What to nebulise my horse with?

[tashcat]

My gelding has COPD/RAO, suffers with coughing (including coughing fits which brings up a fair amount of mucus) and wheezing/ difficultly breathing. The time of year affects how poorly he is, and he's affected by dust and pollen in particular.

We've had a lot of investigations and treatments over the years, and when the problem flared up again I decided to look into more long term solutions. Often his 'go-to' treatment was oral steroids, which I really want to avoid on a long term basis where possible.

So £707 later I bought a Flexineb nebuliser. I have been really pleased with the results, and can see the difference. He now no longer coughs or gets short of breath unless we have a long trot or start to canter (this is a huge improvement - walking in from the field would be straining before). However I cannot help but feeling that I wish his chest would be a bit more clear. I know nebulisers aren't a magical treatment that will cure him, but after spending so much money I would love to see more improvement.

He's currently being treated with dexamethasone. I've heard of something called equisilver which might be worth considering - anyone have any experiences?

I guess I'm hear to ask if anybody has a nebuliser and can talk me through what medicines they use in it, and what you would recommend? Also how much of the medicine do you nebulise each time and how often?

Just a little disclaimer, this treatment option has been devised with the advise of my vet. He suggested dexamethasone so that is currently all I have used. I am speaking with him on monday so will ask him the same questions - I just wanted to hear a few other opinions

 

[Mrs G]

A friend uses balsamic air in her horse's nebuliser now (after steroids and other such medication including dexamethasone I believe). Horses has his nebuliser on for about 20 mins before she rides and she says it has helped hugely X

 

[Equi]

Not horse, but a client of mine uses a saline at 5ml (average human size) when he gets breathless. The respitory nurse said this will help to break up the phlegm and get rid of it on top of the rest of the drugs.

 

[Mrs G]

Yes as equi mentioned; the balsamic air is mixed with saline.

 

[tashcat]

Thank you Mrs G! I have heard of balsamic air, but I always thought it was more for antibacterial purposes than a treatment for COPD - will have a look into it

 

[tashcat]

Haha Equi I feel like I'm always using human things on horses! I currently do give him saline, but its mixed with dexamethasone, and only 2ml once a day. Increasing the dosage could definitely be a possibility, thank you.

 

[GoldenWillow]

My mare had RAO and for the last 3 yrs she was on an inhaler during the pollen season. She used a human asthma preventative inhaler Beclometasone (brown inhaler) prescribed initially through Royal Dick, Edinburgh and then my vet. I used to get a prescription from my vet and get it from a supermarket pharmacy as it was much cheaper this way.

 

[Equi]

Have you a pic of him on the neb ? Never seen one before I'm quite interested.

 

[ILuvCowparsely]

My gelding has COPD/RAO, suffers with coughing (including coughing fits which brings up a fair amount of mucus) and wheezing/ difficultly breathing. The time of year affects how poorly he is, and he's affected by dust and pollen in particular.

We've had a lot of investigations and treatments over the years, and when the problem flared up again I decided to look into more long term solutions. Often his 'go-to' treatment was oral steroids, which I really want to avoid on a long term basis where possible.

So £707 later I bought a Flexineb nebuliser. I have been really pleased with the results, and can see the difference. He now no longer coughs or gets short of breath unless we have a long trot or start to canter (this is a huge improvement - walking in from the field would be straining before). However I cannot help but feeling that I wish his chest would be a bit more clear. I know nebulisers aren't a magical treatment that will cure him, but after spending so much money I would love to see more improvement.

He's currently being treated with dexamethasone. I've heard of something called equisilver which might be worth considering - anyone have any experiences?

I guess I'm hear to ask if anybody has a nebuliser and can talk me through what medicines they use in it, and what you would recommend? Also how much of the medicine do you nebulise each time and how often?

Just a little disclaimer, this treatment option has been devised with the advise of my vet. He suggested dexamethasone so that is currently all I have used. I am speaking with him on monday so will ask him the same questions - I just wanted to hear a few other opinions

I have one of these and it really helped my mare http://eramask.com/

 

