Three H's - Two out of Three

I wrote in this post about being vexed by three H's - Hives, Hydroxyzine, and Hay.

The first one to ease my mind was the Hydroxyzine. It arrived on my doorstep on Tuesday. The first thing I did was take out 70 capsules to give back to my friend. As I haven't had a chance to get out to her barn again, I've been carrying them around, in a test tube, in my purse since then. I hope I don't have to have my purse searched by the cops because I'm sure they will think I'm some sort of drug dealer. I don't even know if they look like commonly abused prescription pills. Regardless, I feel bad that I haven't returned them and that's been bugging me. I really need to get over there but right now we're having a huge snowstorm in Cleveland so it's not happening today, or tomorrow. I'll make a point of going over there next week.

Hives continue to be a problem for us. I was giving Kaswyn a full packet (10 mg) of dexamethasone every other day. I had been advised to give him one full packet once a day, but Dr. B thought that was too much so we did every other day. What has been happening is Kaswyn would be hive free and look great on the days between his doses of dex. However, the day he was due to have the dex he would get hives again. They weren't as bad as before, but I'd give them like a seven out of ten. On Tuesday I spent time on the phone with three vets - OSU vet, the vet who saw my friend's horse, and Dr. B. I left a message for OSU vet and then left a message for friend's vet. Friend's vet called me first and gave her recommendations.

Her first suggestion was to go to 10 mg of dex a day for a week, then go 10 mg every other day for a week, then 10 mg every third day. She also suggested maybe upping the hydroxyzine. She tempered all this by saying that I should talk to OSU vet before I change anything, and also consult with Dr. B because she has never seen my horse in person. With this in mind, I waited for the OSU vet to call.

I gave her the rundown when she called, and she suggested a slightly different approach. She said that the hydroxyzine works best as a preventative for getting hives, not as a cure for them. She also suggested 10 mg a day for a week, but said that if I was nervous about the amount of dex that I could go 5 mg every day for a week and see how things go. Then I could go 5 mg one day, 2.5 the next, then 5 mg again, alternating doses for another week. Then 2.5 per day, and so on until I can wean him off of the dex. She said she would not want me to increase the hydroxyzine at this point, but might want me to do that if I can't seem to decrease the dose of dex. She told me that 5 mg, even 10 mg daily is not a lot of dex, but that regardless I needed to call Dr. B and tell him what's happening.

I asked what the overall plan was. She said that thought that Kaswyn is just reacting to a mold species that is not in his vaccine. She said that in the winter time barns are full of mold because they are closed up a lot of the time. Horses who break out in hives in the winter most likely get better in the spring when they can be outside and the barn is open. As soon as it gets hot outside she imagines that Kaswyn will get a lot better regardless of meds. But the goal here is to get him retested, so as soon as possible we need to get him off of the meds. He needs to be off of dex for three weeks and hydroxyzine for two weeks for the test to be the most accurate. She cautioned me not to wait too long to get him tested because his body is going to have it's best reaction to the test the closer we are to his hive breakout. If I wait six months then his body may have slowed down it's reactions to the molds to the point that he might not react to the test.

As soon as I get him off of the dex I can start vaccinating him again with the serum that I have. She said that the most important thing is getting the hives under control and letting the hydroxyzine do it's work. She says if for some reason the hydroxyzine isn't working that there are other antihistamines we can try that might work on Kaswyn.

So I started with the 5 mg daily dex on Wednesday after calling Dr. B and letting him know the plan. So far it's been pretty good and his hives have been under control. Except yesterday he had some hives on his body. I gave them a three out of ten, which isn't bad but is something I'd consider a breakthrough reaction. I'll just take it a day at a time and see what happens.

The last thing - Hay. It's a long story. You'll have to wait and see how that turned out.