Heaves, Heat & Testing


millionairess1989
 

Jack has been having a really tough time with heaves causing prolonged wheezy respiration and often wide flaring nostrils. The entire month of June has mostly been in the mid to upper 90s with only a few days in the 80s. The heat and humidity are what really affect him.

He's turned out 24 hours with access to a run in shed. I've moved his daytime hay & water there. He's needed Albuterol so often that we're changing to compounded Clenbuterol since Ventipulmin isn't available. He gets a dose of Dexamethasone (usually around 2ccs) when he's really bad. I know that isn't ideal but it's better than not breathing. Luckily he has hooves like iron (knock on wood) to which my foot can attest. I've started Lung EQ twice daily, his hay is soaked, he gets 1 cup of ground flax with his beet pulp and is on 1.5mg of Pergolide.

Is there anything else that I can do to help him?
Will the weather, Albuterol and/or Dex, or the chronic heaves affect rechecking his ACTH, Insulin and Glucose levels? 
I would like do do that soon to see if any of that is adding to the problem.

Thanks,
--
Jennifer in Middle TN  2010
 Millionairess 33 1/3 yrs Arabian-PPID, IR & Pacemaker Dependent; 2-13-89 to 6-11-22
Jack 23 yrs TN Walker- IR & RAO

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Millionairess

https://ecir.groups.io/g/CaseHistory/album?id=831

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Jack-TN%20Walker


Eleanor Kellon, VMD
 

Is he sweating?

ACTH, and therefore insulin and glucose, can spike with acute episodes but usually not longstanding problems like this. However, the dexamethasone can affect results for as long as 2 weeks.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


millionairess1989
 

Yes, he still is sweating.
--
Jennifer in Middle TN  2010
 Mill 33 1/3 yrs Arabian-PPID, IR & Pacemaker Dependent; 2-13-89 to 6-11-22
Jack 23 yrs TN Walker- IR & RAO

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Millionairess

https://ecir.groups.io/g/CaseHistory/album?id=831

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Jack-TN%20Walker


canequinmorgans@...
 

Jennifer, I don't know if this will help Jack, but years ago I sold a horse to a breeder in southern France.
She told me in summer she had to hose all her horses down twice a day AND stall them with a running fan until late evening.  I don't know if Jack would tolerate that, or if it might exacerbate his RAO.  Since he's PPID, he may need a close clip as well.  
--
Beth Benard
2003
Rome. NY


millionairess1989
 

Hi Beth,

Thanks for the ideas. Jack's hair coat is normal aside from a few stray long hairs. I'd worry about sunburn if he was clipped. Since my 33 1/3 year old Arabian mare died 2 weeks ago he has sole access to a run in shed which gives him more ventilation than he would get in a stall. Maybe if we ever get rain it will curt down the dust and help his breathing. 
--
Jennifer in Middle TN  2010
 Mill 33 1/3 yrs Arabian-PPID, IR & Pacemaker Dependent; 2-13-89 to 6-11-22
Jack 23 yrs TN Walker- IR & RAO

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Millionairess

https://ecir.groups.io/g/CaseHistory/album?id=831

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Jack-TN%20Walker


TERRI JENNINGS
 

The combination of Spirulina, elecampane, j herb and euphrasia got Beefy off of his inhalers.  He was using albuterol and fluticazkne inhalers 2-3 times a day before we started treating him with herbs. I dropped the j herb when we found out he had PPID but he is still not needing his inhalers even in the heat, and insane pollen amounts.  I do not know if elecampane and euphrasia are safe for IR horses.  When Beefy was dependent on the inhalers I did notice that the fluticazone worked much better than the albuterol. Again, I’m not sure it’s safe for horses with IR

--
Terri Jennings with Mr. Beefy, Finn, Elliott and Teeny (over the rainbow)
Arcata, CA
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny/Terri%20and%20Beefy
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny/Terri%20and%20Elliott/Elliott%20Case%20History.pdf
https://ecir.groups.io/g/CaseHistory/files/Terri%20and%20Teeny/Terri%20and%20Finn/Finn%20Case%20History.pdf


Joined 2019


Frances C
 

What was the reason for taking him off J-herb once you had a diagnonis of PPID?
--
- Frances C.
December 2017, Washington & California
Case history: https://ecir.groups.io/g/CaseHistory/files/Frances%20and%20Phoenix
Phoenix's Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=12382


millionairess1989
 

Hi Terry,

Thanks for the reply.

Does anyone know if elecampane and euphrasia are safe for PPID & IR horses?

