Chronic Cough Solutions

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Respiratory-tract problems are a pain in the neck, literally and figuratively, for both horse and owner. Whether it’s an annoying chronic discharge or a full-blown case of heaves, your horse needs attention — and you know it — but there never seems to be one simple, effective answer.

Medications, when needed long-term, are costly and carry the risk of side effects. They’re also not allowed during competition. Nutritional- and herbal-remedy ads shout “cure” and “control,” but you may wonder if you’re throwing your money away by purchasing them.

While acute infections due to things like colds and flu viruses are certainly serious and can temporarily incapacitate your horse, it’s those chronic, lingering conditions that become management problems. Most of these are probably allergic in origin and, of course, irritation can also arise from dust or air pollution.

Regardless of the cause, however, your horse needs help and relief. If medications aren’t offering what you need in terms of cost, control and legality, you may be attracted to an alternative or non-drug remedy — and there are a host of them. Deciding which to use can be a game of chance.

To help you narrow down the choices, we tried non-drug cough therapies that claim to bring symptomatic relief to your horse.

These products ranged from vitamins to herbs for long-term control to more traditional “menthol” cough remedies, similar to those humans often use for short-term control.

For our field trial, we divided our field-test horses by ailment into five categories and determined how well these products fit the ailments.

Stable Cough
Stable cough is a cough that occurs at rest when the horse is in the barn. It can be triggered or worsened by the horse eating, lying down or exposure to dust clouds when the barn is swept.

For us to consider the cough chronic, it must have lasted at least four weeks after all signs of any active viral or bacterial infection are gone. The horse’s resting respiratory rate may or may not have been elevated, and the horse may or may not have had a chronic nasal discharge. In addition, a chronic stable cough has no lung involvement.

All the products in our trial provided obvious improvement, however, the coughs tended to return rapidly. Most “cough-drop” remedies had to be administered several times a day for short-term relief. Still, we did find standouts. Hilton’s Freeway and Richdel’s Equitussin each produced rapid, temporary relief with no side effects. The continued use of Freeway also lessened the frequency and severity of coughs.

We obtained consistent long-term results using a combination of immune-strengthening herbs like Equinacea, Herbal-Mune or Herbal Plex, and antioxidants, with Hemocease and Hesperidin Biocomplex leading the pack. If response is incomplete in two to three weeks, we suggest you also try a western-herb mixture, which again gave us consistent long-term results.

For follicular pharyngitis problems in young horses, Equinacea, Herbal-Mune Plus and Herbal-Plex were all effective. Severe cases also will benefit from an antioxidant supplement.

Exercise-Induced Cough
Although it’s self-explanatory, an exercise-induced cough means the horse coughs when exercised, rarely coughing in the stable. His resting respiratory rate may or may not be elevated and may or may not have a nasal discharge when exercising.

All our field-test horses in this category that didn’t have elevated respiratory rates at rest were endoscoped to make sure there was no anatomical problem to cause irritation and account for the cough.

Meticulous environmental control of dust and allergens, plus the regular use of mentholated rubs, like Vicks, at the nostrils, are simple but usually effective control measures for exercise-induced coughs that don’t involve lung problems. However, an exercise-induced cough is a different story from the horse with stable cough.

We didn’t have much luck controlling these problems with the “cough-drop” products alone, although after a week of Freeway the severity and frequency of coughs were less. Our quickest results by far were obtained with the Chinese herbs Jet Breath and Breathe Ease, with marked improvement obvious within a few days.

We also had excellent results with antioxidant/immune combos and the western herbal blends, although these sometimes took a little longer to work. There is considerable overlap of this particular symptom with other problems. Some horses cough only at the start of exercise, apparently as a way of clearing their airways. Others are irritated by exercise and cough more the longer they go or cough the most after you stop work.

We found that when exercise was a factor in the coughing, and no active infection was present, there was a good chance the horse also had lung disease to some extent.

Chronic Nasal Discharge
It’s often difficult for people to decide what is and what is not normal in terms of a nasal discharge. If drainage is clear, it’s usually a matter of degree. Most horses don’t have much, if any, clear drainage when at rest. Immediately after exercise, some increase may be noted. Cold weather normally makes a horse’s nose run more, just like it does ours. The combination of cold weather and exercise can even result in a thin but frothy whitish discharge (like watery, whipped egg whites).

A frothy white discharge at rest, though, is not normal — even though it may reflect irritation from dusts and ammonia in a closed-up winter barn more than it does an allergic or infectious problem.

Thick white, gray or yellow discharge is always abnormal, especially if you see it when the horse is at rest. However, a horse that has been stall confined for a day or more will sometimes have a thicker-than-normal, off-color discharge after exercise the first time. This occurs because secretions can build up in the airways when there is no exercise at all.

Most horses with abnormal nasal discharges also have, or eventually get, coughs. This seems to be one of the earliest and most nonspecific signs of upper-respiratory-tract irritation. Environmental control — better ventilation, avoiding dust, switching from straw to shavings and wetting hay — can virtually eliminate the problem for many early cases. The next step would be antioxidant supplementation, or antioxidants with an herbal immune-stimulator if the horse also has a cough. The antioxidants alone provided significant symptomatic relief, often within three to five days at the most.

We found most horses with persistent problems responded well to Uckele’s Bioquench. If problems persist on Bioquench, move through the sequence for stable cough, but also get the horse scoped to rule out follicular pharyngitis or a gutteral-pouch problem.

