COPD - steroid dilemma

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Mrs Trotter

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has anyone had experience of giving steroids to a good do er for COPD? My pony lives on fresh air and is prone to weight gain and vet says she is in a high risk group for laminitis.
Is there any thing else that's effective? She's on dust free bedding, soaked hay etc and going out as much as mud will allow.
Had only one sputulosin and two ventopulim - not terribly brilliant, haven't got much faith in vet either.

Any thoughts appreciated??
 
I have treated a COPD pony who had previously had a bad case of laminitis. He had 7degree rotations in 1 front foot. Due to the risk, I didnt give injectable dexamthasone but put him on an oral dose of preds. I did consult other vets (including a leaderon cushings/EMS/laminitis) who all said the risk to the pony from laminitis brought on by preds was minimal and tbh, without this the pony was in respiratory distress.

I have since used preds in many many similar cases. Only one had laminitis while on long term treatment and that occurred 24hrs after a change in paddock - most likely unrelated to the steroids. He had been on steroids for 18months at that stage and could not live without them. He stayed on his steroids during treatment and lied in a round pen as even on steroids he could not tolerate being stabled. A year on he is doing well. ETA - he lived in the round pen during treatment (approx 1month) but has been back on grass/starvation paddock ever since.

So my experiences, administering as low a dose of predniolone as is effective is usually the best way to go. Obviously avoid steroids where possible but you and your vet need to weigh up the benefits/disadvantages to come to the best solution for your pony.
 
Depends how you give the steroids. If given orally then yes there is a reasonable chance of laminitis. If given by inhaler then this risk is extremely small.
Inhalers are great at keeping controlled COPD under control, but it is not unusual for a short course of oral steroids to be needed to get it under control in the first place.
 
glenruby said:
I have treated a COPD pony who had previously had a bad case of laminitis. He had 7degree rotations in 1 front foot. Due to the risk, I didnt give injectable dexamthasone but put him on an oral dose of preds. I did consult other vets (including a leaderon cushings/EMS/laminitis) who all said the risk to the pony from laminitis brought on by preds was minimal and tbh, without this the pony was in respiratory distress.

I have since used preds in many many similar cases. Only one had laminitis while on long term treatment and that occurred 24hrs after a change in paddock - most likely unrelated to the steroids. He had been on steroids for 18months at that stage and could not live without them. He stayed on his steroids during treatment and lied in a round pen as even on steroids he could not tolerate being stabled. A year on he is doing well. ETA - he lived in the round pen during treatment (approx 1month) but has been back on grass/starvation paddock ever since.

So my experiences, administering as low a dose of predniolone as is effective is usually the best way to go. Obviously avoid steroids where possible but you and your vet need to weigh up the benefits/disadvantages to come to the best solution for your pony.
Click to expand...

I have had experiences both ways - a mare with no hx of laminitis developed it after 2 weeks of pred @ 1mg/kg SID, and a mare with a storied past of chronic laminitis that had no problems after 4 weeks of 1mg/kg SID, plus gradual reduction. (Both were getting steroids for skin rather than respiratory reasons).
 
I have a rising 29yrs old girlie, who has cushings and COPD.

Last summer she had a respiratory crisis. She was found collapsed in the filed by my friend who got her up and into a stable, where she collapsed again. I called the Vet from my work place and arrived home shortly before he did. She was lying flat out, struggling to breathe and her gums and tongue were blue.

The Vet arrived and asked what I wanted to do. My answer was give her everything - she was going to die without something. She had a massive bolus of steroid IV, along with bute and buscopan (thought she might be colicky too). Gave her 10 mins and then asked her to get up. Stood up, had a little shake, and was fine.

In my opinion, it was worth the risk of the steroid. She was in a very bad place and it was kill or cure. Fortunately I got the latter :)

However, I wouldn't want her on regular steroids because of the cushings. Need to add, she has never had laminitis.
 
Its not a decision to be taken lightly by any means. The majoity of cases I have treated with oral steroids are quite severe. If in resp distress iv steroids or atropine - each of which have their drawbacks, may be warranted. I inform the owner as to what I recommend but the final say is theirs.

It is generally accepted that iv steroids(dex usually) have greater risks - for laminitis, than oral (preds) which inturn have greater risks than topical/inhaled.
 
thanks for your replies, unfortunately the inhaler is a non starter - she won't have anything scented round her face.

So are we saying that the steroids in tablet form are a safer option that intravenously?

Not much confidence in vet, and getting tired of lectures re ponies weight - which I do try and control, she really is a good doer cobbette and is living on next to nothing and not obese, never had laminitis due to rigorous strip grazing.

Does it have to be steroids - is there anything else that's a safer but effective option?

She is not in visible distress but the shortness of breath occurs during exercise, first vet couldn't hear anything ( mainly due to ineffective and prefunctory examination) second vet identified it immediately after a burst on the lunge which left her heaving.

