EQUUS - - Eq Conversati­ons -

In­haled med­i­ca­tions are an ef­fec­tive way to de­liver treat­ment di­rectly into the air­ways of horses with re­cur­rent air­way ob­struc­tion. In­deed, this mode of de­liv­ery may be the best op­tion for horses who need low doses of med­i­ca­tions to keep the air­way in­flam­ma­tion un­der con­trol over the long term. “If you have a horse who needs more than just en­vi­ron­men­tal changes, we sug­gest an aerosolize­d med­i­ca­tion as a main­te­nance ther­apy,” says John­son. “This in­volves a big up-front cost, but in the long term the horses ben­e­fit enough that it is worth­while. Most horses tol­er­ate th­ese de­vices pretty well, but once in a while we find one that wants noth­ing to do with it.” Two ba­sic types of in­hala­tion de­vices are avail­able:

• In­halers

use me­tered dose in­halers (MDIs) to de­liver a drug via a minia­ture aerosol can, much like those used with hu­man pa­tients. To ad­min­is­ter this to a horse, the MDI is at­tached to a cham­ber with a nose piece or mask that can be placed over one or both of the horse’s nos­trils. When the MDI is ac­ti­vated, it “puffs” a dose of med­i­ca­tion into the cham­ber, which is then in­haled by the horse. The horse may need to be ac­cli­mated to the sound of the MDI as well as the mask or cup. The Equine­haler and AeroHip­pus are the more com­mon mod­els avail­able in the United States.

“Ad­min­is­ter­ing med­i­ca­tions by me­tered dose de­liv­ery can be done fairly quickly once the horse gets used to the process. How­ever, the med­i­ca­tions can be ex­pen­sive. If the long-term cost of pro­vid­ing me­tered dose med­i­ca­tion is a fi­nan­cial bur­den for the owner, neb­u­liza­tion pro­vides an­other op­tion for de­liv­er­ing in­haled med­i­ca­tions that gen­er­ally are less ex­pen­sive in the long term,” says Vir­ginia Buech­ner-Maxwell, DVM, MS, DACVIM, of the Vir­ginia–Mary­land Re­gional Col­lege of Ve­teri­nary Medicine.

• Neb­u­liz­ers are elec­tric- or bat­tery­pow­ered de­vices that va­por­ize liq­uid med­i­ca­tions and de­liver them into a mask that cov­ers the horse’s muz­zle; they can also be used with MDIs. One of the newer ones on the mar­ket is called the Flex­ineb. “When clients can af­ford this, it is the prod­uct I rec­om­mend,” says Buech­ner-Maxwell. “All of the ma­te­rial for neb­u­liza­tion is con­tained within the mask. It also de­liv­ers a very con­sis­tent mist and most horses tol­er­ate the mask well once they are used to it. In many cases, own­ers can place the mask on the horse and then work nearby in the barn un­til the med­i­ca­tion has been de­liv­ered and it’s time to re­move the de­vice.”

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