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Discussion on Oral antihistamines
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New Member:
ksojerio
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Posted on Sunday, Jun 17, 2007 - 3:04 pm:
My 4 yo AQHA mare that weighs 1250# has been breaking out in hives every 3 days since April 15. The vet did bloodwork that indicated nothing abnormal. The results of the skin biopsy indicated she has an allergy. Benedryl has been an ineffective treatment in preventing the breakouts. Dexamethasone will remove the swellings after 2 treatments, but 3 days later the cycle repeats.
In your article on hives you recommend "Hydoxyzine: 1 mg/kg every 24 hours"
I have a prescription from my vet for h-y-d-r-o-x-y-z-i-n-e. Can I assume that is the same product? (My local pharmacist identified it as an oral antihistamine.) The pharmacist wants to know if I want hyDrOxyzine HCL or hyDrOxyzine Pamoate? He has both available.
Also, he has it available in different strengths: the HCL is available in 10mg, 25mg and 50mg. The Pamoate is available in 25mg and 50 mg.
Which product should I buy and what strength? My vet was not familiar with this drug and simply wrote "as much as needed" on the prescription.
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Moderator:
DrO
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Posted on Monday, Jun 18, 2007 - 9:09 am:
Yes they are the same and the spelling is a typo in the article.
Either salt could be used and the weights equivalent for the HCL salt so the dose applies to either. Buy the cheapest and the highest strength available to minimize pill crushing.
If you find antihistamines don't do the trick, consider alternate day therapy with prednisolone. For more on this see the article at Treatments and Medications for Horses » Anti-inflammatories (NSAID's, Steroids, Arthritis Rx) ».
DrO
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New Member:
ksojerio
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Posted on Monday, Jun 18, 2007 - 11:51 pm:
I read the article that you mentioned on ADT and it includes the use of prednisolone. My vet's anti-inflammatory of choice seems to be dexamethasone. I have inquired about the prednisolone and was "steered" back to the dex. (He is 77 years old and has been practicing for 46yrs!!Perhaps old habits are hard to break...)
Would it be possible to to use the dex orally and as a stand alone treatment, as I am now, and just use it every 3rd day, tapering it down in the manner you describe? Or, do I just need to get more assertive with my vet and get some prednisolone?
I plan on having an intradermal skin test done, but with current temperatures in AZ over 100, I don't think the stress of 150 mile round trip to see a specialist would be good for either of us!
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Moderator:
DrO
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Posted on Tuesday, Jun 19, 2007 - 8:01 am:
The 1/2 life of dexamethasone is so long that ADT with it does not give the adrenal time to recover from exposure (see the ADT article for more on this). Perhaps if used every 4 to 5 days you might get the same effect but another problem with dex is the variability of time it remains in the system from horse to horse which makes timing to give the adrenals time to recover difficult.
DrO
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Member:
ksojerio
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Posted on Monday, Nov 12, 2007 - 7:50 pm:
This mare's chronic hives lasted from 15 APR to 15 OCT.
As of 15 October, we have not had another hive breakout and she is medication free.
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Moderator:
DrO
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Posted on Tuesday, Nov 13, 2007 - 1:41 pm:
6 months is quite a episode of hives how did you manage over the summer since your last post in June barnbratsmother85650?
DrO
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Member:
ksojerio
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Posted on Tuesday, Jan 8, 2008 - 4:49 pm:
I shouldn't have jinxed myself by posting that her hives were over.
Since Thanksgiving she has been hivey again. I have her back of 2 tabs of hyDrOxyzine daily.
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Member:
dres
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Posted on Tuesday, Jan 8, 2008 - 5:25 pm:
barnbrat.. I have a mare that has hives in the summer months.. I was going to take her in to have the skin test done on her next week by an equine skin specialist.. after talking to Dr. O on my thread and reading more about hives.. i am opting to not spend the money on the test and HOPE that this will run its course .. My mare has this trouble in the summer months now for 3 years.. this past Nov. was the first time she had a break out..small case, & has been hive free since... I JUST talked to my barn vet about my decision and she seems to feel that my mare falls under the catagory, chronic case and will need testing and the shots..  I do show in the summer and can't with the dex or hyDrOxy in her system.. Now i am again on the fence after reading your post..
sorry i have nothing to help you.. but you have added to my thinking.. or 
On the first day God created horses, on the second day he painted them with spots..
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Member:
ksojerio
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Posted on Tuesday, Jan 8, 2008 - 10:04 pm:
Do you have any idea of the cost of testing or shots? Will your local vet do it or are you seeking out a specialist? My vet says that he can't do it.
