Site Menu:
| This is an archived Horseadvice.com Discussion. The parent article and menus are available on the navigation menu below: |
| HorseAdvice.com » Diseases of Horses » Eye Diseases » Cloudy Eyes in Horses » |
| Discussion on Traumatic Injury VS Recurrent Uveitis | |
| Author | Message |
| New Member: andym |
Posted on Monday, Jan 5, 2009 - 12:40 am: I have a 10 yr old TB mare who is stabled and pastured with a 25 yr old Arabian mare. Both generally in good health. On Aug 29, the TB mare came in from pasture with a swollen upper eyelid area and some cloudiness in her right eye. Her left eye was, and still is, normal.My Vet of 25 yrs was called and he examined her on the following morning. He dilated the eye, (atropine) examined it, and said there was no cuts and concluded she had bumped or banged something in the pasture. Put some antibiotic opthalmic ointment (maxitrol) under the eyelid and gave her banamine paste. He left two small tubes of the ointment and two banimine tabs with instrucions to apply the ointment three imes a day. He returned on Sep 2 to re-check. The swelling was down but the cloudiness and eye was not back to normal. At that time, he attributed the cause to a blockage of the eye’s drainage system probably caused by trauma. (My understanding in layman’s terms) . He left me three tubes of ointment to be applied 3X/day for 4 days, then 2X/day for 6 days, then 1X/day for 5 days, then alternate days for a few times. That took it up to Sep 14 and the eye looked pretty clear to me. I quit the ointment but a few days later it looked slightly cloudy so I got more ointment and applied it 1X/day for a few days, then off a few days, then on, etc. It seemed to be much less than it was at the beginning but never went completely away. My vet saw her again on Oct 12 while here for another horse and agreed it was less but to keep on with the ointment and see if it clears up. Mid November, there was no swelling or indication of pain, but I was not satisfied and after reading all I could find, I decided I had to find an Equine Opthalmalogist which I did. So, on Dec 18, she, the Opthalmologist, and he, my Vet, examined the mare together. Her Exam findings are :
On Dec 30, my Vet visually examined the mare’s eye. He agrees it has improved some and recommends continuing the ointment and aspirin. He is not enthusiastic about the implant but suggests I fax a copy of the full exam report to OSU which I intend to do this week. I have had horses for 35+ years but never one with an eye problem like this and, because several eye diseases have the same or similar symptoms , I am looking for second opinions. Her report refers to “ongoing and intermittent history of cloudiness” . Ongoing but not intermittent, I would say continuing. One explanation my Vet gives is that a trauma causes blood to enter the chamber and the eye sets up an autoimmune allergy to it which can’t be reversed. This causes fluid cloudiness, then glaucoma and permanent damge to the nerve. Her diagnosis finds secondary glaucoma but at 31.32 mm hg, it’s high normal but is it glaucoma ? I have read many of your responses to others. I value and understand them. I would very much appreciate your evaluation of this eye condition and look forward to your help. AndyM |
| New Member: andym |
Posted on Tuesday, Jan 6, 2009 - 8:02 pm: Dr OSince posting yesterday, I have read much about uveitis and it's treatment. But it also brings questions. Is there a test positive for uveitus such as a lab test of body fluids or is the diagnosis limited to observance of its symptoms or eye damage, some of which are symptoms of other diseases ? I have had my 10 yr old mare for 3 years and this is the first eye problem she has had. Her previous history is also clear. If topical ointment and oral aspirin treatment alleviate the symptoms, should I wait for a reoccurence, or rush to more aggressive treatment such as the implant? If it doesn't reoccur, I suppose I could assume it was from another cause. I understand that cyclosporin is an anti-immune which acts to counter the auto-immune effect of uveitis which is causing the damage to the eye. Can cyclosporin be given orally or by injection ? I also understand from postings and from a friend who recently had the implants in both eyes of her gelding, that the program is still considered to be in a testing stage and actual results have varied among horses treated. I faxed my Opthamalogist's report to OHS U and they acknowledge it shows some symptoms but suggest I take my mare to Columbus for an evaluation by them. I'm considering that but its 300 miles each way. Look forward to comments, andym |
| Moderator: DrO |
Posted on Wednesday, Jan 7, 2009 - 10:08 am: Welcome Andy,I have reposted your attachment above so that it can be read on line. I have also tried to use line breaks to make reading easier but uncertain in some places if I have done it correctly. Evaluating intraocular pressure accurately in horses in not without some problems so measurements of normal vary somewhat depending on equipment and technique. If the ophthalmologist calls this "high normal" then by definition this is not glaucoma. I agree that the history is consistent with trauma on Aug 29th and the prolonged cloudiness and treatment does not rule this out. If this is indeed the case it does mean there was some damage to the deeper layers of the cornea that are taking some time to recover. I had a stallion once that presented very similarly to your case that went on nearly for a year. One problem with aggressive anti-inflammatory therapy is it may prevent neo-vascularization that may be required for complete healing. However this is conjecture on my part so should be discussed with your veterinarian and ophthalmologist before any treatment decisions are made based on this notion. To answer your latest questions in order: 1) No there are no blood tests, see the article on RU for diagnosis. 2) I do not know of oral preparations nor have I heard of injections for treatment. DrO |
