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  Discussion on Steroid and Aminophylline Dose
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Posted on Saturday, Nov 17, 2001 - 8:22 am:

My 18 year old lg. pony apaloosa schoolmaster gelding has certainly shown signs of COPD over the years, but was still eventing at 17. With each URI, he goes on to a prolonged cough and to localize what seems a chronic bronchitis to the right lower lobe, with creps and wheezes persisting. We find the occasional dense, rubbery creamy gob of "snot" on the floor, usually a good sign, for his cough moderates, and becomes less frequent and racking, but he seems not to shake these lung findings, and will still cough when he eats or exercises. There is no choking, and each episode seems to follow a clear nasal discharge and no obvious signs of fever or bacterial infection. We give him the best we've got for dust control, but he becomes rather porky on hay substitutes and rest. Ventipulmin is obviously effective for symptoms, not resulted in clearance, and horribly costly. I am looking for recommendations using drugs I am familiar with in human medicine which I can compound for this situation that will minimize the risk of steriod toxicity for a fat old pony, perhaps cover bacterial over-growth in this situation, provide acute and chronic bronchodilator effect to accelerate clearance, and not shoot my annual vet budget for the whole herd.
Can you recommend founder-safe prednisone doses and any evidenced based advice on tapering courses (no longer so rigidly observed for humans), respiratory active oral firstline "bronchitis" antibiotic choices and dosages, and aminophyline dosages that I could compound a customized regimen to deal with each phase of this illness? I'd like to avoid nebulized steroids, but could do it cobbling together hospital cast-offs. I am looking for specific dosages per kilo, particularly for anhyDrOus aminophylline, which you may not feel safe to post on the web for generalized consumption His only other medication is pure glucosamine HCl which is mixed into a handful of moistened kibbled feed. We think it has kept him moving very well for an old fella. He's bored and wants to get back to work. If your reply is not suited for a non-medical audience, perhaps it should be posted as a "consultation". My email: afmccall@bmts.com. Thank you, JoAnn McCall, MD, FRCP, Cirrus Hill Farm, Box 3355, Meaford, Ontario, N4L 1A5 Canada.

Posted on Sunday, Nov 18, 2001 - 5:52 am:

Hello DrJ
Most of your questions are answered in the article Equine Diseases: Respiratory System: Heaves & Chronic Obstructive Pulmonary Disease. Be sure to follow the links in the article, especially those on corticosteroids, you will find a alternate day regimen, using prednisolone, for horses. Prednisone is not effective in horses.

Aminophylline has not been found to be a useful drug in horses. There are large variations in response and whenever you approach anything that causes dependable bronchodialation you also approach toxic problems that are mainly manifested by excitement and tachycardia. I am afraid we do not have a good, cheap broncodialator in horses.
DrO
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