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  Discussion on Cough and nose clearing not responsive to dexamethasone
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Member:
lynnland

Posted on Friday, Jul 18, 2014 - 8:27 am:

Hi just hoping for some new ideas on how to treat my lease horse. A bit of background: 11 yr old TB, hunter/jumper riden (by me) 6 days per week; mix of flat, jumping and hacking out. Turnout 2-3 hrs per day. Well ventilated large barn and stalled near the door (although stalls do not have doors horses can hang their heads out). Hay usually of very good quality. Presents with constant nose clearing and head shaking from about late July to mid September for past 3 years, controlled with a nose net. Horse's nasal cavities were scoped last year with no significant findings. Not responsive to antihistamines. This year he started with an intermittent cough in late May. No fever. Cough sounds a bit wet. Cough started when we started feeding a pile of hay brought in for a horse show but we are back to our regular hay (maybe coincidence?).It is accompanied by lots of nose clearing and clear to white nasal discharge with work. Cough may worsen with work but hard to tell as I don't work him when he coughs. On days when not coughing there is still a ton of nose clearing and little throat clearing sounds. Seen by vet and lungs are clear. Have been feeding wet hay since 2nd week of June. He has been unresponsive to dex. We did 14 days at 20mg 1x/day (oral powder) for 14 days (which ended July 16th)and have now started slowly backing off starting with 20mg 1x/day every other day for 5 treatments and DrOpping by 5mg every 5 treatment days. Have only been doing walking and short trot canter work when not coughing then took him completely out of work for 1 week during last of 14 days of initial dex treatment. Seasonal head shaking has just started again last night. We assumed this was an allergic response. Just looking for any other ideas as we were very surprised he did not respond to the dex.
Member:
rtrotter

Posted on Friday, Jul 18, 2014 - 9:17 am:

Hello LynnL

I am not surprised that he did not respond to the dex. This is an irritation problem and not an allergy. I just went through a similar problem with my horse and posted my solution a few weeks ago. Here is my post

https://www.horseadvice.com/horse/messages/7/425449.html#POST179001

I did not stop working my horse throughout my experimentation to see what would work, and my horse had been doing the same thing as your horse, snorts and coughs. Also, I feed good hay, with turnout in a well ventilated barn. I treat my horse with a mixture of Airwaves/Honey to sooth his throat. The nose net worked ok, but I had better results with pantyhose or my complete mask.

I also noticed that the problem returned after a few days of not wearing any nose gear,so its as if it takes a few days for the irritation to build back up again.

I am going back to my complete nose mask tomorrow to see if I get the same result of no head shaking, no snorts and no coughs as he did it a little this morning with no nose gear. He is also a very different horse with and without earplugs( much better with them).
Member:
lynnland

Posted on Friday, Jul 18, 2014 - 9:36 am:

Thanks for the response rtrotter. When he is head shaking, I do use a nose net which completely controls the head shaking when he is in work (although the poor guy leans his nose on everything when in his stall). So, I did try the nose net for the coughing and nose clearing but to no avail. Now, I would suspect they are both allergic responses but am beginning to wonder given the lack of response of the cough to the dex.
Member:
lynnland

Posted on Friday, Jul 18, 2014 - 10:16 am:

Just wanted to clarify that the question I posted was with respect to the cough not improving with dex treatment. I did not expect the dex to improve the head shaking (although that would have been nice but the literature suggests it won't). The cough and associated nose clearing may be related to the head shaking but maybe not. Note that the current nose clearing is much worse than I normally see with his seasonal head shaking synDrOme.
Member:
rtrotter

Posted on Friday, Jul 18, 2014 - 11:24 am:

My response was for why the dex did not work for the coughing. For my horse, this was a daily irritation from flying gnats going up his nose, no gnats up his nose, no coughing or snorting.

The head shaking was caused by the buzzing bugs flying around his ears which I solved with a set of soundproof earplugs and a flymask with ears. He can't hear them now, so he no longer shakes his head even in spots where he has done it for years. So, really, I had two problems not one and solved them both with a few pieces of equipment.

It is my belief that the nose net while it works somewhat for the headshaking, may not be the complete solution for the coughing and snorting. If your horse has the same problem with the gnats that my horse has, the only way to completely control it is with 100% prevention of the gnats flying up his nose or even getting in his mouth.

I have always been of the mind where if I can find a non medical/drug solution, then that's what I try first.

