a day as well but still coughing. I am at my wits end with it all as he has taken a dislike to the nebuliser (dont blame him 4 times a day) but only another week to go on the antibiotics. If no change I am going to go to a very well equine vets and get a second opinion. My vet did tell me that the laminitis risk is very small if you use an inhaler.

 

[GoldenWillow]

My cob has equine asthma, his main symptom was running out of energy, breathing wasn't particularly elevated, occasional cough hut no nasal discharge. He had two scopes which were clear and it was diagnosed with a BAL. He has steroids via a nebuliser during the pollen season which seems to be his main trigger although he i kept as dust free as possible he has haylage, bedded on shavings, large open stable and turned out as much as possible. A previous horse also had equine asthma or COPD as it was called then, and she didn't really respond to ventipulmin.

Good luck, I hope you got some answers today.

 

[Sail_away]

Thanks for the help everyone - had the scope today. Excuse me if I get my terminologies muddled... I was very anxious and wasn’t able to listen particularly closely! They managed the tracheal scope okay, there is a small amount of inflammation and the liquid they put in came out cloudy, which the vets have said means there is something going on as in a healthy horse it would be clear. They tried the bronchial lavage (?) but he objected very firmly to that, he wasn’t naughty but he made it quite clear it wasn’t happening. He was completely drenched in sweat by this point so the vets opted to stop there and just use the tracheal scope. We’ll know results on Tuesday hopefully.
In terms of treatment, the next thing is probably steroids, either oral or through an inhaler type thing. The vet is concerned about how we would convince him to comply with the inhaler given his objections today. My mum asked about antihistamines, I wasn't with her at that point, but she said the vet didn’t seem too keen as he’d have to have an awful lot of them every day. I’ll ask next time they come however, and hopefully at that point we’ll have a better idea of what’s causing it.
With regards to the oil seed rape, I’ll ask my yard owner but as far as I know the surrounding fields are just cattle grazing, horse grazing and a couple of hay fields further on. It is a good point however as we moved last autumn so could have something to do with the yard location.

 

[Ownedby4horses]

The inhalers are easy to use, get a baby spacer (a mask for a baby is just big enough to go over one nostril - get it either from your vet or local pharmacy), theres a purple steroid inhaler which you activate or theres a salamol blue inhaler (preventative) which comes in two designs, breath activated or one you activate.

Stand with your back to your horses chest, arm around head, put the inhaler into the mask, gentle put it over one nostril and cover the other nostril with the other hand, if you get an inhaler you activate (you push the top to deliver), I found it is more of a surprise to the horse but you must wait to make sure your horse doesnt hold their breath.

I found the breath activated (blue inhaler) easier as you just hold it there until they take a breath and it doesnt seem to make them jump as it delivers as they breath in.

 

[GoldenWillow]

The trach wash should hopefully give you answers. With regards to steroids, inhaled is the safest way with least risk of side effects. I've used both a babyhaler and a flexineb nebuliser and have found the flexineb to be much better tolerated, easier to use and more effective especially using liquid steroid and saline mix. The problem I've found with the babyhaler is that it uses the puffer inhalers which make a noise when you dispense a dose which can startle the horse, make it jump and then the inhaler pops off the nostril. The flexineb using liquid is silent, I introduced it gradually to him adding each part separately and he's fine with it. My insurance did pay for the nebuliser (NFU).

 

[GoldenWillow]

There is a new inhaler that has recentlybeen approvedfor use, the Aservo equi haler, but I don't know anything about it.

 

[CanteringCarrot]

Inhalers are quite easy to use and most horses take to them quite well.

I have a Flexineb that I really rate. However, I haven't used it in over half a year because I am able to control my horses symptoms and allergy well enough without it. We also scoped and the lavage came back with nothing noteworthy and he just had some inflammation around his larynx.

Since my horse is of the lami prone type, I felt more comfortable with him inhaling the steroids via the Flexineb. Plus, it goes straight to the airway! He's an odd skeptical sort, but has never objected to the nebulizer (used Flexineb and previously borrowed AirOne).

