Thursday, April 29, 2021

First Schools of the Season

The definition of joy is a fiesty
 mare rolling in fresh arena sand.

Over the last few weeks, things have been pretty busy on the horse-front! I've slowly been legging Annie up into some "real work" since a majority of our rides have been hacking around the subdivision while we waited for the snow to melt from the arena. 

We've been able to lay down a few rides now and I've had the opportunity to play around with a few things. I feel pretty good about the direction we're headed in, both mentally and physically. As always, I'm guarded about her capabilities, especially as we enter the month of May and the alder pollen starts to fall... but I'm keeping my fingers crossed and we'll deal with whatever comes our way as best as we can. 

As most readers know, I had intended to get her allergy tested at the beginning of May, but things got a little shaken up a few weeks back when Bonnie Henry announced travel restrictions for BC and the Vet (Dr. M) we had scheduled appointments with decided to reschedule for later in the Summer. 

It really, really sucks and I know I can't be the only one who is so over the whole COVID thing - vet help in our area is so sparse that it feels like a lifeline is being ripped away and admittedly, I cried I was so frustrated and upset. But, we'll just keep chugging along like we always do. Thankfully, the appointments I had (although of significant importance to me) were not emergency appointments that would completely alter the universe if I didn't attend. It would provide a lot of clarity on some issues, but waiting another two months wouldn't be an end game for either horse (Moo and Annie).

I also did this again.

I mean, I still ran around seeing how far out the one clinic we went to last year (6 hours away) was booking (answer: late June/ early July... ugh), called another that usually comes to the area twice a year (answer: not coming until end of July) and called another 3 hours away to see if they could at least pull blood and do Annie's allergy panel, as they do not have an x-ray machine (answer: no, the equine vet there actually is returning home to Saskatchewan and isn't coming back). 

It's frustrating though, bc I would have liked to have gotten rads of Maizey's fetlock but the best we can do is a virtual appointment with Dr. M. I just wanted some kind of confirmation that sending her to pasture in June is "okay" and won't impede her current soundness. So, we do what we can and at the end of the day that's all we can do. We will get rads and Annie will get her allergy panel, but there is no point hauling both girls 6+ hours when Dr. M rescheduled for around the same time period we'd be going anyways. The plan though is to schedule appointments with the one clinic for a week after Dr. M would be here in July, just in case she cancels again. That way I don't have to wait a month+ for an appointment if things once again go south.

No conformation photos until she doesn't look
so pencil-necked and her mane somewhat grows
back again tho, haha.
Lack of mane also means grab straps are in our future, lol.

Ah, such is the life with COVID and no fully functional vet clinics in the area. 

Anyways, we've been pretty lucky that the weather has been so wonderful the last few weeks that I've been able to swing a leg over the saddle numerous times. And for the moment, I'm just enjoying the ability to school and play with my ponies. 

We've made it to the ring several times and have mixed it up and done some brief trail riding - some of the trails are still snow-laiden and inaccessible, so they'll have to be tabled to a later date. Annie gets shoes this weekend so we'll be ready to walk over river rock and gravel with ease, which means some more intense trail riding will be in our future! Hooray!

I promise she wasn't as miserable as she portrays - I 
think mare was moreso upset I didn't strip her tack and 
let her roll in the sand post-ride.

I've managed to knock the rust off in the ring a few times aboard Annie and I'm really liking how she's come out this year - definitely more ready for tougher questions earlier on and feeling less frazzled when she answers a question wrong and I try to redirect her. She still takes things personally, but I've found she certainly takes it with more grace and tact. Which, for obvious reasons, is appreciated.

Most of our work is playing with corners and circles, since the last several months of our existence has been tied to straight lines on the roadways. It took a bit to get the bendy-ness I was looking for, but we've implemented a lot of bending exercises on our road walks so it wasn't too difficult. She feels moveable and malleable - just not exactly fit enough to commit to certain positioning for any length of time. Which is fine - that'll come with time. The fact she's willing to play is enough for me, especially since her self-esteem waffles when asked tougher questions. 

