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MM's breathing is doing a lot better at rest, but her body has been through a lot and she lost a lot of weight. She's put back on some of the weight, but all her muscle/conditioning is pretty much gone. And I do not know yet what amount of physical activity her respiratory system will be able to handle. This could be a matter of rehabbing her back and eventually getting her back to where she was. Or this could be a matter of finding out what her new limit is, which might mean finding out that she is not really going to be able to be a performance horse again.

The vet has suggested I start slowly/carefully getting her back into work. But I'm at a bit of a loss on how to develop a plan/program for this. I've rehabbed horses that have been injured before but never one that has been sick like this and has something more systemic to keep an eye on as opposed to something specific like a left front. I think first step is probably just walking--in hand or under saddle and seeing how her breathing does with something like 15 minutes of continuous walking. But as a planner, I would love to start thinking through/putting together a program/plan. Would love anyone's thoughts, suggestions, or experiences.

Blob we purchased a horse with severe heaves. After research, medication and everything else we realized that physical fairness is an important part of maintaining that part of the lungs that were still functioning, so I encourage the slow return to work. Because it's breathing, it's fairly easy to monitor how many. Minutes of work and how much rest she will need. Most likely her respiration will take longer to rehab than her musculature.

I think ten minutes walk for a week, followed by ten walk two trot, and then the general gradual increase of aerobic work interspersed with walk work.

Best wushes

Thanks, Chisamba. Yes, the vet and others have suggested that careful exercise might help with management. She went into this episode quite fit, but now we are dealing with a very different situation.

She is a horse who builds muscle easily, so I think once she gets weight back on it will not be too hard to convert that to muscle, but I am quite worried about rehabbing her respiration.

Today I hand-walked her for a continuous 15 minutes and she did ok. Tomorrow I might try 10 minutes walking under saddle.

I would work your way up to 30 min continuous walk before adding trot and I'd continue at least 30 min of walk each ride as you are adding trot. If you have trails, I'd just do a lot of walking around and if there are hills, even better.

Increase only one of the following at a time - duration or intensity. Since you don't have a lameness, you don't need to worry so much about circles, turns, lateral work so doing all of that can help keep things interesting as the rides get longer.

If you are able to work up to trotting continuously for 10-15 min, I don't think you could start ramping up pretty quickly. If you do find the breathing is an issue and you need to keep the trot in smaller intervals, then I think it'll take a lot longer. And don't forget if you start adding later work, transitions, or any collection, you'll need to monitor how she feels muscularly as well as breathing and cardio.

I can't recall what level she was working at before getting sick, but if you are doing third and above, I found doing eventer style canter conditioning was helpful for my very large WB. I think we tried to work our way up to three 7 minute canter sets with 3-5 minute rests in between, after a long walk and short trot warm up.

Thanks, Tlkidding.

Yes, because there is no injury I was hoping to bring in lateral work and figures at the walk to up the ante and the interest while still keeping it relatively low cardio. She also lunges well so that's another option for when I start introducing trot--it'll be easy to see breathing and she won't have my added weight

MM was working at third/fourth before getting sick. The new barn I'm going to has a galloping Lane and xc field so both will be good for a big open canter when/if she's ready.

I'm hopefully she will keep putting on weight so there is something to convert to muscle.

In addition to monitoring respiration, I suggest you also monitor heart rate. Get a good feel for her resting rate and then shoot for roughly 50% increase during exercise. Monitor recovery too, she should return to baseline RR and HR within 15 minutes. As she gains endurance, you can allow HR to increase more. So far as respiration goes, watch for nostril flare as a sign of respiratory stress.

As you start to get into warmer/more humid weather, I would also add that monitoring body temperature would be wise if you note any nostril flare or 20% increase in respiratory rate. Horses with COPD or any respiratory compromise even if they sweat are at more risk of heat stress/stroke and once that cycle starts it must be dealt with (treated) quickly to avoid the full cascade of events that follows.

I agree with the suggestion of a heart rate monitor, esp with warmer weather coming. That will let you know in real time how hard she's working, objectively, and without stopping all the time to check.

I don't know if this is relevant but my BFF has leukemia, the bad kind. She's done many treatments, good news for now she's in remission. All the chemo etc *trashed* her lungs. Several times. She's recovering, and her lungs are healing. They said they wouldn't but they are, lungs are amazing.

She wore a heart rate monitor while she was starting to walk again. She found it really helpful because it would tell her when she was overloading before she felt it.

Best wishes for your horse!

thank you, everyone this is all very helpful.

I will have to look into a heart rate monitor. It is easy to test before and after a ride, but checking during the ride is much harder without a proper monitor. Of course with the vet bills and very expensive apoquel, I'm being careful with budget right now.

Checking body temperature will also be very important this summer. She does tend to be a good sweater, but my vet has mentioned that sometimes asthma episodes are also followed by/paired with anhydrosis episodes which of course just makes everything harder. In the past she is a horse that cools down very quickly. But of course in the past she didn't have any respiratory issues, so it's hard to know how this summer will go.

As a small update, we have been doing about 15-20 minutes walking about every other day. I am keeping the walk marching and mostly doing a free walk, but spending 2-5 minutes in contact, with some big easy leg yields. Currently her resting respiratory rate is about 12 bpm. After several minutes of continuous brisk walking she gets up to about 24-30 bpm. She does return to her 12 bpm pretty quickly after rest, so recovery rate is good right now.

once we move barns I'll have more hills and outdoor space to hack her in to make it a bit less boring for her.