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Dex for breathing issues; update plus more on inhalers and hay steamers

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  • Dex for breathing issues; update plus more on inhalers and hay steamers

    I have a horse whose exercise induced breathing problems have been getting worse as he ages. The coughing was distracting, but then he started getting stiff and actually having trouble breathing on course. He is on SmartBreathe, which seems to help but is not enough. His vets and I suspect IAD.

    I recently started him on dex, and he is on his fourth day. 12 mg per day oral, for four days, and now tapering down for our test course of medication. He is better, not so stiff and he is able to breathe better. The coughing is still there, but he does not get that feeling like he can't exhale. I have also started wetting his hay. He is out all day and in at night in a well ventilated stall, so there is not much else I can do for his environmentl conditions. I am in Central Texas which is a bad place for allergies.

    My question has to do with his dex dosage. Does anyone have their horse on long term dex for breathing issues? What is your dosage regimen? I do not want to give him any more than necessary to keep him ridable. He is 12 and enjoys his work too much too retire.

    A related question is whether anyone has combined dex with allergy testing and shots for IAD or RAO issues. And if so, to what result?

    Thank you so much for any help you can give me! I love this horse.

    UPDATE: Thank you everyone for the GREAT information. He is in the middle of a 12 day course of dex and is doing fabulous. His difficulty breathing is exercise-induced only, really only at canter. Still some coughing, but the stiffnes in his ribs is gone. Plus he is breathing much better at the canter. I am soaking hay, and building a home made hay steamer from a steam cleaner and a plastic tub. My vet is researching inhalers, so hopefully we can just use those. Thanks again everyone, great advice here. As I said he is out a lot and stall is very open so not much I can do about environmental allergens. I am hoping steaming the hay will help a lot. If inhaler and steaming hay are not enough, vet and I will discuss how to treat with more dex.
    Last edited by ToTheNines; Feb. 28, 2013, 07:16 PM.
    Rest in peace Claudius, we will miss you.

  • #2
    What about clenbuterol? Dex scares me.
    McDowell Racing Stables

    Home Away From Home

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    • #3
      I have been giving 1/2 tablet Dex daily along with Smart Breathe from SmartPak for over a year. I keep trying to go without the Dex and he always starts having a hard time expelling his air. My vet says at that low dose he can stay on it for the rest of his life. He is an Icelandic and is already 24.

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      • Original Poster

        #4
        laurierace, I tried clenbuterol (Ventipulmin) and it did not seem to help him. I tried a low daily dose of 5 cc, then a before-work dose of about 8 cc and it did not seem to make a difference. I may try adding a low dose of clenbuterol to a low dose of dex though.

        Countryclips, do you know how many mgs in your 1/2 tablet? I know mine are 4 mg per tablet.

        Dex scares me too, but I have tried all kinds of cough/breathing supplements, and nothing is enough anymore. If the dex works, I will be sure to give him yearly or bi-yearly breaks and take him out of work for those times.
        Rest in peace Claudius, we will miss you.

        Comment


        • #5
          I had my guy on dex for a while (couple months) due to nearly needing to be put down for respiratory issues from RAO a few years back. Worked up a sweat in his stall just trying to breathe, really difficult to watch. Anyways, long story short, he became immunocompromised and had a triple organism infection. Almost had to put him down again for that. Haven't gone back to dex since, just try to keep him as comfortable as possible. So far so good since then.

          On the flip side, he was on high doses of it.

          Funnily enough, the past year or so has been great, he's just on smartbreathe now. Still coughs a lot under saddle, and gets wheezy with hard work, but nothing a trail ride would hurt. Go figure.

          Comment


          • #6
            Dex is not a great option for long-term management. Good chance of eventual infection, small chance of laminitis, etc. Inhaled meds are much safer and very effective but more $$, so depends on your priorities. Allergy shots are helpful in maybe 50-ish % of cases, but it takes around 8-12 months to know if they're going to help. Can't be on dex anytime recently for doing the allergy tests. Consider hay as a major trigger - lots of horses do much better with soaked, steamed, cubed hay or no hay at all. Good luck with your guy!

            Originally posted by ToTheNines View Post
            I have a horse whose exercise induced breathing problems have been getting worse as he ages. The coughing was distracting, but then he started getting stiff and actually having trouble breathing on course. He is on SmartBreathe, which seems to help but is not enough. His vets and I suspect IAD.

            I recently started him on dex, and he is on his fourth day. 12 mg per day oral, for four days, and now tapering down for our test course of medication. He is better, not so stiff and he is able to breathe better. The coughing is still there, but he does not get that feeling like he can't exhale. I have also started wetting his hay. He is out all day and in at night in a well ventilated stall, so there is not much else I can do for his environmentl conditions. I am in Central Texas which is a bad place for allergies.

            My question has to do with his dex dosage. Does anyone have their horse on long term dex for breathing issues? What is your dosage regimen? I do not want to give him any more than necessary to keep him ridable. He is 12 and enjoys his work too much too retire.

            A related question is whether anyone has combined dex with allergy testing and shots for IAD or RAO issues. And if so, to what result?

            Thank you so much for any help you can give me! I love this horse.

            Comment


            • #7
              Thought I would mention that your Ventipulmin dose (5cc once daily) was not high enough to be effective. The lowest end of the dose range is 5cc twice daily for a 1000-lb horse, and I would not expect that dose to be sufficient for your horse's signs. The high end of the dose range is 20cc twice daily, but I don't recommend that due to side effects.

              Originally posted by ToTheNines View Post
              laurierace, I tried clenbuterol (Ventipulmin) and it did not seem to help him. I tried a low daily dose of 5 cc, then a before-work dose of about 8 cc and it did not seem to make a difference. I may try adding a low dose of clenbuterol to a low dose of dex though.