Annie and I even cruised over our first set of fences for the year - a rather unimpressive 18" crossrail - and I'm tentatively booking ourselves into an Anthony clinic for the month of May. It'll all come down to how she's feeling, of course, but I have my fingers so tightly crossed that we'll be able to enter the land of lessons once again since 2020 left me hungry for some instruction. 

Look at this wonderful bean taking the best care of me <3

Thus far, we've had pleasant rides in the ring. She has come back to work quite nicely breathing-wise, so I'm happy to see that things like arena dust and a bit of dryness hasn't impeded her capabilities. She has also maintained a pretty good baseline - although she's out of shape, she's able to get her breath back with relative ease. I tend to measure a lot of her breathing against Spud's - for example, we did a loop around the fairgrounds (where there are a number of huge hills to conquer) and got a bit nervous as Annie was huffing and puffing coming up the last hill. I took a second to look over at Spud (who was being ponied) and saw that he too was just as labored in his breathing. So, just unfit ponies and all that comes with it.

Still, things are looking up and I'm excited to play around with some lateral work with Annie if all the stars align, but I am also happy for the opportunity to enjoy her considering all that we faced last year. Things can change in the blink of an eye, and I am grateful for each day I get to grace her back.

I propped the phone up rather precariously, but it did the job... kind of. 

With that being said, Annie isn't the only one who has had some schooling under her belt this Spring. I dug Spud's cart out of my Grandma's garage and finally hitched him up for the first time in a long time. He was an absolute doll and surprisingly fit, although I shouldn't necessarily be that surprised considering he is ponied off Annie 90% of the time and his little legs certainly need to move faster than hers to keep up.

I actually trailered him into town for this drive, as we stopped off at my Grandma's to say hello prior to heading out. She is absolutely enthralled with Spud and with the restrictions of COVID, has not had many visitors as she typically gets. It's an exceptionally isolating and lonely time, so bringing Spud by definitely brightened up her day. 

The open bridle I custom ordered LAST JUNE finally 
arrived about a month ago. We were able to try it out for the 
first time and I'm pretty happy with the overall fit.
I don't love the noseband isn't moveable (it's attached into the cheek
pieces where the bit attaches), but it's meant to be a schooling/ fun driving 
bridle anyways.
(And yes, his right front looks weird. He had to have a chunk of the wall cut off
last appointment due to some thrush and WLD but we've got it under control now. It 
just needs to grow back now and he's also due for a a trim (this weekend)).

From there we headed down to the MIL's house and hitched up and did a 4km drive over varied terrain. It was nice to get him off of the river rock that is so prevalent where the horses are boarded - a lot of the old logging roads are quite rocky and don't serve the greatest opportunity for speed. We were able to poke along at a trot several times in the drive and I was pleased to see he remembered all of his cues and that there wasn't much rust to knock off.

At the end of the drive, the MIL drove him solo for a few minutes and it was pretty damn pleasing to me to see this little dude take care of someone who admittedly is not horsey nor has driven before in her life. Such a cool, cool guy and definitely worth his weight in gold.

A lot of development is going on in this area. 
It's pretty cool to see.

And now, the rain has returned and I'm waiting with bated breath for the skies to clear and the puddles to disappear so we can get riding/ driving again (because we've been hit with nearly 300+ mm this week alone). 

Monday, April 19, 2021

Let 'Er Rip

Well over a week ago, I had noticed that the outdoor arena was finally free of residual snow and with our above-average temperatures, the ground was pretty decent (ie. dry). It made me excited for the prospective riding season (I am so done with trotting in straight lines!), but it also made me doubly excited to take the horses out to gallop around and act like nutters. 

As such, I opted to clear the whole day and take all the horses to the ring for a chance to gallop, buck, and play around for the first time since last year. Since the arena is in an open clearing, it is one of the first areas to melt and dry out - the horses still have some ice/snow in their paddock so the opportunity to act silly is quite limited while the remainder of the snow melts away. I knew that Annie needed a good gallop the most, as when I rode her days previous, I could just feel her muscles quivering with anticipation. Good mare is always sensible when I'm on her back, but she was itching to let 'er rip.

And when I turned her and Spud loose, she certainly did not disappoint. 

