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When is COPD an emergency? update: he almost crashed :(

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  • When is COPD an emergency? update: he almost crashed :(

    My horse has COPD. Vet is ironically already coming out tomorrow morning because of this and to "officially" diagnose him. It's been recurrent but not so often until this past month. He was breathing fairly heavy when I brought him in and coughing with some nasal drainage. His hay was wet thoroughly but he was still a bit distressed. We left him alone for a couple hours since he wasn't what I would consider in TOO bad of shape... enough that I assumed once he settled down after running outside he'd be ok.

    My mother just called me (he lives at her house) and said that he is still breathing heavy. She went out there and he woke up and started coughing repeatedly... maybe about 10 times in 2 minutes. He also coughed up a clear liquid from somewhere. I guess I'm not sure when respiratory distress is emergency worthy. It's just a mess.... we have his buddy scheduled to be euthanized tomorrow and I know the vet won't want to come back (over an hour away). I don't know if putting the other horse down is going to make him upset and jeopardize him. It's just a mess....


    Update: I just had a very bad feeling and called my vet to discuss things and find out exactly when bad is too bad. He's had "respiratory problems" that have been untreated (in her opinion managed ok on tri-hist) for a few years. I wanted to know what exactly constituted emergent and she basically told me almost in exact words that she would be out tomorrow but that she would not come out for an emergency and I'd have to call another vet.

    I got to my moms and didn't hear coughing in the barn. I snuck up and heard heavy breathing and turned the lights on and he was flaring his nostrils horribly, breathing quickly, and was now sweating all along his chest, barrel, flank, etc. He was clearly in horrible respiratory distress so I ran in and called a vet we used to use and asked him to please come out asap. He got there in about 40 minutes and gave him a few different things (after convincing him my horse was allergic to banamine) and he improved greatly. One was prednisolone and another I can't remember offhand (it was really late ) He was there about an hour and a half and answered SO many questions and was very helpful. He said that it was 150% an urgent life-threatening situation and that he could have "expired" any minute. According to him, any horse that has COPD or underlying respiratory issues starts having breathing difficulties of any kind he needs something THEN and not later because of the possibility of them crashing so quickly like my horse did.

    I'm extremely upset though. I really liked my other vet but I guess I was not proactive in demanding an answer. For the past three years we've been treating his "allergies"and "respiratory issues" which were casually diagnosed (by the vet) with tri-hist. Our vet never once recommended anything further and I accepted that thinking she knew what was best. The other vet said he very clearly had a serious respiratory issue of some sort (at this time still up in the air pending blood work to check for other underlying issues) but that he was sure he had COPD if not something else as well. He said he should have been on ventipulmin years ago and that his lungs have basically been dying since. I have to pick it up tomorrow because he wanted to check his blood work first to make sure he was stable enough to be on it. (He's had bizarre lameness, stocking up, hives, allergies, etc. issues that they want to investigate)

    I feel horribly guilty because I didn't demand something more from the other vet because I trusted her 100% which I guess was my first mistake. Seeing my horse not able to breathe tonight and not being able to do anything to help him made it hit home. I called her a month ago to make an appt. and told her "I am 100% sure he has COPD, can you please come out and help him" and the soonest she could get there was over a month later. I asked if this was something that could wait that long and her answer was "you're the best judge of whether he can or not..." I'm not a vet. I'm just so mad at myself I guess.
    Last edited by dmalbone; Oct. 27, 2009, 02:59 AM.

  • #2
    I'm so sorry. When my horse finally was looking very distressed I called the vet as an emergency. He had difficulty walking well, he'd walk several steps and then have to stop to catch his breath. I have asthma so I knew how he felt. He went downhill so very fast, coughing, etc, for a month or so and then wham, barely able to walk. Waiting for the vet to arrive the next day, I actually thought I was going to loose him.

    I was given ventipulmin for him and it works very well. She also offered an albuterol inhaler but I have my own I use for him. Its been a crummy 6 weeks for my boy, he's gone the last 3 years with no copd symptoms, but lately, very wheezy.
    Being terrible at something is the first step to being truly great at it. Struggle is the evidence of progress.

