Respiratory issues diagnostics and treatment

[palo1]

I have posted in the horse care and feeding forum following another thread but I am sort of hoping that by posting in the Vet forum I might get other input too. Thank you for anyone who can give me any information or experiences!! My 5 y/o Welsh mare has been coming on brilliantly and was in full work; training at prelim/novice flatwork (to be honest we had literally just been playing with some of the novice movements so nothing very ambitious but that is where we were at). Very happy and able to school on the flat and/or with jumps up to 70/80 for an hour with no apparent breathing or recovery issues at all. She was hacking out over hills up to 17 miles and doing some lovely canter work. I 'think' that she wasn't finding it more tiring than I had expected though I did think one day in June that she was taking a while to recover from a hilly ride. She is young though with not a real base fitness so I could be over-thinking that. In any case, she had attended a fun ride where she was perfectly comfortable to canter and jump lots of tiddlers over 10 miles. She was not remotely tired or puffing on that occasion. She had recently been checked over by a vet for her vaccinations and HR, Resp Rate, gut sounds etc all good. The mare has never shown any reluctance or resistance to training and is a sweet and gentle but often typically 'Welsh' cob. I love her.

In the first week of July she made a 'noise' in canter whilst we were cantering up a gently sloping grassy (high unfertilised meadow) field. By the time I had registered the noise we had pulled up anyway. She made that noise once more on the ride by which time we decided that something was not right so turned for home. She was absolutely full of beans and offered another canter with no noise at all. Over the next few days I heard her cough once. Her friend who had also been with us also coughed - probably twice or 3 times. I rode the mare carefully that week with no further 'noises' which can only be described as somewhere between a roar and a wheeze. She was happy to trot and canter very willingly, trotted up hills etc with no problems. That weekend (so after a week of careful but normal work) I took her to a fun ride. Really hot, humid weather with rain showers and environment that was full of grass, crops, trees and a river. Within the first 10 strides of the first canter my horse was definately wheezing. We stopped immediately and I got her home pronto. She seemed fine at that point but I was worried and vet attended the next day. She had also coughed a number of times once we got home. My vet used a re-breathing bag (bin bag!) where she made a noise that he said was 'unexpected' and we discussed how unlikely it was that this mare would be a roarer.

The vet gave my horse a Dexamethasone jab and a week of clenbuterol in syrup form and made an initial diagnosis of summer pasture asthma. Coughing stopped within days but her breathing remains fast and shallow. She is very well in herself, happy to play with the rest of the herd and I have watched her belting round quite easily with no need to cough. She is eating up respiratory supplements and acting normally in every way, except her breathing/resp rate. I have spoken to the vet several times in the last 2 weeks about the impact of heat and a plan and the mare is now booked in for a scope and tracheal wash at the first opportunity.

I have noticed that when grazing the mare makes a noise that the others in the herd don't and it certainly sounds like there is some airway issue. It could be, so I understand, that asthma related inflammation could be causing that and we need to get on top of the asthma symptoms. It may be that she has a physical issue - some of which can be dealt with. I am happy to pay for endoscope, meds, nebuliser etc and any standing surgery for epiglottic entrapment, cysts etc but a GA is both out of budget and my own preference. I can't actually face thinking about the decision I would have to make if the mare needed a GA to get her right.

I am feeling completely lost and panic-stricken; I just don't have experience of chronic respiratory issues (though I once had a horse that had a bacterial pneumonia and got him completely recovered!) and I am not prepared financially to put a horse through a GA so any physical issues would either need standing surgery or none. I feel like I am facing a chasm of doom with a young horse I adore. I literally have no idea why and how this has happened (other than it's horses innit?!) Any helpful comments or experiences about diagnostics and treatment for respiratory issues would be so appreciated! I would also love to know why and how these things 'suddenly' manifest themselves. It is hugely bothering me - the mare has been here under the same management for 2 years; not stabled, decent quality hay fed at just above ground level, a run-in shed, appropriate worming and feeding etc.

