Treatment of Smoke Inhalation in Horses: By Dr. Gary Magdesian
1. Intravenous balanced, polyionic IV fluids to treat shock a. LRS, Vetivex, or PlasmaLyte A
2. Flunixin meglumine (Banamine) after initial fluids to rehydrate
3. Bronchodilators: oral clenbuterol, or nebulized albuterol/salmeterol
4. Antioxidants: Vitamin E (20 IU/kg PO, q 24) [10,000 IU for 500 kg horse]
5. Vitamin C in IV fluids (20 mg/kg)
6. Optional: Pentoxifylline (10 mg/kg PO, q 12 h)
7. Optional: DMSO in fluids (low dose, 20 mg/kg in fluids q 12 h)
8. Corticosteroids: Controversial, not currently recommended in human patients *unless upper airway edema at risk for airway obstruction is present. If used, recommend only one dose to avoid immunosuppression
9. Antibiotics only if pneumonia develops during healing stages
10. If nebulizers available, see 12 below
11.Hospital setting: Oxygen (will reduce half-life of carbon monoxide)
12. Hospital setting: Nebulizing can aid in removal of particulates (acetylcysteine, bronchodilators) 13. Hospital setting: Consider low molecular weight heparin in platelet count normal.
UC Davis VMTH Large Animal Clinic (530) 752-0290 – in house (530) 752-0292 – field service www.vetmed.ucdavis.edu/vmt