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  Discussion on Prednisolone or dexamethasone for seasonal allegries
Author Message
Member:
jamie111

Posted on Wednesday, May 7, 2008 - 11:17 pm:

Hi, Dr. O. I have a 13 year old Oldenberg gelding who we've owned for the past 3 years. Each year, starting in early May, he begins to have a hard sneeze/cough which lasts until late June. Antihistimines have no effect. Last year, after his symptoms had gotten very bad, we started him on IM dex, which definitely helped, but by no means alleviated his symptoms altogether. Tonight was his first bad night this spring. After reading your articles, it sounds as though the sooner I can get him started on meds, the better. What treatment would you recommend, considering that it will be about 6 weeks of treatment that he'll need? Also, is oral as effective as IM? What dosage do you recommend for an 1150 lb. horse?

Also, has anyone else had a horse experience this type of allergy. He does not have a runny nose, but seems to 'cough' or snort through his nose while tossing his head forward. I guess this is the way horses sneeze. When hosed off, he tries to get the water from the hose into his nostrils, so I assume his nose is burning and itching. He is miserable and unrideable during this time.

Your advice is much appreciated.

Amy
Member:
ajudson1

Posted on Thursday, May 8, 2008 - 6:49 am:

Amy,

I have a mare that goes through something allergy related also every year. She doesn't cough, but rather shows a "heave" line for a period of a couple of months. It appears the dust and maybe there is mold in the hay that bothers her. I shake up her hay and wet it and/or feed outside in the wind.

I am giving her a once a day scoop of a product called Cough Free. It seems to be helping although I don't expect her to be 100% until they are on grass 24/7.

Poor guy. Is he being fed as healthy as possible? I ask because I believe that every part of a diet is important for total health, at least for humans, so I am sure that would apply to horses also. I noticed a huge difference in one of my horses with adding selenium to her feed. So just think about some other tweaks you can do that may help over all if he is so miserable.
Moderator:
DrO

Posted on Thursday, May 8, 2008 - 8:40 am:

Amy I would try prednisolone before dex because of the better known half life and follow the dosage and treatment regimen as outlined in the article on Alternate Day Therapy. However let me say sneezing is not typical for most allergic responses in horses. Something else occurs to me, "photic headshaking" commonly has sneezing associated with it see Training & Conditioning Horses » Behavioral Problems » Head Shaking for more.
DrO
Member:
jamie111

Posted on Thursday, May 8, 2008 - 9:38 am:

Thanks for your quick response! We've had/have horses at our barn who have the 'photic headshaking' you refer to. That is different from what my horse is doing. I think what he does is closer to heaves, where he 'snorts' out, tossing his head fairly violently down as he 'snorts'. He also rubs his face and likes splashing his face in his water. He only does it at this time of year, through mid June. Thanks Dr. O. I am going to call my vet and ask for the ADT you describe in the article. I'll let you know how it works for his symptoms.

Angie, thanks for your post also. My horse gets about 3 qts of complete advantage grain, a 1/2 qt of pelleted rice bran, and timothy hay daily. Until recently, he was on a general mineral supplement as well. He actually seems better in his stall vs. outside during this time of year. I think it's the grass pollen that gets to him. I've never known a horse to have the 'allergic' symptoms my horse has, and was curious as to whether or not there are other horses with similar symptoms. It's really hard to say exactly what the cause is. Luckily, for him, it is clearly seasonal.

I'll let you know what happens. Good luck with your mare.
Member:
jamie111

Posted on Thursday, May 8, 2008 - 9:57 am:

When I did the math, at the recommended initial daily dose of 0.5 mg/lb., he'd need 575mg of predilisone. Is that correct?
Moderator:
DrO

Posted on Friday, May 9, 2008 - 6:07 am:

That dosage sounds about right Amy but your description of heaves does not. Horses with heaves don't snort. They cough they breath hard but nothing really resembling a sneeze or snort.

I should have posted above Angie, we do not recommend the use of Cough Free as suppressing a barn cough may be counterproductive to the horse. Coughing brings up the material that is partially responsible for irreversible changes in the lungs. Suppressing the cough without decreasing the inflammation that causes the cough may result in a shorter course till you reach the end point of poorly managed COPD. Cough Free was quite popular for a while back in the 80's but in horses not managed differently to decrease exposure to barn air and hay it was not that effective. On the other hand those so managed would do well whether on Cough Free or not.
DrO
Member:
ajudson1

Posted on Friday, May 9, 2008 - 7:31 am:

DrO,

So, in your scientific opinion, for a horse that is NOT coughing, but showing the sucked in flanks of having some breathing difficulty, am I wasting my money on the Cough Free supplement? BTW, I did post on this horse a few years back, and have a vet check her, and we all came to the conclusion she is fine but yet yearly she shows this "sucks in at the flank area" consistant with heaves. It lasts from late winter til she starts grazing so I believe it is hay related.

Amy,

I hope you don't mind getting off track from your post a bit. I hope your horse gets better.

