You’d think a colic surgery, PSSM and shivers, headshaking, and even a pulled suspensory years ago would be enough problems in one horse. But you’d be wrong.
What’s wrong with the silly horse now?
I don’t know whether my horse is lucky that he has a veterinarian for an owner or unlucky. On the one hand, I notice abnormalities pretty quickly and get right on them, with no farm call or physical exam fees. On the other hand, I probably tend to look at him with a magnifying lens when sometimes it’s best to just look the other way. And in fact I had been “looking the other way” for a couple of years now whenever he coughed or had nasal discharge, hoping I guess, that these signs would just go away or were somehow normal. However, coughing is never normal in a horse, and after the Polar Vortex winter here in the Midwest, his occasional cough at the start of exercise became coughing throughout exercise as well as coughing in the morning. Plus the slightly snotty nose became a seriously snotty nose—especially when I trailered—so it was time to stop burying my head in the sand and face facts before the Inflammatory Airway Disease that my wonderful horse clearly had progressed into full-blown Recurrent Airway Obstruction, aka Heaves.
How much is all this testing going to cost?
Before I could “face facts” I had to gather them, so step number one was having him thoroughly evaluated for a respiratory condition. Worried about trailering my prone-to-colic, tying-up, delicate flower of an equine hours away to the nearest veterinary teaching hospital, I found an equine veterinarian board certified in internal medicine that did farm calls! She was fantastic, performing a full physical examination then specialized testing to definitively diagnose his condition, determine the extent of it, and then develop a treatment protocol around these findings. Newman was a trooper for everything, which included drawing blood, using a rebreathing bag, performing a chest ultrasound, and even subjecting him to bronchoalveolar lavage (BAL). In this procedure, carried out under sedation, a tube is passed into the lungs so that saline can be infused then recovered, capturing inflammatory cells, which are then looked at under a microscope to both quantify and qualify.
But isn’t there anything else I can do to help manage the condition?
As suspected, my horse definitely had Inflammatory Airway Disease, so now it was time to develop a treatment and management plan. Since this disease is triggered by allergens in the horse’s environment, we talked through all the “usual suspects” such as hay (no, we don’t store hay in the horse barn but in a separate barn plus we have a hay steamer), turnout (yes, he’s outside in a paddock or pasture nearly 24/7), barn (no, the aisles are never swept when horses are inside), stall (yes, we use paper bedding), footing (yes we use a humectant/hygroscopic agent). There wasn’t a whole lot more I could do to reduce his exposure so we turned to medication, incorporating supplements with ingredients proven to support normal, health respiratory function.
Puff the Magic Dragon
Starting a horse on prescription inhaled therapy is not cheap. It’s also not for the disorganized. Newman’s regimen began with 4 “puffs” or actuations of a bronchodilator followed in 15 minutes by 12 “puffs” of a corticosteroid. This is accomplished using a MDI (metered dose inhaler) through an EAC (equine aerosol chamber) twice a day. Yikes. Thank goodness my barn owner is willing to help me give one of the treatments, or I’d meet myself coming and going from the barn. Newman gets a gold star for being a model patient, and we don’t even put his halter on anymore to “puff” him (or as I call it, “spritz” him). Could that have something to do with the fact that he gets his favorite treat, Hilton Herballs afterwards? Hmm…
Lydia F. Gray, DVM, MA SmartPak Staff Veterinarian and Medical Director Dr. Lydia Gray has earned a Bachelor of Science in agriculture, a Doctor of Veterinary Medicine (DVM), and a Master of Arts focusing on interpersonal and organizational communication. After “retiring” from private practice, she put her experience and education to work as the American Association of Equine Practitioner’s first-ever Director of Owner Education. Dr. Gray continues to provide health and nutrition information to horse owners through her position at SmartPak, through publication in more than a dozen general and trade publications, and through presentations around the country. She is the very proud owner of a Trakehner named Newman that she actively competes with in dressage and combined driving. In addition to memberships in the USDF and USEF, Dr. Gray is also a member of the Illinois Dressage and Combined Training Association (IDCTA). She is a USDF “L” Program Graduate and is currently working on her Bronze Medal. Find Dr. Gray on Google+
Very interesting. I think every horse owner should be armed with great detailed information. You never know when you or a friend needs the info. when something like this condition begins to surface. Thank you so much for sharing. So happy you were able to help your horse.
Dr. Gray, I’m interested in Newman’s shivers condition. I have a coming 8 year old Trakehner gelding that I bought as a wealing. He was diagnosed with shivers (not PSSM) at 4 years. Compared to videos of shivers horse I have seen, his condition is mild. He shows an unsteadiness when backing up and makes involuntary hind leg movements when standing at rest. The condition doesn’t seem to interfere with his movement under saddle or on the longe line. How old is Newman and has his shivers condition changed over time? I understand that sometimes it progresses and sometimes it doesn’t. I would appreciate any information you have about shivers from personal experience. I’m also an amateur dressage rider and the horse in question is showing 1st level, training 2nd and 3rd and I’ve started half steps. I have a competent trainer who supports the “magnifying glass” approach, while I prefer to “look the other way” and avoid pessimistic self-fulfilling prophecy. I’m looking for evidence to support my outlook. Thanks for your help.
My horse too has this problem, was worked up at Tufts and dignosed with IAD. I was told I needed to act to prevent it from progressing to heaves. With careful management ( now lives outdoors, keep away from dust, barn aisles not swept with horses in etc.) he has done very well. He started with Ventolin (albuterol) and QVAR (beclomethasone) puffers through a one nostril Aerohippus mask. The regimen was tapered and the albuterol removed (except as needed as a “rescue”). He currently gets 5 puffs of QVAR every other day or 3-4 times a week. He has learned to count to 5, which is when he gets the carrot treat – although he will try to make you think you counted wrong! He just stands there and it’s no big deal. I also put him on Smartbreathe powder (no longer available) then switched to the pellets. Except for a one week stretch earlier this fall, I have not had to use the albuterol in the 3 years since his diagnosis. His follow up BAL showed marked improvement but still inflammation even with no obvious symptoms, so we have kept up the treatment. We have not had anymore incidences of him breathing at 60 rpm just standing still which is what started the whole journey. I actually order my meds from a foreign pharmacy, and it is much less expensive than here, similar to what happens when you get your meds in Canada vs US. (ie ventolin $15 vs. $49) You have to allow shipping time, but I have had no issues,and they have the scripts with my horses name, my last name followed by Equine. Since he also has chronic renal failure (managed since age 5 with diet and controlling risk factors) I am careful about heat,humidity, dehydration, medications (which is why the inaled meds are better for him) but he has been able to act like a normal horse. He will be 16 in May, he looks good, feels good, and his labs are almost normal.
I hate to say this, but why did you wait so long? 🙁 I am not a vet and it was clearly not normal. I have seen this happen many times, where the owner looks the other way because they want to keep riding. Meanwhile the horse suffers. It is just not right. I always believe it is better to catch things when they are small.