| New Member: andym |
Posted on Thursday, Jan 8, 2009 - 10:17 am: DrOThank for your response. Yes, your line breaks are correct For now, I am continuing with ointment and aspirin 2X daily and it appears to me to continue gradual improvement. Certainly the cloudiness has diminished a lot.In a few days, I'll have my veterinarian come see her and ask if he thinks we should have the opthamalogist again or continue as we are for awhile. My friend's geldihg which has the implants in both eyes at OH U still has flare ups and returns him to OH U each time for evaluation under the joint research program of NC U, OH U and maybe others. Do you know if any results have been published on their results ? Thanks again and I will keep you posted on our progress. Andy M |
| Moderator: DrO |
Posted on Friday, Jan 9, 2009 - 8:01 am: We have published the results of a large survey of implants at Diseases of Horses » Eye Diseases » Anterior Uveitis, Recurrent Uveitis, Periodic Opthalmia, and Moonblindness.DrO |
| Member: stek |
Posted on Friday, Jan 9, 2009 - 5:15 pm: Andym,One of my horses had trauma to her eye the summer before last and it took almost 2 months to heal to the point where she stopped showing pain, she would get better then worse then better again. We tried several different courses of treatment (my vet recommended applications of meds 6x per day, the most I was able to manage was 5). I will have to look back at her file and see what all we tried, but it started with triple antibiotic opthalmic ointment and atropine and progressed to other antibiotics and anti-inflamatories in addition. In the end though the eye actually healed itself by growing a blood vessel from the white of the eye across the surface of the cornea to reach and drain the spot of trauma, then healing progressed rapidly. The cloudiness took a good year to go away and she still has a very faint spot on that eye, but you have to look to find it. I have two photos that I will post as soon as I find them. |
| Member: stek |
Posted on Friday, Jan 9, 2009 - 5:26 pm: Attached are two photos, the first shows the trauma (ulcerated spot about the size of a pencil eraser).The second shows the blood vessel that grew up to the spot and healed it. The spot started out as convex and yellowish and the blood vessel literally drained it of pus and made it concave. You should be able to just make out the blood vessel starting at about the center of the lower eyelid and working it's way up .. kind of hard to make out with the image resized so small. I can send a larger image if you are interested too. Please let me know if you have any trouble seeing the attachments.  
|
| New Member: andym |
Posted on Saturday, Jan 10, 2009 - 12:04 pm: ShannonYes, I can see the spot at the outer edge in the first and the blood vessel in the second. From your previous post, I gather the eye now has normal vision and no flare ups as seen with uveitis. Your continued treatment was the right thing to do. I am continuing mine also and see improvement. Maybe the blood vessel is the result of the neo-vascularization process DrO referred to in his respons to me. Thanks for sharing your pictures. I have to learn how to show mine. andym |
| Moderator: DrO |
Posted on Sunday, Jan 11, 2009 - 2:32 pm: Great photo Shannon of a small yet fairly deep draining abscess/ulcer. You can see a ring of undermined epitheal layer around the abscess.Surgical debridement might hasten recovery in such cases as it removes necrotic material in which the infection hides and has an effect to slow healing. Even so neovascularization, as Shannon describes, will be needed to heal the stromal damage. I would use heavy sedation, block the nerves to the lids, topical anesthetic on the cornea, then gently debride away the undermined epithelium with a dilute povidone iodine swab. DrO |
| Member: stek |
Posted on Monday, Jan 12, 2009 - 10:32 am: Andy you are right, we have had no flare-ups (knock wood!) and no vision impairment. Aside from a very faint cloudy spot on her eye you would never know it had happened. In my vet's opinion one of the keys to recovery on things like this is to treat as frequently as humanly possible.Dr. O we did consider debridement and were on the verge of doing so when she took a major turn for the better overnight, went from very painful and tearing to no evidence of pain whatsoever. Right around that same time the neovascularization started; it was fascinating to watch. My theory was that she had something tiny stuck in there that was continuing to irritate the eye that her body finally managed to expel, though my vet said that was not the case. Regardless, I'm just happy she recovered fully. |
| Member: stek |
Posted on Monday, Jan 12, 2009 - 10:33 am: ps, Andy best of luck with your mare and please keep us posted on how she is doing!! |
| Member: andym |
Posted on Monday, Jan 12, 2009 - 9:30 pm: DrO,A friend of mine sent me an interesting article re ERU from the Jan '09 issue of Equus magazine.It says "New research from the University of North Carolina suggests that Leptospira bacteria may initiate uveitis in horses but do not contribute to recurrences of the condition." Their study used 93 horses divided in 3 groups including a group of 52 with ERU, 17 with eye inflamation and 24 with no ocular problems. Leptospira bacteria was not found in any of the horses and only two - one with ERU and one with eye inflamation not related to ERU - had antibodies to the bacteria. Dr Gilger, DVM thinks the bacteria set off the first bout of uveitis which damages the eye so even after the organism is gone, the body continues to mount immune responses leading to flare ups, etc. He concludes treatment is best focused on controlling the immune response rather than clearing bacteria That's putting the article in a few sentences which I shouldn't do, but it brings me to my question. If this in my mare is not a trauma, but is instead a very first bout of uveitus, wouldn't continuing the treatment as I am doing to remove the bacteria possibly preclude her body from mounting the auto-immune responses ? In other words, can ERU be stopped by not letting it get started ? I'm not medically educated and perhaps I over simplify, but if there's hope, I will continue treatment as long as it takes. Andy M |