Thanks!
Member:
ajudson1

Posted on Friday, May 9, 2008 - 9:04 am:

I found my original post so I'll repost the question there. "heave line can mean what?"

https://www.horseadvice.com/horse/messages/4/25708.html
Member:
jamie111

Posted on Friday, May 9, 2008 - 9:16 am:

Thanks Dr. O. I think you're right -- it's not heaves -- I've heard horses who have heaves and what he does is definitely different. I'm having difficulty determining what he's doing, because to me it's a cross between a sneeze and a cough. In any case, I'm fairly certain it's related to the pollen (we live in MD, outside of DC), and I'm hoping that the ADT of prednisolone will help. Hopefully my vet will call me back soon! Thanks so much for you articles and your advice -- I utilize your site on regular basis.
Member:
jamie111

Posted on Thursday, May 15, 2008 - 10:27 pm:

Hi, Dr. O. I've had my horse on 540 mg. of prednisolone since Saturday morning. He had it daily thru Tuesday, then skipped Wednesday and back on today. He seemed to be doing better until yesterday, when his symptoms returned. I'm afraid now that the relief in his symptoms may have been due to all the rain we had and not because of the meds. Instead of going to ADT, I'm going to continue him on a daily dosage. What do you recommend if his symptoms don't improve over the next couple of days? He's coughing / sneezing some in his stall (mostly when eating hay if not wet), but worse outside and most noticeable when being ridden. When ridden he alternates tossing his head in the air, and throwing his head down while snorting. At this point, he's not as bad as I've seen him in past springs, but I'd really like to make sure it doesn't get any worse. Any suggestions are appreciated.
Moderator:
DrO

Posted on Friday, May 16, 2008 - 3:56 pm:

Another explanation is that the stimulation for the problem overcomes the day off. So I think I would consider returning to daily dosing and if that does not provide relief you can try higher doses. Still a third explanation to consider is during the rainy days the sun is not as bright and we are back to considering photic rhinitis.
DrO
Member:
jamie111

Posted on Friday, May 16, 2008 - 4:30 pm:

Thanks, Dr. O. He's back on daily. I'll let you know next week how he's doing. (I don't think it's photic rhinitis, as he has symptoms at night as well as during the day, plus it's been limited to late spring for the past two years.)

I never did the shot of dex because when I started the prednisolone, he wasn't having symptoms. Do you think a high dose IV of dex would help? Could it be given orally? Or, should I stick to just the prednisolone.

Thanks, again for your advice!

Amy
Moderator:
DrO

Posted on Saturday, May 17, 2008 - 5:42 pm:

Without knowing the cause I cannot say if increasing the dosage or changing the type steroid will help more but the fact you had some response suggests it might.
DrO
Member:
jamie111

Posted on Sunday, May 18, 2008 - 11:25 pm:

Should I continue the daily dose of 540mg until his symptoms are gone completely? Is it safe to continue this dosage for the next four to six weeks? Or, should I go to ADT and / or lower his dose even if his symptoms aren't completely gone?

He was snorting this weekend some (mostly while being ridden, at which time he also tosses his head in the air), but seems better than in previous seasons. It's hard for me to know if the prednisolone is working or not.

Thanks, again for your advice!

Amy
Moderator:
DrO

Posted on Monday, May 19, 2008 - 7:35 am:

Amy when it comes to specific questions of treatment of your horse you need to address your veterinarian who knows your horse best. We can discuss such conditions and treatment in a general sense but I cannot make specific recommendations for your horse. Concerning your questions about treatment and safety using prednisolone and ADT they are discussed in the article on ADT and the Steroid Overview article. This information along with the help of your veterinarian should be able to find a safe way to discover if your horse's condition is steroid responsive.
DrO
Member:
jamie111

Posted on Monday, May 19, 2008 - 9:16 am:

I understand. Thanks, again.
Member:
jamie111

Posted on Wednesday, Aug 6, 2008 - 10:22 pm:

Hi, Dr. O. I'm back! I'm frustrated because my horse is still experiencing allergies when ridden outside. It's worse at home than when I take him to shows, but not completely gone. I had stopped giving him ADT prednisolone because I thought his allergies had subsided about a month ago. This is the first summer (out of 3 that we've had him) that his allergies have continued into August. I'm not convinced that the predisolone is working. It might be helping but I can't tell for sure. It's very difficult to ride him because he snorts and throws his head down. I'd heard something about a prescription antihistimine called hyDrOxozine. Do you have any recommendations for alleviating his allergy symptoms in addition to or instead of the ADT predinsolone?
Moderator:
DrO

Posted on Thursday, Aug 7, 2008 - 7:29 am:

Amy you seem to have a misunderstanding of the nature of allergies. You do not cure them with medication, you ameliorate the symptoms. If ADT was effective at relieving your horse you should contemplate restarting it since it is also safe and inexpensive.

As to antihistamines you can read more about them at in the use of another allergic condition at, Diseases of Horses » Skin Diseases, Wounds, and Swellings » Hair and Coat Problems / Itching / Irritated Skin » Culicoides Hypersensitivity: Sweet & Queensland Itch. Though the allergy is different dosages would be the same.
DrO
Member:
jamie111

Posted on Thursday, Aug 7, 2008 - 9:41 am:

Hi, Dr. O. Yes, I'm sure I have many misunderstandings! However, I do understand that allergies are an over response by the immune system to some type of allergen--my question was, "do you have any recommendations for alleviating his allergy symptoms." I also understand that there is a lot of different information and varying advice for diagnosis, treatment and testing. I understand that you have not seen my horse, and therefore can only offer advice based on your general knowledge and experience (as you informed me previously). I have read your articles, which have a lot of great information. Thanks, again.
Moderator:
DrO

Posted on Friday, Aug 8, 2008 - 6:17 am:

"If ADT was effective at relieving your horse you should contemplate restarting it since it is also safe and inexpensive."
DrO
Member:
jamie111

Posted on Friday, Aug 8, 2008 - 9:23 am:

Unfortunately, it wasn't totally effective. I felt that his symptoms were less than in the previous two summers, but they never went away. It was/is very hard to assess if he would have been worse if not on the prednisolone or if it really wasn't effective at all. Because the ADT seemed like a safe therapy, I decided to keep him on the meds in case it was in fact helping. I do have him back on 300 mg daily for the past 4 days, and I'll start doing every other day starting this weekend. I have a call into my vet to get her opinion on if and how a combination of prednisolone, and/or dex and/or hyDrOxyzine might work better than the prednisolone on its own. I'll keep you posted. Thanks, again.
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