    Comment

    • Original Poster

      #3
      Thanks. She was going to give him the ventipulmin tomorrow since he wasn't ever that bad when she came. I have asthma as well and I know how I can sometimes just work through it without my inhaler and other times it's bad all of a sudden out of nowhere. He's also not wheezing though.

      Comment


      • #4
        I have a copd mare, and she can get very bad very quickly.

        I now have clenbeuterol(ventipulmin generic) on hand.

        I also have found that it is the hay and in the fall that she has an attack. I can feed her first cut all summer,but come fall, she has to have 2nd cut or else she has coughing and wheezing.
        If I go even one day back to first cut, the coughing starts.
        Not sure if its the mold on the hay, which I don't see, or what it is, but since this has happened two years in a row, she gets 2nd cut.

        I hope your horse is ok. And Godspeed to your other horse.
        save lives...spay/neuter/geld

        Comment


        • #5
          Please, don't beat yourself up for not knowing more than your first vet! You are doing the very best you can to take care of your horse. That's all we can do. And now you've found another vet that seems much better and you are going to be working with him.

          I've been there, done that. I ended up switching vet practices also in a crisis (over my dog) because it became crystal clear that the first practice was not nearly good enough. We just do what we can, and since that is the best we can do there is no reason to get upset at yourself. (If you weren't trying to help your horse, that's another thing, of course, but you are clearly a very very caring owner!).

          Good luck today, with both horses.
          https://www.facebook.com/SugarMapleFarm
          Follow us on Instagram: https://www.instagram.com/peonyvodka/
          www.PeonyVodka.com

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          • #6
            I am also sorry that this got so bad. I wonder if sometimes vets just don't get burned out from trying too hard with owners that don't care to know more and/or don't have the money to find out more. If the horse never really looked bad when the vet saw it the vet may think the owner is over reacting at times. It is a tough job esp for the vets that really have to deal with tough clients, who often wait too long for them, don't want to spend the money, don't care whats wrong as long as it seems ok on the meds etc.

            Good luck with your horse! I am in no way saying you are one of the hard owners either! Just saying I can feel for vets that have to deal with that often and may explain why your old vet was not as aggressive.
            http://community.webshots.com/user/jenn52318

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            • #7
              Originally posted by whbar158 View Post
              I am also sorry that this got so bad. I wonder if sometimes vets just don't get burned out from trying too hard with owners that don't care to know more and/or don't have the money to find out more. If the horse never really looked bad when the vet saw it the vet may think the owner is over reacting at times. It is a tough job esp for the vets that really have to deal with tough clients, who often wait too long for them, don't want to spend the money, don't care whats wrong as long as it seems ok on the meds etc.

              Good luck with your horse! I am in no way saying you are one of the hard owners either! Just saying I can feel for vets that have to deal with that often and may explain why your old vet was not as aggressive.
              This is unfortunately true. I would suggest getting to know your vet very well so they know you're NOT over reactive, you WILL pay your bill, your boundaries as far as 'major' treatments and that they should listen to what you say is going on when they're not around. Most know that there can be issues they're not seeing that are also important pieces of the puzzle.

              Don't beat yourself up. It sounds like you've been trying for some time to get him squared away. I really don't understand her making him wait a whole month for an appointment when you're concerned! You called; obviousl you wanted him seen by a vet and a month sounded like too long to wait or you wouldn't have asked! Does she have the biggest coverage area ever and you're on the outskirts or something? I would switch to the vet that took this seriously as it should have been. They have a tough job but knowing a horse is in distress, denying them emergency care... nope I couldn't keep them as my vet.

              Good luck getting your boy comfortable. It sounds like you're on the right track and he's in very caring capable hands now.

              Comment


              • #8
                Don't beat yourself up- but I'd consider using the vet that came on emergency as your primary vet. IMHO, it's completely unethical for a vet to say a respiratory distress patient needs to wait until it's convenient for the vet to drive there to treat.