I did miss a majority of their play, as I had brought the dogs along for the walk and was busy getting out of the ring to stand along the side and out of the way with them. I did manage to get a bit of the show, though! I think Annie rolled five billion times - she was certainly very pleased with herself. Spud, as always, was content to tag along and kept up pretty good as they galloped back and forth.

Once Spud and Annie had had their fill (after a whole 10 minutes, aha) I let them chill and wander around before hand-walking them the long way home to cool out. After I had brought Annie and Spud back home, I met up with N and we took AJ and Maizey to the grounds.

Admittedly, I was a bit hesitant to see how Maizey looked, as I haven't really asked her to move out in months, mostly due to Winter/snow. We've done a handful of trot sets down the roads when they were clear of ice and snow, but I haven't seen her move on her own in a while. 

I needn't be worried, though, because she looked pretty damn good:

It was pretty funny because it took Maize a second or two to realize she could gallop and play - and once she figured it out, she shifted into fifth gear for a stretch or two. It made me smile seeing how good she looked and felt - I'm keeping my fingers and toes crossed for our vet appointment in early May that we get some good news about her ringbone and that the Vet approves her heading out to pasture for the Summer. I think she needs some time to just grow up, be a horse, and play in the Summer sun with knee-high blades of grass all around her. 

All in all, a good day spent with the ponies.

Friday, April 16, 2021

Spring has Sprung, and so Have the Fresh Ponies

The weather has been absolutely magnificent the last several days - enough so that I've been able to complete the majority of left-over winter chores. There are a few more big ticket items (ie. removing the winter's worth of piled manure from the paddock and doing a big clean-up and clean-out of my trailer/ tack/ feed room) on the list, but they're slowly getting ticked off one by one. There is still some residual snow in the horse's paddock, but winter blankets have firmly been put away for a few weeks now and I'm excited that the weather forecast in our area promises nothing but sunshine.

All of the Spring-time activities are slowly taking place as well - we had a visit with Kelsey from Four Winds Saddle Services to check out Annie's saddles and after some discussion, she did some reflocking work to the dressage and I'm on the hunt for a better fitting jump saddle. We've been looking at this for a year and a half now, but I've always held back from pulling the trigger because I didn't want to spend a large portion of money on something that Annie could potentially outgrow since I would not be purchasing a brand new custom saddle like I did for our dressage. Add in the fact Annie had medical issues most of last year and it was pulled off the table - especially since our current jump saddle is "passable".

Anyways, I've been able to put a few more rides on Annie and it finally feels like the season is truly starting (for those of us who don't have an indoor anyway). I've been schooling on our hacks, but road-riding doesn't lend many opportunities for things like circles. Straight lines have been our life for the last few months and while we have incorporated bend and some leg yields, it's very difficult much more than a walk on the roadside when cars are going by or you run into pedestrians.

Who needs a mounting block when you have a 
truck tailgate?

Still, we were able to put in a pretty decent ride last week - I left Spud at home and wanted to concentrate on riding Annie a bit more seriously, as ponying limits what I can do exponentially. So, I took Annie out solo-style with the intention to put her through her paces and.... the first 1/4 of the route was BUSY. Lots of vehicles passing, kids on bikes, people walking dogs, etc. I had limited space to trot out, as some sides of the road were still full of snow so it made it nearly impossible to do anything.

Unfortunately, Annie also decided to engage rocket-ship mode when a pair of joggers came up behind us and for whatever reason, she got a bit scooty with them passing. I had to turn her around so she could visibly work through whatever it was she was dealing with and then she passaged her way down the road after they had passed for a good minute or two. I brought her to a halt, did a quick rein-back and firmly handed out a half-halt as she quickened her steps again and she complied. I was able to do some trot sets and let the reins slip through my hands a few times to let her stretch and really round her back out (something she struggles with in the contact). 

As the ride progressed, I decided to ask for canter and like most readers know by now, the wheels fell off the bus a bit. She did not like my insistence that we cantered straight on the soft shoulder and threw her haunches to the inside so much that I could actually hear hoofbeats on the asphalt. She gave a good attempt or two at cross-firing but I ran out of room to deal with it (driveway) accordingly and had to bring her back down, regroup and try again. 

We had to wait a few times for cars to pass
so we could continue trying to suss out our canter.

