RAO, 25yr old horse, can't stabilise. What next?

Box_Of_Frogs

Box_Of_Frogs

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I know I need a good kicking but please can someone be brutally honest with me here.

Sunny is 25. He's a Section D x cob - 15.3. Still in light work. Loves his food. For the past 4 summers (May - October) he's had RAO/COPD from an allergic reaction to pollen. It's got progressively worse. He's now on inhaled Ventiplmin and steroids. Supposed to be watching his weight but the grass is knee deep everywhere and it's difficult. He comes in from about 9am to 3pm every day to get him off the grass. He has a flat scoop of Spillers High Fibre cubes to come in to and a handful with a mug of Bailey's Lo Cal when he goes out. Bucket of Hi Fi Lite that he ignores. So I'm not stuffing hard feed down him day and night. Last winter, with a careful diet I got him down to under 500kg (and he looked ghastly) but, as mother nature intended, he's put most of it back on this summer and is currently about 570kg. Shining with health, happy, chilled, adorable lad. But I can't stabilise his breathing. Dyspnoea - there's a terrible word. Trouble breathing. He has permanently damaged lungs and breathes deeply all the time now so that if he needs extra oxygen he's stuffed. I can't believe there's any pollen in the air any more. Hammered down all day here. But Sunny's breathing is laboured to the degree that he couldn't be ridden except for a stroll round the edges of the yard fields. But the vets say he needs llight exercise. I totally understand that being overweight isn't good for anyone, man or beast, but would 40kg lighter miraculously make his allergy less? I could stable him for 23 hours a day but all that will happen is I will end up with a skinny horse with bad RAO who is very very unhappy. What the hell do I do? Today I thought his end might be next year because of the damage done every year by the RAO. The lovely lady who rides him twice a week for me really put the frighteners on me because she said that at age 25 every extra year I had Sunny was a bonus. I was horrified.

So what do I do. Have him pts before next summer? Starve him down to a miserable horse with RAO? Do nothing? Carry on for as long as he's happy? Been browsing vet sites through Google and I've just read something that says grunts and groans in an RAO/COPD horse are usually an indication of pain. Sunny grunts and groans a lot, usually after a coughing bout. Please can you just give me the truth. What's the prognosis for next summer?
 
OK, I hope this isn't too brutal. You have a 25 year old pony that can't breathe. I think you are kidding yourself that he will get better. Unfortunately there are very few vets who will actually say - you should have this pony pts. Sometimes there are hard decisions to be made with horses. If he was mine, to be honest I would have him pts because I would not want to watch my pony struggling to breath, it is no life for him.
 
tracey01 said:
OK, I hope this isn't too brutal. You have a 25 year old pony that can't breathe. I think you are kidding yourself that he will get better. Unfortunately there are very few vets who will actually say - you should have this pony pts. Sometimes there are hard decisions to be made with horses. If he was mine, to be honest I would have him pts because I would not want to watch my pony struggling to breath, it is no life for him.
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I completely agree.
 
tracey01 said:
OK, I hope this isn't too brutal. You have a 25 year old pony that can't breathe. I think you are kidding yourself that he will get better. Unfortunately there are very few vets who will actually say - you should have this pony pts. Sometimes there are hard decisions to be made with horses. If he was mine, to be honest I would have him pts because I would not want to watch my pony struggling to breath, it is no life for him.
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I'm another to agree totally. In fact I am totally surprised you're even having to ask what to do, I always thought you were a sensible practical down to earth person who thinks of their ponies first. This was the same scenario for Ben, our Border T who was put down last week for virtually the same reason; it just wasn't fair on him.
 
Sadly, I think PTS as well, although without actually seeing him, it is abit harsh to just assume that is the correct thing. It really depends on how much he is in pain, and if breathing really is difficult. For instance, my lovely father in law sounds terrible with his breathing, huffs and puffs really loudly,sounds like he is gasping his last! YET his GP says his lungs/heart are fine. FIL adamant he can breathe fine, and isn't finding it a problem,apart from if faced with stairs.He otherwise is very self sufficient,and active.
If he were a horse, I would be thinking of him being PTS. However, because he can tell us he isn't having problems, and GP confirms, then this leads me to believe that he sounds far worse than he is.
I have, however, always believed with horses, if they have heave lines, then they are finding life tough with struggling to breath.
Re weight: Personally, unless there is a medical reason to give him the low cal and cubes, or you need it for a supplement,I would stop it altogether. I would only bring in/turn out with a carrott. Any hard feed maybe adding to the weight issue, even a scoop. Assuming your scoop is a round plastic one, a scoop of each feed actually weighs quite alot. Hope I don't sound patronising, as I don't mean to, but maybe cut the feed out,and see if that helps the weight too.
 
