High Altitude Trouble in Dogs and Horses

High Altitude Disease in Dogs and Horses: Pulmonary Edema

Signs, Prevention, Treatment

Sid Gustafson DVM

Dog First Aid guide link

Practicing in Big Sky, at 6000-10000 feet and higher, our practice sees and treats many cases of pulmonary edema, altitude sickness, and heart disease in horses and dogs are exacerbated by the altitude.

Difficult Breathing is the first and most obvious sign.

Altitude Sickness

Pulmonary edema/altitude sickness can include swelling of the lungs or accumulation of fluid that interferes with effective breathing. Struggling for air is uncomfortable, and afflicted dogs and horses cannot catch their breath, even at rest.

Causes: Unacclimated to high altitudes accompanied by high altitude activity. Distressed, rapid, relentless, or difficult breathing may be associated with underlying med¬ical conditions such as heart disease, respiratory infection, asthma, collapsing trachea, etc. That said, the healthiest dogs and humans can succumb to the vagaries of altitude sickness from time to time. The body likes oxygen, and when oxygenation becomes impaired, breathing troubles can be intense. High temperatures contribute to the breathing distress. Make sure your dog and horse stay cool. 

Heart weaknesses and lung conditions contribute to the severity of the condition, as can allergies and infection. Gradual, measured acclimation to altitude is recommended. Subtle conditions not apparent at lower altitudes may present themselves clinically under the duress of altitude and exercise. Aging dogs become susceptible as time wears on. Just because Fido had an uneventful climb last year doesn't mean the trip will be a merry one this year. Don't forget your dog's annual physical before tackling the mountain peaks this year. Make sure your dog stays hydrated during mountain adventures.

Signs: Difficult and labored breathing caused by airway inflammation or fluid in the airways and/or lungs. Your horse or dog tires easily and requires frequent rests, refuses to continue (can’t continue); relentless panting fails to diminish with rest.The dog may refuse to sit or lie down, as those postures makes breathing more difficult. As the condition worsens, coughing and blood-tainted spittle accompany shortness of breath. Milder cases of altitude sickness manifest as coughing at night, often beginning a few hours after activity has subsided. The dog may prefer a sitting position with the elbows held wide and head stretched out, refusing to lie down. Other signs include a worried expression, distressed eyes and unremitting panting. When horses pant, the condition is sever. In young dogs and horses, the cause can be congenital heart disease or anemia from internal parasites. Older or heavy dogs and horses may suffer from congestive heart failure. that is severely worsened with exercise at altitude. Backup of fluid into the lungs from a weak or aging heart is aggravated by strenuous or even mild activity at high elevations. Intake of untoward amounts of salt can aggravate heart disease and pulmonary edema. Many aging dogs should be on a low sodium, or sodium-free diet. Adequate hydration and maintenance of normal electrolyte levels becomes compensated at high elevations, and medical problems ensue on several levels.

Prevention: Careful conditioning and gradual acclimation to high altitudes are recommended before all high altitude trips. Proper medical treatment of underlying health conditions can prevent exercise-associated breathing complications at any altitude. Avoid strenuous exercise—especially at high altitudes—to which your dog is not accustomed, difficult snow (deep, wind-pressed, crusted) and extremes of hot or cold weather. See your veterinarian for a physical exam and consultation prior to departure. He or she will discuss proper conditioning and consider the need for administration of preventive and ameliorative medications, which can be critical as pulmonary edema and altitude sickness can be life-threatening. Retreating to a lower altitude is always recommended and often required for the breathing to return to normal. Avoid salt, and salty treats, bacon, ham, and cheap dog treats, as these cause additional fluid retention and contribute to pulmonary edema. Many dogs coming to altitude manifest symptoms of underlying heart disease that was asympotamtic at sea level. Weak hearts and lungs become even weaker at altitude. It is possible to prevent lung and heart issues with medication prescribed by your veterinarian.

Treatment: Discontinue activity. Transport the dog to a lower altitude in a manner that allows easy breathing. If the gums become pale or purple, mouth-to-nose breathing may be necessary until the gums regain their normal color and refill time. Administer oxygen if available, which it often is at high altitudes. I recommend that you bring oxygen for yourself and your dog if you plan to travel at unaccustomed elevations where there could be problems. Simply allow the oxygen to flow near your dog's nostrils, rather than into the mouth, in a wind- free environment.