 

[palo1]

I can't quite believe this but just now whilst checking my mare's breathing (again ) My older horse coughed 3 times. Whaaaaaat?????? Unless I am totally losing the plot that shouldn't just be a coincidence surely. He is 15, very fit and has never had anything other than crystal clear wind. I really don't know what to do now; should I call the vet again? It sort of suggests we might have a viral problem as now 3 out of 4 horses kept together have coughed in the last 3 weeks. What is the best thing to do:-

1. Continue with appointment for mare to be scoped
2. Call vet to discuss how we identify/diagnose a virus in our herd today
3. Get vet out to check both the mare and older horse (and probably 3rd horse that also coughed earlier in the month)

If anyone else has had this situation/scenario I would be grateful to hear your experiences.

 

[palo1]

Vet has been. We have 2 horses with high respiratory rates and 2 with slightly higher than normal rates. Poor Alw appears to have swollen lymph nodes, a high end of normal temperature and asthma. She is going in for a scope early next week and swabs have been taken from the others. Vet was very reassuring but it feels a bit of a disaster. A large vets bill isn't really needed but my mare can have a scope and then we can potentially move on to inhaled or nebulised medication as needed. I am really glad the vet has been in all honesty though the news is very unwelcome.

 

[Roxylola]

Sounds like a nightmare. I hate little invisible niggles - things you think could be your imagination but you just know aren't. They're so difficult to pin down. Hopefully you get them sorted and they're feeling better soon

 

[TheMule]

Sorry I can’t be of much use as no personal experience, but just wanted to offer you support and wish you and Alw luck for next week

 

[palo1]

Thank you. I feel devastated that my gorgeous young horse has asthma, I really do. I am worried about the others too but feel confident that they are not finding it quite so difficult. The vet can't organise a scope for earlier than next Friday which is frustrating and so we may have to change tack - if my mare can't cope that long without medication then we will have to find a plan B. Nebulisers are effective I know but depressingly expensive...

 

[milliepops]

no experience to offer but also sending well wishes and hope you get some better news soon. i'm missing Alw's adventures x

 

[hollyandivy123]

do you have any late flowering rape near you, i know the season is late in places in the uk this year?

 

[palo1]

no experience to offer but also sending well wishes and hope you get some better news soon. i'm missing Alw's adventures x

Thank you! I too am missing Alw's adventures but vet has been very positive about restoring her to full Welsh vim and vigour and has explained kindly that if we can get on top of this virus and asthmatic issue and clear out any pollen/spores or allergens in her lungs with inhaled drugs, then her lungs can heal without scarring and that then we will be looking at a 'prevention' protocol to pre-empt any hypersensitivity that her respiratory system has as a legacy of this event. That makes sense to me and I am perfectly happy to pay for scoping, drugs and nebulisers/inhalers etc if they will keep her healthy and happy. I have been here before with horses (of course!) with specific issues and have survived those so I am sure I can work through this too. It is a learning curve and expense that I would not have sought out at this time particularly but hey ho, if you find yourself in a hole you have to find a way of getting out as it is very boring being stuck there!! Time will not be an issue though it is hard emotionally for me to bear not knowing how long it may take to make the right kind of progress. It is worrying having 4 potentially unwell horses but at the moment 2 out of the 3 seem pretty good in themselves and the other 2 are under vet supervision.

 

[palo1]

do you have any late flowering rape near you, i know the season is late in places in the uk this year?

No, but thank you for asking about that. We don't have much rape here - there is some in the village but that is over now. Vet isn't clear at this point whether potential asthma or virus are having the greatest impact but also said that if this is part of a summer pasture asthma event then looking for the specific cause might send me mad as it could be anything in an up to 3 mile radius (depending on weather conditions, plant conditions etc etc). She didn't feel it was particularly productive to try to identify the exact trigger especially as the respiratory virus that also seems present could be responsible. I was slightly horrified that the vet felt that summer pasture asthma was a 'good' outcome as it is reasonably well understood. It felt disastrous to me but I am trying to get my head round the idea that this is a potentially 'better' outcome of a respiratory issue...also that vets are seeing huge numbers of these problems in horses this summer. That is a bit sad; just horrible thinking of your horse struggling to be comfortable in it's breathing

 

[ihatework]

I’ve had one horse with structural wind issues and one with allergic/inflammatory wind issues.

At the moment yours sounds like the latter, or even more likely viral given your second horse has gone down with something. The scoping for this will be done under standing sedation and will be able to check for any major structural stuff at the same time as the tracheal wash.

Fingers ? for viral as that should resolve itself in time and will be the cheapest option too!

