What is nebulisation?

Nebulisaton is the process of administering inhaled drugs via an equine nebuliser. The drugs are then breathed into the airways where they reach their intended site of action such as the naso-pharynx, trachea, the bronchi, bronchioles, alveoli etc. Nebulisers convert a liquid solution drug into a continuous fine aerosol mist which is then inhaled easily and allow you to directly target the airways.


Why would a horse need nebulisation?

Nebulisation is a common treatment recommendation by veterinary surgeons when treating respiratory disease in horses. It is probably most commonly used to treat allergic inflammatory respiratory diseases such as equine asthma, but it can also be used to deliver antibiotics for bacterial pneumonia for example. This is often second-line treatment if the horse isn’t responding well enough to oral systemic treatment, or if they’re looking at long-term management or prevention of the disease and don’t want to rely on systemic medication.

In addition, inhaled antibiotics for equine pneumonia might be recommended as an adjunctive therapy alongside systemic treatment for more effective treatment.

It is always recommended to speak to your veterinarian if you’re interested in exploring the option of nebulisation treatment to find out if it is right for your horse and their specific medical needs. They will be able to recommend the correct approach, and treatment plans and help you find, fit, and use the equine nebuliser correctly if you do go ahead and use one.


Why is nebulisation treatment sometimes better than systemic?

Systemic treatment means that a horse receives a drug that is absorbed by the whole body, as well as the intended or affected organ e.g., the lungs. This leaves the horse with more chance of unwanted side effects.

When treating native ponies and overweight horses with corticosteroids for equine asthma, there is a small risk of causing laminitis which is a debilitating disease and can sometimes even exacerbate the respiratory disease if they must then be stabled 24/7 as a result. Corticosteroids also dampen the immune system and can leave horses at a higher risk of infection, especially in older, immunocompromised horses (e.g. with Cushing’s disease) or horses with wounds.

With these situations in mind, nebulisation allows you to directly target a very specific site in the body, namely the lungs and therefore decreases the risk of these side effects.


What options are there for horse owners?

If your veterinarian recommends nebulisation for your horse to treat them, you might want to jump straight onto the internet to find out what types of nebulisers you can get. Flexineb is a horse nebuliser that is commonly recommended by vets because they’re designed specifically for horses, which makes administering their treatment safely, very effective and easy for their owners.

The other useful feature of Flexineb nebuliser that makes it superior to just making do with a human or other species product is that there are different sizes for ponies, horses, and larger horses. This makes fitting the Flexineb even easier, makes sure your horse is comfortable while receiving their treatment and that you’re not wasting any drug as there shouldn’t be any large gaps between the device and the horse.

Often equine nebulisers can be used as a preventative measure once a horse’s asthma is under control. You might read about horse owners nebulising saline and can be very effective at managing horses that are especially prone to serious equine asthma flare ups. Although saline isn’t a prescribed medication, always consult your veterinarian first and they will be able to advise you how much and how often to give, as well as where to source appropriate sterile saline solution.


How to fit a Flexineb nebuliser properly on your horse

When you go to put a Flexineb nebuliser on your horse, depending on their temperament, they might panic a little. It pays dividends in the long run to be patient with getting your horse to gradually become used to the nebuliser and I’d recommend starting off small by just holding it in your hand as you stroke them and give them treats.

Allow them to sniff it if they want but don’t put any pressure on them to put it on their head yet. You may need to do this a few times over a few days if your horse is very nervous or you might be able to move on to getting them to put their nose in it a lot sooner – you know them best.

You can put some little treats or a smear molasses in the bottom of the Flexineb nebuliser to encourage your horse to get comfortable popping their nose in and getting used to having their nostrils and muzzle covered by it (just remember to clean it properly before you use it with medication). Remember to keep the valve open while you do this so they can breathe easily.

Each time they let you put the Flexineb over their nose, take it off and give them a treat, gradually keeping it on for longer and longer. If they panic, just take it back a couple of steps and work up to it again.

The strap that hooks over their head behind their ears works just like the headband on a bridle and is adjustable so you can alter it to your horse’s size.


How to use an equine nebuliser

Your veterinary surgeon will prescribe your horse the necessary drugs and these will come in a liquid solution form. It’s often easiest to measure out the prescribed amount by sucking up the solution from the vial or bottle with a syringe and needle – ask your vet for one and they can show you how to use them safely.

You just need to transfer the drugs into the clear medication cup of the equine nebuliser, and once you’ve fitted the nebuliser onto your horse, just press the on button and it will start to nebulise, with your horses breathing the medication in. Treatment usually takes on average 10 minutes and you can stand with your horse until the solution runs out.



Nebulisation can be a very effective way of treating respiratory disease, most commonly equine asthma, but also infectious diseases such as pneumonia. Using an equine nebuliser that is vet-approved and developed for horses will make administering your horse’s treatment much more effective and easier from an owner’s perspective.

Before buying a nebuliser like Flexineb, always ask your veterinarian for their expert advice on whether nebulisation will be effective for your horse and which medication and doses they recommend.

You can find out more about the Flexineb nebuliser here

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