Frequently Asked Questions

General Qestions, Flexineb E3 Controller & Mask, Medication Cups & Power Levels.

General Questions

What is Flexineb E3?

Flexineb® E3 is a simple to use, silent and portable equine nebuliser system without the standard noisy compressor, hoses, wires, and typical inconveniences of old horse nebulisers. The Flexineb® E3 is a revolutionary equine nebuliser that enables delivery of nebulised (inhaled) medications and natural therapies directly to the airways of the horse. It operates from a rechargeable battery powered controller and has a unique flexible mask interface with a clear aerosol chamber and medication cup.

Why use Flexineb E3?

Respiratory problems in horses are frequently the cause of poor sportive performances and can also impact the daily wellbeing of an animal. Historically there were several known types of respiratory disease in horses such as RAO (recurrent Airway Obstruction), Heaves, COPD and Inflammatory Airway Disease(IAD) which are now known under the umbrella term ‘Equine Asthma’ which is graded into two categories, Mild to Moderate, & Severe. Historically, the treatment options for respiratory disease, includes systemic administration of drugs using injections or the oral route, however administration via inhalation through horse nebuliser masks and inhalers are now considered to be a viable alternative way to treat respiratory disorders (including breathing, airway, or lung problems). Flexineb® is an easy-to-use delivery device that produces a very fine mist of aerosolized drug or natural therapy solution enabling you to deliver a variety of medications via inhalation for the horse. This has allowed thousands of horses globally, to continue their working careers, rehabilitate from acute illness and allows owners to manage their horses’ respiratory issues efficiently in the long term.

Where can I find information on the benefits of Nebulisation and Aerosol Therapy?

Aerosol therapy offers the benefit of delivering nebulised medication directly to the site of infection in the airways of the horse rather than going indirectly to the problem by delivering the drug orally or by injection.

Will Flexineb® help chronic airway inflammation and/or Equine Asthma?

Flexineb® has the ability to deliver a wide range of medications commonly used to treat airway inflammation & equine asthma. Your veterinarian will prescribe medications suitable for your horse’s condition and combined with further management of your horse’s environment (bedding/forage stabling away from common irritants etc.) many veterinarians & horse owners have reported significant improvements in their horse’s wellbeing.

Is the Flexineb easy to use and does it come with instructions?

Yes, Flexineb is very easy to set-up and each system comes with a User Manual. You can also download our Flexineb+ App to your phone for more information on Getting Started and information on Flexineb.

Will Flexineb help my horse?

Respiratory disease and allergies vary in severity across the equine species – no two horses are the same and neither are their respiratory problems. Helping your horse by incorporating Flexineb® into their routine will certainly help them maintain healthy airways. However, you will also need to manage their environment carefully to maximise fresh air circulation and minimise airborne dust and allergens in their breathing zone. Your horse may also be prescribed medications by your veterinarian depending on the severity of the issue, and your horse may need long term management.

What is different about the Flexineb E3 compared to other equine nebulisers on the market?

Our Flexineb vibrating mesh nebuliser was designed specifically for the comfort of the horse and ease of use for the caregiver. The robust, portable, silent, lightweight design lends itself to better compliance in looking after your horse and gives the owner freedom to nebulise their horse on the go.

Once your horse is familiar and relaxed wearing Flexineb® and it is safe to do so you can walk with the horse during nebulisation to encourage deeper breathing and deep inhalation of nebulised solutions. The Flexineb® is also unique in that it can efficiently nebulise a broad range of medications and natural solutions for maintaining and treating your horses’ airways.

We are here to help you when things go wrong and offer advice in getting the best from your Flexineb® device. Flexineb® is a fully serviceable product.

Older traditional horse nebulisers are based on noisy air compressors or high frequency ultrasonic sound waves to generate the aerosol mist. Both these technologies need to be plugged into mains electricity and have hoses connected to the mask. You cannot walk your horse with these type devices. They are cumbersome to use and limited in the range of solutions they can nebulise, and delivery time is typically slow.

Compressor based systems force compressed air into the mask leading to major aerosol leaks and losses from an open mask design.

Ultrasonic based technologies produce high volumes of aerosol but there can be major losses in the long hose system connected to the mask. Medication integrity may be adversely affected by heating due to the high frequency crystal method of generating the mist.

Can I use the Flexineb everyday or multiple times per day?

Yes, you can use your Flexineb® several times per day if required or prescribed.

It is very important to follow the cleaning instructions in the User Manual and Video Instructions to maintain the system and avoid cross contamination if used on multiple horses.

My vet has no experience of the technology, where can I get advice on drug dosage?

