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  Discussion on Treating 1st Uveitis Episode - Can't Stop Medicating
Author Message
New Member:
Bmckinne

Posted on Monday, Sep 9, 2002 - 4:07 pm:

Thank you for your quick response. I really appreciate your advice.

If the inflammation/swelling is severe after one day of not medicating, should I resume the once a day treatment with the neopolydex and aspirin or should I treat more aggressively?
Moderator:
DrO

Posted on Tuesday, Sep 10, 2002 - 5:52 am:

When severe or worsening you should use aggrssive treatment, you reduce only when things are normal or at least near normal and rapidly improving.
DrO
New Member:
Bmckinne

Posted on Monday, Nov 4, 2002 - 1:19 pm:

My horse is doing very well. She is back in training and her eye appears to be doing fine. However, we are still medicating – neopolydex and aspirin one time per day. She went back to the ophthalmologist in mid September. Prior to visiting the doctor, I tried to wean her off the neopolydex by increasing the time between applications (from 24 hours to 28-30 hours). Her eye would start to swell within 30 hours of no meds. The ophthalmologist recommended that we continue to treat her eye once a day with the neopolydex and aspirin as long as it works. He believed that the flare-ups while weaning her off the meds were worse than continuing to treat her long-term. She is now in training in a different state with a new general veterinarian. Her new veterinarian is concerned that the long-term treatment with the neopolydex will hurt her immune system. I am not sure which is the lesser of the evils or how to proceed. My horse’s ophthalmologist recommended that she be checked every 3-4 months by an ophthalmologist, which I plan to do (December-January time frame). Should I wait that long? Have there been other cases where the neopolydex is used long-term?
Moderator:
DrO

Posted on Tuesday, Nov 5, 2002 - 4:22 am:

I do not believe there are many systemic concerns about the long term use of neopolydex, the dosage that enters the system is just too small. However there are local concerns with the suppressed immune function around the eye: fungal keratitis. But if the RU goes untreated you lose the eye. You should continue with your opthamologist plan, I believe.
DrO
New Member:
Bajamari

Posted on Friday, Jan 9, 2004 - 1:41 pm:

Dear Horsemen's Advisor, I live in Baja, Mexico where equine vets are not available. I adopted a three year old wild horse two years ago. He was healthy when I got him but developed bacterial infections in both eyes. The first episode was found by the lab test to be pseudomonas. I treated him with sulpha trim and it cleared up. The second episode was found to be caused by staphylococcus. Again the sulphatrim worked and in adition I used optical gentamacin. This also cleared up . He is now having a third episode found to be caused by staphlococcus and streptococcus. I am using the same medication and it is slightly better. The lab told me to try vancocin but I can find no information on dosage or side effects. I have two main questions .What do you recomend for treatment and 2. I have another horse brought down from the States. They are kept in a large enclosure together and the other horse has healthy eyes. Is this problem contagious? I believe this is some kind of uveitus. I would appreciate any help you could give me
Moderator:
DrO

Posted on Sunday, Jan 11, 2004 - 11:58 am:

Since we cannot examine your horse we cannot make specific treatment recommendations. If you believe this to be a bacterial infection you must use the results of the culture to match up with medications you have available locally. 1% vancomycin hyDrOchloride (VCM) ophthalmic ointment has been investigated and found suitable for treating eyes (once every 6 hours)of some species but I do not know if it is available commercially. I would check with a regular opthamologist. I have not seen any work in horses but do not know why it should not be used.

Nor do we know if this is a transmissable disease for your other horse so recommend you keep them seperate until a firm diagnosis is established.

Recurrent primary bacterial infections of the eyes is quite rare in horses so I wonder if you are having trouble with Recurrent Uveitis which is not a primary infection. All of these organisms, including pseudomonas, can be found in healthy eyes so I am uncertain of their significance. For more on this see, Equine Diseases » Eye Diseases » Anterior Uveitis, Recurrent Uveitis, Periodic Opthalmia, and Moonblindness.
DrO
Member:
Bajamari

Posted on Monday, Jan 12, 2004 - 10:46 am:

Dear Horsemen's advisor: Thankyou for your response. I think I jumped into this from the middle instead of at the beginning. At his ist episode Monty had reddened, swollen schlera in the eye. It was weeping and as the episode conttinued the eye became more red and swollen and started producing mucous. I did not notice any cloudiness in the eye. when I called the vet he thought it was an eye infection. When I had it cultured the lab reported abundant amounts of pseudonomus so we used sulpha trim to treat that. The second and third episodes were the same except the lab reported abundant staphylococcus, the third episode was reported as moderate amounts of staph and strep. I have been treating this as a bacterial infection not knowing specifics about recurrent uveitis. I know you cannot examine the horse but the one and only horse vet here has not heard of uveitis. Can you give me a recommendation for treating the redness and swollen schlera. I know these are not an ideal situations but given the restraints on competant equine vetinarians I have nothing to lose and without help would end up putting the horse down which I wouild hate to do,. I can fing nothing on neopolydex so I do not know what this medication is and what it does. My husband is contactting the lab today to find out whether lepto was present in the sample.Many thanks for your hepl
Member:
Gafarm

Posted on Monday, Jan 12, 2004 - 2:06 pm:

There is a support group for owners of blind and partially blind horses at https://www.smartgroups.com/groups/blindhorses
The most common cause is ERU, cataracts, or direct injury to the eye. There is lots of information and other people's experiences with treating the disease as well as handling and training of blind horses in the archives. The one thing we have all noted is that not all horses respond to the same treatment so you really need to explore all the options and see what works best for your horse! "There Is Life After Blindness" is our motto. There are two members who have trained their totally blind horses and used them in hunter/jumper events and endurance rides! The extent to which their other senses take over and how well they adapt never ceases to amaze all of us!
Moderator:
DrO

Posted on Tuesday, Jan 13, 2004 - 6:39 am:

Neopolydex is a standard eye ointment that contains antibiotics and a steroid. The steroid is a powerful antiinflammatory that as a general rule should not be used in the prescence of infection. Note the problem with lepto induced recurrent uveitis, is that it is in the eye not an external infection: it will not usually be detected in a conjunctival culture.

So you are saying you seem to have a bilateral conjunctivitis and not a keratitis? I would have the conjunctivia carefully examined for foreign bodies, like splinters or plant awns. This will require sedation and blocking of the motor nerves to the lids. For more on this condition and possible causes see, Equine Diseases » Eye Diseases » Inflammed, Tearing, and Swollen Eyes.
DrO
Member:
Bajamari

Posted on Friday, Jan 30, 2004 - 2:40 pm:

Dear Dr.Oglesby, many thanks for your help I had been injecting Monty with Septetrim for about six weeks without much improvement , after your last reply I went to the pharmacy with a list of medications and they had Blephamide ( sulpacetamide and prednisolone). A week ago I stopped the shots and started applying the blephamide. In one week his eyes are almost better, the redness is gone, the mucous discharge is ggone and the swelling has almost disappeared. The vet here who I dont think knows about uveitis,thinks it may be some form of conjuctivitis triggered by flies or insects. The flies are not a problem right now so I'm leaning toward uveitis given his rapid response to the cream. Can you give me some suggestions for maintaining this improvement and preventing or delaying another outbreak?
Moderator:
DrO

Posted on Saturday, Jan 31, 2004 - 5:50 pm:

The article has treatments and suggestions for prevention Jose.
DrO
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