                Comment

                • Original Poster

                  #9
                  Thanks. The thing is that I've paid her THOUSANDS in bills already.. always the day she's there. She's been out for a cruciate ligament tear/took part of the bone with it and knows that I'm serious and knowledgeable about my horses, their care, and want the best for them. So I really don't think it's a case of her not thinking I'm good for the money or overreacting. I called her before about the breathing and she had be come pick up dex without seeing him. She used to have no problems coming out to see him but I think she's busier now and just plain doesn't want to come out that far. We ARE an hour away, which I understand. I guess I just wish she had had the balls to tell me that instead of brushing me off until I got the hint. No, I don't think she's ever seen him when he's TOO bad because I couldn't get her out there to see him! She has been out there when he was having breathing difficulties though, just not this bad.

                  I'm sitting here waiting for a call from my vet again because he's not as bad as last night, but he's not doing great still. I guess it's not over yet. We have officially decided though that we are using this vet as the primary though. He was out there for so long and was so thorough and not rushing out. He apologized for being asleep at midnight for pete's sake lol! We had problems with his bedside manner when we used to use him, but something must have happened- maybe he started losing more clients- and he was like a different person last night.

                  Comment


                  • #10
                    Jingles for a quick recovery. Respiratory issues are never ever something to take lightly, even is they are "mild", they can crash quickly. Does it help leaving him outside? Knock on wood, we've managed our old guy by having him out as much as possible.

                    Comment

                    • Original Poster

                      #11
                      No, leaving him outside almost seems to do more harm some days. It's a dusty pasture (his new one will not be) and has a lot of weeds and is surrounded by cornfields. Then again, the fresh air does help. His stall is right by the door so he gets decent air movement. His new barn will have a lot of doors and a dutch door in his stall.

                      Comment


                      • #12
                        On the vet question:

                        In the past few years, I have noticed that it has become more typical for horse owners to have "lameness gurus" and then "the vet that does everything else, including emergencies."

                        Moving to PA for a two-month job thing with my horse in tow, I was advised by my home vet to establish an account with a local large animal practice before I left. Leaving credit card number with the new practice they said, was the only reasonable way to insure that I could get a vet to come for an emergency to an unknown client. Fair enough, but I'm glad someone told me to set this up ahead of time.

                        As it turned, out, I had a local small animal guy down the road do the Health Certificate that Horseboy needed to get back into his home state of NY. That dude charged me a fraction of what the large animal practice would have. Also, he pointed out my horse's enlarged thyroid that no other vet had. The moral of the story so far is: Be up front with your finances, but shop around if you like.

                        Now in CT and moving barns so that I'm *allowed* to choose my own vet, I have had to learn what to ask. A couple of good candidates that past muster in other respects, have told me up front that they didn't want to travel so far for emergencies. No problem and again, I'm glad they mentioned that up front. At least I know that I need to set up that relationship with a closer vet.

                        It didn't used to be this complicated, but I can adjust. Like the OP, I'd just like to know I had it all covered before disaster strikes.
                        The armchair saddler
                        Politically Pro-Cat

                        Comment


                        • #13
                          Originally posted by dmalbone View Post
                          I feel horribly guilty because I didn't demand something more from the other vet because I trusted her 100% which I guess was my first mistake. Seeing my horse not able to breathe tonight and not being able to do anything to help him made it hit home. I called her a month ago to make an appt. and told her "I am 100% sure he has COPD, can you please come out and help him" and the soonest she could get there was over a month later. I asked if this was something that could wait that long and her answer was "you're the best judge of whether he can or not..." I'm not a vet. I'm just so mad at myself I guess.
                          Don't beat yourself up. Your vet should have realized that many times these worsening symptoms can signal a looming crisis. They did for my horse who had carried an "allergy" diagnosis for 6 months before a respiratory crisis ... gurgling and nostrils like trumpets as he struggled for breath. This was ten years ago. Vet gave him a TINY dose of Dex (I was petrified of founder!) and said it would be diagnostic for COPD ... the symptoms would temporarily abate and I would have to make his world free of dry hay and any other allergens that were "triggers" for him. He said there was no magic pill and that management changes diligently followed would give him the best shot.