Seek veterinary care if breathing difficulty doesn't improve with rest or the return to a lower elevation. Subsequent or underlying lung disorders or infections and aggravation of pre-existing medical conditions can complicate altitude sickness. See your veterinarian if your dog experiences difficulty breathing or tires easily on high altitude hikes. Furosemide is a commonly employed pharmaceutical treatment. It is a diuretic which lowers the arterial blood pressure in the lungs. Side effects include electrolyte imbalances and dehydration. Other preventive medications include triamcinolone. Cortisones that have a fluid retention effect should be avoided (prednisone and the like).

Dr Gustafson is a practicing veterinarian, equine behavior educator, and novelist. The application of behavior science enhances optimum health, performance, soundness, contentment, and longevity in animal athletes. Behavioral and nutritional strategies enrich the lives of stabled horses. Training and husbandry from the horse's perspective result in content, cooperative horses who are willing to learn and perform.

Locomotion: Essential Horse Health

Horses in natural settings forage two thirds of the time, walking and grazing together. in constant communication and group-survivalist harmony. The key to keeping confined horses healthy is to re-create this scenario in the stable as best one can manage. All systems of the horse are dependent on miles of daily locomotion for proper function. Digestion, respiration, metabolism, behaviour, learning, training, and hoof health are all dependent on abundant daily locomotion. Horses are born to move, and move they must to maintain health and prosperity. The last place a horse evolved to live is in a stall. When horses are stalled, natural must be re-created for them.

 Movement is necessary for normal, optimal digestion. Roughage is the diet of preference, and horses in natural settings arrange their lives to generally always have grass roughage in their stomach and grass roughage before them. Horses at pasture move most all the time. In caudal cecal grazers such as horses, digestion is linked to locomotion. Digestion is dependent on locomotion accompanied by near-constant grazing.

Colic is often initiated by deprivations of locomotion. Digestion is locomotion dependent. For the horse's gut to move, the horse must move, abundantly. Stalled horses require miles of daily walking to maintain digestive health. When stalled they should have constant access to appropriate forage. Bedding stalled on horses on clean straw helps re-create the constant moving and grazing horses are won't to do. Horses bedded on straw (with 24/7 access to hay), spend hours moving about, head down, lipping, and tonguing through the straw. Straw encourages the constant movement that aids digestion in a big way. It is relatively easy to keep stabled horses' stomachs full with roughage. Appropriate hay should always be present, in addition to the straw bedding. The straw bedding needs cleaned of manure and fluffed several times a day.

Behaviourists know stomach volume, and so now do all of you, 1-4 gallons. How easy is it to keep a horse's stomach full of a gallon or two of hay? Quite easy

Listen to McGreevy: Lack of forage is the most important management factor causing the development of stereotypic behaviours. 

Please understand horse's dependence on roughage, and please come to fully appreciate that the horse did not evolve to assimilate grains or concentrated protein, please. And for goodness sake, do not feed locomotion deprived horses grain, as the practice is detrimental. Only moving horses can handle grain. Long-standing horses fed grain develop obesity, and metabolic syndrome, laminitis follows, keeping the veterinarians busy, and the horse owner bank accounts depleted.

Tell me the ways that horsefolk in-the-know provide stabled horses roughage to graze two thirds of the time, and the necessary movement and locomotion to digest and assimilate the roughage.

Of course, by now we all know what failing to provide these simple roughage and stomach-content requirements causes in horses (poor learning ability, stereotypies, lack of motivation to perform, lameness, tying -up, ulcers, more veterinary bills...)

Oh, and do not forget water. And where the water is placed.

Tell me the reasons why when you lead a horse to water she will not drink the water, please, and remember horses will seldom eat when they start to become dehydrated (when they are thirsty), or after you clip their vibrissae.

Remember horses' good and essential friend, salt. Lead a horse to salt and she will lick and later drink. Make sure salt always travels with your horse. It seems lack of salt while traveling causes a lack of hydration, which leads to colic. Horses require salt and water 24/7 as they do forage and locomotion.

Minerals may also be required to be supplemented, and of course the most important minerals after salt are calcium and phosphorus, balanced please. Calcium and phosphorus make up bone, and bone makes a horse durable and sound. Do not forget the bone minerals, please.

Healthy horses make happy and willing partners.

When we have problems with a horse in this class, we all know to first make sure that the forage, friends, and locomotion are adequate, plentiful, and appropriate before devising some heavy handed training strategy. Unhappy horses are hard to train, yes, as are horses who are not pairbonded to their trainer.