Because we were heading home, she was very sproingy and any leg pressure sent her into a nose-dived canter that felt like we were tumbling down an embankment. So, suffice to say, not fun.

I knew that I had limited means to deal with the whole canter charade on the road, so kept walking back up the road (away from home) to where the sides were longer and redoing the entire process again. She sucked back hard at turning away and continued to bound in place, yanking the reins down to her knees and refusing to give me straightness (or the correct leads). I pulled out the Zen Ninja of 2019 and simply repeated the exercise without playing into her theatrics. I didn't need correct leads - I just needed quiet and willing.

We repeated it probably... 5 times? The side shoulder only allowed for 10-12 strides of canter at a time so it meant I didn't have a lot of time to influence her.

Once she amicably gave me straight and quiet, I dropped the reins, patted her and we continued the ride. A few more times we popped into trot, let her stretch and we did a few more impromptu canters and she was great. We finished up with a longer walk home with plans to take both her and Spud to the fairgrounds over the weekend (because guess what, it's finally clear!) and let them kick up their heels (spoiler alert; N and I also took Maizey and AJ!).

Thursday, April 1, 2021

COPD Explained, Part 2: Diagnostic Tools and Procedures

A very drunk Annie post-endoscope, being 

One of the most important things as an owner (of any animal, really), is having a rough understanding of the diagnostic tools and procedures that our trusted Vets and Techs perform. Some might say, "Well, this is why they went for the training - so they can help us make the best decision possible for our pet." 

Which isn't untrue.

But, I also firmly believe that advocating for our pets is super important and a majority of that is knowing the process. We might not be able to understand it to the levels that our Vets can, but being able to participate in the discussion and advocate for your animal is a responsibility we all should be so passionate about. 

For some background information - I had to really push to get referred to a secondary clinic upon receiving Annie's initial diagnosis. The ideology with some veterinary professionals is that COPD is COPD - wet your hay and reduce dust in your stable, use this drug when things get bad. Done and done.

Out in the open air is best, but not always possible
in some situations and doesn't always resolve
the problem.

Except, my experience and Annie's overall health did not improve with the very mild housekeeping changes and being told, "There isn't really anything else to do... its environmental and you have to manage it better," was very, very frustrating. While I understand that a lot of clinics are limited to what kinds of diagnostics they can run and they are simply doing the best they can with the information they can obtain, I spent a lot of hours changing, modifying and removing things from Annie's life to see if I could make a sustainable change. Much like hundreds of other owners just like me - it didn't work and it made me upset, frustrated, and annoyed at myself for letting my horse down repeatedly. 

It was during this time I found the Faceb00k groups and posted a lengthy SOS message, asking for any and all help. I received an influx of information that quite honestly overwhelmed me at first. There were SO many options I did not know about and so many more diagnostics that could be run that were not talked about during many frustrated e-mail exchanges and phone calls. 

I felt a sense of relief - there were more things that could be done to help my horse and to garner more information about her specific condition. And that alone, made me feel hopeful. 

It made me hopeful that we could get back to this - enjoying
the sunshine and some long trails with my best girl!

I started off by researching the different procedures used to diagnose COPD horses and what information they would provide and started to cross-reference these procedures with clinics in the area to see if they were able to perform them. Long time readers will know I travelled 7+ hrs one way to a clinic that performed a variety of procedures on Annie - and ironically enough, the very first tracheal wash in years. In fact, they had to order tubing and tools because the resident vet hadn't done one in a very, very long time.

So let's dive in - you have a suspected COPD horse or a COPD horse you are trying to manage. What kind of diagnostics can you or do you want to look into? 

(It should go without saying, do NOT attempt any of these procedures yourself. These are meant to be done by a certified veterinary professional and some of them, in a clean and sterile environment).

Respiratory rates and lung sounds will be monitored as part of 
the regular examination.

1. General Exam

The first and foremost of every appointment is a general wellness exam - listening to the horse's respiratory and heart rates, as well as taking their temperature and examining their overall demeanor. This can tell a Veterinarian a lot - such as, if the horse is in respiratory distress and requires emergency medications to assist the lungs in functioning properly. 