We can consult with and supply this information directly to your veterinarian if they contact us directly oninfo@nortev.com.

What medication can I use with Flexineb®?

Flexineb® can deliver a broad range of medications commonly used to treat equine asthma and respiratory infections.

We can provide this information directly to your veterinarian on request toinfo@nortev.com.

Some examples of drug categories that have been successfully nebulised using the Flexineb® E3 are: — Antibiotics — Corticosteroids — Bronchodilators — Mucolytics.

Please note the viscosity of the drug will affect the nebulisation rate and delivery time. To overcome this some drugs can be diluted with saline solution to increase the nebulisation rate and delivery time.

Please note the following are NOT to be nebulised with Flexineb® and may damage the medication cup: AZIUM, VET ONE DEX, VEDCO DEX, DUPHACORT, RESPRADIL, VETADINE, BROMINE, MILTON / BLEACH, COLLOIDAL SILVER, DE-IONISED WATER, IONISED WATER.

My veterinarian has prescribed a human puffer (MDI) for my horse to inhale, can I use a Metered Dose Inhaler with the Flexineb® E3?

Yes, each Flexineb® system is sold with an MDI adapter, allowing you to deliver MDIs to your horse using the Flexineb® Mask System. Flexineb® really allows you huge flexibility and options on medication choices for your horse. Check our User Manual for MDI set-up.

Can I mix liquid medications in the cup to save time?

This is not advisable for therapeutic reasons and medication cup life reasons.

Mixing medications in the Flexineb® medication cup may impact on your horse’s clinical response and may also reduce the operation life of medication cup.

Do you supply medications?

We do not supply medications for use with Flexineb® – your veterinarian will prescribe and dispense medications or provide you with a prescription to purchase from your pharmacy.

What arrives when I receive a Flexineb® E3 and can I start using it immediately?

Flexineb® E3 Complete Nebuliser System has everything you need to begin nebulising your horse. Normal 0.9% saline solution is included for you to begin you nebulisation journey and familiarize yourself and your horse with their new nebulizer.

Do you have testimonials from veterinarians and customers who already use Flexineb®?

Yes, check out our Testimonial page to read our customers experience of using Flexineb®. Our social media channels frequently post customer experiences also.

Do you have Clinical Research on Equine Nebulisation and Flexineb?

Yes, refer to our Clinical Publications page for some reading.

How do I clean my Flexineb unit?

Check out our User Manual and Video Instructions for cleaning instructions.

Please note the Flexineb® Controller must be used and stored in dry conditions.

Don’t forget to remove it when washing the Mask!.

Can my horse still breathe with the mask on?

Yes, the Flexineb® mask has a valved system to allow fresh air in at the top of the chamber during inhalation and exhaled air out through the bottom when the horse exhales.

When introducing your horse to Flexineb® for the first time you can leave out the medication cup and open the exit valve vents at the bottom of the mask by rotating it.

Once your horse is relaxed and familiar with wearing Flexineb® you can plug in the medication cup and close the exit valve slowly to activate the valve system. Once they are relaxed and breathing normally you can begin nebulisation of normal saline solution.

You should see the chamber filling and emptying of aerosol mist each time your horse inhales. If this is not happening the mask may be too loose on the muzzle of the horse or the exit valve is not fully closed. You can also walk the horse to encourage deeper breathing as they can shallow breath if standing.

Ensure the mask creates a good seal around the muzzle of the horse.

Always check the Inlet and Exit Valves are working ok and not blocked or taped up before use.

What is the warranty on Flexineb?

Information on Warranty can be found in your User Manual.

Are Spare Parts readily available for Flexineb?

Yes, Flexineb® is a fully serviceable product, and our distributors carry spare parts for servicing.

Find your local distributor here.

Are there discounts or sales coming up?

Some of our global distributors run promotional offers throughout the year – you will need to keep an eye on their social media channels to see these.

Do you offer payment plans?

Some of our distributors offer payment plans. Check our Distributor Page to find your local agent and contact them directly to see if they offer payment plans.

I can't find the answer to my questions?

Please check out the other sections in our FAQs or contact your local distributor. Alternatively email us at technicalsupport@nortev.comwith any technical questions and we will help you.

Medication Cup

How do I store the medication cup?

The medication cup should always be cleaned after every use as per our Video Instructions and User Manual and prior to storage. This eliminates a build-up of potentially corrosive residues on the mesh inside the cup. Once the medication cup has been cleaned and allowed to dry, it should be stored safely with the other electronic components of your nebulizer (controller, cable and battery charger) in a dry and frost proof environment.

Do you have different type medication cups and how do I know which one to use?