| Moderator: DrO |
Posted on Wednesday, Jan 14, 2009 - 7:31 am: Hello Andy,We discuss this finding by Dr Gilger last November at Diseases of Horses » Eye Diseases » Anterior Uveitis, Recurrent Uveitis, Periodic Opthalmia, and Moonblindness » New study says Lepto not a cause? DrO |
| Member: andym |
Posted on Wednesday, Jan 14, 2009 - 10:55 pm: DrOThank you for pointing out your summary and conclusion about the new study re Lepto/Uveitis. Seems there's much yet to learn in that regard. As I indicated previously, I have been treating my mare's eye problem with daily applications of ointment since early September and ointment and aspirin since mid December as directed by the opthalmologist and my vet. I believe there has been improvement and expect to have my vet and probably the opthalmologist come in a few days for their evaluation. However, today I read the printed info with the ointment and have some concern it's the right (best) to use. It is Neomycin and Polymyxin B Sulfates and Dexamethasone Opthalmic Ointment distributed by Falcon Pharmaceuticals and is described as a multi dose anti-infective steroid combination in a sterile ointment form. It also adds - Cortcoids suppress the inflammatory response to a variety of agents and they probably delay or slow healing. It also gives warnings such as - If this product is used for 10 days or longer, intraocular pressure should be routinely monitored Also - renewal of the prescription beyond 8g should be made by the vet only after examination with the aid of magnification. As well as a warning that prolonged use may result in glaucoma. And more. Each tube is 3.5g and I have used several, each lasting 4 or 5 days at most. Am I being overly concerned about this? Does this sound like the best and right ointment ? Could it do harm ? Your opinion would be greatly appreciated. Thanks Andy |
| Moderator: DrO |
Posted on Thursday, Jan 15, 2009 - 9:46 am: The glaucoma complication is not one I have ever seen or see commonly reported so I don't check IOP in horses with long term NPB/with steroid use that don't have any clinical evidence of glaucoma. If this remains a concern you can have the IOP retested.The choice of the right ointment for your horse will depend on your veterinarian's diagnosis but this ointment is good for eye trauma with active inflammation but no ulceration or other signs of active infection. There are not any treatments that don't have downsides and possible adverse reactions but don't forget there may be risks with not treating. The question with any treatment is whether the benefits out-weigh the risks. DrO |
| Member: andym |
Posted on Thursday, Jan 15, 2009 - 8:59 pm: DrOThank you. I am continuing with the ointment and have confidence in my vet that he is prescribing the right treatment for the symptoms. I have enclosed a picture taken today of my mare's right eye. Her left eye has no problem. Any comments will be appreciated.  andym |
| Member: andym |
Posted on Saturday, Jan 17, 2009 - 1:32 pm: DrOAfter reading your helpful response to my concerns about the ointment I'm using, I decided to also read in Medications about Aspirin which I am also using. I was surprised to read it's half life is so short. When the opthalmologist and my vet were talking, they mentioned Bute but then decided on Aspirin. In the past,(not with this eye problem) I have tried to avoid a continual use of treating with Bute. Just because, I guess. But with this problem maybe it would be a better choice, especially if any indication of pain would show up which it hasn't so far. Is there an adverse risk using bute which should be watched for ? On the other hand, the condition, as shown by the picture, is improving with Aspirin. Andym |
| Moderator: DrO |
Posted on Monday, Jan 19, 2009 - 7:31 am: Andym, we cover the aspirin versus bute debate in the article Diseases of Horses » Eye Diseases » Anterior Uveitis, Recurrent Uveitis, Periodic Opthalmia, and Moonblindness.DrO |
| Member: andym |
Posted on Sunday, Feb 8, 2009 - 10:17 pm: DrOI'm still treating the eye with an ointment of Neomycin, Polymyxin B Sulfates and Dexamethasone and aspirin twice a day. I believe it's improving (certainly it's not worsening) but it's not well yet. In reading info on Uveitis, I see there are some studies that indicate a possible connection with leptospira and others that show no relationship. I also read that leptospirosis is relatively minor in the horse population and possibly because of the widespread use of Ivermectin. As a routine, it's time to worm and I plan to worm her with Ivermectin which is what I normally use. Am I correct in assuming there is no adversity in doing that and no reason to assume there would be any interaction between that and the condition of her eye ? Thank you, Andy |
| Moderator: DrO |
Posted on Monday, Feb 9, 2009 - 8:39 am: Hopefully we have not made a connection between lepto and ivermectin on this site as I don't believe there is one. You may be confusing some of the eye worms found most often in the third world countries that are sensitive to ivermectin. I don't believe you have anything to worry about.DrO |
| Member: andym |
Posted on Tuesday, Feb 10, 2009 - 9:56 am: DrOThank you for response. I'm proceeding with ivermectin and continuing the ointment and aspirin. I apologise for any implication of a connection between lepto and ivermectin on your site. That was not my intent and there is none. Andy |
| Moderator: DrO |