Also did an allergy test to find out what he is allergic to, and that helped. His dust allergy was very, very, high. So damp hay, dust-free bedding (not straw or dusty wood shavings), living outside, and keeping him fit has really helped. He also eats MSM and linseed. He's doing surprisingly very well seeing how dry and dusty it has been here!

So medicate as necessary, but managing the environment as best as you can really is crucial.

 

[shergar]

Check for anaemia as this can also cause shortness of breath .

 

[Sail_away]

Scope results (hopefully) come back tomorrow so fingers crossed!!
It’s reassuring to know that other horses don’t mind the inhaler so thank you all for that.
The inhaler our vet has suggested is the new one - the Aservo equi haler. I’ll need to have a proper chat with the vet about that, I would much prefer an inhaler type as it cuts the time on steroids down massively and of course the reduced laminitis risk. He is a good-doing half ID ISH so would be prone to it.
Shergar yes I’d thought about that - however the scope did show a small amount of inflammation and mucus so the vet thought we were along the right lines with a respiratory issue.
Canteringcarrot can I ask how you did the allergy test/what did it test for? It would be very helpful for us as we’re thinking it’s something pollen-related so knowing the type and season of the allergen would be super useful - would the test be able to identify that sort of thing?

 

[CanteringCarrot]

Scope results (hopefully) come back tomorrow so fingers crossed!!
It’s reassuring to know that other horses don’t mind the inhaler so thank you all for that.
The inhaler our vet has suggested is the new one - the Aservo equi haler. I’ll need to have a proper chat with the vet about that, I would much prefer an inhaler type as it cuts the time on steroids down massively and of course the reduced laminitis risk. He is a good-doing half ID ISH so would be prone to it.
Shergar yes I’d thought about that - however the scope did show a small amount of inflammation and mucus so the vet thought we were along the right lines with a respiratory issue.
Canteringcarrot can I ask how you did the allergy test/what did it test for? It would be very helpful for us as we’re thinking it’s something pollen-related so knowing the type and season of the allergen would be super useful - would the test be able to identify that sort of thing?

There is a blood test (I've heard this is not the most accurate) and a skin test. Your vet can definitely take and send off blood. The skin prick test usually requires a stay at the clinic for close monitoring of the site. It's just like a human allergy test really. They just see what the horse reacts to. Your vet should know the details about both and can perhaps make a recommendation on what to do.

There were many things in the list and he was basically allergic to them all. Trees surprisingly weren't bad. There are a few different grasses and herbs specified that he showed a reaction to.

For some reason, I thought that during the scope/lavage the vet determined that there was no pollen allergy. Or so it said on the report. I can't remember details exactly.

Some vets told me he had no allergy. His lungs sounded fine, but he still had a cough, so they kept thinking he had an infection. Even though antibiotics did nothing. Somehow the vet scoping determined he had some inflammation but couldn't be an allergy. It was a weird time! When I moved to another area I found a vet that believed me and said let's do some testing. I wanted to mail the previous vets the results of the tests ? it was so apparent that he did and God forbid they listen to the owner! It was a strange time!

Anyway, I recommend it so you know what you're dealing with.

 

[Sail_away]

Thank you for taking the time to explain that canteringcarrot, that’s really helpful. I’ll ask our vets when we see them next week.
We got the scope results on Tuesday - except they didn’t get the cell sample needed to determine what type of steroids they would use. So he’s going to liphook on Monday to have the full scope done and we’ll hopefully get some more conclusive results from that. They did say from the results they got that it looks like summer pasture associated equine asthma, which would make sense.

 

[SEL]

Thank you for taking the time to explain that canteringcarrot, that’s really helpful. I’ll ask our vets when we see them next week.
We got the scope results on Tuesday - except they didn’t get the cell sample needed to determine what type of steroids they would use. So he’s going to liphook on Monday to have the full scope done and we’ll hopefully get some more conclusive results from that. They did say from the results they got that it looks like summer pasture associated equine asthma, which would make sense.

I'd really like to know what they find. I have a 13h pony who is struggling with her breathing and piriton and ventapulmin aren't making any difference. Vet can't hear anything on her chest. I guess next option is the scope you had done.