When confronted with a horse with behaviour or training issues, we have all learned to first consider stabling as a primary factor in teaching, learning, and training. The proper method to address training issues is to first address stabling and socialization issues. 

Locomotion is also essential for pulmonary health. Horses locked down all day bleed into their lungs when exercised strenuously, as in a race. The leading cause of bleeding in racehorses is a lack of abundant daily locomotion. 

Metabolic disease and laminitis are caused by a lack of adequate locomotion. Colic is caused by a lack of locomotion. Obesity is caused by a lack of locomotion. Tying up is caused by a lack of locomotion. Bucking is caused by a lack of locomotion. Cribbing is caused by a lack of locomotion and constant chewing and grazing. Take locomotion away from a horse and she will give movement back to you in the arena in ways you do not prefer.

Happy horses train up happily. Set yourself and your horses up to succeed, please. Keep your horses happy with friends, forage, and locomotion, and grooming. 

Stalled horses require movement. For horses unable to move because of injury, we must re-create movement with massage and passive flexion of all the limbs.

Dr Gustafson is an equine veterinarian, veterinary behaviorist, and novelist. Applied veterinary behavior enhances optimum health, performance, soundness, contentment, and longevity in animal athletes. Natural approaches to development, training, nutrition, and conditioning sustain equine health and enhance performance.
Behavioral and nutritional enrichment strategies enhance the lives of stabled horses. Training and husbandry from the horse's perspective result in content, cooperative horses. 

Vetwrite: The Textured Life

Vetwrite: The Textured Life:
This month I spoke with Dr. Sid Gustafson, equine veterinarian and author who lives and works in Montana. Sid has just published his third novel, Swift Dam, a story of a veterinarian, Native Americans, and the land. Sid is also the author of numerous short stories and non-fiction pieces, including magazine articles, and a New York Times column. His take on the balance of veterinary medicine with a hobby is refreshing and inspiring for those of us looking for a creative outlet. Here's what he had to say.

Sid Gustafson, DVM, teaching at the University of Guelph

Sid has always written. As a young man in the Air Force Academy and even prior to that working at a cattle ranch away from home, his letters to his parents received accolades. "I didn't think they were any big deal but my father just appeared stunned and commented several times on the nature of the writing in an approving way," Sid says. "When you get patted on the back for writing when you are young, you keep doing it."

The Textured Life

This month I spoke with Dr. Sid Gustafson, equine veterinarian and author who lives and works in Montana. Sid has just published his third novel, Swift Dam, a story of a veterinarian, Native Americans, and the land. Sid is also the author of numerous short stories and non-fiction pieces, including magazine articles, and a New York Times column. His take on the balance of veterinary medicine with a hobby is refreshing and inspiring for those of us looking for a creative outlet. Here's what he had to say.

Sid Gustafson, DVM, teaching at the University of Guelph

Sid has always written. As a young man in the Air Force Academy and even prior to that working at a cattle ranch away from home, his letters to his parents received accolades. "I didn't think they were any big deal but my father just appeared stunned and commented several times on the nature of the writing in an approving way," Sid says. "When you get patted on the back for writing when you are young, you keep doing it."

Sid's third and most recent novel

Somewhere in the combination of Sid's love of horses and the fact that his own father was a veterinarian, he found himself in the mix and graduated from Washington State University's College of Veterinary Medicine in 1979. His debut novel, Prisoners of Flightwas published in 2003. So, how does one go from a history of writing to vet school, only to produce a published novel almost 25 years later? "All I can say is that's how long it takes to learn to write a novel that a publisher would be interested in," he says patiently.

Sid's debut novel available here

Sid acknowledges there wasn't much time to write in college. I can vouch for that. "Through the entire education, I felt deprived," he says, "because there were no humanities required. Everyone else [in undergrad] was taking philosophy and literature and I was taking chemistry. So I wasn't able to write but I could see in vet school, along with the fact that my father was a veterinarian, that there was a lot to be written about."

After graduation, Sid worked on the track with racehorses. "I was fascinated with horses and still am," he says. Returning to Montana to raise a family, Sid was able to find the time to work on the craft of writing. "What I had to do was read an awful lot of novels," he says of those years. He also took college classes on literature, writing, and poetry.

Prisoners of Flight, although published first, was not Sid's first novel. His second published novel, Horses They Rode, was actually his first written novel. "The first novel I wrote could not get anyone interested," explains Sid. The advice from local writing circles was: "Write another one." And so he did.

Sid's second published novel available here

After the success of his first published novel, he was able to then follow with the second.

