Let the medicating begin!

I got a call yesterday from the OSU resident. She had spoken with the two dermatology vets and the conclusion was to get the hives under control ASAP. So she said to start him on an antihistamine call hydroxyzine in conjunction with the dex to get rid of the hives. As soon as the hives are gone I should start with the allergy shots again. Then we can try to back him off of the hydroxyzine and get him re-tested. She said when I make my appointment for the re-test that I should make sure that both dermatology doctors are there to consult on the horse and results.

I called Dr. B and gave him the update on his cell phone voicemail, then I called the vet office to see if they had hydroxyzine in stock. They did not, but they said if I found the drug online from one of the veterinary pharmacies I could have the pharmacy fax them a form, they would fill out the prescription, and I could get the drugs directly from the pharmacy. I located hydroxyzine but found that there were two kinds - hydroxyzine pamoate and hydroxyzine hydrochloride.

I called my friend with the hivey horse and asked her which kind I wanted (since I knew she had used the hydroxyzine and I thought it would be easier to get a hold of her than it would be to get an OSU vet on the phone again), but she couldn't remember which form is the correct one. She said she was heading out to the barn at some point and would text me with the correct type. In the meantime she suggested I call her vet who had dealt with her horse's hives because she knew which was the correct form.

It was hours before anyone got back to me (again). After talking with my friend, her vet, and Dr.B, here is what I've come up with as a plan.

I will give one pack of dexamethasone every other day for a week, then every second day for a week, then stop the dex.

I will start the hydroxyzine pamoate (which Dr. B found one bottle to give me) the same day I start the dex because the hydroxyzine doesn't work as well alone initially, and takes about a week to really kick in and start working. The suggested dose is 1 to 2 mg/kg, two times a day. My horse weighs about 900 pounds, which is about 400 kg. I decided to give him 500 mg twice a day. Also, the hydroxizone that I'll be using is not compounded by the pharmacy, but is in capsule form from the manufacturer. It was suggested to me that the compounded hydroxizine might not be as effective, if it works at all.

I will keep him on the hay from the old barn until I can get him re-tested and started on new shots. I want to get him desensitized as soon as possible so I don't have to worry about every strand of hay that goes in his mouth. I really don't want to have a Horse in the Plastic Bubble.

After yesterday's information gathering session I called Susan this morning to get a report. Kaswyn's hives seemed a bit worse to her, so Susan gave him a packet of dex. I was able to pick up the hydroxyzine this afternoon so he started both today. And by the time I got to the barn this afternoon his hives were only at about 20% of their worst. So I think either the hay switch or the dex is doing it's job.

Now I just have to order more hydroxyzine, because what Dr. B gave me will only last 5 days, and get a hold of the hay guy and see when and how much hay he's able to deliver to me. I see this hay thing being a potential pain in my ass. But since when are things with horses ever easy?