She's a very sweet compliant pony but was struggling on a walk hack today that she would usually bounce around. I got off her in the end.

 

[Sail_away]

I'd really like to know what they find. I have a 13h pony who is struggling with her breathing and piriton and ventapulmin aren't making any difference. Vet can't hear anything on her chest. I guess next option is the scope you had done.

She's a very sweet compliant pony but was struggling on a walk hack today that she would usually bounce around. I got off her in the end.

This sounds very like mine, except we haven’t tried antihistamines- our vet wanted to get the scope done first and then explore our options. But ventipulmin makes no difference and same as yours there’s no sound in the chest. He was trying very hard to work well, and at the start of it produced one of the nicest schooling sessions he’s done, but it came apparent over a few days that it was getting harder for him (I assume as the inflammation of the trachea got worse). I’ll let you know how we decide to treat/manage and what works for him.
It seems a very bad year for equine asthma, a surprising number of people have mentioned they own/know horses who have had their first episode of it.

 

[shergar]

I have asthma ,and find it hard to cope with products that other people at the yard use on the horses ,there are some horse shampoos and fly sprays that really effect my breathing.
Could this be the cause of seasonal asthma in horses ? plus the fact that they like to groom each other when they are turned out and are actually getting it in there mouth Years ago we had no fly rugs and no fly spray , and do not recall any horses with asthma . One more thought you could save money not buying fly spray as everyone says it does not work anyway ,the only shampoo I use to bath the horse is simple shampoo £1 a bottle unperfumed ,the 25 year old mare has a coat that is gleaming.

 

[Sail_away]

Bit of a delay but got the results back today - it’s definitely asthma, and there’s fungal spores in his lungs. So oral steroids, then a nebuliser with steroids and ventipulmin and that should clear it up. The fungal spores are going to be tricky because he’s already on soaked hay and shavings, in a large stable with an extra window for airflow. He’s out during the day. I had a look at paper/cardboard bedding but it seems to be either horribly expensive (£18 for a small bale) or you have to order in bulk, which we just don’t have the storage for. Our vet also suggested a hay steamer but I don’t know if our yard owner would be very enthusiastic about that, plus the point of giving hay is that I can soak to reduce calories. So he might go back on Timothy haylage and a lot of exercise to keep him trim.
There were a couple of nebuliser options - one was the new Aservo and the other was the flexineb. Aservo is initially cheaper and covered by insurance but it’s not reusable after 10 days and it seems harder to use/more stressful for the stress-inclined horse. Flexineb is around 700 and our insurance won’t cover it as it’s a long term reusable thing but in terms of ease of use for both me and Paddy it looks much better. And of course if this is a yearly issue we will have it for the next flare up.

 

[CanteringCarrot]

I really rate my flexineb. Easy to use and clean. It was costly, and I don't use it anymore (haven't needed it), but I keep it around!

I'm not sure that I'd do oral AND inhaled steroids though? I've always done one or the other. Usually inhaled because it goes directly to the airway, laminitis risk is far less, and the dose is smaller.

In the past I've used Pulmicort and Atrovent in the flexineb. I did use Dex a while back too.

 

[SEL]

Scope booked for mine next week - vet and I wanted to wait for the silly temperatures and storms to pass. I think we're going to end up where you are. In fact I sort of hope so because I've been worrying myself with other 'struggles to breath' horror stories!

I keep one of my other horses on Easibed which is large woodchips and one of the least dusty beds I've mucked out.

Any idea how the fungal spores end up in the lungs? Or is it just something most horses have and a few react to?

 

[asmp]

Can I suggest you get rid of the rubber mats? I abandoned mine when I realised that the urine was sitting under them (apologies if you regular clean under them but mine were too heavy). My horse used to cough when in but removing the mats and using Laysoft bedding helped.

 

[Sail_away]

I really rate my flexineb. Easy to use and clean. It was costly, and I don't use it anymore (haven't needed it), but I keep it around!

I'm not sure that I'd do oral AND inhaled steroids though? I've always done one or the other. Usually inhaled because it goes directly to the airway, laminitis risk is far less, and the dose is smaller.