[loz9]

hi tashcat,
I have being using a flexineb on my mare for almost 3yrs now. She is allergic to grass pollen, so has summer copd, & is luckily fine with dust in winter.
I have used several variations on meds/saline/balsamic/equisilver so I will try & explain what I have found with them. But feel free to ask me anything & I will offer my opinion
Meds - I only use these when she is really bad, but this can mean being on them throughout the spring/summer. I usually give it to her just before exercise to maximise the effect. She has a combination of dexadreson (steroid), ventapulmin & if she has a lot of mucus we add in antibiotics for 10days. I will also add here she has had lami in the past, & is still very prone to it. The vet has said the lami risk from the steroids is so minimal as it is being targeted specifically at her airways, & because of this we can use such a small amount. She receives 1-2ml of each drug + the equivalent in saline, so usually 6-10mls per session.
Saline on its own - I occasionally give her (or my other horses) a session of 5-10mls if they are particularly snotty at anytime of the year. It helps to soften the mucus making it much easier for them to clear.
Balsamic air - smells very menthol-y. It seems to dilate the airways making it much easier for them to expel the mucus. I mix with equal amounts of saline as this is what the advisory sheet suggested.
Equisilver - I used this for a short while, but it seemed to turn the medication cup black. No idea why, sent it back to the manufacturer & they couldn't understand it either, but did send me a new cup out Haven't tried it since as the medications cups cost a fortune!! May try again this year, but so far she is doing really well without her neb at all.
At its highest she was on 16ml per session, which was twice a day, but her average is about 8-10mls as I sometimes add a bit more saline to help break everything up.

 

[loz9]

Have you a pic of him on the neb ? Never seen one before I'm quite interested.

Hopefully this should be a pic of my mare, she's cross tied in her door to stop her breaking it as parts are rather expensive!

[/URL]

 

[tashcat]

hi tashcat,
I have being using a flexineb on my mare for almost 3yrs now. She is allergic to grass pollen, so has summer copd, & is luckily fine with dust in winter.
I have used several variations on meds/saline/balsamic/equisilver so I will try & explain what I have found with them. But feel free to ask me anything & I will offer my opinion
Meds - I only use these when she is really bad, but this can mean being on them throughout the spring/summer. I usually give it to her just before exercise to maximise the effect. She has a combination of dexadreson (steroid), ventapulmin & if she has a lot of mucus we add in antibiotics for 10days. I will also add here she has had lami in the past, & is still very prone to it. The vet has said the lami risk from the steroids is so minimal as it is being targeted specifically at her airways, & because of this we can use such a small amount. She receives 1-2ml of each drug + the equivalent in saline, so usually 6-10mls per session.
Saline on its own - I occasionally give her (or my other horses) a session of 5-10mls if they are particularly snotty at anytime of the year. It helps to soften the mucus making it much easier for them to clear.
Balsamic air - smells very menthol-y. It seems to dilate the airways making it much easier for them to expel the mucus. I mix with equal amounts of saline as this is what the advisory sheet suggested.
Equisilver - I used this for a short while, but it seemed to turn the medication cup black. No idea why, sent it back to the manufacturer & they couldn't understand it either, but did send me a new cup out Haven't tried it since as the medications cups cost a fortune!! May try again this year, but so far she is doing really well without her neb at all.
At its highest she was on 16ml per session, which was twice a day, but her average is about 8-10mls as I sometimes add a bit more saline to help break everything up.

Thank you for such a fab answer!
I believe dexadreson is another name for dexamethasone so sounds like we're giving them the same thing. Following on from your and Mrs G suggestions, I think I will try balsamic air - its not too expensive too Will ask my vet about ventipulmin - I know he's had it before (maybe in powder form?) but not in his nebuliser. Don't remember it being that effective when it was oral, but nebuliser might mean the drug targets the area better.
Your experience with equisilver sounds strange - thankfully they replaced the cup!
Do you wash your cup immediately after every use? I'm finding this bit a tad tedious (and I end up using so much distilled water every time!) but I don't want to mess things up by not doing it!
So what do you give your mare on a daily basis if you try to avoid medication unless necessary? Do you mix balsamic with the steroids (when you give it) or do you nebulise these separately?

Sorry for all the questions and thank you x
Also this is a random question, but it is okay if the medication cap is not full before starting right?

 

[tashcat]

Have you a pic of him on the neb ? Never seen one before I'm quite interested.

I do have quite a few photos but for some reason the forum won't let me upload them! Will try again tonight

 

[loz9]

You're welcome I actually know the livery Mrs G is on about (& I'm sure she will have worked out who I am now!) & it was me who put the livery on to the flexineb as she had been using human inhalers with no success.
The ventipulmin is sold as injectable & quite pricey, altho I now get a prescription with the 3 drugs on with 3 repeats which saves a fortune. The powdered form was useless for mine & she was on a massive amount, at 1 point I was going through a tub every week. The injectable lasts a minimum of 25days at 2ml/day, so much more cost effective. I was however told it is only effective for around an hour after use, hence why I give it just before exercise.
I fetch the cup & battery into the house after each use to clean, but I usually ride, etc first so can be left for a couple of hours. I bought the specific cleaner that was recommended by the manufactures (sorry cant remember name) & it has lasted ages. I'm only on my 3rd bottle 3yrs later! Spray 3 squirts in, shake, leave for 5mins (unless I forget about it & then it can be a fair bit longer!!) & then nebulise it through. I've lost count of how many medication cups I've used now, but seem to get a pretty good run out of them with this cleaning technique.
Daily neb would be approx 5ml balsamic air & 5ml saline mixed together when avoiding drugs. I mix anything & everything together, have done steroids with the balsamic to no ill effects. I usually quickly make up her dosage & get it running then get out tack etc, & groom whilst she's wearing it, & its finished when I am.
I have run my cups empty before, usually towards the end of the dose so not intentional, but it hasn't damaged them.
Honestly ask away & I will try & help There were so few people using them when I got mine that I had no one to ask & felt rather lost.