A bright-eyed and moderately spirited horse (like Annie), may not show outward symptoms that they are unwell. In fact, one of the comments from the Vet was that she would not have guessed Annie had all that gunk in her lungs based off of how she sounded in her lungs, her respiratory rate and her overall demeanor. 

It looks a bit scary - and can be for some horses - but 
most are pretty reasonable with the entire process.

2. The Rebreathe Test

This can be a moderately confrontational procedure, but it is a basic one that all clinics can perform. Simply put, a bag is placed over the horses nose and "sealed" so the horse is rebreathing exhaled air while the Vet is listening to their lungs for crackling or popping sounds which would indicate damage to the lungs. The rebreathe is a good way of determining this, as it causes the horse to breathe much more intensely. Of course, a horse who is already struggling to breathe is not a necessary candidate for the rebreathe test.

In Annie's first rebreathe, she passed but coughed after the bag was removed. In her second rebreathe, the bag was left on longer and she panicked a bit. She did go into a coughing fit during this, and took a bit to recover from it. It was a bit puzzling for me, considering she marginally passed the first rebreathe but failed the second - so keep this in mind. It does require a level of complacency from your horse (some horses do. not. like. plastic bags over their noses), and a firm handedness from the Vet Tech to hold the bag on steadily.

In both tests, neither Vet who examined Annie heard any lung crackling or popping sounds. Of course, during the exam, horses and Techs and Vets were moving around so it isn't something that is 100% accurate. It can be a good marker for some scenarios, though.

A routine blood draw - there are a variety of different panels 
you can do, but most are similar if you are attempting to assess
the presence of infection.

3. Blood Test

In most cases, Vets will draw blood to search for infection or other diseases that may display on a blood panel. I don't have much to add to this obvious one, as it isn't a very involved procedure but do have one very large cautionary tale: 

This is NOT an accurate indication of infection.

Full stop.

Annie, along with several other horses I have met through the Faceb00k channels had normal blood tests but they did in fact have a large accumulation of mucus and infection in the lungs. 

I had asked the Vet about why Annie's didn't show up and there wasn't really a big answer for me other than, "Sometimes the body compensates." I had asked a few other posters on the groups about their own horses and no one really had an answer either, so it's something to be aware of when you are crossing diagnostics off of your list. 

Would I do a blood test again if I could go back? 

Yes. It had a lot of good information and could have been relevant to her condition (or perhaps another underlying condition which was exacerbating the COPD). 

Food for thought, regardless.

Annie, receiving a tracheal wash at the clinic last year.

4. Tracheal Wash (Transtrachael Wash)

Cornell has a really good article on tracheal wash's here that I've always shared with friends/ those interested in learning more about certain procedures. However, if you don't want to click over and prefer to just read on here, I'll go into some detail about what it's all about!

Tracheal wash's are a procedure where the objective is to collect a lower-tracheal sample (read: NOT into the lungs) to review and diagnose what specimen(s) is present. It can be done in more than just an equine setting and has been used in cows to determine the presence of parasites and other bacteria or viruses, which is pretty cool.

In the case of horses (and also cows, but we're not going to refer to cows anymore other than that point above, haha), the animal is sedated and restrained. The neck will be positioned in a way that allows it to be extended upwards and outwards so that the area where the incision will be is easily accessible and has no potential to be contaminated. 

Once the animal is restrained, sedated and the neck is set, approximately halfway down the neck the Vet will inject a numbing agent and make a small incision to allow the tip of the needle for the tracheal wash to pass through. From there, a large needle with a catheter surrounding it is passed through the incision and through some form of Veterinary magic, the needle is removed and the catheter remains in place in the lower trachea.

Sterile saline will then be injected into the catheter and "washed" down into the trachea. Once it is injected, the Vet will aspirate it back into a syringe to recover most, if not all of the fluid. The fluid that is drawn up will be able to be looked at microscopically. If you have the option to send the slides away for cytologic evaluation, I highly recommend this. Not all Vet clinics are able to perform in-house cytology and it really helps determine what is sitting in the lungs. In Annie's case, the clinic did not have the right dye for the slides and despite them looking at it under a microscope, they couldn't determine all of the findings.

A blurry photo of what was pulled from her 
trachea. Yuck.