Im not going to say whether you should PTS or not as i haven't seen him, but are you doing everything you can to manage his environment - is he on a supplement like Winergy Ventilate? Do you bed him on paper/cardboard - is he fed well soaked hay or even better haylage? Do you stable him during the day when pollen counts are high? Do you feed him things such as Ventipulmin when times are tough for him?

TBH it sounds like his breathing is his biggest problem and I would try to improve/control this before I worried about his weight.
 
Have a similar decision to make myself hun (old horse losing weight, do I try for another winter or not...). It's so difficult without seeing the horse and how is in himself - only you know that.

I would possibly be thinking about PTS I'm afraid.

However, experience with OH's pollen allergy has shown that different pollens affect different areas in different ways.

I know you love your yard, but would you consider trying him at a different yard? Even if just for a few weeks to see if it makes a difference? Perhaps the pollen levels would be different and give him some relief.

There may still be some pollen lurking around - have a quick google for hayfever causes, you should find a couple of tables which show which pollen is present and at what time of year.

Remember that it's about quality of life, not quantity.... xxx
 
I apologise if this is of no help but i find the trimmer and fitter my dales is the less of a problem his wind issues are he also has some long term damage to his lungs resulting in coughing and snot issues. The best way i have found to manage his weight and keep him happy is a greenguard muzzle on for most of the time he is out. (24/7). I also have a bit of a supplement addiction not sure how much it helps him but i feel as if i'm doing all i can. I can recommend global herbs ones and they do one called pollenex may be worth a try they have a fairly informative FREE help line to. As for PTS i am sure you will make the right decision you know your horse the best and will know wether he is ready to go or can still be happy. Good luck and have a nice cup of tea and some biscuits while you think.
 
Although PTS may end up as the best option, when you say steroids, is it tablets or a steroidal inhaler you are using? My 28yr old has RAO ( and Cushings) to a degree and occasionally has a crisis and I have used other inhalers such as serevent and becotide along side the Ventolin. Becotide is a regular use and the Ventolin is for more immediate relief.

This is just if you want to try other things before you make the decision. I have an Equihaler which is rather like a human spacer inhaler.
 
I have a fat horse who hasnt got a breathing problem but starts getting one if he gets any fatter than he is i do think weight is a huge problem with their breathing just like people my horse wears his muzzle all year round even in snow and soaked hay for eight hours or more im yet to find a rib.But if it dosent improve then you have no choice to pts
 
If you do want to try help him lose the weight before making a final decision of PTS then I can not recommend Healthy Hooves enough. My lamanitic pony who I have always had issues weightwise with is a changed pony. It is not terribly expensive at all and a complete low calorie feed. More importantly it isn't some random little bit of dried chaff which is all dusty and unappetising. It is quite moist and has little fibre nuts in it so it doesn't look like just chaff. With this feed she has lost approx 80kgs and she is maintaining the new low weight. Apart from that I do have her in a muzzle so she can spend more time out in the field. Since she has been on the different feed (even when on box rest so before being able to go out) she was much more lively and alert. Before I had been worrying about her as she seemed to be very slow and not aging well but all those have gone now.

I wish you luck in your decision. You will make the right one x
 
Do you rug him at all in winter? Ive found the best way to get weight off is to minimally rug- just a LW to keep off rain and wind when wet and naked when cold but dry.

When stabled what bedding do you use? What bedding is nearby? The only bedding i would consider for a RAO horse is mats and cardboard or paper. Wet removed everyday and never muck out when horse is in the stable. If there is unsoaked hay, deep litter, straw or shavings, etc in his stable or close by then the dust and ammonia will not help- quite the opposite.

Have you seen Nostrilvet? its a fine powder that turns to a sticky 'glue' on contact with moisture. you squirt it up their nostrils and it traps the allergens like pollen or dust beforeit can reach the lungs.

Have you tried a vitamin c supplement? or very high antioxidant supplement. Winergy ventilate springs to kind, especially as its scientifically proven to improve lung health. Herbs wise nettles are very good (antioxidants), as are things like hawthorn and buckwheat as they improve capillary strength and hence blood flow. Marshmallow leaves help get rid of mucous if there is any.
With lung damage the free radicals are very high and antioxidants are a must to help keep them at a level that isnt damaging. so if youre not feeding anything then that might be worth a try- and they wont put weight on!

You may have thought of all of this but it may help?
 
My RAO pony was better for getting some weight off.

We use a Ventolin/Salbutamol inhaler with an equihaler spacer (it was about £95, I know, expensive, but the baby spacers weren't useful)

May be worth a go asking for this?
 
We have a 25 yo pony with RAO, she has been on Feedmark's Clarity all summer and has improved greatly. Also a pony who usually has a serious summer cough - she hasn't coughed all summer. It's worth a try, before making the final decision.
 