 

[thezulu]

Watching this with interest. Having purchased my nebuliser today! My mare suddenly started coughing in March. It was a dry cough and no mucus. Scoped/bloods and only issue is white blood cells (so inflammation) so we are left with Asthma. So out of the blue and unexpected! She has tried all the drugs ventipulmin, sputolosin and oral steroids. All the time she was getting worse and worse. So we are now on a nebuliser with ventipulmin and a steroid. Which will hopefully start to see the rate go down as I have no idea where we go from here..... she started coughing about 7 days after having her flu jab. So can only assume this has had some influencing factor in either causing or triggering these events.

 

[tashcat]

Honestly ask away & I will try & help There were so few people using them when I got mine that I had no one to ask & felt rather lost.

Thank you again - I know horse nebulisers are a lot more common now then when you started, but it still felt very daunting when I bought mine, and I felt there weren't that many people who I could talk to about it! I could only really find testimonials from race horses, and thats definitely nothing like my fluffy 14'2!

Interesting to hear the ventipulmin is pricey (I remember it to be steep in powder form) - glad to hear I'm not the only one with little success with it in the powder form! Thank you for telling me about it, but think I might forego it; as much as I want him to be able to breathe like he used to when we ride, I think longer lasting drugs might be more beneficial. Also I tend to nebulise when it suits us best so I'd probably always forget to do it before we ride!

Also I'm pleased to hear you don't religiously clean yours straight after use - the Flexineb team scared me slightly in saying it would wear out in weeks if I didn't! I generally wash it after every use, but usually a few hours later! I've been using washing up liquid and distilled water so if you do remember the name of the cleaner that sounds so much easier! Will do some internet research and see if I can't find it.

Do you find Balsamic air and saline effective enough in themselves? And would you say Balsamic air helps out more than the steroids alone?

Thanks loz9

 

[tashcat]

Watching this with interest. Having purchased my nebuliser today! My mare suddenly started coughing in March. It was a dry cough and no mucus. Scoped/bloods and only issue is white blood cells (so inflammation) so we are left with Asthma. So out of the blue and unexpected! She has tried all the drugs ventipulmin, sputolosin and oral steroids. All the time she was getting worse and worse. So we are now on a nebuliser with ventipulmin and a steroid. Which will hopefully start to see the rate go down as I have no idea where we go from here..... she started coughing about 7 days after having her flu jab. So can only assume this has had some influencing factor in either causing or triggering these events.

Oh no that sounds awful, especially as it was so unexpected! Thankfully I've been dealing with mine for a few years, so got quite used to it now. Did you order a flexineb or different branded nebuliser?

Fingers crossed the nebuliser will work for you mare - I've been really pleased so far. I also couldn't believe how amazing my chap was with it - he was so scared of it even if I just held it to begin with - and a week later he's happily putting it on. I think he might realise its helping as he breathes super deeply when its on! If you haven't put it on your mare yet (and if she's easily spooked) I'd say spend a few days introducing it to her, and putting it on her face without turing it on. I think a lot of repetition and positive reinforcement really helped mine adjust to the scary machine! If you have already put it on, how did she take it? Would be interested to hear how different horses react!

Keep us updated, this is such a new topic to me and would be really interesting to see how it works for different horses and conditions!

 

[thezulu]

My mare stuck her nose in the first time I attempted it!! Bless here heart. Initially a bit stressed when the drugs came billowing out, but I just opened the vets a bit and she calmed down. Their trust in us never ceases to amaze me So we started nebulising on Saturday. As she took to it like a duck to water I purchased the Flexineb one yesterday. The vet charges £10 a day.... so at what point do you buy your own? Sooner rather than later I guessed and from what I could gather it would be used for a fair amount of time.
Her Resting Respiratory Rate had been in mid to late 20's from when this all started a few weeks ago and peaked Sunday night at 31! (I *****e myself). I am now compiling a diary of diet/turnout/pollen count/etc. Someone was cutting there lawn when I rode Sunday and she started coughing almost immediately.