The tracheal wash is a good indicator of what degree of inflammatory response is present, and can also determine is in the immediate area. The procedure can also determine what antibiotic is best to treat the infection (if any is present). For example, the bronchoalveolar lavage (BAL) goes further into the lungs whereas the tracheal wash does not. I know I have mentioned in the past "all the gunk in Annie's lungs", but it is only half-true, as the procedure we did only extended down a portion of her trachea. However, it is a good indicator of what is probably brewing further down.

For who don't know or maybe don't remember, Annie's cytology report showed the following: 70% nondegenerate neutrophils (neutrophils are a kind of white blood cell that deals with infections and damaged tissues), 5% lymophocytes (these are responsible for the immune system and low numbers can be indicative of stress, viral infections, or bacterial infections), 25% vaculated macrophages (a phagocytic cell (one that absorbs bacteria and other damaged cells) that tends to group at sites of infection, and a variety of Kirschman spirals (mucus), mild amounts of plant material and rod shaped bacteria which was indicative of a neutrophilic inflammatory response (ie. a higher than normal count of neutrophils in the body, indicating inflammation/ infection) . 

A closer look at the cells collected from a tracheal wash (not Annie's),
revealing mucus (it causes the cells to "line up" and "stick together), as well as
non degenerate neutrophils (arrow) and hundreds of eosinophils. 

As a quite sidenote, if you want more information, South Mountain has a great list of all the different cells in the horses body (along with vitamins and minerals) with a detailed explanation in regards to blood tests. The whole learning curve on cells and what they do is still a mystery to me in some ways, but it's important to research your horse's medical findings to fully understand what it all means. I have been unable to find any concrete research regarding the "normal" levels of cells in a healthy horse, as I imagine it's something that is still being researched and understood.

Injecting sterile saline down the tube as part of a routine
BAL procedure.

5. Bronchoalveolar Lavage (BAL)

As said previously, the bronchoalveolar lavage (BAL) allows the Veterinarian a deeper look into the lungs and to determine what level of inflammation is present. There is arguments that the BAL is "better" than a regular tracheal wash, as it is pulling information from directly down into the lungs itself. However, it may not be available in your clinic (it wasn't for me), so a tracheal wash may be the only way to go.

This sample is indicative of EHV-5. The large cell is a mutlinucleated macrophage, which
contains prominent large nucleoli, indicating an activated state

The BAL is a lot less invasive of a procedure (and can be done out of clinic), but does require some additional gear. Once your horse is sedated, your horse's neck and head will be lifted and stretched to make entry into the trachea much easier. The Veterinarian will insert a tube down into the horse's trachea and into the lower airway. From there, sterile saline (and quite a lot of it) is flushed into the area and pulled back where the liquid will be made into slides and sent away for analysis. One thing to know is that even if some fluid is retained in the lungs, it generally does not cause any issues as the large veins within the lungs rapidly absorb the fluid.  

An endoscopic exam being performed.

6. Endoscope

While it can be confused with a gastroscope (a scope that looks into the stomach; ie: for ulcers), this tool is used to view the contents of the trachea. It is commonly used in COPD cases to determine what is in the trachea, and with some endoscopes, small samples can be taken from identified problem areas. Horses can be sedated or not, as it is widely dependent on if the horse's larynx also needs to be actively viewed (ie. assessing the normal function of the larynx).

In Annie's case, she was sedated and reacted heavily to the endoscope being moved within her trachea. There was a lot of coughing and the poor vet ended up getting a nice coat of mucus on her face and in her hair (we were the very first appointment of the day to boot, oops). The findings were consistent with the tracheal wash - irritation was present in the airways, as well as some mucus along the sides of the trachea. However, it was also noted that the endoscope was performed after the tracheal wash, so findings weren't as severe as they potentially could have been. 

A repeat photo because I can't find a stock
image of a thoracic ultrasound being performed.

7. Ultrasound

While it isn't always a common procedure in the world of diagnosing COPD, it can be very beneficial in determining the overall health of the lungs and what the structures look like from an imaging level. It's important to remember that an ultrasound will only show you the surface of the lungs itself, so while it is not entirely a three dimensional view, it can provide a lot of information about how the lungs are working and if there is any damage present. 

