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COPD and SAD
 
Horse Image All we need is the air that we breathe....
But sometimes that's not enough......
Kindly written by Karry Gardner

I've been prompted to write this article about breathing problems because there have been a number of questions recently regarding COPD (Chronic Obstructive Pulmonary Disease) , coughing and SAD (small airway disease) and as I have a horse with asthma/hayfever symptoms, I have a fair bit  of experience with this type of problem that I feel it's time I shared with everyone.
 
Madame Ginger Bits (Hayley) is a 15.3 hand Anglo Arab who is teaching me to ride (along with lots of help from my instructors) . She is 23 years young and usually very fit. Until 18 months ago, her breathing was never an issue.
 
I went away on holiday for 5 weeks at the beginning of January 2001 and when I came back, I noticed that she was coughing a lot - great big hacking coughs that would shake her body and make her sides heave with effort . I felt mean just riding her. She made a gurgling noise in her throat and left her feed most mornings.
 
I got the vet out to see her  and he examined her mouth and told me that I should really have a  split back tooth removed as it was digging into her tongue and causing her distress and stopping her from accepting the bit. He didn't at that time feel that there was any cause for concern with her breathing  and even put her  under a general anaesthetic to remove the tooth.  She still coughed. The vet said that slow cantering would help clear the airways as the rocking motion  would loosen the phlegm in the airways and make it easier to cough up. However, slow cantering a horse having difficulty just breathing felt cruel - there had to another and better way.
 
Horses are not very good at clearing their airways if they become congested and so coughing is like physiotherapy to a horse - it's the only means he has of clearing all the gunk out of his upper respiratory tract so coughing in itself is good - it means the horses immune system and response to debris in the tract is working.
 
When that cough starts to affect the horse's way of going and the horse's sides are heaving with  exertion and effort, it's time to have a re-think.
 
I started by buying Ventipulmin granules to put in my horse's feed which was a complete waste of time and money - the drugs go into the horse's stomach NOT into the respiratory tract so giving medication of this type orally is a waste of time in my opinion. I also bought a herbal remedy (there are many on the market) which, again was useless even after several weeks of feeding it to her.

You've Done Your Best - Now CALL THE VET!!

Time to get the vet involved and so I called him out to examine her properly.
 
First of all, my vet found "whistling" in one bronchial tract which meant she was having difficulty breathing and that explained the "heaves". He suggested two things. The first was that she had a shot of cortisone which suppresses the immune system  and stops the horse from having the allergic reaction  to whatever it was that was causing the allergy. Now, cortisone is not without it's problems and shouldn't be given to overweight horses or ponies by injection. The reason for this is that it can trigger an attack of laminitis so it's not the answer in all cases. However, my mare was not overweight and it was worth the risk. There are two doses that can be given. The first has a shorter effect than the second but is less likely to cause laminitis so we opted for the short dose. MGB was terrified (she hates needles) and wouldn't relax her neck so it took some doing on the vet's part.
 
MGB reacted badly to the cortisone - she sweated up in minutes  and had to be turned out to cool off quickly. This can be a totally normal response even in humans although not all humans or horses experience this. The horse isn't dying , just get it cool as quickly as possible. I went up again later in the evening and she was fine.
 
The vet suggested that we move her to a different box. Her old home ( for 19 years) was in a "box of four" where the boxes looked at each other rather than the more usual arrangement of a line of loose boxes. We moved her into the "line" into a larger box , across from her old box , with more air flow (a great big hole in the ceiling) and also this box was sealed off physically from the box next door. This also meant that the pollen generated by the trees could flow over her box rather than into it .
 
He also wanted her on shavings but I thought that if I did too many things at once then I wouldn't have a clue which of them had worked so she stayed on straw.
 
MGB moved house the next day and seemed happy in her new upgraded bedroom.
 
I talked  at length to my husband, a life long asthmatic who has a vast knowledge of the kinds of drugs available and the effects that these drugs have on the body - he also told me that the very last thing he wanted to do when his breathing is compromised is any kind of physical exercise so I stopped riding immediately. I also talked to my vet again  who was going to a trade show in Scotland and he offered to track me down an equine "spacer" which is a similar device to the one used by human asthmatics to take their sprays. The difference is that humans take their medication through their mouths and horses take it through their nostrils.
 
Now just a word about sprays here.
 
Sprays administer cortisone and bronchio-dilators using actuated particles which are the most effective way of getting the drug into the horses bronchial passages where it can have an effect. Even using a nebuliser either electric or a foot pumped one does not get the particles fine enough to line the tubes properly and so the effect is reduced.
 
On average, a horse of around 15.2 requires 10 times the daily dose that a human requires as a maintenance dosage.
 
The only way of giving these sprays is to use a proper equine "spacer"  with a one way valve system which is clamped over one nostril whilst the other nostril is closed using your hand. The spray is then inserted into the end of the spacer and depressed into it . The horse breathes in, taking the drugs through the spacer and the one way valve through  the nostril and up into the nasal passages and finally into the bronchial passages and lungs. The fine particles line the tubes and lungs where they can begin their job.
 
The first spray is a corticosteriod and the brand name is "Becloforte" or "Becotide" . The spray is usually in a brown "puffer".
 
