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Discussion on Possible ulcer and medication questions
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New Member:
Tanyaw
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Posted on Saturday, Jun 10, 2006 - 8:35 pm:
K, I just found this sight looking up info on corneal ulcers.
Here's the background:
I've got a not yet 2 month old appy colt that got a bad eye infection. I noticed Sunday the may 21st that his eye was a little puffy. by that evening it was a bit cloudy but nothing I was really alarmed about so I decided to wait till Monday to call the vet. I don't mess with eye infections but it didn't look bad enough to try to get the vet on call to come out that night. I called the vet 1st thing Monday morning and she came out that day by 10 am. The eye was quite a bit more cloudy we put him on SMZs, Gentamicin Sulfate ointment, Atropine, banamine and held our breath. The next day (Tuesday) it looked a little better and I called and let her know. however it took a sudden turn for the worst Wednesday we called her and we decided to ship him to Cornell university first thing Thursday. They did a bunch of tests, did an ultrasound of his eye and lungs because they though it could be some kind of infection that had sped to his eye. Through this all he maintained a good attitude, was as hyper as ever, ate and pooped fine so I doubted the infection idea. My vet and I are thinking he bumped or banged himself in some way since the other eye was perfectly fine and his temp was fine as well. Anyways, Cornell put him on an ointment that contained Neomycin and Polymyxin B and Dexamethasone. continued the Atropine, Banamine and SMZ's as well as putting him on ulcer guard to protect his tummy. They eye has since gotten much better and cleared up nicely. My vet came out Tuesday the 6th and checked his eye and re did his blood. That came back fine (his white counts were a little high when they did blood work at Cornell) She knocked his meds back to 2X/day insted of 4 and he is currently off all other medication accept the Neomycin and Polymyxin B and Dexamethasone. She also gave me permission to start turning him out at night. I got him a foal fly mask that ended up a bit big but I figured it would help protect the eye from dirt and what little light he might be exposed to but now I'm worried it wasn't such a good idea after reading the part about fly masks can actually cause ulcers if not properly fitted. While when I first put it on it doesn’t hit his eye, Its close and he could be rubbing it because tonight it looks like he may have developed a corneal ulcer.
My concern:
is I know steroidal eye ointments can cause ulcers to get much worse, but I'm afraid to take him off it because of the infection that is finally under control. Of course this would have to happen on Saturday when no one is around to take calls. I have on hand: Gentamicin Sulfate ointment, Neomycin and Polymyxin B and Bacitracin Zinc ointment and then the one he's on now Neomycin and Polymyxin B and Dexamethasone. (I am under the impression that the only difference between the two is one’s steroidal and one is antibacterial, please correct me if I’m wrong)
My Question:
Should I switch him to either the other Neomycin ointment (the one with Bacitracin Zinc) or the Gentamicin ointment? Should I put in an emergency call to the vet or can it wait till Monday if I switch ointments?
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Member:
Vickiann
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Posted on Saturday, Jun 10, 2006 - 9:02 pm:
I would do the emergency call to the vet. This whole situation could quickly go downhill with a real possibility of blindness for your horse. If there is an ulcer, the steroidal ointment could cause blindness. It seems to me the eye needs to be rechecked and stained to determine the condition. Sometimes it is necessary to treat by rotation with a couple of different antibiotics every couple of hours to completely clear infections. The horse may have began rubbing the eye due to discomfort, and could have scratched the eye. It sounds to me like the horse was turned out too quickly. With eye infections, it seems like they never clear up if the horse goes outside, whether wearing a fly mask or not. This is just my personal opinion based on my experiences.
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New Member:
Tanyaw
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Posted on Saturday, Jun 10, 2006 - 9:47 pm:
Thank you for the quick response. Unfortunately he's already blind in that eye. I forgot to mention that. by Thursday when we got him in at Cornell the retina had already begun to detach in several places and my vet confirmed when she came out for the re-check that it was detached. He's adjusted better than I have. I'm still reeling from all this and he's just as happy as a clam as though nothing's wrong. He torments his mother endlessly and is always into trouble. but for having such an attitude he is really great to deal with through all of this, still comes up to me without hesitation and goes willingly into the corner where we give him his medication. Right now our goal is to allow the eye to heal and to "maintain a comfortable eye" as the vet at Cornell put it. . I'm going to call the vet and see what she says
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Member:
Vickiann
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Posted on Sunday, Jun 11, 2006 - 2:10 pm:
Sorry to hear of the vision loss Tanya. I've ridden on the trail with many riders who have horses blind in one eye and they adjust well. Other riders should be cautious, however; and I prefer to avoid riding on the blind side of a horse because if they spook suddenly a bad wreck can result. Take real good care of that other eye!
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New Member:
Tanyaw
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Posted on Monday, Jun 12, 2006 - 5:33 pm:
I called Cornell this morning and had the vet come out this after noon because he started squinting with the other eye. He has a pin point ulcer in the right eye now. She drew 4 vials of blood and is going to run a bunch of test. She's worried about an immune system problem. I don't know what to do now. We're giving him NPB every hour and then tomorrow we're suppose to give it to him 6 times a day. She’s also going to give me serum to put in his eye as well. The problem is mom's got her own eye appointment Wednesday and I work full time. Mom and dad have been great helping me medicate him and helping me pay for the vet bills but I don't know what to do Wednesday I can't afford to take time off (works been great letting me leave early the day we took him to Cornell and let me take a sick day when he first got sick but I don’t want to push my luck and I need the job to pay for this) and I don't have anyone to ask for help medicating that has horse knowledge that doesn’t work all day as well. I know medication consistently is important but mom's eye appointment is going to mean he's going to go about 6 hrs on Wednesday between treatments. Do you think it’s going to be a problem? And if this does turn out to be an immune system problem do you think it would be kinder to have him put down? I’ve gotten very attached to him and I hate to think about that option but I want to prepare myself for the worst and I don’t want to make him suffer because I don’t want to let go. That being said I don’t want to give up on him either. I know this section is about eye problems but if his immune system isn’t working right what can I expect and what can I do?
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Member:
Vickiann
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Posted on Monday, Jun 12, 2006 - 8:28 pm:
When my horse had an ulcerated cornea I was able to take care of it personally. It was not easy because my other two horses also had bad problems at the same time, resulting in at least 8 hours daily of pure labor, not counting my sleeping in the barn to administer eye ointment every two hours (it became necessary to alternate two different ointments) Had I not been able to do this, my Vet office had an assistant who could have taken my horse to her place and made sure he got his treatment as needed. I only spent one night in my bed before having to go to hospital intensive care 4 + hours South of here where my brother was in critical condition. He passed away without ever getting out of there about 3 weeks later. Caring for my horses for a few weeks before my brother got critical left me emotionally exhausted, but that didn't really change anything. And as I left to care for my brother I had to board my 3 boys out. By then things were stable, though the horse with the eye problem still needed ointment a couple of times daily and needed to be stalled. All we can do is the best we can do. All best wishes. I am very sorry you are having to go through this struggle. Caring for our loved ones can be very challenging and we must try our best to meet the challenge. The answer about WHEN to let go, I am sure is variable. Above all, our equines should not suffer.
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Moderator:
DrO
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Posted on Tuesday, Jun 13, 2006 - 7:02 am:
Hello Tanya,
It is unlikely anything is going to show up in the blood that clearly indicates the foal will need to be put down. Concerning treatment changes, we really cannot make these type decisions without examining the eye. Most likely your first eye problem was traumatic since the retinae detached and Cornell prescribed dexamethasone. The problem with the other side is unlucky but I suspect if you treat it regularly you will be fine.
DrO
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