I like to bother veterinarians with questions about how they find the time to pursue their creative outlets. I bothered Sid with this question as well. "I've always chosen to live in places where there are a lot of veterinarians," he says. The logic was that then his particular practice was never overwhelmed. "I never had a busy veterinary practice and that in fact was one of the things that inspired me to write. You're expected to be in the office during a certain set of hours so I thought I needed to do something to take up the slack while I'm sitting around waiting for the phone to ring. So I started writing--I've always had free time to write."

"Writing seems to be a more textured life than just being a veterinarian alone."

Sid acknowledges, however, that it's not just time that's needed. It's motivation. "Really, [time] is not an issue for writers. They can have all the time they want. It's just finding that space or motivation to write. You have to find the zone. I was always careful to find that. Somewhere back there I always wanted to write. I don't know what the reason is. You want yourself to be published; you want affirmation; you want dialog. It seems to be a more textured life than just being a veterinarian alone."

Sid not only practices veterinary medicine and writes, but also teaches at the University of Guelph as an equine behavior educator. Animal behavior is Sid's passion and his interest in the subject is seen in his non-fiction writing and how he practices veterinary medicine. "The most interesting aspect of veterinary medicine I've ever encountered is animal behavior," he says. "My point has also been to start educating veterinarians about animal behavior because it is the basis of animal welfare." Sid is a strong promoter of adding animal behavior to the educational repertoire of veterinarians. "My last novel tries to educate people about animal welfare and animal behavior."

"I honor every single veterinarian. What a rugged way to make a living." 

It's an awesome thought to combine one's creative outlet with a subject that one advocates and this seems like a good tool to prevent burnout. "I was careful not to let veterinary medicine overwhelm me like it seemed to overwhelm a lot of my associates," Sid says. "I think you have to do other things to survive. It's a brutal business. I honor every single veterinarian. What a rugged way to make a living. You got to diversify, get out of the trench a little bit. Avocations of veterinarians are equal to their vocation."
Anna O'Brien DVM Vetwrite: The Textured Life:


Dr Gustafson is a practicing veterinarian, equine behavior educator, and novelist. The application of behavior science enhances optimum health, performance, soundness, contentment, and longevity in animal athletes. Behavioral and nutritional strategies enrich the lives of stabled horses. Training and husbandry from the horse's perspective result in content, cooperative horses who are willing to learn and perform.

Swift Dam Novel Review

Prairie Mary reviews Swift Dam:

"The best novels, however one defines them and judges them, include the knowledge of something we’ve known little about on the level of expertise that the practitioners have.  Consider “Moby Dick.”  In this novel Moby Dick is a monumental rebuilt dam and the special knowledge is about horses and veterinary meds and instruments.  Flesh of several kinds." 

Praire Mary's Blog






1.  Rain:  The set-up begins, the “Water Dream.”
2.  Water:  How Swift Dam was built in Blackfeet vision dream country.
3.  The Black Bag:  Moon drivers and car sleepers, a demanding son.
4.  Spirit:  The story of Spokane, a famous race horse.
5.  Pavlov:  Relationship between Bird Oberly, sheriff, and “Fingers” DVM.
6.  Luck:  “Mardo” brings in the quilled dog of “Riel Du Pré.”  Some will guess who these people really are.  How a vet became a writer.
7.  Medicine:  About Pondera County livestock practices.
8.  The Storyteller:  Mardo comes through as an agent.
9.  Recapitulation:  Surgery under the moon.
10.  Sun:  Sleeping in the street, in broad daylight.  Doctor Sally Jo’s intervention is nearly a seduction.
11.  Shine:  Interviewing the vet’s wife, Maple, leads into an early rescue story from above Swift Dam.
12.  What Horses Know:  How “Fingers” tried to save his friend Ivan and at least brought back his body.
13.  The Living:  Bird Oberly makes a double discovery.

When it comes to books, one of the more stupid on-going literary wrangles is about what is true and what is “fiction”.  Stupid, because stories are always mixtures of the writer’s experience and the underlying structure of the world.  Neither one is known or knowable, however entwined they are.  But is it convincing?  Does it move us with passion and regret?  Does it recommend strategies for survival?  This one does.  

Especially in a place which might be called the East Slope of the Rockies, the Blackfeet Reservation, Pondera County, the Crown of the Continent, and so on, the fancy names hide the fact that around here success is really more of a narrow escape.  But it sure does encourage the circulation of blood.  It’s healthy if you can keep moving, which is also the secret of horse health.  That and a bonded buddy.