Posted on Tuesday, Feb 10, 2009 - 5:17 pm: Hey no need for apology, that is what we are here for.DrO |
| Member: andym |
Posted on Wednesday, Feb 18, 2009 - 4:00 pm: DrO,My Vet was here yesterday and gave a quick exam of my mare's eye condition. I was out at the time and I called him later but talking on the phone doesn't allow questioning like being there. Anyway, he agrees with me that there is some improvement. He didn't see any direct injury but said that the origination could have been caused by trauma. He agrees that I keep on treating with the ointment and aspirin and, in particular, that I get the ointment under the upper eyelid. I have been putting it in both corners of her eye thinking it would spread naturally but will try as he suggests. After his call, I re-read your site on Cloudy Eyes, etc. in detail. I was surprised to find in there, under Viral Infections in eyes, it says "cyclosporine should be avoided" Since the NC State and OH State are placing cyclosporine implants to control RU, I wondered why it would be harmful. Is this suggesting that for a Viral infection, cyclosporine might wrongly be topically applied and also should be avoided from any application to the eye ? Not planning or even heard of such, but just wondering. Andy |
| Moderator: DrO |
Posted on Wednesday, Feb 18, 2009 - 7:50 pm: That sounds good though I know how frustratingly slow it all is. The ointment does not need to go under the upper eyelid. It needs to be placed in the lateral (outside) corner. Blinking will distribute it up and down but tears sweep from the outside corner to the inside corner of the eye where they are drained by the nasolacrimal duct.DrO |
| Member: andym |
Posted on Wednesday, Feb 18, 2009 - 11:13 pm: DrOThanks for your response. As usual, your advice is logically supported. I will continue placing ointment in the outboard corner of her eye. With perseverance, hopefully I can succeed in clearing up her problem. Andy |
| Member: stevens |
Posted on Thursday, Feb 19, 2009 - 5:09 pm: I spent Monday at the vet hospital with a friend who's horse is suspected of having uveitis. Something I thought was interesting is that the vets have her using banamine instead of bute. Something about bute "not working" for eyes??The vet did some debriding of the affected eye which has a ulceration. She's also using some special mix of medication that had to be ordered from a lab in S. Carolina. |
| Member: vickiann |
Posted on Friday, Feb 20, 2009 - 4:01 pm: Banamine is what has been used for the various eye-related problems my horses have encountered (blunt trauma;ulcerated cornea;superficial keratitis).For the keratitis, the cyclosporin was used long term and another ointment additionally for a shorter term with one bad flare. Following a particularly bad keratitis flare up, my daughter's horse had the debridement procedure, which while requiring some special aftercare for a week or two, caused a tremendous overall improvement with regard to the problem. I believe the horse will always have some scaring and cloudiness to his eye but his condition has been stable for quite a long time without the use of the ointments. |
| Moderator: DrO |
Posted on Saturday, Feb 21, 2009 - 10:25 am: I guess it depends on what you mean by "not working in the eye" but phenylbutazone is a effective antiinflammatory and analgesic for uveitis. Neither will cure a eye infection or turn around a exacerbation of recurrent uveitis alone however.DrO |
| Member: andym |
Posted on Saturday, Mar 7, 2009 - 1:59 pm: DrOI am continuing treating with ointment and asprin. As I reported before, my mare's right eye is improved but not well. A few days ago, I noticed a streak which starts in the lower right and travels up to the center, then goes off to the left. This shows in the enclosed picture taken 3/5 but is not in the previous posted taken 1/5. Is that streak significant or meaningful?  Also, I read of a surgery that is performed on people's eyes to open the drainage canal to relieve the cloudiness. Didn't say cloudiness from what cause, but did describe as minimally invasive. Is there a similar performed for horses? As you earlier told me, it's frustrating, but I'm persevering. Thanks for your much valued help. Andy |
| Moderator: DrO |
Posted on Saturday, Mar 7, 2009 - 7:27 pm: The cloudiness may represent corneal edema (inflammation) due to exacerbation of the RU Andy. What ointment are you treating with and how often?There have been discusssions about opening chronically blocked lacrimal glands but it would depend on the location and nature of the blockage. Blockages away from the openings may not be repairable. DrO |
| Member: andym |
Posted on Saturday, Mar 7, 2009 - 9:48 pm: DrOThe ointment I am using is Neomycin and Polymyxin B Sulfates and Dexamethasone Opthalmic Ointment which I apply twice a day - at 8:00 AM and about 9:00PM. I also am giving a tablespoon of aspirin twice a day (AM & PM) on her feed. Does light sensitivity increase the cloudiness? After our as usual cloudy winters, we are now starting to get some sunny days. This evening when I brought her in from pasture, I noticed more cloudiness than when she was put out in the AM. The increase was to the right and above the streak Last Fall, I put a fly mask on when she was out in the sun and wonder if I should do that now also. Thanks for getting back. I will try to re-find the surgery reference I mentioned just for info. As I noted, it was for humans but was interesting detail. Andy |
| Moderator: DrO |
Posted on Sunday, Mar 8, 2009 - 8:49 am: Light sensitivity indicates a painful eye, which can accompany cloudiness. One does not cause the other they may happen concurrently however. The interesting thing about the above image is that the eye does not look painful, something expected with a RU exacerbation. Does the horse squint this eye in bright light?What is the concentration of the dex? During exacerbation's of RU usually you want to treat at least 4 times daily with a potent steroid product. DrO |