Allergic is a bit of a PITA if I’m honest, but you can do allergy testing and manage with drugs (but that limits competing) and I’d say overall is more expensive than just doing a wind op!

Some wind ops get done under standing sedation but some may need a GA - for ref a standing hobday cost me £600 and a tie back under GA 2.5k. From what you are saying though this sounds less structural

 

[palo1]

I’ve had one horse with structural wind issues and one with allergic/inflammatory wind issues.

At the moment yours sounds like the latter, or even more likely viral given your second horse has gone down with something. The scoping for this will be done under standing sedation and will be able to check for any major structural stuff at the same time as the tracheal wash.

Fingers ? for viral as that should resolve itself in time and will be the cheapest option too!

Allergic is a bit of a PITA if I’m honest, but you can do allergy testing and manage with drugs (but that limits competing) and I’d say overall is more expensive than just doing a wind op!

Some wind ops get done under standing sedation but some may need a GA - for ref a standing hobday cost me £600 and a tie back under GA 2.5k. From what you are saying though this sounds less structural

Thank you - yes, I very much hope that the primary culprit is viral and that if there is some underlying respiratory issue/weakness like pasture asthma that management can keep that firmly at bay!! Having said that the vet explained about asthma meds and competing with the primary issue being around medication withdrawal times etc. It is not likely to be a huge issue for us as currently other stuff (and now this) has put competing out of the frame financially if for no other reason this year!!

In fact the vet kept telling me about high level competing horses with asthma. That didn't make me feel much better in all honesty but I think she was just trying to be encouraging. Interestingly, whilst I was faffing with my poorly horses yesterday I repeated the re-breathing exercise that my older vet tried at first visit; on that occasion my mare did make an 'unexpected' noise (query roaring) but yesterday I wasn't able to provoke that at all which suggests that at least some inflammation has gone and/or that structural issues are less 'likely'. I agree that structural things might be less of a pain but as a GA is out that would limit the kind of surgery for some structural stuff so I am kind of relieved about that tbh! The vet I saw yesterday actually said that under the sedation of a scope it might be harder to see any structural problems as the sedation makes everything less 'normal' but I had understood the same as you; that a scope would identify potentially structural stuff as well as being able to retrieve mucous, nutrafils and esonophils etc. Ho hum...

There seems little question now that the herd at home are all affected to a greater or lesser degree though my young mare is of greatest concern. The others, hopefully, can just have time to deal with it but bloods and a swab from one of them have been taken in case they do need specific medication or it is something unpleasant enough to warrant further attention...Allergy testing is a possibility but there is no guarantee that I could avoid the likely allergens in the future as the mare has had this reaction after just being at home essentially (though we have done a couple of outings too). It has been a difficult year in relation to allergies so I understand...The change in weather here will them to feel more comfortable however and as they are all slightly older I would hope they have a good level of resistance to circuiting viruses.

Gah!! It's been a really difficult year in lots of ways - I probably should have expected the inevitable horse trouble as well!

 

[SEL]

My microcob started heavy breathing last year and set me on a journey to some rather large vet bills! Pollen was found when they did a wash but I wasn't convinced that was the issue (mainly because I'd already tried piriton). Steroid inhaler etc didn't help and it was only the 2nd camera scope that spotted something odd. Long story short she had standing sedation for a hobday and soft palate cauterization - I wouldn't have been able to afford a GA either.

Her soft palate was pretty bad and cauterization didn't help much but bitless she's fine - although runs out of puff still.

But that's worst case scenario and I'm sure you'll find its minor and hopefully something steroids can get on top of. We've had loads of coughs at the yard and vets saying it's common this year

 

[palo1]

My microcob started heavy breathing last year and set me on a journey to some rather large vet bills! Pollen was found when they did a wash but I wasn't convinced that was the issue (mainly because I'd already tried piriton). Steroid inhaler etc didn't help and it was only the 2nd camera scope that spotted something odd. Long story short she had standing sedation for a hobday and soft palate cauterization - I wouldn't have been able to afford a GA either.

Her soft palate was pretty bad and cauterization didn't help much but bitless she's fine - although runs out of puff still.

