COPD Advice

[misswoods]

Hi all,

I'm well aware that many of you are not vets and am not seeking veterinary advice, as I've had plenty of it already, I'm simply looking for advice as to what YOU would do. Please no nasty comments, as this is already difficult enough.

I have a 23 year old arab x TB mare who has suffered from COPD on and off for a good few years, although I've only had her 3, and have always kept her as a companion, her previous owners said she had been on medication before., it never really affected her apart from the occasional cough. She was still quite happy to bomb around the field and acted like a 2 year old, not the 23 that she is! Around September 2017, she came in very wheezy and laboured breathing, so obviously I had the vet straight out who made her comfortable and put her on steroids and ventipulmin. A few weeks later we tried taking her off the ventipulmin in the hope she won't need to be on it on a permanent basis but she started deteriorating again and we had to put her back on again. Obviously we took the routine of having two weeks on the medications, one week off, and she was very happy until mid December, when I noticed towards the end of the 'week off' the meds she would become less and less comfortable. We're now at the stage where she's wheezing profusely at the end of the week without meds and she's not at all comfortable. She's out all the time and only fed hayledge, and because of her past, inhalers are not an option. I'm really struggling to pay for the medication (which is as much as 110 every three weeks or so). I can see shes not herself and not happy when she's like this, and I know theres only so long ventipulmin will work for, which it has already started decreasing in its usefulness.

So my question to you all is;
What would you do? Have any of you been in this situation or similar?

Thanks
L x

 

[SallyBatty]

I have copied the advice my vets provide for COPD below in case it differs in any way to what your own vets have said if you want to go the medicinal route:-

"Possible Medication
The most useful medications are bronchodilators and corticosteroids.

Bronchodilators
Bronchodilators are used to relieve the respiratory distress experienced by horses during acute episodes. They relax the smooth muscle in the airways. Bronchodilators are useful in the short term to relieve bronchospasm, but they do not address the underlying problem of inflammation of the small airways.

The commonly used ones include:

Clenbuterol (Dilaterol or Ventipulmin) relieves bronchospasm and increases the speed of clearance of mucus from the airways. The drug can be given intravenously or orally. Advice should be sought from Bell Equine regarding the dose if your horse fails to show a satisfactory response to the standard dose – any increase in dose rate must be undertaken gradually. At higher doses, side effects of sweating, trembling and raised heart rate may occur. With long term use, horses can become resistant to the effects of Clenbuterol, so it is generally best used in acute episodes or “flare ups”.
Inhaled bronchodilators such as Salbutamol (Ventolin) are occasionally administered using an Equine Aeromask or other inhalation devices but their duration of action is relatively short.
Atropine which may be given once by intravenous injection at the start of treatment to relieve acute respiratory distress. If bronchospasm is a contributory factor, the drug will be effective and provide relief within 15-20 minutes, but this can cause colic as a side effect so is not safe for regular usage.

Corticosteroids
Corticosteroids are the most effective drugs for reducing inflammation in the lungs of horses with RAO. They can be administered systemically (ie by injection or orally) or by inhalation. A horse with severe disease may need corticosteroids to be given by injection or by mouth because to start with they are unable to breathe in enough of the drug in by inhalation. Alternatively, bronchodilators may be given first, to allow better distribution of the inhaled drug. Dexamethasone and prednisolone are commonly used injectable and oral forms. Once the symptoms are controlled, inhaled medication is preferable as there is less risk of side effects which include laminitis, Cushings-type signs and suppression of the immune system. Immunosuppression increases the risk of the horse succumbing to bacterial infection. The inhaled corticosteroids include beclomethasone dipropionate and fluticasone propionate. The horse is treated twice a day using an inhaler. A number of systems for delivering the drug are now available. Examples are the Aeromask (which is a facemask with an attached spacer and metered dose canister) and the “Equine Haler” inhalation spacer or in smaller ponies pediatric spacing chambers can be used.

Other Medications
Mucolytics are medicines that help to break up the mucus so it is more easily cleared from the airways. They can be useful in cases where there is a lot of thick, tenacious mucus present in the airways. Examples include sputolosin and secreta pro supplement."

Luckily I have not been in this situation. However, if you are struggling with the vet bills then I think if I was in your shoes and looking at long term high usage of drugs and my mare was as uncomfortable as yours sounds then I would most likely opt to pts as I would much rather that than see her suffering and not being able to treat it.