I have a 16 year old paint that has awful COPD from having pneumonia a few years ago. It almost killed him but now he has so so much lung damage   Nothing we’re doing is working. He’s fine in a pasture or stall but if I try to work him, even without a saddle, he goes into coughing fits and starts wheezing. He’s to the point we’ve either got to find something that will help him or he’s just going to have to be retired. He’s currently on 5cc albuterol syrup twice a day and as needed during the day. And 5cc Dex once a day. I don’t know what I’m looking for. Maybe something feed through daily. We looked into getting one of the systems that’s like a breathing treatment but 2 vets advised against it because we have such high humidity that they were afraid that would cause him to have too much unwanted moisture in his lungs. Don’t even care about cost anymore, there has got to be something out there that will help him. 

Have you tried CurOst?  Talk to Herbie.

Does your vet feel his lung damage is just from pneumonia or does he believe he has allergies too? I'm asking because obviously they can get loss of lung function from scaring from the pneumonia but if he's on dex daily you are treating on going inflammation... Which is different from scaring damage that occurred. If it is just scaring he should not have to be on steroids the rest of his life unless there is active inflammation from allergies. But even then dex is just for emergencies or short term treatment when they have inflammation from allergies. Its not something they should live on... Do you feed him hay? 99% of copd is allergies to hay. The inability to maintain and get a copd horse to go into remission comes from owners still feeding hay.. even good hay. Take the hay away... The inflammation resolves because you took the allergy/ irritation away.  My copd gelding lived on dex for over a year... He still struggled and had several bouts of full blown respiratory distress. It was scary and we thought about putting him down. His hay was watered then steamed.. didn't help. We had really good hay too. One vet finally said pull the hay. For the last 2 years he's been given hay soaked cubes and you would never know he has heaves. I have not heaed him cough in 2 years nor has he received one dose of dex.... Scary thing is he is now a cushings horse. Besides his age I wonder at times with the amount of dex he received if it enhanced his risk of getting it. He is on prascend and does great! He does not look 26!! He trail rides daily too.

The dex was kinda like a last ditch effort from our one vet before he sent us somewhere else. It’s not working. We went through 2 rounds(6 months) of daily allergy medicine and it didn’t make a difference either. Our vet even told us he didn’t know what else to do for him. We go see a vet in Texas in a few weeks. He’s the one that originally found the pneumonia a few years ago and got him where our local vet could manage him but now it just isn’t working. 

ETA, no he isn’t on hay right now. They get a round roll in the winter. Now just grass and grain. 

Something I’ve though about is right now we’re in a bad drought. Have been for a few months now. I’m wondering if this can have something to do with it. It’s so so dusty right now no matter where you go. I can wet his stall,which I have done before, and I can wet my round pen which I’ve done but other than that there isn’t much I can do for dust. 

Not saying this will heal him but there has been some amazing testimonies on this and I know its crazy! But look up 1N she is from another country and she explains the technique and it teaches them to not breath so shallow and If nostrils are wide they cant get any more air than that.  I have done this technique and it does help with the breathing!  and now my horses nostrils is narrow like they should be.  I havent done in long while but I will now that Im back to running.  My horse was not as bad as yours but it is worth a try!  its free!  She does have some mask that you can leave on that helps too!  Havent done the masks.  Hope your horse gets some relief!  Also, my horses love the 1N  it does relax them and you can see them breath deep.  Now you all can laugh at me! lol

Heck, Why not, I’ll  try it. Where do I look it up? 

I would not put back on a round bale. They are slow suicide for heaves horses. Worse then any sort of hay you could give. Id ask if he can have aerosol meds in a steroid and bronchodilator either from mdi inhalers asthmatics use or solutions you put in a nebulizber. That way the medication goes directly to his lungs. Id also bipass any general vet and go right to an internal medicine vet that specializes in respiratory.

I want to add that if bronchodilators and steroids wont help feed through supplements wont either... This is coming from someone with a full blown copd horse and also another horse that has Equine asthma that I'm trying to manage so it won't turn into heaves. Both are off of hay.  Ive dealt with a couple great vets that specialize in respiratory and they're the ones that get the credit for the proper management and control... Both my horses have pretty serious problems and they receive no breathing supplements.  I'm curious what the cell cytology is of your horses latest BAL?

The inhaler is one thing I’m going to ask about. I feel like I’m wasting money with styrip albuterol. I didn’t know their was such until a few weeks ago. The vet were going to see isn’t a respiratory specialist but he is a performance specialist. He found the pneumonia when 2 other vets didn’t. 

Good! You'll get better results with the inhaler . I'd use that before you ride. Did he have a bal done?

I’m not sure. They ran a bunch of blood work on him about 3-4 weeks ago. I’m not sure what all they checked but said everything was normal other than being boarded line Cushings. I’m almost done with this round of steroids. I may have a week left. Not going to do another round. 

What is 1N?

You need to PM Herbie. You won't regret it. She saved a horse like this. Turned him completely around. 

I sent her a message. 

Have you tried wind aid from Hawthorne products?  I love it and have had great results with it. My horse has some  similar issues as yours. It’s fairly cheap compared to other products. It is something you can give everyday or just before hard exercise depends on what your horse needs.