But that's worst case scenario and I'm sure you'll find its minor and hopefully something steroids can get on top of. We've had loads of coughs at the yard and vets saying it's common this year

Thank you - yes the idea of structural issues to deal with is certainly still a consideration and I will try to emphasise the need to the vets to look carefully at everything possible on the upcoming scope as I really don't want to have to revisit that unless things change. I think 1 decent scope with a decent vet should be able to identify most 'normal' problems!! At least without having insurance in place I am able to ask for what I need and what is according to my means. I wish that I had some insurance at this point but then I also know that can have added and sometimes unwanted implications too and then the dynamic of the conversation with vets etc can be different. I have been there and done that in the past and vowed after one notable experience never to go down that road again!! For me, if there were structural things to be dealt with I would probably have to let the mare hang out in the field at home whilst I saved up for surgery (unless it was a quick laser job lol!!). No GA is wanted by me regardless of cost atm.

Thankfully no-one has a temperature today and breathing is looking better all round; the weather has undoubtedly helped and whilst I am still rather anxious, I am not panic-stricken about imminent disaster so things are, sort of, looking up!

 

[Tiddlypom]

Hope that you soon get to the bottom of the problem, and that it can be fixed.

I also self insure, and my vet is good at keeping costs down. She'll tell me what diagnostics we really should do, which ones we could do and which ones she doesn't thing will add anything to the picture.

My friend's sec D was diagnosed with some sort of exercise induced entrapment by scoping him on a treadmill - it only showed up when he was working. It was Leahurst's new toy at the time, he was the first on it and they were very excited at the findings. He then had an op which fully sorted it.

That's just a waffley was of saying that it can be cheaper to go to a specialist early on, rather than stay with a first opinion vet, no matter how good they are.

Good luck.

 

[palo1]

Hope that you soon get to the bottom of the problem, and that it can be fixed.

I also self insure, and my vet is good at keeping costs down. She'll tell me what diagnostics we really should do, which ones we could do and which ones she doesn't thing will add anything to the picture.

My friend's sec D was diagnosed with some sort of exercise induced entrapment by scoping him on a treadmill - it only showed up when he was working. It was Leahurst's new toy at the time, he was the first on it and they were very excited at the findings. He then had an op which fully sorted it.

That's just a waffley was of saying that it can be cheaper to go to a specialist early on, rather than stay with a first opinion vet, no matter how good they are.

Good luck.

Thank you. Yes, I am happy to go to a specialist if the initial routine stuff isn't working and using your own funds directly does seem to help some vets cut to the chase in terms of diagnostics and treatment. I am planning to have a routine scope and cytology, then medication as indicated/if indicated then I would consider asking for a referral. It is financially daunting but at least I feel somewhat in charge of communications...

 

[scats]

Diva had an overground endoscopy aswell as a normal one. She had the scope put in, then I had to ride her. It was quite uncomfortable because my rein was caught under the scope which attached to a big battery pack that sat in front of my saddle. They made me ride her quite hard.
It wasn’t used much so we had a huge load of students who had come to watch.
We then went in and had the normal scope. The tracheal problem was found with the normal scope and the collapsing pharynx was found with the overground.

I think the bill for that day was only around £850, from what I can remember.

 

[palo1]

Diva had an overground endoscopy aswell as a normal one. She had the scope put in, then I had to ride her. It was quite uncomfortable because my rein was caught under the scope which attached to a big battery pack that sat in front of my saddle. They made me ride her quite hard.
It wasn’t used much so we had a huge load of students who had come to watch.
We then went in and had the normal scope. The tracheal problem was found with the normal scope and the collapsing pharynx was found with the overground.

I think the bill for that day was only around £850, from what I can remember.

Gosh that sounds like a difficult diagnostic journey - am I correct in thinking that you have/had retired that horse because of those issues? I would very much hope we don't need an overground scope tbh especially as we haven't had any issues relating to fitness or performance so far; my mare had been getting fitter, quicker and working more 'correctly' the more we did. Fingers, and everything crossed here that we are not looking at anything too complex.

 

[scats]

Gosh that sounds like a difficult diagnostic journey - am I correct in thinking that you have/had retired that horse because of those issues? I would very much hope we don't need an overground scope tbh especially as we haven't had any issues relating to fitness or performance so far; my mare had been getting fitter, quicker and working more 'correctly' the more we did. Fingers, and everything crossed here that we are not looking at anything too complex.