This spray suppresses the immune system to allow the other drugs to work. It can be reduced after a period of ten days , halving the dose each day after the tenth day until the horse cortisone free. The good news about this way of administration is that it has not been known to cause laminitis like injected or oral steroids so it's safer . I used 20 puffs daily (10 twice a day)
 
The second spray is a fast acting bronchio dilator , brand name "Ventolin" or "Salbutamol" and is blue in colour. This immediately opens up the airways and makes breathing easier and the horse more comfortable. This is used in a consistent amount and I used 20 puffs daily (10 twice a day)
 
The final spray is a long acting bronchio dilator brand name " Serevent" in a green puffer  and this is the one my husband says he could not live without. Serevent keeps the airways open for twelve hours at a time . Again, the dosage is the same.
 
And so MGB lived on this regime all last summer with no breathing problems until the coughing began again in November of 2001. The vet duly came and gave her another cortisone injection and shook his head sadly saying he thought we had really cracked it. I still believed there must be a rational explanation for her relapse and so we made sure that her hay was thoroughly soaked before feeding it to her. She stayed "cough free" on wet hay  and her drugs until Christmas when it was cold and someone gave her dry hay instead and the coughing began again.
 
We took her off hay totally and gave her haylage which at another £20 a week isn't cheap but she coughs only if someone accidentally mixes hay in with her bedding and she then tries to eat it. She is also off all medication and I would only use it now if she began to relapse but I believe that we have found the source of her allergy -HAY !!
 
A lot of horses on our yard are coughing now and I think it's because  we are now feeding last years hay and it's dusty. It might be OK for younger horses with stronger immune systems but my horse needs a bit more coddling at her age .
 
In the past, vets labelled this condition COPD (Chronic Obstructive Pulmonary Disease) but I thinks it's a misnomer.
 
Almost  all the humans who are diagnosed with COPD are smokers - horses don't smoke and so I believe it's an allergy to hay spores, nothing more than that. It gets worse in winter when hay cannot be soaked because it's too cold and the hay freezes and also because the hay is old and dusty. It gets better for some horses if they are turned out because they are away from the source of the problem -  ie .HAY.

Questions & Answers
 
Q. So why should it be that we have fed horses hay for years to no ill effects ?
 
A. Well, I would challenge that statement because how many horses in years gone  by were diagnosed as being "broken winded" and destroyed, possibly as a result of an allergy to hay ? This allergy has been around for years, we were too blind to see it. Hay is not a natural first choice  food for horses - grass is the food that a horse would eat in the wild, hay is man-made.
 
Q. Do why do some horses and ponies get worse when they are turned out ?
 
A. Possibly because like humans, horses have different allergies and some may be allergic or sensitive  to grass pollen or tree pollen and so turning them out makes it worse. Also, think of the increase in chemical spraying these days - how can anyone know what has accidentally got into their field, borne on the wind or into their hay when it was made ?
 
Q. Will my horse get better - the condition is now pretty advanced ?
 
A. Only you can decide how far down he road you want to go with your horse or pony. It's a long task and you have to be prepared not to ride when the horse is bad and to access the situation on an ongoing basis and to spend money on drugs that work - that's not cheap.  I personally  can't put a price on the way I feel about my horse. If the horse gets bad because the condition is untreated  for years, it may not be possible to reverse the situation and euthanasia may be kinder than a suffering horse.
 
Q. Can I prevent this happening?
 
A. You can take  sensible steps to safeguard your horse. Flu injections for younger horses, I think, must be routine. A Flu epidemic can lower  your horse's immunity and cause long term breathing problems ,leaving the horse vulnerable to allergies.
 
You can make sure that you always feed good quality, wet hay. If the quality gets poor or the hay gets old or it's too cold to wet it, feed haylage instead.
 
You can put your horse onto wood shavings so he can't eat the bed and inhale straw spores but  I don't think that straw is the culprit here. It's harder  and less dusty so less likely to go mouldy and harbour spores.
 
You can take on board that older horses have weaker immune systems so as your horse gets older be aware that his dietary need will alter and his ability to shake off minor coughs lessens and his lung function isn't as strong so your horse needs food appropriate to his age along with all other considerations.
 
Q. Are there any homeopathic alternatives to the use of the drugs ?
 
One suggestion that I was unable to try was feeding locally gathered honey (within a 3 mile radius of where your horse is kept). Honey is a naturally occurring anti-biotic and contains histamine. Histamine can cause allergies in people and animals and so feeding a little back strengthens the immune response and the horse can fight the reaction using his own immune system.
 
I had no success with other proprietary "herbal mixes" and it would have taken months to build up the levels in the horse to have any noticeable effect and I didn't have months - I had a sick horse !!
 
There may be some mileage in contacting a homeopathic vet - one who trained in conventional medicine as well as homeopathy as some horses have benefited from being given naturally occurring anti-histamines to build the immune response  and have been "cured" of their hay allergy. I don't know the specific homeopathic remedies but there are vets out their who swear by this approach.
 
(I hate the word cured - only bacon is cured in my opinion !!)
 
I am not an expert, I am not a vet and so any of the information contained in this article is a statement based directly  upon my own experiences.
 
If I can be of help to anyone on this subject , please email me , I am happy to discuss even if I cannot promise a cure -  but   please be prepared - I can be quite blunt if I think that you should have called the vet out ages ago and your horse is suffering as a result.
 
Horses are not cheap to keep and only a vet can prescribe any of the drugs I mention here for your horse and that may involve expense.
 
I cannot put a price on the life of my little mare . . .
- can you put a price on the life of yours ?

 
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