| Member: andym |
Posted on Sunday, Mar 8, 2009 - 12:01 pm: DrOThe ointment - Neomycin Sulfates(equiv to 3.5mg Neomycin base), Polymyxin B Sulfate 10,000 units, Dexamethasone 1 mg per gram in a base containing White Petrolatum and mineral oil. Each tube contains 3.5 grams of ointment. No, she doesn't squint or seem to be painful, but I do notice that the area above her upper eyelid seems to be a bit more pronounced than on her other eye although hardly noticeable. This AM the cloudiness is a bit more than last night. Andy |
| Member: stevens |
Posted on Sunday, Mar 8, 2009 - 5:23 pm: Sorry, late response. By "not working for eyes" I meant that bute was not as effective at reducing inflammation in the eye compared to banamine.I got a chance to ask about this as we spent last Friday with the same horse back at the vet hospital for a recheck and more debriding. The regular vet, not the vet opthamologist, indicated that bute didn't "penetrate" the eye area as well. I may well be misquoting her as we were both fascinated by the ongoing debriding of the horse's eye with what looked like a teeny tiny dremel tool. Regarding use of dex; don't you need to be sure that there aren't corneal ulcers present before using steriods? |
| Member: andym |
Posted on Sunday, Mar 8, 2009 - 5:53 pm: DrOI've read enough on this page to know you're alert to this, but just a reminder - please don't confuse my mare's problem with Chris's horse problem. Put my mare, Willy, out today w/o her fly mask and she came in this PM more cloudy than when she went out. Tomorrow, fly mask for sure ! and 4 times/day w/ointment if you suggest. Andy Andy |
| Moderator: DrO |
Posted on Monday, Mar 9, 2009 - 9:37 am: Chris, yes corticosteroid use is contraindicated in the presence of ulcers however I cannot find any work that compares the intraocular concentration of systemically administered flunixin and phenylbutazone. Maybe there is a clinical impression of more efficacy at a given dose?Andy, I cannot make specific recommendations for your horse. I would contact your veterinarian and see if he thinks this is a wise course or whether a exam would be best. DrO |
| Member: andym |
Posted on Monday, Mar 9, 2009 - 12:57 pm: DrOThanks for the response but I'm a bit confused. You commented on the picture of my horse's eye and asked what ointment and how often. I responded with the ointment description and frequency I am following as prescribed by my vet. You then asked for the concentration of Dex in the ointment. I answered that, but before you got back, Chris entered my subject and made reference to Dex and corneal ulcers. In an earlier post Chris refers to a horse with ulcers. Chris is a different person from me and talking about some different horse, not mine. I have been given no diagnosis of ulceration in my horse's eye by my vet who has examined the eye twice, or the opthamologist. Since you asked about the concentration and frequency of Dex, I expected a general response as to it's sufficiency - a second opinion, if you will. I understand you cannot prescribe for my horse from a distance, but depending on your answer, I would ask my vet if he agrees and, if so, ask him to prescribe. I very much value the information you provide and hope you understand I am asking questions, not disagreeing. Respectfully, Andy M |
| Member: stevens |
Posted on Monday, Mar 9, 2009 - 1:39 pm: Andy,Other members frequently enter discussions started by others. Typically, we are relating similar experiences or asking questions related to the main topic so that we can all learn. Everyone here is, I suspect, very clear that you and I are different people and are talking about different horses. Since your horse is suffering from eye problems, I entered the information about my friend's horse in case there was any information there that would be use to you. In this case, you indicated that you were using bute; I offered that my friend had been instructed to use banamine. I entered the question about dex and ulcers because I did not see in your earlier posts where corneal ulcers had been ruled out and thought you might want this information. You seem to be under the impression that this is your private vet consultation, "your subject" as you put it. This is a message board where many people share experiences and information. Good luck with your horse. |
| Moderator: DrO |
Posted on Tuesday, Mar 10, 2009 - 8:07 am: Andy I cannot answer the question you are asking: what is appropriate therapy for my horse? I can discuss what is appropriate therapy for the diagnosis of RU and we address the ointment you are using and the appropriate frequency in the article on RU and I would refer you there. But the proper treatment for your horse has to be made by your veterinarian I cannot diagnose RU from behind my computer. If he is confident of the diagnosis it may take as little as a phone call to adjust your meds or he may feel that an exam is needed.Andy, you need not worry I will confuse your and other member's posts. Look upon their infusions of information or questions as helpful. You may not know this but you have hundreds of eyes watching your postings, including veterinarians, doctors, and other health professionals. Of course there are many horsemen with decades of experience. Even when incorrect information is posted often I will correct if and this is how many miss-notions are fixed on these boards. On the other hand they may catch something I miss or even get wrong. I think I made a mistake...once.  DrO
|
| Member: andym |