Anyway, this mornings RRR 18!!! I am so happy. Long may this continue The one could thing with the nebuliser is at least you can hear when they are breathing to count

 

[tashcat]

How fab she sounds, I love how trusting they can be!

My vet told me to count his RRR and I've been struggling to count - never even thought to do it when the nebuliser is on so thank you for that; he breathes like a steam train then so it would be hard not to count!!

My vet didn't seemed to have much experience with nebulisers, so I actually found out about it online then asked him what he thought - the trial idea sounds fab, apart from the £10 a go! Did your vet use a flexineb one too? I found a few other nebulisers online but thought flexineb looked best.

Glad to hear its helping - lets hope it keeps getting better!

 

[thezulu]

Yes my vets also had the flexineb one. They have two at the practice. Breathing rate still at 18 I am looking at purchasing the Balsamic Air and the Silverstuff to try for when we cut down the drugs. Currently on 3ml ventipulmin/3ml Colvasone (steroid) twice a day for another 7 days, then to 2ml of each for 7 days and then to once a day.....

 

[tashcat]

Yes my vets also had the flexineb one. They have two at the practice. Breathing rate still at 18 I am looking at purchasing the Balsamic Air and the Silverstuff to try for when we cut down the drugs. Currently on 3ml ventipulmin/3ml Colvasone (steroid) twice a day for another 7 days, then to 2ml of each for 7 days and then to once a day.....

Thats interesting that they had two! We're on 2ml dexamethasone and 2ml saline so sounds like we've got the cheaper option! Yes me too with the balsamic air, and equisilver. His resting respiratory rate was around 11 yesterday! So pleased Vet was thinking high teens, early twenties - a bit like yours now. So we're hoping to reduce his dosage from Monday! Thrilled is an understatement! Any improvement for your mare over the last couple of days?

 

[ester]

things have definitely improved, we had a pony at the RS 15 odd years ago and that one came with a foot pump... foot pump was rapidly dispensed of in favour of YO's daughters nebuliser attached to the nosebag!

 

[tashcat]

things have definitely improved, we had a pony at the RS 15 odd years ago and that one came with a foot pump... foot pump was rapidly dispensed of in favour of YO's daughters nebuliser attached to the nosebag!

Haha that sounds fab! I can imagine the pumper getting a very achey foot! All joking aside its probably a much cheaper option and works just as well - I did consider making a horse nebuliser with an upturned bucket attached to a human nebuliser; at 1/20th of the price! Sadly my DIY skills wouldn't be up to the mark..!

 

[brucea]

You can get Salbutamol nebules for use with a nebuliser. Under the trade name Ventolin

I have one with COPD and this is what we use in the Trudell AeroMask.

We used Clenil inhalers for a while but found they were pretty much useless.

 

[brucea]

Just to add this is something that the vet will have to give you a prescription for and you get frm a chemist who can file a vet prescription.

http://www.drugs.com/uk/ventolin-nebules-2-5mg-leaflet.html

It's what they use in humans for emergency symptomatic relief and works well.

 

[ester]

Haha that sounds fab! I can imagine the pumper getting a very achey foot! All joking aside its probably a much cheaper option and works just as well - I did consider making a horse nebuliser with an upturned bucket attached to a human nebuliser; at 1/20th of the price! Sadly my DIY skills wouldn't be up to the mark..!

Child labour

 

[tashcat]

Child labour

Hahahhahhaaha

 

[tashcat]

You can get Salbutamol nebules for use with a nebuliser. Under the trade name Ventolin

I have one with COPD and this is what we use in the Trudell AeroMask.

We used Clenil inhalers for a while but found they were pretty much useless.

That a a type of bronchodilator right? Thank you, will have a look into that! How much do you give your COPD sufferer?

 

[loz9]

Sorry it's taken so long for my to reply to this thread!
This is the disinfectant I use: http://www.breatheazy.co.uk/product/protek-envirocair-disinfectant-2/

With regards to if the balsamic air works as well as when used without the steroids, I honestly don't know as its rare that I use them separately during the pollen season with her, & when not in pollen season she's usually fine with nothing. She's also a bit more complicated than just copd as sadly (if I'm remembering it correctly!) when she was first diagnosed the inflammation from her allergic reaction was causing her soft palate to collapse. So initially she was misdiagnosed & the copd missed, the displacement of the soft palate was treated (unsuccessfully, was only given 20% chance of success anyway due to severity) & it was only when I kept pushing as to why the soft palate had suddenly started collapsing did we discover the allergy. Now the allergy causes very few issues, but the soft palate means when she is ridden in any outline she starts to 'choke' And I thought I'd be getting a nice simple Newfie cross when I bought her at 10mths! She's one of the most high maintenance horses I know!!