              Countryclips, do you know how many mgs in your 1/2 tablet? I know mine are 4 mg per tablet.

              Dex scares me too, but I have tried all kinds of cough/breathing supplements, and nothing is enough anymore. If the dex works, I will be sure to give him yearly or bi-yearly breaks and take him out of work for those times.

              Comment


              • #8
                The best thing for long term is to get a "mask" and a steriod inhaler. I had a horse come to me with a horrendous case of IAD..........and was easily managed in bad weather conditions with the masks and inhalers we got from Canada RX (much cheaper).
                www.flyingcolorsfarm.comHome of pinto stallion Claim to Fame and his homozygous son, Counterclaim. Friend us on Facebook!https://www.facebook.com/#!/pages/Fl...04678589573428

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                • #9
                  I had both a horse and pony that without a doubt enjoyed additional years of life thanks to Ventipulmin; it was truly a miracle drug for both of them. Both were on a higher dose than you mention. Unfortunately, neither was a candidate for steroid therapy (as in, they were both on the "don't even let them SEE a bottle of it" kind of management plan). However, my vet did say that the recommended course of therapy would be to combine a steroid with the Ventipulmin; they are apparently much more effective together.

                  Both of these guys were old (30+) and with one, once we had a euthanasia date scheduled, we did start him on Dex 3 days prior, along with the Ventipulmin, just to make him extra comfortable, since I knew we didn't have to worry about the risks of Dex for such a short term. Sadly we didn't time it quite right, and he did relapse with EPM prior to being euthanized, but I will say that the drugs in combination definitely made him feel like a million bucks - the night prior to euthanasia, he got out of his stall and put on a show around the property, acting like he was about 10 years old and not having a breathing problem in the least. Hope you can find a solution for your guy! I did not try the mask route because both were boarded and it would have been really challenging (and they responded so well to Ventipulmin that we didn't really get to that stage), but they do work wonders for horses.

                  Comment


                  • #10
                    We have a horse in the barn who is on daily Dex and has been for the last year or more. She currently gets 4mg daily. Sometimes in the winter I can wean her to every other day but in the warm weather that isn't enough relief for her. She's in her 20's and is a pleasure horse who is ridden lightly- being able to breathe outweighs the potential risk in this situation. And her owner cannot afford the better alternatives. We have also changed her management-her hay is ALWAYS soaked (which has been fun this winter!) and when it is very hot and humid she also gets Anihist and clenbuterol when she's having trouble breathing. Knock on wood this is working well for us.

                    Comment


                    • #11
                      I should add too that my philosophy on animal care has evolved over several years of caring for aging dogs and horses. I have become a big believer that animals live in the moment, and are far more concerned with how they feel RIGHT NOW than with how long their life is going to last. To explain to my vets this treatment approach, I always say that if they have some medical problem, and there is a treatment that would shorten their life to 6 more months but make them feel great every day, I would prefer that to a treatment that would make them feel ok every day but give them 12 more months. Dex is one of those rare situations where this hypothetical is really true - yes, it's a risky drug with really devastating potential side effects. But it can also get results that no other class of drug will. Never an easy choice, but not being able to breathe easily is miserable and will affect their whole system.

                      Comment


                      • #12
                        my gelding gets 4cc of dex every second day as needed or 8cc three days in a row if needed when he gets really bad. he has mild heaves and a lot of allergies, he spent years on ventipulmin before i got him and it no longer does much of anything for him. dex wasnt my first choice or my vets but it has helped him soooo much. i take him off the dex almost all fall/winter when his breathing seems much better and it is not needed. he is going to be 22 this year, if he were younger i might be more concerned but due to his age and other meds not working as well this is a good option for him.

                        Comment


                        • #13
                          Just adding that inhaled meds can give you those same great results, plus the added bonus of a better long-term safety profile. This may not be your choice for your horse, of course, but for the sake of others reading the thread I wanted to be very clear that the inhaled meds work fantastic for most horses.

                          Originally posted by Pookah View Post
                          I should add too that my philosophy on animal care has evolved over several years of caring for aging dogs and horses. I have become a big believer that animals live in the moment, and are far more concerned with how they feel RIGHT NOW than with how long their life is going to last. To explain to my vets this treatment approach, I always say that if they have some medical problem, and there is a treatment that would shorten their life to 6 more months but make them feel great every day, I would prefer that to a treatment that would make them feel ok every day but give them 12 more months. Dex is one of those rare situations where this hypothetical is really true - yes, it's a risky drug with really devastating potential side effects. But it can also get results that no other class of drug will. Never an easy choice, but not being able to breathe easily is miserable and will affect their whole system.

                          Comment


                          • #14
                            I did dex injections when our old guy got worse. Ventipulmin stopped working with him so we made the switch. He was on the injection for 2 years. I gave it as needed. So some days it was every other day some days it was weekly. He lived a much happier life for those 2 years. We had no side effects from the dex and when we put him down it had nothing to do with the dex. It was because he had gotten so bad that the dex didn't do a lot anymore either and it was time. Also wetting the hay is great but if he could be out 24/7 would be best for his lungs. Out on grass and less sand/dirt as possible. I didn't mind the dex because it was the only thing left that kept him comfortable and he was 32 years old when we put him on it so he lived to be 34. A long happy life IMO.

                            Eta. We did do the dex/ventipulmin combo for a few months but it didn't seem to work any better than just the straight dex.
                            Also is he past the point of an inhaler? Have you tried that?
                            Horses aren't our whole life, but makes our life whole

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                            • #15
                              I will add that inhalers are great but with later stages of heaves they usually don't work that well. ESP in older horses.
                              Horses aren't our whole life, but makes our life whole

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                              • #16
                                The tablets are 4 mg. So he gets 2 mg daily. And it works for him.

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