RESPIRATORY DISTRESS IN HORSES


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TABLE 1 Drugs commonly used in the treatment of respiratory distress. Drug


Upper respiratory tract obstruction


Severe equine asthma a Tracheostomy tube placement


Bronchodilators Systemic


Sedation: xylazine Dose


0.2–0.4 mg/kg i.v. (1.0–2.0 mL for 500 kg horse)


N- butylscopolammonium bromide (Buscopan®)


Atropine Clenbuterol Inhaled Albuterol/salbuterol Salmeterol Ipratropium bromide Corticosteroids


Systemic injection recommended in horses with distress


Inhaled corticosteroids less effective in crisis


Hydrostatic pulmonary oedema a


Increased permeability pulmonary oedema a


Pneumothorax and pleural effusion a


Diuretics


Treat underlying disease Corticosteroids for ARDS


Thoracocentesis and drainage Treat underlying condition


a Intranasal oxygen at 10–30 L/min via uni- or bilateral intranasal cannulas is useful if available. Furosemide 1–2 mg/kg i.v. q 4–6 h


Most effective in cardiogenic pulmonary oedema; not effective once hydrostatic pressure has returned to normal


Prednisolone sodium succinate or methylprednisolone


0.1–0.2 mg/kg i.v. divided in 2–4 doses


Based on anecdotal reports in foals and weanlings Dexamethasone Prednisolone


0.05–0.1 mg/kg i.v./i.m./po q 24 h


1.0 mg/kg po s.i.d. 0.3 mg/kg i.v. once 0.02 mg/kg i.v. once 0.75–0.8 μg/kg i.v. q 12 h


1–2 μg/kg q 1–4 h 100 μg/actuation: 5–10


0.25–1.0 μg/kg q 6–8 h 25 μg/actuation: 5–20


0.8–5.5 μg/kg q 6–8 h


Higher risk of systemic side effects than Buscopan®


Anticholinergics might be preferable Onset of action 5 min; duration of action 30–60 min


Onset of action 30 min; peak activity 3 h; duration of action 8 h


Onset of action 30–60 min; duration of action 4–6 h Full effect can take up to 7 days to establish Injectable route preferable


Possibly less effective than dexamethasone Notes


Start with low dose of short acting α- agonist to establish response


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