Coughing

["guest@endurance.net" <guest@endurance.net>]

K S SWIGART  katswig@earthlink.net



> Lynn Turck morningstar@hitter.net said:
> Help.. I have been treating 3 horses for a persistant cough, had the vet
> out 2 weeks ago, no fever, but all 3 had upper respitory congestion.  Vet
> said to give them antibiotics[bactrim] for 10 days[960mg/20 per day ea.] The
> 3 yr old is now ok, the 7 yr old is better, still a little cough/mucus, but
> running around.  The 18 yr old is worse, lots of coughing and white mucus
> from her nose.  I called the vet again and she said to put the older mare
> back on antibiotics for 7 more days, we're now on day 4 and she's still
> coughing hard.  She is separated from the others.  Its killing me to watch
> her cough so hard...I need help/suggestions...should I put her in a stall?
> We are in central Fl and the weather has been rainy all week with temps in
> the 40s to 60.  She's out now in a 3 acre pasture with a shelter. Please all
> advise will be welcomed. Thank you, Lynn

Yes, I would probably put her in a stall, but it depends on the kind of 
stall you are talking about.  She does need to breathe fresh air, but 
she also needs to not be breathing hard, so if she does any running 
around in her 3 acres, then she needs to be stopped from running 
around, since that increases her respiratory stress.  SO if you 
have a stall that has good ventilation but provides her shelter 
from the elements, that can keep her inactive, then I would use it.

If the only stall you have is a closed up box, I would evaluate how 
active she is in her 3 acres and decide if keeping her confined so 
she doesn't breathe hard is more important than keeping her somewhere 
where the air is not quite as fresh.

Also, I would evaluate whether I thought she was having to work hard 
to keep warm (e.g. does she stand out in the rain or does she use her 
shelter), because even if she is not shivering, if she is having to work 
hard to keep warm, then that is diverting her bodily resources to 
keeping warm away from healing her (hopefully it still is) upper 
respiratory infection.

However, I would also check to see if the upper respiratory infection
had migrated down into her lungs.  Monitor her temperature and the 
color of her mucus.  Although putting her on anti-biotics (even when 
the initial infection that she had was probably viral in which case 
anti-biotics will do nothing for it) would be the treatment of choice 
if the infection has become bacterial and has migrated to her lungs.

And if the infection has migrated to her lungs, then I would say full 
stall rest (as in confined to reduce activity) becomes more important 
(and it takes longer for the horse to get over it...it can take months).

Some other things that you can consider would include putting the 
horse on an expectorant for a few days (an expectorant is something 
that MAKES the horse cough) in order to get her to cough out the 
infection.  

But also, if the anti-biotics have already killed whatever infection 
she may have had, and now she is coughing, not because she still has 
an infection but because her throat and/or lungs are "irritated" by 
all the coughing she is doing.  Then she is coughing because she is 
coughing, and putting her on a cough SUPRESSANT for a couple of 
days could help (but you only want to do this if you are pretty sure 
that the infection is gone).

And a final thing to consider would be to culture what she is coughing 
up (or what is running out of her nose) to a) see if it really is a 
bacterial infection and b) to identify what would be the best 
anti-biotic to kill it with if it is a bacterial infection.  Understanding 
that a bacterial culture can take 1-2 weeks so that by the time you 
identify the bacteria you may have already killed it :) 

But it may be that she does have a bacterial infection, that has 
migrated to her lungs, but that she is on the wrong anti-biotic because 
that anti-biotic won't kill that particular bacteria.

My experience is that most upper respiratory infections resolve 
themselves within a week or two of stall rest (i.e. limited activity 
that puts ANY stress on the respiratory system) and that they are 
something to watch, not something to worry about.  The fact that all 
three of your horses probably had the same infection to start with,
but that it has resolved itself in the other two, but not in this one 
has turned it into something that I probably ought to do more than 
just watch, or maybe just to watch more closely--and I need to 
prepare myself to identify what it is (the best that I can) and treat 
what it is.

But no matter what it is, reducing your horse's respiratory stress is 
essential, so if she is "active" on her three acres, then she needs to be 
confined: not to keep her warm, but to keep her inactive.  If she does 
no more than mosey around in her paddock, then confining her probably 
wouldn't make a difference.

She needs to be kept fairly warm too because you don't want her to 
have to "work" at keeping warm.  Even if she is not shivering, that 
doesn't mean that she isn't having to work at keeping warm. This, 
however, could be achieved with a blanket as easily as a boxed up stall.

From what you have described, what _I_ would do is everyting that I 
could to best alleviate any respriatory stress (and you know your horse
and your facilities better than I do as to what is the best way to do 
that for your horse on your property), and to reduce any other energy 
intense effort (which may include keeping warm depending on the 
climate you have there--but it may also include keeping cool).  

I would also find some tactful way to tell my vet that I wanted her to 
treat the horse, not me (many vets prescribe anti-biotics for upper 
respiratory viral infections because it makes the owner feel better 
that they are "doing something" for the horse rather than just doing 
nothing and letting the horse rest so it can get over it all by itself).  
You know your vet better than I do as to whether she is having you 
give the horse anti-biotics to make the horse feel better to to make 
you feel better, and that the horse should feel better in 7 days 
regardless of what you do :).

Many diseases (and viral upper respiratory infections fall into this 
category) just need to "run their course" and the best thing that you 
can do for your horse is to do nothing.  Rather like the old joke about 
how to treat a cold (human), which is:

If you have a cold and you do nothing to treat it, it will take you about
a week to get over it.  If, on the other hand, you really take care of 
yoursels, you take medications, etc. it will only take you seven days.

Before I started to attempt to treat an infection with anything more
than "stall rest" and "doing nothing" (i.e. administering drugs), I would
identify the infection, the status of the infection, and treat what it
actually is.  So if it really concerned me, I would ask my vet, "do you 
think that this is something that needs to be agressively treated, or
should I just be giving my horse some time off."

kat
Orange County, Calif.