Posted on Tuesday, Mar 10, 2009 - 2:05 pm: DrOI understand and thank you. My vet of 25 yrs lives about a mile down the road from me and I see him regularly. He's coming by tomorrow and we'll be reviewing my mare's condition and continuation of her treatment. Another general question I have is in regard to ticks, Lyme's disease, etc and their affects on horses. I have read your articles on ticks, lice, their related diseases etc and from several other sources on the internet and find nowhere that those affects are related to eyes. We have many deer and small animals here on the farm and not long ago I found some ticks (deer ticks maybe) on the chest area of my horses. Are there any reports of inflammation from tick related diseases of any kind possibly affecting the eyes ? Andy |
| Member: vickiann |
Posted on Tuesday, Mar 10, 2009 - 4:14 pm: Andy, Lyme disease sufferers reportedly sometimes have eye problems such as conjunctivitis, photophobia (sensitivity to light) and floaters. |
| Moderator: DrO |
Posted on Wednesday, Mar 11, 2009 - 7:57 am: Not in horses andym,DrO |
| Member: andym |
Posted on Wednesday, Mar 11, 2009 - 2:53 pm: DrOThank you, in horses is what I was interested in. Still looking for a cause. Andy M |
| Member: andym |
Posted on Sunday, Mar 15, 2009 - 2:34 pm: DrOJust an update. My vet was here Saturday morning and examined my mare's eye. He said it's active and changed the medication. The stable area is not bright and he pointed out that her pupil was smaller and not opened wide like her good eye's pupil. While here, he gave her an injection of banamine and applied an atropine ointment to her eye. He gave me banamine paste which I am to apply orally once each of the next three days. Also to continue the dex ointment three times a day. He also left atropine ointment which I am to apply three times a day or until her pupil opens wide. After he left, I put Willy out with her friend Melody for the day. When I brought them in late afternoon, her eye was more cloudy, but her pupil was wide open so I did the Dex but skipped the atropine. Then at 10:00 PM did the dex again. Early this AM,applied the dex and gave her the banamine. The pupil still open. I checked with the vet Brad, and he said OK but if the pupil gets small, apply the atropine. He's coming by again tomorrow AM. He's very knowledgeable and answered my questions well. We also talked about cyclosporine implants. He said he has cyclosporine ointment but it hasn't done any (or maybe much) good in his experience when applied topically to the eye. Do you have info on it's use or results ? Thank you, Will let you know our progress. Andy M |
| Moderator: DrO |
Posted on Monday, Mar 16, 2009 - 10:02 am: Andy we have case reports on the use of cyclosporin. Run a search and the best ones come up first.DrO |
| Member: vickiann |
Posted on Monday, Mar 16, 2009 - 7:48 pm: Eye problems in horses with Lyme have been suggested:Reading some articles from "The Horse" magazine, I came across the following (excerpt) "Lameness, arthritis, neurologic disease, uveitis (moon blindness), and dermatitis have been the most commonly described signs of Lyme disease in horses, although, as we shall learn, both symptoms and test results often are confusing." Infected Horses "At the risk of being redundant, we must again point out that a definitive diagnosis of the disease in horses is difficult. As mentioned earlier, there are the clinical signs of lameness, arthritis, neurologic disease, eye disease, and dermatitis." Unless since scientifically disproven, some of these observations are quite recent. Whether of not it meets the scientific tests. I do not know, but there are many seemingly reliable sources who have been making a connection. Only send this along for those who may want to consider all opinions on this subject. Here are some other articles: https://www.horse-canada.com/articles/HMdiseases03.99.htm https://www.heartlandvetsupply.com/Equine/RiskLyme.pdf https://www.veterinarypartner.com/Content.plx?P=A&A=2298&S=0&SourceID=69 https://www.cs.cmu.edu/afs/cs.cmu.edu/user/jake/mosaic/lyme.html https://www.equinevetservice.com/lyme.htm In conclusion (excerpt): LYME DISEASE IN DOMESTIC ANIMALS "Lyme disease has been described in dogs, cats, horses, cows and goats. Symptoms can include fever, lameness and soreness, listlessness, loss of appetite, swollen glands and joints. Heart, kidney, liver, eye and nervous system problems are also described in animals. Laminitis is reported in horses and cows, as are poor fertility, abortions and chronic weight loss. Temperament changes have been reported in dogs and horses. Untreated animals can develop chronic progressive arthritis." |
| Moderator: DrO |
Posted on Tuesday, Mar 17, 2009 - 12:03 am: Vicki, I am aware that there are folks including veterinarians that think Lymes may be responsible for overt clinical disease in the horse. However the current research, both in the laboratory and epidemiological studies do not support this notion. For a complete discussion on this see Diseases of Horses » Lameness » Joint, Bone, Ligament Diseases » Lyme Disease, Borreliosis, in Horses.DrO |
| Member: vickiann |
Posted on Tuesday, Mar 17, 2009 - 9:21 am: Thanks, Dr. O. That is a very good review. As one reads about Lyme disease it sounds very frightening and it is good to be reminded that there is credibility to the thought that this is probably over-diagnosed.There is a holistic Vet in our area who I believe quite often diagnoses and "cures" this disease. Your article does seem to imply, however, that some individuals perhaps have a greater problem from this disease due to how their immune system reacts? Does that then mean that in some individual cases any number of extreme, adverse things could result from the disease, in spite of the failure to replicate scientifically? |
| Moderator: DrO |
Posted on Wednesday, Mar 18, 2009 - 8:47 am: It just is a fact that animals can develop allergies to any antigenic stimulation and we know the horse develops antibodies to the organism. So you have to concede the "idea" of an allergy to the organism. I do not know of any reported cases and the epidemiological studies have not found any correlation.DrO |
| Member: andym |