                          He said to wash the hay. This was the end of his good advice! He then said to DRY it. WRONG !!! Once the hay dries, the allergens can again be inhaled (plus the risk of adding mold to the mix).

                          My horses (yes, his pasture pal went onto the regimen, too, so she could stay with him) eat their hay out of a tub of water. I use the 18 gal tubs with rope handles from WalMart. I thoroughly hose the hay as I'm filling the tub. The great thing is that if they don't finish it all, then it's still wet for a later munchie session. Water is dumped and replaced with fresh every time they get hay.

                          That's only part of the picture. Dampen all grain/feed because the manufacturing process can leave minute traces of dust that doesn't bother most horses but can keep the airways fired up in a sensitized horse. I've lost the link, but years ago I read in a research paper that it takes up to FIVE days for the airways of a sensitized horse to recover from a SINGLE exposure to trigger allergens. So if there are any long-forgotten scraps from a round bale in a far corner of the paddock ... this could be enough to keep the horse symptomatic.

                          More difficult for those who stable inside ... even if your horse has his tub of wet hay, the allergens from hay in the other stalls will drift to him.

                          Some horses are allergic to pine shavings ... my horse is fine with them. He lives in a 30' long run-in shelter -- stallmats are down. I don't put down shavings unless we're in a bad storm ... his lungs are healthier if he goes into corral or pasture to urinate. Ammonia in stalls is treacherous for the airways of these horses. Some people find paper pellets work well. Others say peat moss is good ... although dusty, this link I can no longer find said that the dust molecules from the peat moss were too large to pass into the alveoli (the primary gas exchange units of the lung) and thus don't interfere with breathing. If humidity is low, you may have to mist the peat moss. I never tried it because my guy does well with the stall mats and pine shavings in storms.

                          If weather is bad, his tub of hay goes in the run-in shelter. You can use a lead rope thru the rope handles to drag it for dumping.

                          When we had the "allergy" diagnosis he was on TriHist but it really tastes terrible and he's so picky he decided to pass on his feed and just live on hay and pasture. I've since found that Ani-Hist is more palatable, I can get that into him in the spring when pollen is high.

                          Some people have found that Spirulina (from www.herbalcom.com) helps. I believe it's a natural antihistimine ... don't feed with other anti-histimines. My guy is such a picky eater he baulked at the green colored feed.

                          Some people keep a spreadsheet to track environmental triggers ... pollen, humidity, ozone etc. Others find that chemicals used for crop spraying in the area can be a trigger.

                          There's a yahoo list for COPD-Heaves ... I'll add the link in if I can find it.

                          My guy is 24 now and doing well. It seems overwhelming but you'll get a routine going.

                          Tarn in OK

                          Comment


                          • #14
                            dmalbone, do not beat yourself up, the person you should be angry at is the vet who told you she would not come out when you called. I am so sick of prima donna vets! I have encountered a few where I live, and its an awful, helpless feeling.

                            Fortunately, I am an hour away to New England Equine, and they are so supportive and helpful.

                            I am curious, if a horse has copd, should they be on clenbeuterol/ventipulmin ongoing?

                            I thought it was a temporary thing to put them on. How do others use it?
                            save lives...spay/neuter/geld

                            Comment


                            • #15
                              Originally posted by fivehorses View Post
                              I am curious, if a horse has copd, should they be on clenbeuterol/ventipulmin ongoing?

                              I thought it was a temporary thing to put them on. How do others use it?
                              My 10-yrs-with-COPD gelding has never been on either. We were able to get his COPD under control with lifestyle/management changes. He has access to pasture 24/7 and in very cold weather he's blanketed if needed.