Yes, we offer three different categories of medication cups, coded Grey, Blue and Green. The Flexineb® system is sold with our standard Grey Code Cup and is suitable for nebulising most solutions. In some cases, you may need one of our special medication cups depending on the solution nebulised and the application. Check out our Flexineb+ App for details or refer to our Medication Cup and Power Levels Guide for more information.

What type of solutions will damage the medication cup?

The Flexineb medication cup incorporates a gold-plated metallic mesh containing thousands of tiny holes. A fine aerosol mist is generated when this mesh is energised and vibrated at high frequency.

If corrosive solutions come into contact with the metallic mesh, then the life of the medication cup will be greatly reduced so this should be avoided.

The following table identifies known solutions that must not be used in the Medication Cup.

Can I use a Q-Tip to clean the bottom of the medication cup?

We strongly advise against using Q-Tips or any other instruments inside the medication cup because it can lead to damage of the gold-plated mesh inside. It is better to clean and rinse the cup out following the guidance of our Video Instructions and User Manual.

How many uses will I get from my cup before I need to replace it?

Unfortunately, it is difficult to be specific here, it depends on the medication or natural solutions nebulised, volume per run and how well the cup is cleaned after each use. From customers experience and feedback you can expect up to 120 uses from your medication cup (Calculated Usage based on 10ml Saline per use, other drugs and solutions may give a reduced number of usages).

Why has my cup stopped working before I reach the expected number of uses?

Firstly, clean the med cup per our User Manual and Video Instructions and retry with normal saline solution. If still not working, then check the mesh inside the cup for large pinholes or cracks using the light on your phone shining from underneath.

If there is nothing obvious then firstly contact your local distributor for assistance or email us on technicalsupport@nortev.comand send details of the drug or solution nebulised, the volume per run and the number of doses delivered so we can help you out.

How long does it take to nebulise 10ml?

It really does depend on the drug or liquid nebulised, all have different viscosity properties that will affect the delivery rate. As a guide our Flexineb® Grey Code Cup supplied with each system will deliver 10mls of normal 0.9% saline in approximately 8-12 minutes. This variance is down to manufacturing tolerances, for example there are thousands of tiny holes in the vibrating mesh, a small change in hole size can have a big impact on delivery rate.

What do I use to clean the cup/mask?

Refer to our User ManualVideo Instructions or download our App for details on maintaining and cleaning your Flexineb®.

For Medication Cup Cleaning: refer to cleaning video or manual. For Mask Disinfecting & Cleaning: refer to our approved cleaning agents list.

See below question 'How do I clean and disinfect the Mask?' for more information.

The solution I'm nebulising is slow using the standard gray coded cup, what can I do?

Firstly, check your medication cup is clean and running ok with normal saline to eliminate a problem with the cup. If all is ok when nebulising saline, then try nebulising the thicker solution at power level 3.If still running slow you can try diluting 1:1 with normal saline solution 0.9% to see if that helps the nebulisation rate.If the delivery time is still very slow then you probably need a green coded cup to nebulise higher viscosity solution successfully. Check with us first by emailing technicalsupport@nortev.com in case the medication you are using is not suitable for nebulisation.

The Controller is on, but the cup is slow or not producing any aerosol, what's wrong?

It’s likely your medication cup has reached its end of life and needs to be replaced. Check the mesh inside the cup for large pinholes or cracks using the light on your phone shining from underneath. If no damage is evident, you can try cleaning it as per the cleaning instructions in the User Manual and Video Instructions and then try nebulising again with just normal 0.9% saline.

How do I know when to change my medication cup?

When the medication cup is reaching end of life you may notice liquid dripping from the base of the cup, or the aerosol output is weakening or sputtering. Clean the medication cup per instructions in our User Manual and Video Instructions to see if any improvement when nebulising normal saline. Check the mesh inside the cup for large pinholes or cracks using the light on your phone shining from underneath.If any of the above is evident it is time to replace the cup.It is advisable to carry spare med cups to ensure continuity of treatment for your horse.

I can't find the answer to my question?

Please check out the other sections in our FAQs or contact your local distributor. Alternatively email us attechnicalsupport@nortev.comwith any technical questions and we will help you.

Flexineb® E3 Controller

What do the three numbers on the left represent?

Flexineb® E3 has three power levels, 1, 2 and 3. The default is power level 1.

To change the power level at start-up, press the ON black button when the LED is flashing to change to level 2 or 3. Once the LED stops flashing the power level is set and cannot be changed unless you power off and turn on again.

How do I decide what Power Level to use?

Refer to our Medication Cup and Power Levels Guide for recommendations on choosing the correct medication cup and power level.