I have located one board certified equine dermatologist in the state of Arizona and I dread the thought of hauling to Phoenix.
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Moderator:
DrO
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Posted on Wednesday, Jan 9, 2008 - 8:43 am:
Ann when you spoke to the skin specialist did you discuss the accuracy of skin testing and if so what did he say?
DrO
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Member:
dres
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Posted on Wednesday, Jan 9, 2008 - 10:32 am:
DR. O , no I did not speak to her , i just called and cancelled the appointment.... I went with what i have read here and what others have said on other Bulletin Boards.. What i read on other sites is that folks that went for help with a equine dermatologist was AFTER years of dealing with the break outs.. 1/2 had good results and the other 1/2 saw no change.. So i decided to sit this out one more spring / summer with a wait and see..
I did ask my barn vet tho, if push comes to shove that i can do the tests while she has an out break and she can be treated and shown at the same time..She also said that her referrals had 50 / 50 results as well.. My barn vet agreed that my mare is not uncomfortable with her out breaks, it is just unsightly.. IF i have to take her in in the future i will be sure to ask the accuracy of the skin testing..
Barnbrat.. this specialist comes to our clinic as needed..
On the first day God created horses, on the second day he painted them with spots..
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Member:
sryder11
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Posted on Wednesday, Jan 9, 2008 - 8:51 pm:
Barnbrat, I have been following your story with great interest since I have also been dealing with hives from July 25 through November. My horse which I posted about in Hives and Dex Dosage is doing much better now, off meds, but I am dreading next fly season and considering doing the skin testing also. I talked to a veterinary dermatologist in the Santa Barbara CA area but is not near you - if you like I can email you her contact info and you could talk to her. Please let us know what else you find out.
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Member:
dres
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Posted on Thursday, Jan 10, 2008 - 1:49 pm:
yikes.. we are jinxed ! went out to the barn this AM and my mare is bumped up again!~ THE DAY AFTER i canceled our appointment!~
Nothing has changed the last 48 hours! Weather / feed / bedding ???
I will wait till spring and better weather to pursue this .. ugh..
On the first day God created horses, on the second day he painted them with spots..
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Moderator:
DrO
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Posted on Friday, Jan 11, 2008 - 7:02 am:
How about blanketing: have you blanketed the horses or kept them in a heated barn when they developed the hives? Be sure to treat quickly and aggressively to get them back down.
DrO
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Member:
dres
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Posted on Friday, Jan 11, 2008 - 12:15 pm:
Dr. O why blanket? I thought that cold water was helpful with hives not heat?
No, my mare is not blanketed... but since I washed off her mud * SHOW ME YOUR MUD * several weeks ago, I do put on a rain sheet to keep her clean in turn out..
What I noticed yesterday , in bringing her in from all day turn out with her sheet on her bumps were less, OR maybe the hairs were down.. Anyway, this AM , no blanket in her stall the bumps are more pronounced again..
You say to treat quickly and aggressively now , why? I thought to run their course without intervention would help develop her antibodies.. ?
If I were to treat her now , what would you suggest? Dex IM or orally? or hyDrOxyzine?
*Note, I have never treated her hives with anything..
On the first day God created horses, on the second day he painted them with spots..
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Moderator:
DrO
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Posted on Sunday, Jan 13, 2008 - 10:52 am:
Concerning the blanket, you misunderstand the nature of my question. I too would suggest blanketing would contribute to the hives as heating of the skin often contributes to it's reactivity for those prone to the problem.
Hives are not a problem of "lack of antibodies" indeed just the opposite in some cases. Hives is the over-reaction of the immune system to some stimulus that involves the histamine portion of the immune response. Sometimes this may first involve antibodies to things that are not truly a infection.
I have always thought allowing it to continue to overreact may increase the sensitivity of the immune system as this is consistent with some folks with serious allergic reaction. They sometimes start off mild and build with repeated reactions.
Ann the article on Hives explains carefully the different treatments and the differences between them and answers your questions directly. If after reading it you still have questions bring them here.
DrO
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Member:
ksojerio
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Posted on Wednesday, Feb 6, 2008 - 2:10 pm:
Well, Dr. O, we still have hives. We are using 5 capsules per day of hyDrOxyzine and DEX abt once per week.
I was wondering about hay allergies.....Which hays are the least likely to cause a reaction?
This mare is fed 25 lbs of oat hay pellets per day currently. Nothing else. We have tried other types of feed during the past year and haven't seen any difference in how she reacts to them.