In the past I've used Pulmicort and Atrovent in the flexineb. I did use Dex a while back too.

Good to know the flexineb works, it does seem like the best option currently. Oral steroids was what the vet at liphook suggested - the reasoning is that it’s going to take a couple of weeks at least to get the flexineb and then get him used to it and we’d ideally start treatment straight away. They’re keen for him not to lose any more fitness and it would be the difference between three weeks off work or five as he’s starting with ridden walking as soon as we start the oral steroids. Apparently the rehab is much harder going if they’ve already lost fitness. Definitely something to check with our vet this morning, he’ll probably go back on the starvation paddock for the two weeks.

I keep one of my other horses on Easibed which is large woodchips and one of the least dusty beds I've mucked out.

Any idea how the fungal spores end up in the lungs? Or is it just something most horses have and a few react to?

I’ll have a look at Easibed - I think a low-dust shavings bed is the way we’ll have to go as I can’t see a way to make paper bedding feasible. The fungal spores suggest ‘poor air quality’ of some sort - and again we’re hopefully having a more in depth discussion with our vet about exactly what that means. Realistically we can only make very small changes to reduce dust levels as he’s already pretty dust-free, he was actually on 24/7 turnout when it happened.

Can I suggest you get rid of the rubber mats? I abandoned mine when I realised that the urine was sitting under them (apologies if you regular clean under them but mine were too heavy). My horse used to cough when in but removing the mats and using Laysoft bedding helped.

Doing that today! I try to clean them fairly often but haven’t for a while so that could well be a factor. They’re light mats so would be easy to clean them out every week if needed. His stable’s on a slope so urine occasionally collected at the front under the mats when he was on straw, it’s been much better on shavings but I haven’t cleaned it for a while so I suppose I’ll find out.

 

[CanteringCarrot]

Good to know the flexineb works, it does seem like the best option currently. Oral steroids was what the vet at liphook suggested - the reasoning is that it’s going to take a couple of weeks at least to get the flexineb and then get him used to it and we’d ideally start treatment straight away. They’re keen for him not to lose any more fitness and it would be the difference between three weeks off work or five as he’s starting with ridden walking as soon as we start the oral steroids. Apparently the rehab is much harder going if they’ve already lost fitness. Definitely something to check with our vet this morning, he’ll probably go back on the starvation paddock for the two weeks.

Ah, got it.

I ordered my Flexineb when they had a 10% off sale about 2 years ago and it took about a week to get here. Wasn't too bad.

I do think fitness is important. I think that's one of the big reasons why mine is doing so well at the moment. Best of luck moving forward with everything!

ETA: my guy does well on flax straw and currently flax straw pellets. We also have this wood chip stuff called "Waldboden" or forest floor that is very minimal dust.

 

[Sail_away]

Update: We got the flexineb e3, he’s really good with it so he’s been on the inhaled steroids for two weeks. Although yesterday he managed to break the seal... so we’ll have to see if we can get a replacement part, or failing that superglue. It slowed his breathing down pretty quickly so he’s back to trot work and we might have a canter today seeing on how he’s feeling. It’s up and down at the moment though the general trend is upwards - as in, yesterday he coughed once and was a bit snorty during a 30 minute schooling session, but he hacked out the day before that for over an hour in walk and trot and his lungs were completely clear. We’re updating our vet as we go - I think the real test will be whether he can get back to full work and stay in it without any problems, obviously right now it’s hard to tell how he’s going as he’s still got a month of steroids and isn’t at full fitness.

 

[fjordgirl75]

I'd really like to know what they find. I have a 13h pony who is struggling with her breathing and piriton and ventapulmin aren't making any difference. Vet can't hear anything on her chest. I guess next option is the scope you had done.

She's a very sweet compliant pony but was struggling on a walk hack today that she would usually bounce around. I got off her in the end.

What was it in the end? My horse is the same.

 

[SEL]

What was it in the end? My horse is the same.

She ended up having her soft palate cauterized and a hobday procedure. The first scope missed the floppy palate but we rescoped at the same time as doing X rays to check there wasn't something in her sinuses and then you could see it.
Has to be ridden bit less now but fine for hacking and light schooling.