Glad your girl pulled through Brightstar - horses eh..who'd have 'em!
 
Mrs Trotter - please read.

My 26 yr old veteran has severe COPD from a tree pollen allergy. He has got worse and worse every summer. Last summer was bad and by September he was on inhaled ventipulmin and inhaled steroids. Didn't make a huge amount of difference to be honest because the way he copes with the pain in his chest is to take very shallow, very fast breaths. His breaths per minute at rest rose as high as 65 when they should have been 8 - 12. So the inhaled drugs don't get deep into the lungs where they're needed. Nightmare. He is also a very good doer and weight gain has been a problem. Against my better judgement, he had to start oral steroids in November because he was in a pretty bad way but, again, I think they didn't make much difference. The only things that makes a difference is when he goes into partial remission every late winter. Because I guessed that this winter might be his last because of quality of life issues (he couldn't be sedated for an emergency endoscopy as the vets thought he'd stop breathing altogether) I haven't bothered to restrict him feedwise at all. Now for the exciting bit: my vets attended a talk on a product called Cavalesse a while back. It's a product that's been out 2 years but the manufacturers are giving it a bit of a publicity push. It is primarily advertised for sweet itch but the rep told my vets that it works by interrupting the action of the mast cells that produce histamine. They categorically told my equine vets that it worked for COPD as well. They gave my vets 3 trial packs and the vets have kindly given me 1 trial pack for my horse Sunny. The pack is £90 to buy and it contains 3 sachets that you mix with water, 1 per month, then administer 2 mls daily onto a sugar lump. You have to start before the allergic response starts. I'm a bit sceptical about it as I've been told many times by my vet that standard antihistamines don't work for horses and if it was so brilliant at relieving COPD surely it would have hit the press big time. Anyway, I'm starting Sunny on it early April ready for the May tree blossom. I'm going to keep a diary and I will know by the end of the 3 months pack whether it has made a difference. If so, I'll happily buy the next 3 month pack.

Couple of suggestions: ask Fidavet (something like that) if you can trial a pack. Or ask your vets if they can get a trial pack. Or just watch this space and I'll let you know if it's the magic bullet I've been praying for over the last 5 years x
 
B_O_F - unfortunately Fidavet will not give out trial packs, I have tried, as it is not an official trial. Just an individual case - my horse. Again they do not sell the packets without the cream as was originally set up for sweetitch, so paying for something I wont use. They did say that people had been enquiring about its use for COPD so they may consider at a later date selling the packets separately. I am still sitting on the fence as to whether to spend £70 for something unproven, although I can see that the mechanisms for sweet itch and COPD are related.
 
My mare was on steroids for COPD after trying inhalers (couldnt get anywhere near her with the baby inhaler), ventipulmin didnt work & neither did the steroids. They did make her a bit loopy but she didnt have laminitis altho I was told the risk is huge.
 
Always Blue, your horse having COPD doesnt mean he will be worse over summer.

It depends on what the trigger for his condition is. If your horse is stabled year round then he may suffer year round. If he lives out during summer then he will probably be fine once moved to live in his field.

For those that suffer more during summer it is usually due to a pollen allery rather than just a dust allery.

My cob mare has COPD when stabled during winter, this is managed, but also suffers SPAOPD during the summer months due to pollen allery, not so easy to manage as how can you keep a pony living out in the summer in a pollen free zone.

Will be watching eagerly for Box_Of_Frogs trial progress.
 
Thanks Lucy...I am not too sure but blue is on haylage now and he is absolutely fine...does cough accasionally when sweeping/mucking out etc....but my friend did him for me other day and gave him hay by mistake and didnt soak it either so next day his breathing was really bad - really struggling and roaring and coughing...but has been fine since back on haylage. so do think its a dust allergy...he will live out all summer..but at the mo he is in 24/7 - he seems to cope ok as long as fed haylage. x
 
Mrs T and anyone interested: Fidavet have been running a "give away" of 3 packs of Cavalesse (so that's 3 x 3-months supply) in one of the 3 big horse mags. Can't remember which one but only a week or so ago. At £90 for 3 months and absolutely NO side effects (it's mostly water soluble vit B3) I think it is a viable alternative to steroids, that's if it works of course. The oral steroid tablets, at the very high dose my vets wanted Sunny to be on and for only 12 weeks, worked out at £650 from the vets, £1200 odd from an on-line vet supplier and a staggering £2,700 through Boots. Sunny is aged 26/27 and I can only insure him for field injuries so we had to compromise with half the steroid dosage for a trial period of 6 weeks. Like I said, I WILL know whether Cavalesse has helped Sunny at all by early June and will post again in the Forum. If they do help, I'll try to get a letter or article into one of the big horsey mags to spread the knowledge as widely as possible.
 
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