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  Discussion on Irritability as side effect to desensitization therapy
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Posted on Saturday, Apr 6, 2002 - 11:22 am:

My 12 year old ot-tbred has been undergoing desensitization for allergies
which have cause acute respiratory problems for the past two springs. Severe
cough which lasts for around 3 months, somewhat responsive to dexamethasone
and antihistamine cough syrup.
He was tested using Equine ELISA routine, and has been treated with
resulting serum since last October. The problem is I've noticed an
increasing irritability, which is reaching the point of making him dangerous.
He can no longer be cross tied as he becomes quite hysterical and out of
control at what would normally be routine noises around the barn, etc. So
far he is manageable when being ridden, but even then is more tense than
usual.
I've discussed this problem with the PhD president of the company which
provides the treatment. He had no knowledge of this kind of problem with
horses, but is aware that "some" dogs and cats will present agitated
behavior. He recommends diluting the serum.
Stopping the treatment does not seem to be an option at the moment, because
we are in the peak of allergy season. If untreated this horse is a prime
candidate for chronic COPD (heaves).
Has anyone out there had any experience with desensitizing a horse, and have
you run into problems like this?
My vets have not offered much help, especially since all but one indicated
they had little faith in this type of testing and treatment.
I've done everything possible to modify his environment and feed. So far
this season he has not developed a cough.
Has anyone out there had any experience with desensitizing a horse, and have
you run into problems like this?
Thanks in advance for information, help and advice.
Heather

Posted on Monday, Apr 8, 2002 - 5:45 am:

Hello Heather,
It is not a matter of faith but a matter science that makes your veterinarians not put much credence in this type diagnosis and therapy. But I sense you were becoming desperate and I hope you the best and since this was not what your question is about I will get along with that.

Your post is not very helpful concerning the change in your horses behavior. For instance you mention cross ties: is this were he is treated with the injections? How often are you treating the horse and how are the treatment given? How is he reacting to the treatment itself?

I have not heard of such a reaction to desensitization but only deal with it once in a blue moon and if this is not some response to the pain of the treatment or caused by the treatment I am unsure how else it could be related.
DrO

Posted on Monday, Apr 8, 2002 - 12:08 pm:

Thanks so much for your response, Dr. O. I do respect the nature of your message "it is not a matter of faith but...science" and believe me, I'm aware of how little scientific data appears to be available on this topic. To help you know where I'm coming from, I have a BS from Cornell in biology ('55), and an MS from Clark in Biochem ('64). So although my education is obsolete, my foundation in scientific method is fairly good.
Yes, I was/am desperate. The cough was severe and prolonged and returned each year. I felt threatened by COPD and chronic heaves. The dexamethasone treatment for three months didn't help that much, and worried me. The testing revealed sensitivity to some things I could modify (oats, fescue, etc.) and some I couldn't (alder, cottonwood, etc.) I've done everything I could think of to modify his environment. This year so far there is no cough. It well could be that the modifications to environment have made the difference, but with the numerous guilty trees in the area, I'm dubious.
The irritability became apparent last November, and seems to be increasing. He startles at noises, visual stimulii, anything unexpected, but nothing dramatic - things that haven't bothered him in the past. This happens when tied, cross tied, or when I'm just holding him by a lead. He is most calm when being ridden, but even then isn't entirely relaxed and content. I have given him shots in all these situations, in the barn, in his paddock, or held outside by lead. We are now down to monthly shots, and the shot itself doesn't seem to disturb him as long as I don't pinch his skin. I'm careful to keep the hypo out of site, as this definitely disturbs him. But the irritability is present all of the time, under a variety of situations.
While I'm not "into" homeopathic stuff, I'm curious about "vaccinosis" - a new term for me. I've read about this in relation to canine responses to vaccination programs.
Even though we are at the peak of allergy season, I'm considering stopping all shots (including monthly IM injection of Adequan), to see if this makes a difference. The headache will be that if the cough returns, I'll want to go through the entire program of testing and reformulation of antigen serum. I'll let you know what happens!
It has been reassuring to hear from several horse owners with similar problems who feel that the therapy has made a significant difference.

Posted on Monday, Apr 8, 2002 - 5:40 pm:

Heather what the housing arrangements like during the cough? What dose of dex (how much, how often, how long) would you use. You really cannot use the results of a elisa blood test to determine allergies, I am afraid that information is meaningless so the comment about the trees is equally so. If he gets better well... I will raise a toast to you and your horse....but it surely has nothing to do with this test and treatment. Continue them if you feel they are helping and not hurting but concentrate on those environmental factors.

It is always interesting to see large long term studies of COPD horses when controls are in place. There is always about 30% that improve with no treatment or a placebo. A product can get a pretty good reputation helping 30% of horses with a chronic difficult to live with disease like COPD. Heres hoping you are in that group.
DrO

Posted on Friday, Apr 12, 2002 - 10:31 am:

Dr. O - I can't tell you how much I appreciate your feedback - you really are providing balance to my stressed outlook!
Lad lives in a "private" shelter attached to a barn, with a 30' x 20' paddock. I've put mats down in the shelter, and use a light layer of uneaten Eastern Washington grass plus pine shavings when necessary for bedding. Goal is to minimize dust, and provide enough cushion to keep away the dreaded hock/fetlock sores. The shelter faces south,with prevailing wind/breezes from the west (Whidbey Island, WA). Grove of Alders about 100 yards to the west.
I've taken him off oats (on his "list" - and yes, I understand your position about that list !), and he gets the cleanest grass hay that can be obtained from Eastern WA (our local stuff is inclined to harbor molds).
During the day he is turned out to pasture with two buddies.
Dex therapy consisted of 10mg daily for a week, then every other day for two weeks, then every 2-3 days for the duration of allergy season.
It helped somewhat, but still couldn't exercise to the usual level. Just walk around. He was also on Albuterol.
So far this spring he isn't coughing at all.
But - he sure hates those shots (he is also on Adequan, both administered monthly at this point.)

I'll keep you posted. Thanks again.
Heather

Posted on Sunday, Apr 14, 2002 - 10:13 am:

I think it is possible that the reason for the change in behavior is he is associating you with the pain of the injections. You might try some more "positive reward" to reshape the behavior to where he accepts the shots more willingly. As I seem to be referencing more and more now-a-days, see Training Horses: Training the Mind of Your Horse: Modifying a Horses Behavior: Conditioned Responses. Remember you are not trying to teach him to take the shots but to be happy about them: reward a good and willing attitude, not just standing there.

The dexamethasone doses were a bit on the small side I would quadruple this dose but continue with the same frequency ssuming a good clinical response.
DrO
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