Jack seems to be doing a little better since starting the Clenbuterol. The wheeziness has decreased some and there's less heaving and nostril flaring.
--
Jennifer in Middle TN  2010
 Mill 33 1/3 yrs Arabian-PPID, IR & Pacemaker Dependent; 2-13-89 to 6-11-22
Jack 23 yrs TN Walker- IR & RAO

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Millionairess

https://ecir.groups.io/g/CaseHistory/album?id=831

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Jack-TN%20Walker


Eleanor Kellon, VMD
 

Jennifer,

They are safe but unlikely to help.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Sherry Morse
 

Hi Jennifer,

For my mare who had breathing issues for years pre-PPID diagnosis she actually did better in a stall with a fan on her during the day than being outside.  We would hose her off before putting her in, kept the bedding to a minimum and kept it damp and she was in a shed row so as much air moving as possible.  Spirulina helped as did some homeopathics and Breather Powder from Spring Time Inc. worked great until she stopped eating it.  

I'd definitely check ACTH level as soon as you can after the Dex is out of his system as it may have an effect on the breathing too, but if you can you might want to see if he's better inside than out, at least for during the day.




celestinefarm
 

Jennifer,
Having just gone through a number of years of this with Tipperary, I would also suggest you consider a nebulizer for Jack. I wish I would have had one several years ago when Tipperary's heaves symptoms became chronic. Most vets seem hesitant to recommend one because of the cost, but in reality, with the cost of ventipulmin( clenbuterol syrup) and the fact that when administered daily, it loses its effectiveness around 30 days, and you have to discontinue then ramp up again, a nebulizer's cost ends up equivalent and less over time. Albuterol ampules that you use to drop it in the nebulizer cup are extremely inexpensive. I paid $23 for a box of 30. If you only nebulize once or twice a day, you're looking at barely $1 a day as opposed to systemic clenbuterol which was costing $130 for a 120 ml bottle that lasted 12 days at 5ml 2x a day.(minimum dose for a 1000# horse) . I tried Albuterol syrup and it didn't do much of anything. I also tried the Aservo Equihaler last fall with aerosolized ciclesonide and it made a major difference for the week he was adminstered it. It seemed to last for a few weeks then you needed another one. The last time I bought one it cost $350. And helped for two weeks. 

I bought the Flexineb Nebulizer after researching what was out there. My vet only has one other person in the practice using one and he had me call her for advice on how to use as he did not know how to work one himself. She has a Halflinger with heaves in which she had gone down the same path I had and felt that without the nebulizer , she would have had to euthanize him a couple of years ago. Tipperary got to the point he was perturbed if I didn't give him his nebulizing treatment( some cool breezy clear days this spring he was breathing well and didn't seem to need it). It helped him that much and he knew that within five minutes of nebulizing he could breathe better, the halflinger apparently was the same way . A Flexineb is $1200 but can be used for all kinds of meds,or just saline, and on different horses. 

I also steamed Tipperary's hay, bedded him on Guardian shavings we had to make a 3 hour round trip to get( they are triple vacuumed and are the only ones I found he didn't react with wheezing) and made sure he had big fans, doors open, and double buckets of water. Wetting him down was essential . I was going to clip him this year, you can clip Jack and keep him out of direct sun. I know the conventional wisdom is that he needs to be outside, but these older horses cannot tolerate direct sun and having them in constant shade with air moving is preferable IMO, to having them outside. Also make sure you have him on an amount of pergolide that keeps his ACTH in the low teens. Tipperary had more flare ups when his ACTH was elevated. 
--
Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

Juniper Case history: https://ecir.groups.io/g/CaseHistory/files/Dawn%20and%20Juniper/Case%20history%20Juniper.pdf .


millionairess1989
 

Thank you Dr. Kellon.
--
Jennifer in Middle TN  2010
 Mill 33 1/3 yrs Arabian-PPID, IR & Pacemaker Dependent; 2-13-89 to 6-11-22
Jack 23 yrs TN Walker- IR & RAO

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Millionairess

https://ecir.groups.io/g/CaseHistory/album?id=831

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Jack-TN%20Walker


millionairess1989
 

Hi Sherry,

What homeopathics did you try? Was your horse IR as well? It looks like the Breather Powder contains sucrose :(

Unfortunately I have a typical gable roof 6 stall barn. I'd worry about leaving him inside for 12 hours while I'm at work. The run in shed is actually a continuation of the roofline off to the side so the entrance is about 10 feet wide and 20 feet deep. He'll get better air flow and it will be less dusty that in the barn.