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Moderator:
DrO
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Posted on Wednesday, Feb 6, 2008 - 6:31 pm:
I am not aware of a single documented case of allergies to hay causing a chronic urticaria. I personally believe some of these cases may be a mild form of autoimmune disorder but I have no proof. Until proven about the only way to test for allergy is to remove the possible allergen from the environment. When all things that can be removed have been you might try a totally different environment.
In the meantime how much Dex (in mg) are you giving once weekly? Is there any impression the hyDrOxyzine is helping keep the Dex dosage lower?
DrO
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Member:
sryder11
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Posted on Wednesday, Feb 6, 2008 - 11:26 pm:
Barnbrat, my vet took a skin biopsy and sent it to UC Davis as well as the State of Calif lab and (interestingly in view of Dr O's comment above) one of the experts thought it was a food allergy, the other thought it immune system related.
My horse is doing better and I have not changed any of his food but he gets orchard grass hay, and there have been some other posts in some of the other hives discussions about grass hay also. I thought possibly it could have been a certain batch of hay, something in the fertilizer or otherwise.
One thing which seems to be helping is the Platinum Vet Skin & Allergy supplement which contains Omega 3 fatty acid and an immune booster called thymic protein. I would like to know if other horses have had any results from this, or as Dr O has said, sometimes the last thing you try seems to be the "miracle cure."
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Member:
ksojerio
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Posted on Thursday, Feb 7, 2008 - 9:55 am:
Dr. O:
Since I am responding from work I can't tell you what strength the DEX is, but I am giving 3-4cc, usually once per week. Yes, that is less than she was receiving last summer when I began using the hyDrOxyzine. Before hyDrOxyzine, she was getting 5cc about every 4th day.
I, too, am hesitant to think it is a food allergy, as I have tried every possible combination of feeds available during th past 10 mos. However, I have to keep trying things to see if anything works.
Results of blood work were unremarkable and the skin biopsy report was "allergy of undetermined origin".
Susanne:
I started using ground flax seed in the last few days because of the Omega 3's. Someone else suggested vinegar; so now she is getting about 1 1/2 c per day of that.
Cheval International advertises an allergy product that seems to have vinegar, garlic and brewer's yeast as the main ingredients. How does that compare to the ingredients in the Platinum product?
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Member:
sryder11
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Posted on Thursday, Feb 7, 2008 - 11:25 pm:
per scoop (1 gram)
Algal Omega 3 docosahexaenoic acid 700 mg
Quercetin Dihydrate 120 mg
Purified Calf Thymus extract 1250 mcg
I Googled these ingredients and learned that quercetin is a bioflavenoid which occurs in many fruits and vegetables. It supposedly has many properties including anti-histamine. Thymus protein is an immune booster used in human supplements.
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Member:
ajudson1
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Posted on Friday, Feb 8, 2008 - 6:57 am:
I used to use a product called I think, Blue Bonnet Super Quercetin when our whole family went through allergy problems. I thnk the dosage for my grade school aged children was a lot higher than 1 scoop of the product you are giving for the horse.
Also freeze dried stinging nettles is an antihistamine and good for the immune system.
These 2 products took care of our allergies, when allergy shots and/or DrOps was not working out.
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Moderator:
DrO
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Posted on Friday, Feb 8, 2008 - 1:32 pm:
Hello All,
There has been some work that suggests that quercetin is effective as a antiinflammatory and antihistamine in non-horse species. However the amount found effective was 15 mg per kg and much higher than the presumed dosage of 1 or 2 scoops above for a thousand lb horse. More than 20 times higher. Lower measured dosages did not have antihistamine effects in this latest study. There have been no pharmacokinetic nor toxicological studies in horses. Until more is known I can't not see a reason to recommend this. The use of thymus extract is so odd I don't even know where to begin but it is likely any bioactive chemicals will be digested and those that are not is such low concentration that it is hard to imagine a pharmacological action. Lastly concerning the omega-3 fatty acid horses do not seem to have a requirement for omega-3's as the horse can convert omega-6 to omega-3 and the two are in excess amounts in the horses diet.
I would suggest saving that money unless you are absolutely convinced this is helping you in some way.
DrO
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Member:
ksojerio
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Posted on Sunday, Feb 17, 2008 - 4:29 pm:
I noticed something about her hives today. Immediately following exercise they large hives were reduced by half and some of the smaller ones were completely gone. I suppose this has something to do with increased circulation??
By her pm feeding they were back to their earlier sizes.
I haven't used any dex in abt 2 weeks. She is getting 2 cloves of garlic per day, 1 1/2 cups vinegar and 4 oz of ground flax seed with her daily ration of oat hay pellets and beet pulp.
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