Posted on Tuesday, Apr 14, 2009 - 10:00 am: Dr OAfter continued treatment with Banamine 1x/day and Dex 3 0r 4x/day since March 15 but am having continued cloudiness. I am taking my mare to Ohio State on Thursday 4/16 for evaluation and recommendations. Her pupil stays open (used Atropine only twice in the last month) but the cloudiness stays and mostly is below the line that was visible in my photos. Doesn't seem to be in pain but feel we can't let it continue as it is. Have had regular attendance from my vet who has spoken with Dr Gilger of NC U who recommended I take her to OH U. Will update you when I return from OHU Andy |
| Moderator: DrO |
Posted on Tuesday, Apr 14, 2009 - 6:38 pm: I look forward to hearing what they find and you finding some resolution.DrO |
| Member: andym |
Posted on Wednesday, Apr 29, 2009 - 3:18 pm: Dr OExcuse my slow report - had computer virus problems. Took willy to OHU on 4/16 for evaluation of her right eye disease. Thorough exam with findings similar to December, but slightly more evidence of past inflamation and the probability of ERU. However in what I feel are significant findings, the results were the same as those of December. Ie: past but no current inflamation and right eye IOP 30 mmHg now vs 31 mmHg in Dec with left eye IOP 17 mmHg now and 19 mmHg in Dec. Following the exam, Dr Metzler, DVM,ACVO spoke with me for about 30 minutes regarding their findings and recommendations. This included a cyclosporine implant for ERU and laser treatment for glaucoma. But concluding, per their Report, "As we cannot determine with certainty that this disease is the cause of Willy's inflamation, we are going to taper the anti-inflamatory medications that Willy is on. If the inflamation comes back then she has ERU." I am now gradually reducing the dex and banamine and now giving a DrOp of cosopt 2or3X/day. I have an appointment with local opthalmologist and my vet for next week to evaluate again. BTW, I recorded our 30 minute discussion on a $50 digital recorder I bought for that meeting. I have listened to it several times and it is a great help in remembering and understanding all that was explained. I'd recommend it. Andym |
| Moderator: DrO |
Posted on Thursday, Apr 30, 2009 - 6:01 am: Thanks for the update Andym, let us know how decreasing meds goes.DrO |
| Member: andym |
Posted on Sunday, May 10, 2009 - 1:25 pm: DrOUpdate on my mare's eye condition. Gradually reduced the meds to once a day and then to every other day. The edema (cloudiness) increased in area and density. Opthalmologist and my vet here Wed 5/6 for evaluation. Both concerned by the edema. Could not see through it like she wanted to. IOP read 34,46,51 at three spots in same eye. Said that's high and obvious glaucoma. However also found no obvious flare (inflamation). Diagnosis "chronic" uveitis. Changed medications to cosopt,flurbiprofin, bnp, NaCl, acetazolamide each three times a day and banamine once a day. If no dramatic improvement, recommend cyclosporine implant and at the same time, laser surgery for the glaucoma. Allowing three weeks, I talked with OHU to schedule OHU accordingly. I got the prescriptions all filled on Thursday and started all of them Friday. That's a lot of meds and requires some small intervals between them. Keeps me at the barn a lot but if it does good, I'll be there as often as needed. BTW, I'ved talked in person or by email with four equine opthalmologists and the recommendation is consistently the implant as the best currently available. And nothing really new expected anytime soon. Not asking for a diagnosis, but any comments you have on any of the above would be greatly appreciated. Thanks AndyM |
| Member: canter |
Posted on Sunday, May 10, 2009 - 7:19 pm: AndyM,I looked back at the beginning and realized this has really been a long haul for you. Kudos to you for the diligent care you've given your horse and I hope this finally clears up for you. Best wishes! |
| Moderator: DrO |
Posted on Sunday, May 10, 2009 - 10:12 pm: I am beginning to believe the cyclosporine implants are the best choice also. This has been a long hard road for you and it appears to be getting harder.DrO |
| Member: mrose |
Posted on Monday, May 11, 2009 - 10:01 am: Wasn't there a post not too long ago where someone was announcing an upcoming conference call or web meeting regarding the latest research on Uvetis? The person was asking for reservations? I deleted the post because I wasn't going to be around the day of the event. If you can't find the notice, I'll do a search. I'm pretty sure it was on HA. |
| Member: andym |
Posted on Tuesday, May 12, 2009 - 8:57 am: SaraThat conference call was posted by Lora at the below discussion. I intend to participate. A great idea by Lora to stimulate awareness of this disease. andym HorseAdvice.com: Diseases of Horses: Eye Diseases: Anterior Uveitis, Recurrent Uveitis, Periodic Opthalmia, and Moonblindness: Recurrent Uveitis - Cyclosporine Implant or Rapamycin Injection? |
| Member: mrose |
Posted on Tuesday, May 12, 2009 - 10:49 am: Thanks andym. I obviously didn't realize you were the one that had posted about it. I agree. I think it's something too few are aware of. I wish you luck; you've really been giving it your all. |
| Member: andym |
Posted on Saturday, May 23, 2009 - 12:58 pm: Dr OA brief update on my mare's uveitis and a general question. For two weeks now, I have been medicating as above prescribed by opthalmologist. I see no improvement but not worse. Does not show tearing, swelling, or apparent pain but does not reduce the edema. Without measurement of the IOP, can't tell about glaucoma, but from appearance, no indication of that worsening. Will be taking her to Ohio State U next Thursday. Intent is to have implant if exam indicates advisable. Now the question. My daughter who works one day a week as a volunteer at the Washington, DC Zoo as an observer of animal programs. In particular,the Pandas and a study of characteristics in the wild vs in captivity. We talked about uveitis and how it affects an estimated 10 to 12% of horses. She asked if that was also true of the mustangs that roam free in the West. Is it widespread in that population ? Do you know if such a study has been done? Could the results of such a study be helpful ? I thought it an interesting question. AndyM |