                              Tarn in OK

                              Comment


                              • #16
                                Spirulina proportions

                                Hi, could you tell me what proportion of Spirulina do you give to your horses? I have a 16 yo gelding with allergy problems, I give him Special Respiration by Wendall Herbs and an herb tea suggested by the vet. He lives outside 24/7 and eats wet hay. He is usually quite ok (he doesn't look panting and he doesn't cough, if I bring my ear near to his nose sometimes I hear a very very light whistle, the vet says it's just a bit of catarrh. Then when we go out after a ten minutes of trot he snorts and then I can't hear the whistle no more) but last weekend he wasn't fine (and I'm still wondering why...same hay, same place just a quite heavy temperature rising...could it be that?)and I gave him an injection of cortisone. Now I'd like to try whit spirulina but nobody seems to use it here for allergy problems, could you suggest me how much spirulina should I give him? (he's about 400 Kgs). In your experience do you think I should go on also with special repiration and the herb tea together with spirulina?
                                Thank you so much!

                                Comment


                                • #17
                                  Have you considered switching his hay to dengie? My late mare Chutney had COPD and had a few bad flareups that required emergency vet visits...one of the vets said that even soaked hay can trigger problems. We switched to dengie, which she loved, and it helped immensely. She lived to be 31 1/2 years old and had COPD since she was 9 or 10.

                                  Good luck - I know it can be scary.
                                  In loving memory of Chutney (1977 - 2008)

                                  Comment


                                  • #18
                                    Spirulina

                                    Originally posted by cilla View Post
                                    Hi, could you tell me what proportion of Spirulina do you give to your horses?
                                    I've used Spirulina on my horses for a number of reasons; one being that my gelding has had respiratory problems, the worst a few years ago when the first treatment was going through a couple bottles of Ventipulmin, which seemed to get it under control.

                                    I then discontinued the Ventipulmin and put him on Spirulina. No problems since then.

                                    I buy mine from www.horsetech.com as, last time I checked, it's actually cheaper than www.herbalcom.com (where I've been buying herbs for years). Horsetech's spirulina is easier to deal with since I buy the 2-lb size that comes in a plastic screw-top canister rather than just a bag. Spirulina is pretty difficult to work with as it's very powdery, so if you get it in a bag, I suggest you take it outside and transfer amounts into a rigid container with a wide top (coffee can works good).

                                    The reason I say take it outside is that as soon as you open it, green dust will poof out, and you'll end up with a thin green layer of dust all over everything.

                                    My horses didn't much like it at first, but in about a week, they ate it just fine. Start with a small amount, like any other new supplement.

                                    Dosage: approx. 2 grams per 100 lbs. of bodyweight/day (so a total of 20 grams/day for a 1,000 horse). Horsetech's spirulina comes with a 10-gram scoop.

                                    Hope that helps!

                                    ETA: Horsetech.com ($25.95 w/free shipping) is still cheaper than herbalcom.com ($26.20 + $6.95 handling charge), and if you're a member of the roadside assistance folks, USRider.org, you get 10% off on anything you buy from Horsetech (using USRider's discount code).
                                    Equus Keepus Brokus

                                    Comment


                                    • #19
                                      I was reading on another thread that one should get spirulina wafers rather than powder, as it's easier to use.

                                      I concur about reading articles that say wet hay doesn't always help, but NO hay does, and that it takes a week to resolve respiratory issues from a single exposure. Also, reaction to a single exposure happens within 6 hours of exposure -- so it helps narrow down what the irritant might be.

                                      jan

                                      Comment


                                      • #20
                                        Originally posted by 3Spots View Post
                                        I was reading on another thread that one should get spirulina wafers rather than powder, as it's easier to use.
                                        Wafers would certainly be easier to use, but that convenience comes at a price - around triple the cost of feeding the powdered stuff (~$1.80/day for wafers vs. ~$.60 cents for powdered; $.52 cents w/my USRider discount).

                                        I'll put up with dealing with the powder to save that kind of money.
                                        Equus Keepus Brokus

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