The best novels, however one defines them and judges them, include the knowledge of something we’ve known little about on the level of expertise that the practitioners have.  Consider “Moby Dick.”  In this novel Moby Dick is a monumental rebuilt dam and the special knowledge is about horses and veterinary meds and instruments.  Flesh of several kinds.  The Gustafson family is full of veterinarians and in fact Rib was our veterinarian in the Sixties, when we presented him with the challenge of bobcat kittens and pet badgers as well as horses and occasional rodeo stock used as models.


Sid’s father Rib was colorful.  (Sid is, too, but in a different way.)  Imagine Max van Sydow.  He was very much a family man and when he and his wife had aged, his children — Sid, Kris, Erik, Barr and Wylie — put their careers on hold and returned to the area to care for them.  A few years ago, when Rib realized that I was friends with Sid, he took me to lunch to see what I was about.  Of course, he was also curious about my marriage to Bob Scriver.  We had a good time, telling stories.


For reasons of his own, Rib sent teenaged Sid out to be a range rider/cowboy with Billy Big Springs, a massive Blackfeet Indian whose allotment turned out to have an oil well.  Billy was a second father and took that seriously.  The effect was much like Bob Scriver being sent out as a teenager to the Jim Stone ranch where Mrs. Stone, Blackfeet, took him in hand.  The result in both young men was a yearning affinity to Blackfeet life that cannot be challenged or thinned.  But they were somehow unsettled for life.  Neither found a partnership with a woman that lasted.

So this novel has in its guts something about marriage.  There are two married men, a veterinarian and a cop.  The cop is young enough to have been the veterinarian’s son.  (The vet’s son is named Ricky.)  Both have faithful, fulfilling lives in spite of the often interrupted time of such jobs when emergencies come often, at night, without warning.  I love the description of the veterinarian (called “Fingers” which is the nickname of Sid’s musical brother who did NOT become a vet) returning home chilled and aroused from doing surgery under the moon that has resulted in a new creature being given life.  He comes into the marital bed where his wife is just surfacing from the warm pool of her dreams, her flesh slightly swollen, and embraces her with shared love.


Some of these vignettes have been published as short stories, one of them being about Fingers’ habit of sleeping in the shadow of Swift Dam, which stands like some monument to hubris and human industrialism, ignoring the life-ways ended, the suffering, the little rule-bendings.  This leads to the narcolepsy of aging, sitting behind the wheel of his big old-fashioned car at the only stoplight in Conrad.  The book is dedicated to Rib and is clearly in part a reconciliation with his death.

The Macguffin of the plot, to use Alfred Hitchcock’s term, is the medical black bag with contents so secret but potent that locals imagine all sort of contents, esp since they seem to be kept in the bank safety deposit at least part of the time.  They think drugs.  Some speculate money.  None quite understand Fingers’ fascination with Swift Dam, even knowing that his best friend, Ivan Buffalo Heart was killed in the flood.  Fingers took pack horses and rode along Birch Creek’s flood plane until he found him, tangled in debris in a tree, and took him tenderly home to his wife, Tess.  There’s more to it than that, but you need to read the book to find out.

Since modern books constrained by time and money have stopped including a Table of Contents, I supplied my own at the top, sans page numbers.  It’s a small paperback, 150 pages, but complete and coherent in spite of its many layers.  It is packed with poetry, lyric images. 


I had not heard before the term “orographic lift” which is the term for the contraction of water-laden air struggling up over the mountains, off-loading rain or snow, to become a catabatic warm wind on the other side where it can expand again, creating a rain shadow.  The country of the “Chinook Arch” is one of the most apt and evocative names, a kind of empty blue rainbow that is full of sky.


Alongside the hydraulics of the land, “Swift Dam” is driven by psychological dynamics older than Freud or even the Greeks.  Father and the oldest son of five share a vocation except that Sid expanded his to include thoroughbred racing horses, which brought him into a strong moral culture advocating against treating animals like machines, injecting and confining them out of greedy convenience.  He has a gut-level affinity for the old ways of buffalo hunters.  Rib also wrote, but only small local books illustrated by his wife.  This novel begs for a screenplay.

Dr Gustafson is a practicing veterinarian, equine behavior educator, and novelist. The application of behavior science enhances optimum health, performance, soundness, contentment, and longevity in animal athletes. Behavioral and nutritional strategies enrich the lives of stabled horses. Training and husbandry from the horse's perspective result in content, cooperative horses who are willing to learn and perform.