Yes, I do plan to retest ATCH as soon as possible and increase Pergolide accordingly. 
--
Jennifer in Middle TN  2010
 Mill 33 1/3 yrs Arabian-PPID, IR & Pacemaker Dependent; 2-13-89 to 6-11-22
Jack 23 yrs TN Walker- IR & RAO

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Millionairess

https://ecir.groups.io/g/CaseHistory/album?id=831

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Jack-TN%20Walker


millionairess1989
 

Hi Dawn,

Thank you for sharing your vast experience with Tipperary. Nebulizing is certainly a possibility that I hadn't considered yet and will look into. Our nearly unrelenting hot and humid weather here in TN has made us move past Albuterol to compounded Clenbuterol. 
--
Jennifer in Middle TN  2010
 Mill 33 1/3 yrs Arabian-PPID, IR & Pacemaker Dependent; 2-13-89 to 6-11-22
Jack 23 yrs TN Walker- IR & RAO

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Millionairess

https://ecir.groups.io/g/CaseHistory/album?id=831

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Jack-TN%20Walker


celestinefarm
 

Jennifer, you're welcome. If you need any help or suggestions with the Flexineb, contact me privately here . I don't want to clog up the list with details on nebulizer instructions. 
--
Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

Juniper Case history: https://ecir.groups.io/g/CaseHistory/files/Dawn%20and%20Juniper/Case%20history%20Juniper.pdf .


Sherry Morse
 

Hi Jennifer,

Off the top of my head we used Nux Vomica, Carbo Veg and Boiron but I can't remember at this point if we did all 3 at once or did the Boiron separately and then added the others in.  Scarlet was not IR so didn't need to worry about the sucrose.

If you can get a fan out into the run in that would probably be very helpful - one of my friends has something like this (MaxxAir 42" Belt Drive Barn Fan - BF42BDRED/BF42BDGALV | Blain's Farm & Fleet (farmandfleet.com) out in her overhang for her horse who's PPID and has breathing issues. 




AnnCN
 

I have a Flexineb nebulizer for our PPID/IR/heaves pony.  We live near the grass seed capital and there's lots of pollen the air for basically the entire growing season.  The nebulizer has really helped and is easy to use.  
--
Ann Carney Nelson
"mom" to Lolly (20 yr old EMS/PPID Welsh pony who foundered in July 2019)
Joined ECIR in Sept 2019
Eugene, Oregon

Case History:  https://ecir.groups.io/g/CaseHistory/files/Ann%20and%20Lolly 
Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=234320


millionairess1989
 

Hi Dr. Kellon,

Jack's still having trouble which Clenbuterol isn't helping. He continues to be very wheezy to the point of having a "heaves" line and flared nostrils a few times. This necessitated a second dose of Dex (2.5cc) which has delayed our rechecking his blood work. He's been on 1.5 mg of Pergolide. Would it be better to double the dose and see how he responds or just wait until the Dex is clear?

The Flexineb inhaler is cost prohibitive and BI's Aservo is only for a particular corticosteroid. Are you aware of any other options that might be appropriate and affordable? This is an entirely new area for us :(

Jack is getting Lung EQ twice daily. Do you think that he would benefit from the addition of Bio-Quench or Phyto-Quench (with or without Devil's Claw), or something like Jet Breathe or Hilton Herbs Freeway? 

Thank you,
--
Jennifer in Middle TN  2010
 Mill 33 1/3 yrs Arabian-PPID, IR & Pacemaker Dependent; 2-13-89 to 6-11-22
Jack 23 yrs TN Walker- IR & RAO

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Millionairess

https://ecir.groups.io/g/CaseHistory/album?id=831

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Jack-TN%20Walker


Eleanor Kellon, VMD
 

Jennifer, I'm so sorry to hear this. This disease reaches an end stage where the tissue damage is not reversible. I'm not saying you are there yet, just informing.

The major factors are to keep him in an area free of hay or straw, including in lofts; soaking all food. Given the timing of your e-mail, it's also possible that airborne pollens, etc, are setting him off in which case you would want to keep him inside rather than out.

If I had to pick something to try at this point it would be Jet Breath.

Also talk to your vet about injectable alternatives, like epinephrine or atropine. You can easily learn how to do this at home.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


celestinefarm
 

Jennifer, you can try generic Zyrtec. Cetirizine. Anti-histamine that might help if the increase is due to heavier pollen exposure.  I believe the studied dose is 4 mgs/kgs. but I would first try 2 mgs and see if that helps. You can buy Cetirizine online at Amazon or at Costco. It's very inexpensive.  The pills are tiny, and most horses just eat them up in food.
Dr. Kellon or your vet should confirm the dosage.  I would increase the amount of flax or Omega 3's he's getting and you might get improvement out of increased Pergolide.
--
Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

Juniper Case history: https://ecir.groups.io/g/CaseHistory/files/Dawn%20and%20Juniper/Case%20history%20Juniper.pdf .