Tuesday, December 13, 2022

COPD Explained, Part 3: Medications and Supplements

In continuing with my COPD journey and learning how to best help and manage my respiratory affected horse, I wanted to share what I have learned over the last few years and what kinds of options there are available on the market. 

In terms of providing medication for a respiratory compromised horse, it is certainly up to you and your Veterinarian to discuss an ethical and sustainable treatment plan, as there are an abundance of drugs and dosages that are available. As on owner, it doesn't hurt to be educated and know the general gist of most medications and what they do. I find it simplifies things, as Vets are not always able to get it right the first time and with COPD, it truly is a dance of trial and error. 

Being able to follow your horse's diagnosis and treatment plans without seeing gibberish is exclusively important - being able to understand the pros and cons of each and every medication not only allows for you to make the best possible choice for your horse, it helps you understand what to expect or what is considered abnormal.

This is not a complete list - I'm sure over the years there will be more information and more medication that comes to light. Science is ever evolving and I don't claim to know every single thing about COPD or respiratory conditions - I simply have been unlucky enough to experience first-hand in my own horse and have put in the time to understand and research the condition.

I don't have all the answers, but I try to do the very
best I can for my mare.

First things first - always consult with your Vet. Period. 

Playing around with medications and monkeying around with dosages is scary and can lead to additional problems for your animal, so read and utilize this information at your own risk.

That being said, there are a few different medications that you might see be used in your horse's life after being diagnosed with COPD. These medications can be grouped roughly into 5 different categories:

Mixing meds on the way to the barn - not 
weird at all!

1. Antibiotics

Antibiotics are used to treat bacterial infections - some fight a broad spectrum of bacteria, while others are more specialized and focus on a singular bacteria. Simply, they work by killing or decreasing the growth of certain bacteria. With respiratory issues, it's important to recognize if it is due to a bacteria, fungus, or viral infection in order to determine which antibiotic would be useful (or if an antibiotic would be useful at all).

I could rattle off a list of antibiotics and what they do, but I admittedly am not as well-versed in them as I am with bronchodilators and steroids. However, Uniprim, Excenel and Excede are all very common prescriptions. Some are injectables (Excenel and Excede, exclusively) while others are oral (Uniprim). There are other antibiotics on the market that can be administered via a nebulizer, which can be doubly helpful in ensuring the medication is delivered deep within the lungs. It is best to discuss this with your Vet before attempting to nebulize, as not all antibiotics are created equal.

We used primarily albuterol with mixed results - it 
seemed to help short term, but because her symptoms are 
not shortness of breath, it didn't seem to really make a 
huge impact on her overall condition.

2. Bronchodilators

As the name suggests, it is a medication that opens up (dilates) the breathing passages by relaxing the bronchial muscles. They are often used in a situation where the patient is wheezy, breathless, or is experiencing chest tightness. Common bronchodilators include: albuterol (salbutamol), clenbuterol and the less commonly used ipratropium. 

Some owners may be more familiar with clenbuterol's trade name, which is Ventipulmin. This drug can be administered as a injectable or orally in a syrup-style formulation. 

The marest face of them all.

3. Corticosteroids

Corticosteroids are used to fight inflammation which can be synthetically manufactured or produced in the adrenal cortex. They act by lowering inflammation in the body by reducing the production of certain chemicals. While they are effective at reducing the inflammatory response, they are also known as immunosuppressants (ie. cause the body not to fight infection or function as appropriately as it should be).

Steroids should be used with immense caution, as they can predispose certain horses to laminitis and founder, especially when injected. I've learned that nebulized or inhaled corticosteroids are "safer" than injectables because they simply target the lungs whereas injectable are processed throughout the entire body. However, there is scientific findings that nebulized steroids are better suited to "mild" COPD cases whereas injectables are appropriate for more "severe" cases, as the injectable provides relief more immediate than the inhaled steroids.

With my own experience, I found Annie had a lot more abscesses than usual when we were attempting to manage her with steroids. However, this could also be attributed to the fact it was a rather wet year that year as well. Regardless, it definitely made me pause.

Perhaps the most famous steroid most horse owners will be aware of is Dexamethasone. It comes in injectable/ inhalable and oral forms. 

Knowing what "normal" is for your horse is so important.
Getting familiar with their mucus (if they have any discharge),
what it looks like, and when it worsens are all important.

4. Mucolytics

Mucolytics have one job - they increase the output of secretions from the lungs by thinning the mucus. This can be especially helpful for horses who, like Annie, have a build up of mucus and gunk in their lungs whenever they flair. 

