So you have qualified for the Royal Winter Fair—Congratulations! You cannot wait to make the trip down to the glamorous Exhibition Place for the best time of year and thoughts of pre-Royal preparation start to fill your mind. Schooling sessions, saddle fitting, coggins and performance evaluations are typical for this time of year but what about your horse’s respiratory health?
When most people think about respiratory disease in horses, they tend to think of the typical “heaves” horse. We think of an older horse that has a persistent dry cough and flared nostrils with a prominent “heave line” on their abdomen. Recurrent Airway Obstruction (RAO, previously referred to as COPD or heaves) is probably the most common respiratory condition we manage in horses. This condition can present at any age and is not curable but can be managed with environmental and dietary modifications in addition to various medications. Although we think of RAO quite commonly, there are also a variety of other respiratory conditions including Inflammatory Airway Disease (IAD), allergies, pneumonia and respiratory viruses which can pose challenges to the sport horse.
Respiratory function is especially important in our equine athletes and is incredibly challenged during rigorous competition schedules. Lengthy trailering, close interactions with other horses and lack of turnout can all pose challenges to the respiratory health of our equine athletes. Low grade respiratory inflammation can also be a common cause of poor performance or decreased exercise tolerance and should be considered in horses presenting with these complaints. Managing these respiratory conditions can be incredibly challenging in these horses as commonly used medications will have a withdrawal period prior to competition and many of these treatments will have adverse effects if administered long term.
When talking to clients about Royal preparation, it is important to discuss strategies to limit dietary and environmental changes for these show horses as much as possible. Outdoor turnout is not possible at the show but we can walk these horses frequently especially to remove them from the stabling area during peak dust periods (mucking, haying). Many of our RAO horses are maintained on steamed or soaked hay and special types of bedding to limit dust and allergens. Incorporating a dietary oil supplement which is high in omega 3s has also been shown to be beneficial in decreasing inflammation and minimizing clinical signs. Consistent exercise will be especially important to these horses in order to improve mucociliary clearance.
We know that environmental control is extremely important to these horses but what about medications? This is where the Flexineb system comes in. Not only is it easy to use and durable but it is also well tolerated by the horse making everyone’s lives easier. This system allows for direct delivery of aerosolized medication to the horse’s lungs while also minimizing (or completely eliminating) the amount of systemic medications needed. Many scintigraphy studies have shown that 71% of aerosolized particles are able to reach the lower airways which sets this nebulizer apart from other systems.
There are a variety of medications which can be nebulized using the Flexineb system. These medications include corticosteroids, bronchodilators, antibiotics and even saline with essential oils. We always recommend discussing these products with your veterinarian to determine the most appropriate treatment regimen for your horse. Each patient is different and there will often be a trial period to determine the most appropriate dosing regimen for these medications. Nebulizing antibiotics has been extremely beneficial in managing bacterial pneumonia cases while a combination of bronchodilators and corticosteroids is commonly reached for in our RAO cases. Medications given via the nebulized route will also have a shorter withdrawal time than these same medications given systemically.
I have recently started nebulizing horses with a newer product called Immuno-San. This product is a natural solution which has both anti-inflammatory and antibacterial properties and can be used concurrently with other treatments or to optimize respiratory health. One of the biggest benefits to this product is that there is no withdrawal time from competition (in most jurisdictions) which makes it an excellent product for show horses. We will often administer this product as a 10-day treatment but it can also be given as needed prior to rigorous competition or a prolonged shipping period with good results. I have been impressed with the results seen in equine athletes using the Flexineb system especially when there has to be a change in their daily management during competition. Here’s to wishing everyone a happy and successful 2019 Royal!