The controller power LED flashes, nebulisation stops but the medication cup still has solution in it, what's wrong?

Flexineb® E3 controller has a dry cup indicator function, meaning when the medication cup runs dry the controller will recognise this and turn off power to the cup. In some cases this can occur before the cup runs dry and a false trigger / flashing LED occurs. To fix this problem please update the software on your E3 controller. Firmware updates can be found on our website here.

My doesn't seem to be working right, what do I do?

Please refer to the Controller Function section of the User Manual for an explanation of the LEDs and functions. If the lights you are experiencing are not outlined here, please contact your place of sale for advice or alternatively contact us directly on technicalsupport@nortev.com.

I haven't used my Flexineb E3 in a long time, and now it won't work. What can I do?

Re-charge the battery which will take a few hours if completely discharged, if you have the E3 version the right-side LEDs should scroll during charging. When fully charged the top right LED will stay on constant.

If you have an E2 version refer to the Flexineb® E2 User Manual for charging light details.

If there is no response from the charging LEDs when you plug in the charger then remove the battery door and disconnect the battery for two minutes and plug it back in again in case a reset is necessary.

Clean out the medication cup per the instructions in the User Manual.

Inspect the medication cup for any signs of corrosion or damage to the mesh inside the cup, use the light from your phone to inspect, shine it from the underside and look for cracks or large pin holes which indicates the cup needs replacement. If all looks ok, try nebulising normal saline solution.

If after these checks, there is still no life from your Flexineb® contact your local distributor for customer service advice and they will advise you on servicing options.

Why will the controller not charge?

The charger, battery or controller unit may be faulty. Refer to the user Manual first to check if the charging lights are acting normally, if nothing obvious is wrong then contact you customer service provider or email technicalsupport@nortev.comfor assistance.

What operating time will I get from a fully charged battery?

Operating time from a new fully charged battery is approximately 6 hours.

Can I buy a spare battery for my controller?

Yes, you can purchase Flexineb® spare parts from your local Distribution Partner.

I can't find the answer to my question?

Please check out the other sections in our FAQs or contact your local distributor. Alternatively email us at technicalsupport@nortev.com with any technical questions and we will help you.

Flexineb® E3 Mask

What size Flexineb should I buy?

We offer three sizes, Foal, Adult and Adult XL. Refer to our Size Guide to select the correct size Flexineb® for your horse.

How do I clean and disinfect the Mask?

Cleaning

The mask can be washed using clean warm tap water with some dish washing up lqiuid. Rinse off with warm clean tap water and dry off before re-use.

Disinfection

Firstly, disassemble all parts of the Mask and wash them thoroughly with clean warm tap water and dish washing up liquid. Rinse the parts off and let them air dry on a clean dry surface. Disinfect each part by wiping down thoroughly with anti-bacterial wipes before re-assembly. Alternatively the Mask parts can be soaked in Nortev approved disinfectant chemicals.

Examples of Approved Solutions:

  • Accel TB
  • Dettol
  • Equisept
  • Protek EnviroCair
  • Safe4
  • Steri-7
  • Virkon

Why does the clear aerosol chamber not empty when my horse inhales?

You should see the chamber emptying of aerosol each time your horse inhales. If this is not happening it means, there are air leaks in the system. Check if you can push the mask up further and adjust the strap so the mask creates a good seal around the horse’s muzzle.

Check the vents in the bottom of the mask is closed by rotating the exit valve housing.

Some horses’ shallow breath when standing still, bring your horse for a walk to encourage deeper breathing and see if that helps.

If you suspect there are gaps and air leaks around the mask seal, try squeezing the mask onto the horse’s face and see if that makes a difference. If it solves the problem, you probably need our Mask Adaptor Kit which fits over the mask and creates a better seal on horses who are in between sizes.

How do I get the Inlet Valve cap off without breaking it?

To remove or fit the Inlet Valve Cap, heat it in warm tap water first to soften the plastic cap. This makes a big difference.

The Exit Valve falls out, what can I do?

Check the Exit Valve is inserted the correct way around, the rubber valve should face outwards so it can open when the horse exhales. The handgrip should also be outside the mask.

If the exit valve was forced in the wrong way around it can create a loose fit in the mask and cause it to fall out. Check our User Manual and Video Instructions to see the correct orientation of the Exit Valve Housing.

If you think the mask or exit valve is damaged contact your local distributor to order spare parts.

I can't find the answer to my question?

Please check out the other sections in our FAQs or contact your local distributor. Alternatively email us at technicalsupport@nortev.com with any technical questions and we will help you.