There are several different types of mucolytics that are on the market - some are inhalable and some are oral. I have only had experience with Sputolysin which increased an uncomfortable amount of mucus and seemed to clear a lot of gunk from Annie's lungs in a short period of time. Unfortunately, at least for my area, it is an expensive drug, but it works really, really well. 

I've also utilized saline solution (0.9%) in the nebulizer, but did not find it as effective as the sputolysin. 

I should've done a photo of alllll the supplements 
I've tried, but I don't have all of them anymore and
some have since been discarded and/or rehomed.

5. Supplements and "Other" Medications

A lot of what maintains a COPD horse can be attributed to the supportive care and maintenance they receive. While one horse may need nebulized steroids, another may be well supported on a variety of scientifically proven supplements or other medications. 

Keep in mind that there are SO MANY supplements out there and not all are created equal. I strongly encourage anyone to stick to basic products (ie. pure products) to avoid introducing a potential irritant back into the horse's diet (which is why I strongly encourage allergy testing). 

Some good supplements or other medications to consider are the following:

a. Antihistamines - this can be over the counter/ human-grade, but know that the active ingredient must be cetirizine hydrochloride. I've used Zyrtec in the past for Annie, but unfortunately it doesn't seem to do much in her case. Regardless, I've found that its a good 50/50 shot if it'll work for your horse. They're relatively cheap (especially if you live in the States) and although they are a bit of a pain to administer (2x a day), it can be a cheap and easy way to manage COPD symptoms.

b. Jiaogulan - a powder that increase blood flow and supports respiratory health. Typically advised to go hand in hand with spirulina.

c. Spirulina - a powder that is rich in blue-green algae that provides help with the respiratory system and immune system. I did use this with Annie in her early diagnosis stages and did not see an improvement, but we were still fussing around with what worked and didn't to be really sure.

d. Respi-Free - a liquid that contains several different herbs and supportive antioxidating items. I've used this with good results in the past with Annie.

e. Vitamin E - All-around good supplement that supports a variety of functions. In respiratory health, vitamin E supports the immune system and in turn, the lungs themselves. Because most horse owners feed hay, often times their horses are low in vitamin E, as pasture is the only really good source of vitamin E. Additionally, vitamin E helps reduce phlegm (something I am going to be utilizing in Annie! I'll report back with my thoughts!).

f. Cough Free - A supportive pellet that has a lot of good herbs, but also things like flax and oils. I did use this in Annie before I became aware she was allergic to flax. These pellets STINK. They took forever for Annie to even begin to eat and by then we were almost done with the container. I've heard they work for some horses, but again it did not work for me and my circumstances.

g. Air Power - This is a liquid that provides relief for coughing. It is not necessarily meant for long-term use, so is better utilized (in my opinion) in very, very mild cases. I've used it in both horses and it's worked well, but I saw it worked more in Spud than it did in Annie for the circumstance.

h. Aleira - This is a supportive powder that has a mixture of omegas, vitamins, and herbs. While I haven't used it personally, there are rave reviews on a lot of the COPD forums I'm on about this particular supplement. This supplement, in comparison to the one below, is DHA (omega fatty acid) heavy.

i. CEP Daily Lung - Again, a supportive powder that has a variety of herbs and antioxidants. I have not used this one either, but again, its widely approved by a majority of COPD forum members. This supplement, in comparison to the one above, is herbal-heavy.

j. Lung EQ - Mixture of pelleted herbs and antioxidants. This particular mixture does have flax, which again is a red flag to me and my circumstances. 

The list goes on from there - there are endless supplements and mixtures available on the market to combat and support horses with COPD. Perhaps the most frustrating part of this disease (which I've already spoken about), is the lack of consistency across the board - what works for one horse may not work for another and in that, it takes a lot of experimentation and tears of frustration before landing on something that works.

Motion is lotion, always.
Taking adventures in the snowy wilderness is a great
way to get the lungs working!

In my own case, I've found success for several months before my mare's condition has worsened and have had to go back to the drawing board. It is increasingly frustrating and borderline maddening, but it is important to know you are not alone. One of the most helpful comments I have received in the online forums is to take this disease day by day. There is no magic cure and a lot of us are just doing the best we can do for our horses, and that is all we can do.

I still have a few more parts of the series left - Part 4 will be on nebulizers (where to buy, features, how to use, as well as cost effective options), Part 5 will be on feeding options (talking about things like hay cubes, haylage, steamed hay, soaked hay, etc) and if there is more to say, potentially a Part 6!

