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  Discussion on Cataract and head tilt
Author Message
Member:
Saswain

Posted on Thursday, May 22, 2003 - 8:05 am:

Since January I have had a number of problems with my horse. She started mounting the mares in her field, ovaries and hormone levels normal. Put on Regumate. Then I notice she was very nervous, particularly when handling on the left. Vet noticed pupil slower to constrict to light compared to right and absent blink response when testing in different areas of visual field. The nervous behaviour has also been accompanied by a possible hind limb incoordination (but very difficult to tell). I also notice one episode when left side of face appeared lower, no paralysis. I had a second opinion yesterday and the vet reported a catact in her left eye and head tilt. He said it might be a vestibular disorder - otitis media or brain stem problem. My horse is now on bute for two months. Is there any possibility these symptoms are all related? Could uveitis be the cause of the catract and missed by the vet(he did not use dye or slit lamp)? I would estimate that the horse has had four or so episodes of whatever the problem is since January.
Moderator:
DrO

Posted on Thursday, May 22, 2003 - 4:25 pm:

Hello DrS,
The problem is your symptomology all seems rather vague, and I am uncertain what has happened in these 4 episodes. With the symptoms so uncertain it makes it difficult to guess if there is a relation. Certainly multiple cranial nerve deficits, incoordination, and behavioral changes, could be related to a mild generalized brain disorder with a past episode of viral encephalitis with residual deficits at the top of the list.

I don't think the nervous system signs are related to the cataract and while it might be related to uveitis, this is unlikely without other chronic inflammatory signs. Cataracts are common in horses and mostly innocuous though there are exceptions. We have an article that helps prognosticate them by appearance and location in the lens, see » Equine Diseases » Eye Diseases » Cataracts in Horses.

What time of the year did you check hormones and which hormones were checked?
DrO
Member:
Saswain

Posted on Tuesday, May 27, 2003 - 10:18 am:

Thanks for your response. After speaking to my vet, it seems that the main problem is a possible vestibular disorder. We are treating with a 6-8 week course of bute and if this seems to help I can add an antiobiotic. Your article on temporohyoid osteoarthropathy was very informative. I was given the impression that the treatment may be long term, and the problems could re-occur but this is not implied in the article?
Moderator:
DrO

Posted on Tuesday, May 27, 2003 - 9:30 pm:

If the head tilt is real this would represent vestibular involvement which also might explain some amount of inccordiantion. But it does not explain the other cranial nerve deficits, taken together this seems either generalized or at least multifocal.
DrO
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