We semi-retired her and went to just very light hacking, but unfortunately we then struggled to control her EMS and we had a difficult few months in her final summer with her not being quite right and her breathing rate became almost double what it should be at rest. I made the heart breaking decision to put her to sleep at just 10 years old. She was pretty much the other half of me and I’ve never been so close to a pony before. It absolutely killed me to make that decision but we were in an almost impossible situation.

 

[palo1]

We semi-retired her and went to just very light hacking, but unfortunately we then struggled to control her EMS and we had a difficult few months in her final summer with her not being quite right and her breathing rate became almost double what it should be at rest. I made the heart breaking decision to put her to sleep at just 10 years old. She was pretty much the other half of me and I’ve never been so close to a pony before. It absolutely killed me to make that decision but we were in an almost impossible situation.

I am so sorry you had to lose her. It is utterly devastating to lose a good friend and somehow the ones that need a great deal of help feel even worse. Thank goodness she had you to help her and make all those right decisions for her. I don't imagine you could have done any more or any better at all so she was lucky in that sense. Horribly sad for you.

 

[scats]

I am so sorry you had to lose her. It is utterly devastating to lose a good friend and somehow the ones that need a great deal of help feel even worse. Thank goodness she had you to help her and make all those right decisions for her. I don't imagine you could have done any more or any better at all so she was lucky in that sense. Horribly sad for you.

Thank you. I had an amazing amount of support from people on here who had followed our journey and my struggles to get the vets to believe there was a problem (I was told initially she was simply fat and unfit).

 

[palo1]

Just rushed out to check my herd - it looks very viral here today; 2 horses with high resp rates again and 1 horse (not my mare) with a cough I still thing perhaps my mare has something else going on as she hasn't really moved on in the last couple of weeks which you would hope she might with a virus. So frustrating and worrying!

 

[DirectorFury]

I think AA had a problem with a virus causing respiratory issues a few summers ago - hopefully she’ll see this or it might be worth looking back at her old posts.

Ive nothing helpful to add but sending best wishes, Alw is one of my favourite HHO horses (she comes from the same stud as my mare!) so fingers crossed you can get her sorted and back to normal soon .

 

[SEL]

Just rushed out to check my herd - it looks very viral here today; 2 horses with high resp rates again and 1 horse (not my mare) with a cough I still thing perhaps my mare has something else going on as she hasn't really moved on in the last couple of weeks which you would hope she might with a virus. So frustrating and worrying!

The wash will also look for bacteria in case there's a bacterial infection, so you can rule that in / out. If its all of them then I doubt pollen and that was a real red herring with my investigations (also expensive because of the steroid inhaler - if you are self insured then go for cheapest one!). Have you got any cases of horse flu in the area?

(I was told initially she was simply fat and unfit).

I had that too. In fact it was the experience with my myopathy mare and the fact that I think I feel I let her down by not standing my ground with the vets that made me insist that they kept looking with the microcob. I also flatly refused to ride her when she was so distressed - I KNEW this wasn't anything to do with her fitness levels. I'm not blaming the vets because they are general practitioners but I think sometimes they can be very quick to dismiss an owner's concerns and few of us get the vet out for no reason.

 

[ihatework]

Gosh that sounds like a difficult diagnostic journey - am I correct in thinking that you have/had retired that horse because of those issues? I would very much hope we don't need an overground scope tbh especially as we haven't had any issues relating to fitness or performance so far; my mare had been getting fitter, quicker and working more 'correctly' the more we did. Fingers, and everything crossed here that we are not looking at anything too complex.

An overground scope (dynamic scope) is a really normal procedure to have done. It shows up structural issues when they are at exercise rather than rest, which a regular standing scope while doing trac wash wouldn’t necessarily pick up.

 

[palo1]

I think AA had a problem with a virus causing respiratory issues a few summers ago - hopefully she’ll see this or it might be worth looking back at her old posts.

Ive nothing helpful to add but sending best wishes, Alw is one of my favourite HHO horses (she comes from the same stud as my mare!) so fingers crossed you can get her sorted and back to normal soon .

Thank you so much. I think my little mare is very special; maybe not competitively but in her outlook and willingness. I so hope this won't be too difficult a time for her.

