Heaves is the equine equivalent of asthma. In its later stages, it’s closer to emphysema. How much management changes, diet and even medications can help a horse with heaves depends on how long he has had the condition and how much irreversible damage has been done to his lungs. Usually, however, you can make a difference in his comfort level.
Although a few horses have sensitivities to certain pasture plants, or possibly molds growing on them, most horses with COPD (chronic obstructive pulmonary disease, the proper term for heaves) do better when kept outside as much as possible.
Even when a horse is allergic to airborne allergens like molds and pollens, it helps to keep him outside as opposed to in a barn, where the air inevitably stagnates to some degree and moisture in the air is higher. Hot, humid air is the most difficult to breathe, followed by high humidity at any temperature. Extremes of cold may trigger some spasms, but most horses do best in the fall and winter months, when air is crisp/cold and humidity usually low.
Molds abound on straw, making clean shavings a better choice for most horses with heaves. However, the aromatic oils in some shavings and dust can create problems of their own. Purchase the lowest-dust bedding you can find, adding stall mats to reduce the amount of bedding necessary for times the horse must be in the stall. Remember that even if your horse is stalled on a low-dust bedding it won’t do much good if the stalls around him have straw or dusty shavings in them.
Hays are problematic for most COPD horses. Unless skin testing has confirmed that the horse is allergic to specific hays, it’s likely they’re reacting to mold spores in the hay. The hay we recognize has safe to feed most horses has minute levels of mold and dust, but a sensitive horse can react to levels that you can’t detect. Hay that is dusty from dirt may also contain mold spores from the soil itself.
Thoroughly soaking the hay will settle airborne particles but won’t help with a reaction to spores that are ingested. Cubed or pelleted hay helps most COPD horses. Oven-dried bagged forages are also good choices, since the heat used in processing reduces moisture and limits the possibility of mold growth. Many ingredients in feeds/grains, or low levels of molds growing on them, may also be allergy triggers for some horses.
Avoid grain in COPD horses. Replace up to 50% of the calories with beet pulp blended with rice bran or wheat bran, or a beet-pulp-based grain alternative often significantly improves symptoms. Examples include Sweet Rely from Manna Pro (913-621-2355), Moorman’s Rocky Mountain Pack Cubes (www.moormans.com, 800-680-82540), Alam from McCauley Brothers (www.mccauleybros.com, 800-222-8635), and New Hope from Hubbard Feeds (www.hubbardfeeds.com, 507-388-9400).
Although sweet feeds keep the dust to a minimum they may not be the best choice because of the chance of a feed-ingredient-related allergy and also because the dust and mold may remain. They’re just covered up by the molasses.
Magnesium deficiency can contribute to bronchospasm and bronchial allergy. In fact, intravenous magnesium is used in human ERs to treat bronchospasm. Get your horse’s dietary magnesium level checked and supplement, if necessary, to maintain a calcium-to-magnesium ratio of from 1.5:1 to 2:1.
Supplementing the diet with antioxidant nutrients can also help, especially over time, in reducing allergic and inflammatory reactions. Feed flaxseed oil (1 to 3 tablespoons), whole freshly ground flax (1 to 3 oz.) or same amount of a stabilized ground flax, like from Enreco (www.enreco.com, 800-558-3535) or Horse Tech (www.horsetech.com, 800-831-3309). Vita-Key’s Antioxidant Concentrate (www.vita-key.com, 800-539-8482) can be a good choice, if the horse isn’t sensitive to the yeast base.
A number of herbs and plant antioxidants are useful in stabilizing mast cells, the cells that release histamine, and combating inflammation. These include plant flavones/bioflavinoids (e.g. citrus bioflavinoids), polyphenols (e.g. grapeseed extract) and many other herbs.
Enreco’s Omega Antioxidant or Uckele’s Phyto-Quench or Bio-Quench (www.uckele.com 800-234-0330) both would be good products to try along these lines.
Medications are sometimes needed, at least temporarily, during acute attacks. Drugs like albuterol and clenbuterol provide significant relief of bronchospasm and ease the work of breathing. Both can be given orally or added to a nebulizer. There is also an inhaler for horses available, Torpex, which uses albuterol (ask your veterinarian).
Resistant cases will benefit from corticosteroids, which must always be done under veterinary supervision and dosage recommendations followed carefully. When a horse is known to have a high-risk time of year, starting oral antihistamines in advance of symptoms worsening can be an effective strategy.
Liberal use of Vicks on the nostrils and cough medicines with aromatic oils like peppermint and eucalyptus relax the bronchi and thin mucus. Some veterinarians use intramuscular injections of camphor. Sodium and potassium iodide treatments are also effective in thinning mucus and clearing airways. They should be used only as needed, however.
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