For those who are wanting to find the first two installments, you can find them here:

Monday, December 5, 2022

The Year of Change

It's been a while, Blog Land.

A lot has changed since I last blogged nearly twelve months ago.

My day to day has changed.

My herd has changed.

My goals have changed.

I am still transitioning from a state of high pressure, impossible deadlines, 3am electrical wiring and drywall installations to a calm and quiet sea and it's... weird. My clock seems to tick on endlessly, reminding me that I finally have time to do things other than rearrange gravel and rock or measure and remeasure cabinets. And a weird part of me is almost perturbed at the idea that spending 14 hours a day at the barn isn't on the docket for my weekend plans yet again. 

The past 365+ days of barn building have been emotionally, mentally, and physically exhausting. I remember thinking that the day we brought the horses home that things would almost feel magical, but I think we've been running off of adrenaline, hot dogs (so many hot dogs) and lack of sleep that I haven't had the chance to really let it sink in yet.

Case in point - wiring electrical by flashlight.

I am enjoying it, though, and allowing myself to feel thankful to finally have my own space. There is still a lot left to do, but the bulk of it is complete and we can finally breathe a little bit. As we transition back into the warmer months (ie. Spring 2023), we will be creating more paddocks and subsequently more room for the horses to enjoy their new home. 

If this entire process has taught me anything, it is that anything worth having doesn't come easy and if you want something bad enough, you can make it happen.

This build took a lot of blood, sweat, and tears - literal and copious amounts of each and I could not be any more prouder of my partner than I am now. When I approached him nearly six years ago with drawings and plans of what I wanted for a barn, he simply said, "Oh that's easy."

It was anything but easy, but it's here and it's all mine.
It still looks a little derelict given that there is no siding, but
good things come to those who wait (or something like that).

And not once did he complain, even when we had to shovel snow and ice out of a 4ft deep foundation. Not once did he say, "This it out of our element" - we simply forged onwards and figured it out. And not once did he turn down an opportunity to work on the barn - even when it was rain-slushing sideways or it was a balmy -20C.

This is singlehandedly one of the biggest project's we have taken on as a team, and as we draw a close on the year, I am thankful he has always been my biggest cheerleader and biggest advocate of the entire process. 

Of course, the year did not come without its own bouts of sadness as I laid my sweet Moo to rest. I'm still not ready to talk about it or acknowledge how angry I am that I had to say goodbye. 

But maybe one day. 

Forever three years old.
Forever the very best three year old.
I had sat on her precisely once before this day.

Maybe one day I won't be so angry, and I'll share her story right to the end.

One day, but for now I hold the memory in my heart and in my mind and I hope that wherever she is she is finally free.

Over the last year I've learned that horses hold a special place in my heart, but they are not my entire life. Part of me feels grief over that, but part of me feels relief that there are no external pressures to ride and compete. 

With Annie's COPD worsening over the last few months, I've had to learn to adapt to the health of my horses yet again and although things look a little more bleak and uncertain once again, I feel weirdly humbled to know that whatever comes my way, I can and will deal with it the most graceful and appropriate way possible. 

They already love the new place and immediately
took to snoozing in the soft sand every single night.

I am simply enjoying my horses - eager for warmer days to ride (or drive) or simply hand-walk and be in their presence. I still love them with a fierceness that only a horse-person can understand, but I am also letting go of that part of me that longed for competitions, new tack, early morning lessons and braiding the perfect button braids.

I don't know what the future holds for my special black war horse, and although a large part of me is very nervous to see such serious changes in less than a year, I am reminded yet again that I know my animals better than anyone. And for now, I'll do what needs to be done to protect, nurture, and keep her as well as I can. 

The same goes for a silly little potato pony, who never ceases to keep me on my toes and reminds me to laugh even when I really, really don't want to.

Things are chugging along as they always have - a bit of triumph and a bit of tragedy. Horses are one of the most frustrating yet endearing animals I have ever had in my life (and if anyone has any insight into feeding a cube-only diet, please comment below so we can connect!) and yet, I cannot imagine life without them.

Looking at the back of the property, which will
eventually be grass for her to munch on to her heart's

2022 has been a whirlwind of emotions and change, both good and bad. I'm still sitting with and processing a lot of these big feelings, but I finally feel like I can catch my breath.

For the bad that came out of 2022, I am still thankful, and I am still here - learning to let old dreams die in place of what is best for not only my animals, but for me. 

One day there will be a return to the show ring and one day I may miss the feeling of a really good centerline, but for now I am content. For now, I am happy and so are my horses.