I'd try the panty hose tightly over his nose for a few days and see if that works. If it stops or reduces the coughing and snorting problem, then you know you are going in the right direction. There is a link to a video showing how to use the panty hose. You should go to You tube and search for it. Its pretty easy to do.
Member:
lynnland

Posted on Friday, Jul 18, 2014 - 11:35 am:

Thanks for the clarification rtrotter. The flies we have this time of the year in northern Ontario are bigger and nastier, but much less in number, than we get in the spring. In the spring we get tons of black flies and mosquitoes which he is very tolerant of (covering his face, ears, and body) so I don't believe this is fly related. Actually we have had several bouts of very cool and fly free weather this summer without any resolution to the coughing or nose clearing. Bummer as that would be a pretty easy fix with your nose cover :-) Unless...it is an allergic reaction to the bites, in which case the dex should have worked. Keep up the good ideas
Member:
rtrotter

Posted on Friday, Jul 18, 2014 - 12:18 pm:

It is not the flies you can see,its the gnats you can not see unless you hit a spot where the sunlight reflects off of them, they are exceedingly small. I have had really nice weather for the last few days too, which is why I left off my mask. They are still there, even though I thought they were gone.

The next time you take your horse out, pay attention to where he snorts and coughs. I jog and train my horses in a largely wooded area, but in general, his heaviest snorts and his coughs coincide with just one spot. In that spot, as I was jogging, there was a stream of sunlight and thousands of swarming gnats. That's how I figured it out. Had I not looked directly into that sunlight stream I would have never seen them and my horse would still be miserable and I'd still be looking for answers.
Moderator:
DrO

Posted on Sunday, Jul 20, 2014 - 2:01 pm:

Hello Lynn,
Since your horse did not respond to the dex it does make hay mold allergies less likely and he may be recovering from a mild respiratory infection that did not give much else for symptoms. However the symptoms sound more upper respiratory. The next diagnostic steps are to have the horse rescoped to be sure everything is Ok and see if there is abnormal exudate coming from the lower trachea, if so a TTW or BAL may help with the type of inflammation you are having and a proper treatment, for more on this see HorseAdvice.com » Diseases of Horses » Respiratory System » Chronic Lower Airway Disease.

Before you do all that you may just want to turn the horse out to pasture without exercise or hay for a month to see if the cough does not clear up.
DrO
Member:
lynnland

Posted on Monday, Jul 21, 2014 - 8:44 am:

Thanks Dr O. Pasture turnout is not an option at the facility the horse is boarded at so that would require moving him locations (which I doubt the owner would want). Pasture board is generally supplemented with round bales in our area so finding something appropriate would be tough. We would also need to remove his back shoes and ensure the pasture and management was suitable for a horse still on dex and find him suitable pasture mates (he is quite playful). The above makes turning him out to pasture unfeasible. I am having a bit of difficulty teasing apart what symptoms are part of the head-shaking synDrOme and what is related to the cough. I will go back through the articles you recommended. Thanks for the comments.
Member:
rtrotter

Posted on Monday, Jul 21, 2014 - 10:14 am:

LynnL,

It is my belief in your case, that the headshaking and the cough are related. I can only use my own recent experience.

Over the last few days, I have gone back to my full face mask and voila, no headshaking and no snorts or coughs.

I also believe that you might want to rig something up using panty hose, along with a very light muzzle( similar to my full face mask, if you do not want to use the pantyhose by itself.

You will need to do this for a few days to see the complete reduction in head shaking and coughing.

My horse tries to chew on the directly applied pantyhose, but does not mess with his full mask. If you do try the full mask,you might want to get him used to it before you try it on a ride. Although once my horse realized the thing on his nose was not going to hurt him, he was fine with it.

Another thing I observed this morning, since he has been wearing this to jog for the last three days, he did not go out in the field and cough after he rolled, so I think there is a residual effect to him wearing his full mask(maybe because the irritation is drastically reduced) and everything else I tried on him.

With my horse, I believe that because his nostrils are completely covered, but not stretched tightly that this allows him to breathe better and allows his nostrils more air intake without sucking the gnats into his nose. He is also much more relaxed.I would be too if I knew I could breathe without choking on gnats.

You really should try this, if it doesn't work you don't have to continue, but I would give it a few days. I think you might be surprised!
Member:
lynnland

Posted on Monday, Jul 21, 2014 - 10:31 am:

Hi rtrotter, my lease horse will cough inside suggesting that flies are not the issue to the cough. It does get worse with work; as many coughs do. As for the head shaking, he displays typical nose rubbing and leaning behaviour when indoors. At the peak of his seasonal head-shaking he will do the standard sudden up and down head toss when standing in the barn aisleway. I know you are convinced that bugs are the issue but you are simply going to have to believe me when I say that, in this case, the evidence is strongly against that being the cause of either the cough or head-shaking.
Member:
rtrotter

Posted on Monday, Jul 21, 2014 - 12:06 pm:

Ok LynnL,

My horse has the same violent reaction to, of all things, rainDrOps. He goes absolutely bonkers if he is out in the field and if he is on the track, his head flicks violently as if he is getting stung by bees. He is ok in a downpour, just not when it's spritzing or drizzling.

I have reduced the violence using earplugs and a fly mask with ears,and at least now if he's on the track he keeps moving.

Good luck with him, this can be very frustrating.

One more thing, My horse gets a mixture of 1/2 and 1/2 Airwaves/Honey before he goes out. Soothes his throat and helps his breathing, you might want to try that.
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