Essentially, your horse will have a large amount of isopropyl alcohol squirted over their barrel and the vet will run their imaging probe over the area as the horse inhales and exhales normally. The Vet can identify any damage, fluid, tumors, or abscesses (etc) easily with this process. In Annie's ultrasound, the damage was easily seen as rippled "waves" instead of a smooth line and was categorized as moderate.

An xray of the fetlock joint, because I couldn't find a photo of 
chest xrays being taken.

8. Radiographs

If needed, a Vet may want to obtain some radiographs of the thoracic region (ie. chest) to further investigate for any potentially missed obstruction or otherwise if your horse is not actively responding to COPD treatments. If an ultrasound is not possible at your Veterinary location, radiographs may be a good option for investigating what the lungs actually look like.

For reference, Annie did not receive any radiographs of her lung/chest region. 

It is typical to do a blood test to determine allergens.

9. Allergy Testing

One of the most underrated and widely misunderstood tools out there is the allergy panel. Based off of what I've seen online and in practice, some Vets swerve away from the idea of allergen testing for reasons I am not privy to, but some seem to recommend it above several other diagnostics. While I have not had the opportunity to have Annie allergy tested since her diagnosis, we are scheduled for an allergen test in May which will hopefully bring about more answers about her condition and her sensitivities. 

So what is an allergy test?

In most cases, it is an blood test performed by a licensed veterinarian that is then sent off to a lab for processing. It can also be a skin test where a small amount of suspected allergens are injected beneath the skin and monitored for a reaction.

An alternative way to test for allergies.

Depending on what lab you use, your horse will be tested for the items/ factors they have on file. I researched several labs extensively, and found that Nextmune (formally Spectrum Labs) is the only equine-approved lab that also tests food sensitivities (ie. rice bran, beet pulp, apples, etc). 

Most labs I found (Heska, Idexx) test for the following: Grasses, Weeds, Trees, and sometimes Fungus/ Molds. 

However, please do your research when deciding what lab to go with. For example, Nextmune tests for: Grasses, Weeds, Trees, Fungi, Foods, Indoor items (ie. shavings (variety of types), wool, etc), Insects and Grains whereas Heska only tests for Grasses, Weeds and Trees. It can be pretty disheartening to spend the money on a test and not get the information you need, so please do the research or ask your Vet what each lab cover, or if there is a possibility of adding additional allergens to the panel itself.

From there, the results will give you a guideline as to what your horses tolerance levels are and if the exposures can be managed externally (ie. a horse allergic to alfalfa being removed from alfalfa hay and only receiving grass hay) there is no further action required. However, if the allergen cannot be completely removed (ie. trees, weeds, etc), immunotherapy is the next step.

Once the test results are received, a special and personalized immunotherapy
shot is developed based off of the specific sensitivities your individual horse has.

Immunotherapy is the process in which the allergens are introduced slowly to allow the body time to build a tolerance level for it (them). It is a series of shots in very small doses (3-5ml) that are injected (there is also an oral series for needle-phobic horses and owners) just under the skin. These injections are given on a set schedule, especially during the beginning of the process as the body is working to become desensitized. From there, injections may be given every month or few months depending on the horse and their requirements. 

As more research and more diagnostic tools are developed and the world of COPD is better understood, I am sure this list will become larger and much more refined. For now, there are several options for owners who are looking to diagnose and improve the lives of their horses. It can be a very frustrating condition, but knowing what options you have and arming yourself with the knowledge is half the battle - in my own case, pushing for "off the beaten path" diagnostics saved my horse additional scarring and trauma to her lungs and the side effects of being on medications long-term. 

If anything - take the time to find out what services your immediate clinic offers and see what procedures would best benefit your scenario. As always, talk with your Vet and develop a game-plan as to what the best options are and being mindful with any financial restrictions you may have in place.

The next installment I am excited for - I'm going to go over medications, what they do and what they are for, the use of the nebulizer (Flexineb) and if it isn't too long and boring, possibly some supplements/ homeopathic options.

For those looking for other parts of the series, you can find them here:

Part 1: Introduction to Respiratory Conditions 
Part 3: Medications and Supplements