Conditions Involving Lungs
More serious and, unfortunately, more insidious are problems involving the lungs themselves. We tend to count on coughs and nasal discharge to warn us of lung problems, but these symptoms don’t necessarily indicate lung involvement.

The first sign of lung involvement may be nothing more than a mildly elevated respiratory rate at rest or prolonged respi ratory-rate recovery after work. Eventually, the horse’s work capacity is lessened, whether it’s in the amount of time he works, the intensity of the work or both. Because these changes are gradual, it’s easy to overlook or dismiss them in the early stages. The horse with a lung problem is often labeled lazy, but it’s not that he doesn’t want to work harder — he actually can’t.

Lung involvement should be suspected any time the respiratory rate at rest is elevated and/or when it takes the horse longer than normal to come back to a resting rate after work. It should also be considered when he breathes harder with and after work than he should for the level of work.

Your veterinarian usually can confirm the diagnosis with a chest exam. It also helps to have the horse scoped to see how much mucus is in the lungs, if they look inflamed, and to see if there are changes that would warrant a culture to check for infection. Antioxidants and immune-stimulator/modulator products often help, but they may not give you good control of mucus and bronchial irritation. This is where we found the herbal blends really come into play.

Breathe was found by the Nutraceutical Alliance to reduce the work of breathing and reduce the respiratory rate of horses with allergic lung disease, and we found it to be a good choice for stable cough and mild lung problems, including early heaves or COPD.

We also had obvious improvement with the other western herbal blends we tested, as well as Hilton Freeway, even though the mixtures of herbs they employ are often quite different.

The toughest test of effectiveness, though, was in horses that had decreased exercise tolerance and abnormal recoveries from exercise. In these horses, Jet Breathe and Breathe Ease produced superior results.

Chronic Infections
Any horse receiving treatment for a respiratory problem is likely to get antibiotics somewhere along the line, even if it is only “just in case.” Chronic coughs in young horses typically start after a viral infection and usually are characterized by lymphoid hyperplasia in the throat, which is the equivalent of chronic tonsillitis in children.

This may or may not have an element of chronic infection. Gutteral-pouch infections, bacterial or fungal, are a common cause of chronic nasal discharge and throat irritation. With lung infections, it is often hard to tell if it’s the chicken or the egg. Low-grade infections make the lungs more sensitive to irritation and allergic reactions, and vice versa.

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Lymphoid hyperplasia following an upper-respiratory tract infection is a common cause of chronic cough in young horses. Long courses of antibiotics usually fail, probably because bacteria aren’t involved. We had excellent results using the immune-stimulating products with this condition, alone or in combination with additional antioxidants in tough cases. Coughs cleared in a maximum of 10 days.

Chronic gutteral-pouch infections may also be at the root of persistent coughs or nasal discharge, sometimes also with decreased exercise tolerance. To make this diagnosis, the horse needs to be scoped. If your veterinarian determines an infection is at the root of your problem or is complicating an allergic process, use the drug he or she prescribes.

We suggest you also support the horse’s immune system and ability to clear these infections by using Equinacea, Herbal-Plex or Herbal-Mune Plus at the same time. The antioxidants in these products will help with symptom control. These are also excellent products to keep on hand for use before shipping or before competitions in horses with allergic respiratory problems. An allergy, like any type of inflammation, can make the horse more vulnerable to infections.

Bottom Line
With any respiratory-tract problem, your first course of action should be to guarantee the baseline intake of all important antioxidants is adequate and consider adding an antioxidant supplement to the horse’s diet, if necessary. Frankly, this should be part of your regular supplement routine with horses prone to allergic problems anyway.

In addition, good management is always a necessity involving respiratory problems. Limit exposure to dust and allergens while providing maximum ventilation without drafts. If you bed on straw, consider a switch to shavings or another low-dust bedding alternative.

Hay should be clean, and wet it down if necessary. Feeding soaked hay cubes instead of hay can be an excellent choice for some sensitive horses. Although cubes cost more and are usually recommended to be fed at the same rate (pounds per day) as hay, we find cubes keep the weight on better for most horses and you can usually cut the amount fed in pounds by 25 to 30%.

Overall, we found Freeway consistently gave good and rapid results for the milder cough ailments, like stable cough and exercise-induced coughing without lung involvement. It provided both fast short-term relief as well as consistent long-term results in most cases with continued regular use.

Also quite effective for chronic coughs is a combination of immune-stimulant/modulating herbs and bioflavinoid-based antioxidants like Bioquench or Hesperidin complex or one of the dried western herbs products. Respiratory Relief Formula seemed to give results in the shortest amount of time in our field trial.

For follicular pharyngitis problems in young horses, we like Equinacea. Although it costs more, the cat’s claw in it makes it a good choice when an allergic component is suspected.

With chronic nasal discharges, basic environmental controls and solid antioxidant supplementation should do the trick. However, if you need a little more help, we think Bioquench from Uckele Health & Nutrition is your best first defense.

For chronic lung problems, we got good symptomatic control in mild cases with the same products as for stable cough. For horses also exhibiting exercise intolerance, Breathe Ease is the way to go with its slightly better price. However, when lungs are involved you should always consult your vet, too.

Chronic lung or gutteral-pouch infections require a vet and will likely need an antifungal or antibacterial agent. We’d also add an immune-system booster, with Herbal-Plex offering a slight price advantage and excellent results.

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