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  Discussion on Aerohippus for Heaves?
Author Message
New Member:
milaneqn

Posted on Monday, Oct 27, 2008 - 6:29 pm:

Hi everyone,
Does anybody have any experience, good or bad, with the AeroHippus aerosolizer? It's by the makers of the AeroMask and is a lower-cost device. Thanks for any help!
Moderator:
DrO

Posted on Tuesday, Oct 28, 2008 - 7:04 am:

Welcome DrB,
I have not seen the Aerol-Hippus and must say I have been slow to incorporate aerosolized medication into my practice for the treatment of Heaves. Maybe I am just an old timer but I continue to have excellent response to IV and oral steroid use for acute exacerbations combined with long term management to avoid any contact with hay mold spores and barn air. With good long term management the acute episodes stop. Unfortunately some folks forget after a year or two of no problems so it seems that I must always have a bottle of dex ready.

I would be interested in discussing cases where you feel the use of such devices is indicated.
DrO
New Member:
milaneqn

Posted on Tuesday, Oct 28, 2008 - 7:05 pm:

Hi Dr. O,
Thanks for your response. Mostly I am curious about this device and its practicality.

<and must say I have been slow to incorporate aerosolized medication into my practice for the treatment of Heaves. Maybe I am just an old timer but I continue to have excellent response to IV and oral steroid use for acute exacerbations combined with long term management to avoid any contact with hay mold spores and barn air.<

As have I....although in rural IL I sometimes have a problem with client compliance concerning the required environmental changes. A typical set-up is a bunch of horses in a dry-lot with a round bale and a field of beans being harvested 20 feet away. Many times the heaves have been going on for some time. I also manage my cases with steroids.
At AAEP last December in a round-table discussion on managing heaves, the moderators clearly favored the aerosolized drugs, and kind of poo-pooed everything else. I don't see myself going with aerosol anytime soon, but was just curious.

Thanks!
New Member:
shrnhncc

Posted on Tuesday, Oct 28, 2008 - 10:28 pm:

I have used a people nebulizer machine and a non simple mask to deliver albuterol nebs to my mare for months now. I hold the mask near her nostril and she breathes in the medicine and a treatment does her good when the hot weather (90 +) is getting to her. She is a great patient! We also have used the pediatric inhaler devices to deliver albuterol inhalers but you have to time it right and they have to already be moving air well to get good affects.
Moderator:
DrO

Posted on Wednesday, Oct 29, 2008 - 9:18 am:

I know what you mean DrB. I attend these discussions and scratch my head: these guys seem to be reinventing the spoked wheel by substituting a log roller. And this includes the parental use of the expensive and only mildly effective clenbuterol. I don't have to deal with SPAOPD so perhaps they are dealing with different problems than what I see but I think the real problem is the ongoing irrational fear of anti-inflammatory steroid use in horses. Develop a way to make these horses not allergic anymore and I will start writing something down.

Thanks for the input Sharon. What type heaves does your horse have, how much albuterol do you administer, and what is the cost? When you say you hold the mask near the nostrils, does it cover the nose so that it insures the horse gets the whole dose?

Here's a wild thought. I have long believed the dex treatment just makes it too easy and cheap: a shot of dex and within 24 hours the symptoms disappear for a period, at least early in the disease. The result is the client does not really get what a terrible disease this is with continued exposure over time. What if instead you institute nebulization as a negative reinforcement to exposing their horse to mold spores. If the cost of the nebulizer and the time to administer is not enough to get them to "get it", I don't know what would. I like it and might have to give that a try.
DrO
New Member:
milaneqn

Posted on Wednesday, Oct 29, 2008 - 11:05 am:

Dr. O, you bring up excellent points about the lack of understanding about the severity of this disease. A few weeks ago, while trying to explain heaves to a client, she said, "WHEW! It's like asthma! I was so worried that this was something serious." Me: "This is VERY serious!"
I agree that we may be shooting ourselves in the foot with dex. When the fix is easy and/or cheap, I do find clients tend to backslide and neglect the environmental changes, which can be more difficult to implement and maintain than just giving that shot. Maybe I should start with nebulization and then warn them that if the environmental changes are not adhered to, then we'll be back on the nebulizer <laughing>!
I don't even have clenbuterol in my truck. With my clientele, something that expensive would have to be a wonder-drug to fly, and I have never been impressed with its efficacy anyway.
New Member:
shrnhncc

Posted on Wednesday, Oct 29, 2008 - 9:24 pm:

Thanks for your response and I agree the steroids are the bomb but my mare also has Cushings so I sparingly use steroids and go with environmental changes and the occassional neb. My mare was diagnosed with Inflamed Airway Disease.
Member:
paul303

Posted on Wednesday, Oct 29, 2008 - 10:39 pm:

Interesting...my niece is an Equine Vet in Mass. Before she went to Tufts for her DVM, she was a respiratory therapist. She took a great interest in respiratory disease in horses and belongs to an international group that meets every 4 years. I asked her for her view on this:

For those that want the benefit of inhaled steroids, the Aeromask is good. There is a spacer available from Jorvet, but my clients can't afford the MDI's. I am lucky to get them on cheap oral steroids-like Dr. Ogelsby. I have not seen Aerohippus advertised. I'd say that anyone using a mask not fit to the horse, may be wasting a lot of money in drugs.
--
Bonnie Smith DVM
MVMA Large Animal Committee Chair

Crosscountry Veterinary Service
Mapletree Office Center
21 Wilbraham Rd. Suite 217
Palmer, MA, 01069
Office 413-283-6610
Moderator:
DrO

Posted on Thursday, Oct 30, 2008 - 6:24 pm:

Thank you Lee and Sharon for your input, this has been a great discussion that should help others with their decisions on how to treat COPD.

Sharon your concern about steroids in a Cushinoid horse certainly has logical foundations. Experience has often suggested short term use seems to be without complications in Cushinoid horses, even those with histories of laminitis but this has not been tested in large well controlled studies.
DrO
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