 

[palo1]

Really impressed with my vet. The vet coming to do the scope on Friday rang this morning to see how our horses are doing. I have been taking temperatures and resp rates all weekend and all are looking better though of course Alw is back on a low dose of clenbuterol which is helping her. Vet answered loads of questions about what the endoscope will hope to achieve and reassured me that she is confident that any serious enough structural issues will be identifiable through this scope and that a BAL is planned so that anything/everything deeper into the lungs can be identified. We did discuss the possibility of an overground scope if needed. At this point I do feel more confident that the plan will explore as much as possible structurally, bacterially and in terms of asthma. The swab results from one of our others horses with a raised resp rate should be back by then too so that will provide a few more pieces in the puzzle.

I have been feeling very despairing tbh. Alw is so young and the management of asthma in the summer seems enormously difficult, especially under our grazing/yard system so several deep breaths have had to be taken and not a few tears shed. It is not something I want to get wrong either as every exacerbation potentially creates further respiratory damage and for such a young horse that isn't great. I have managed to purchase a second hand flexineb (basic model) to which I can add the essential nebulising bits if need be and I can go with that. I just can't imagine how on earth you avoid or minimise summer asthma triggers...and I want her to have both a decent quality of life firstly but also a ridden life too (for me). Awful things happen of course and I was so saddened to read the shocking news of LadyGascoyne's beautiful young horse's death which put things into perspective a bit for me. I am just not sure what else (and there will be other things) that I can do to support my horse and her recovery/management.

If anyone has experience of other things, no matter how unusual I would be interested to hear; I am totally up for supplementation etc to run alongside veterinary meds as well as things like grazing shorter grass and breathing techniques (i.e Buteyko breathing - well tried with human asthma sufferers I know but not sure about with a horse...!). Still feeling lost and despairing but I am so glad I have a decent vet on side. And my sweet mare is looking happy enough - gobbling up her supplements and meds and happy out with the others. Onward.

 

[Tiddlypom]

You are getting ahead of yourself a bit here, Palo. Understandably you are very worried about your young mare.

Find out what's wrong first. You have your own land and yard, so are better set up to manage a respiratory issue better than many livery yard clients.

If I need short grass, I run over the paddock with the self propelled petrol garden lawnmower and grass collection box.

 

[palo1]

You are getting ahead of yourself a bit here, Palo. Understandably you are very worried about your young mare.

Find out what's wrong first. You have your own land and yard, so are better set up to manage a respiratory issue better than many livery yard clients.

If I need short grass, I run over the paddock with the self propelled petrol garden lawnmower and grass collection box.

Thank you. That is much appreciated. I know that my anxiety about this is running away with me but it's hard not to consider the future and everything I read about this condition is pretty negative Having our own land and yard does make some options easier but in other ways not so much; I can't really move to somewhere to try that for example and for land and horse management reasons there are some challenges around separating 1 horse but I will do what I can. It is a long wait until Friday and then more waiting for BAL results; the waiting is killing me!! Just like anyone I think who finds that a much loved animal has a (likely) chronic condition there is a sense of broken dreams and horses are generally enough hard work...But you are right and I am doing my best not to catastrophise too much at this point.

 

[SEL]

Thank you. That is much appreciated. I know that my anxiety about this is running away with me but it's hard not to consider the future and everything I read about this condition is pretty negative Having our own land and yard does make some options easier but in other ways not so much; I can't really move to somewhere to try that for example and for land and horse management reasons there are some challenges around separating 1 horse but I will do what I can. It is a long wait until Friday and then more waiting for BAL results; the waiting is killing me!! Just like anyone I think who finds that a much loved animal has a (likely) chronic condition there is a sense of broken dreams and horses are generally enough hard work...But you are right and I am doing my best not to catastrophise too much at this point.

I completely get your anxiety - I have 3 horses at various levels of brokenness and it can be incredibly stressful. I still suspect that if all of your horses are struggling then it is some kind of bug. If it is environmental then have you changed anything at all recently? No matter how minor it might have seemed.

We have a mare with asthma on our yard. She's in her late teens and fast hacks for miles daily - only doesn't school because of an old leg injury. She has a nebuliser for bad days (we had a lot of horse struggle in June this year for some reason) and her owner runs the hose through her hay.

A friend has used salt therapy for her horse which depending on your vet results might be worth investigating. She swears by it.

Keeping fingers crossed its something that is easily fixable