Thanks all. Losing weight in the winter isn't a problem, it's the summer grazing + lingering pollens + damage already done to his lungs. Long, long talk with my wonderful equine vets today. There are changes deep in the lungs when a horse has COPD/RAO. Some cells change to start producing mucus and it's only reversible with time + no further allergic response, ie not reversible. For the last 3 summers, Sunny's been on oral Ventipulmin to relax the airways and Sputolosin to break up the sticky mucus. Last summer he got a viral chest infection on top of the COPD and on top of that, a secondary throat infection caused by the constant coughing. He was on 10 days of Noradine to help the secondary infection and it helped a little. This year, the oral drugs weren't helping so he's gone over to inhaled Ventipulmin + inhaled steriods. He's also just gone onto another 10 days antibx as it helped a little last year. He's bedded on deep litter shavings and he has the softest, most fragrant bed for miles around. He doesn't have hay at all - haylage in the winter, bucket of hi fi lite in the summer which he usually ignores. It's a pollen allergy he has, not a hay or dust allergy. The reason it drags on past when the pollen is high is that his lungs are damaged so take a while to recover (as much as they can ever recover). Grazing muzzles a) he'd have off in 3 minutes and b) they're not safe unsupervised, to my mind (and YO's mind). Making him shiver weight off in the winter is unethical and anyway, I can control his weight with ease over the winter. It's the summer that's the problem. My vets said today to keep him on inhaled steroids all year so that's the next thing to try. Make no mistake guys I am NOT NOT NOT fooling myself that he will get better. Of course not. Shocked to think people thought that. He'll never get better and at 25 all I can hope for is to keep him as comfortable as possible through each summer. My vets 100% agreed with me today that if I stabled Sunny for 23 hours a day to get his weight down, instead of a happy, porky ned with COPD I'd have a thin, miserable, stressed, anxious ned with COPD.

Caring for veteran animals, like veteran people, we need to be sure we add life to years, not just years to life. I always say on the Forum if owners don't know whether it's time to say goodbye: If your horse could talk, would he say, mum I'm tired and I hurt all over and I wish I could just lay down and go to sleep. Or would he say: Mother for god's sake get a grip! I've got a cough but so what, now move over coz you're standing on the bit of grass I want and anyway, where's my tea?

I know what Sunny would say today. Hopefully he'll think the same for lots of tomorrows but if/when he changes his mind, I'll know and I'll help him through that last goodbye.

Thank you all for your kind and thoughtful replies - it's really helped me get my head round a problem that won't ever go away but can be managed carefully for as long as Sunny is comfortable and enjoying life xxxxx
 
correct me if im wrong, but with the steriods doest it increase the chances of lami? also the steriods could be paying a part in his weight gain?
 
jhoward said:
correct me if im wrong, but with the steriods doest it increase the chances of lami? also the steriods could be paying a part in his weight gain?
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This is partly true, my horse is exactly the same as Sunny. And mine too is on steriods. There is a belief that with exessive use of steriods, they "could" bring on lami. But as my vet told me before my boy was put on them, there is no proof that this is true and has never been prooved to have hightened the chances of your horse getting lami. They told me that as my horse has never had lami (him being 23) there would be very little chance of this happening, I think its more for horses and ponies prone to laminitis. They do have sideaffects though! my boy could never grow his mane! ( wonderful when everone was pulling theres ) but now! its by his shoulders! :D
 
Just wanted to add that I queried with my vets about the use of steroids and the well-known increased risk of laminitis. They advise that inhaled steroids pose a negligible risk because they go straight to the lungs and are not absorbed by the blood vessels there. And they also advised that they attended an event where Nostrilvet was being promoted. They say it's a nice idea but hopelessly useless in the application. A squirt or two of Nostrilvet can only cover a tiny proportion of the horse's nasal passages. And when the horse breathes in, it inhales a huge quantity of air, 99% of which (if you think about it) doesn't touch the sides of the airways where the Nostrilvet may or may not be. They say total waste of money and offered me their trial pack because it wasn't worth the surgery space. Will post a picture of Sunny tomorrow. Again, thanks everyone for your thoughtful and thought provoking replies x
 
He's bedded on deep litter shavings and he has the softest, most fragrant bed for miles around.
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Won't be helping his COPD at all BOF. Rubber matting and a sprinkling of shavings only.....
 
Honest guys - he's absolutely fine right from October through to late April - the very time when he's stabled MORE than in the summer. Sunny has Summer Pasture Disease which is what COPD caused by pollen as the allergen is called. It's only pollen that triggers his allergic reaction. His bed is fine. He's got no problems with hay, although he's fed haylage through the winter because that's what the yard has. It's just pollen.
 
It may be pollen that is causing the major problem but any form of dust or other allergen (such as ammonia) will also challenge the already compromised lungs. Theyre just another irritant and although it might not be the primary cause of disease keeping the air as clean as possible with minimal dust, mould and ammonia can only help.

Interesting what you say about nostrilvet. My friend has used it this summer and her horse has been much better. Whilst she cant categorically say its definately that, all other management is the same and the horse improved within a very short time after she started to use it.
 
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