| Moderator: DrO |
Posted on Monday, May 25, 2009 - 8:16 am: I agree andym, it is a great question that has epidemiological implications. I have never seen the results of such a study.DrO |
| New Member: dusty05 |
Posted on Monday, Jun 1, 2009 - 7:32 pm: Dr Gilger,North Carolina did implants for frequently RU on my horse. 1 1/2 yrs later and no recurrence! Wonderful doctor. Recommended someone to take care of her while recuperating and she did a wonderful job also. |
| Member: andym |
Posted on Tuesday, Jun 2, 2009 - 8:55 am: dusty05,That's good news for sure. Especially since my mare had the implant procedure a few days ago (June 29) at Ohio State which is working with North Carolina in that research effort. My vet spoke with Dr Gilger for advice but we worked with Dr Metzler at Ohio State because of our location. She is very good also. In addition to the implant, my mare also had a lazer procedure to alleviate the edema. She's now home and I am following up on her recovery myself. I would be very interested in knowing how long your horse had had ERU and what eye conditions existed when the implant was done. As you can see from my previous postings, I doctored for about six months before the implant. Hind sight says I should have done it sooner. They tell me ERU can be controlled but not cured. Of course, they also say there's an exception to every rule. A year and a half ! That's great !Here's wishing your horse is that exception ! AndyM |
| New Member: dusty05 |
Posted on Tuesday, Jun 2, 2009 - 10:03 am: I just emailed her previous owner to find out how long she had Uveitis.She had cataracts and a bad case of Uveitis in both eyes. They felt the implants and removing the cataracts from both eyes would be too much so they did the implants in both and removed the cataract from the worst eye. Good luck. |
| New Member: dusty05 |
Posted on Tuesday, Jun 2, 2009 - 5:52 pm: AndyM,My horse had Uveitis for 3 - 4 years and the last year she was having frequent occurrences. |
| Member: andym |
Posted on Saturday, Jun 27, 2009 - 11:06 am: DrO and OthersUpdate - On 5/29 my mare had a CSA implant and Laser procedure of the right eye at OH U. Treatment continued with Cosopt DrOps, PBM ointment, Acetazolomide, and Banamine daily until return visit to OH U on 6/25. Exam Findings 5/29 vs 6/25 PLR Right Eye 5/29 decreased 6/25 positive Left Eye 5/29 positive 6/25 positive Menace Right Eye 5/29 decreased 6/25 present Left Eye 5/29 present 6/25 present IOP Right Eye 5/29 22-34 mmHg 6/25 7 mmHg Left Eye 5/29 13 mmHg 6/25 12 mmHg Summary-"Calcific band keratopathy in the right eye. No inflamation and IOP well controlled 1 mo post CSA implant and laser in the right eye. Suspect retinal hemorrhage is secondary to previous IOP pressure spikes or inflamation. They should not significantly decrease vision." Left Eye- Normal eye other than temporal fibrillar vitreous (which is a normal eye change) Now I am to discontinue previous medications and start on 1%EDTA gel 2-3x day for 2-4 weeks to attempt to stop corneal calcification. Monitor corneal edema which will likely be a sensitive indicator of increased IOP or IO inflamation. If increased, restart Cosopt and call OSU. Lengthy update I know, but I thought it would be of interest to others experiencing ERU and wondering what is available and what's involved. Dr Metzler at OSU and I are very pleased with the improvement and results so far. Next appointment scheduled for Aug 27. Will update then. AndyM |
| Moderator: DrO |
Posted on Sunday, Jun 28, 2009 - 8:38 pm: So far so good AndyM and thanks for keeping us in the loop. You are right this should help many.DrO |
| Member: andym |
Posted on Friday, Nov 20, 2009 - 2:40 pm: Dr O,An update on my mare, Willie, who had a cyclosporine implant by OHSU for ERU on 5/29/09. For about a month after, I gradually discontinued medications and have given No medications since. Returned to OHSU yesterday for a 6 month check up with the following results : PLR:Right Eye - positive direct and consensual Left Eye - positive direct and consensual Menace: Right Eye - present Left Eye - present IOP: Right Eye - 25 mmHg Left Eye - 21 mmHg Summary opthalmic findings: Left Eye : No abnormal changes Right Eye : "The corneal edema has not worsened and intraocular pressure is well controlled 6 months past Csa implant and laser in the right eye. Willie is doing well being off all medications." In addition, I can report Willie sees well, has no irritation, tearing or swelling. She does have some cloudiness below a line which I referenced in a previous photo and that will probably be permanent. It is described to me as caused by a "crack" in the cornea (?) which occurred when the glaucoma peaked and will never heal together. It does not bother her vision, however. Although expensive, I am pleased with the results and believe, in the long run, we have saved her eye for at least the next several years and probably without medications. My only regret is that I didn't have it done sooner. |
| Member: vickiann |
Posted on Friday, Nov 20, 2009 - 5:37 pm: Thanks very much for sharing this important up-date.I am pleased to hear about your good experience. |
| Member: kpaint |
Posted on Friday, Nov 20, 2009 - 7:33 pm: Thank you for your diligent posting Andy. Glad to hear your mare is doing so much better. |
Horseadvice.com
is The Horseman's Advisor
Helping Thousands of Equestrians, Farriers, and Veterinarians Every Day
All rights reserved, © 1997 -
is The Horseman's Advisor
Helping Thousands of Equestrians, Farriers, and Veterinarians Every Day
All rights reserved, © 1997 -
