Are you ready for Eyes Part 2? Really, eyes could be a 5 or 6-part blog, but for now we’ll keep it to two. These will keep the most common eye problems horses have in the spotlight, so you know what to look out for. Conjunctivitis, abscesses, and lacerations happen often, and almost always on the weekend. If it hasn’t already been ingrained in your head, I’ll say it again: Eye problems are ALWAYS an emergency!

Conjunctivitis

The conjunctiva is the mucous membrane that covers the inside of the eyelids and lies over the white part, or sclera, of the eye. When this tissue becomes inflamed, the result is conjunctivitis. Conjunctivitis can have similar clinical signs to other common eye problems, including corneal ulcers, uveitis, and abscesses.

Horses with conjunctivitis often will have tearing from the eye, generalized redness, and swelling. It’s not uncommon for horses with conjunctivitis to be seen rubbing their eyes, making them more prone to developing corneal ulcers. As usual with horses, conjunctivitis can be caused by a number of different reasons, like allergies, insect hypersensitivity, and other environmental irritants. Conjunctivitis can also lead to secondary ocular problems such as obstructed tear ducts, which can require veterinary attention to resolve. 

Treatment of conjunctivitis includes anti-inflammatories, antihistamines, and occasionally, anti-biotics. Topical anti-inflammatories can be dangerous if there is any kind of insult to the cornea and can result in a small scratch becoming a large, melting, sight-threatening ulcer. Therefore, it is never a good idea to treat an eye before your veterinarian assesses the eye and prescribes the appropriate treatment. Similarly, treatment of an obstructed tear duct requires veterinary involvement. If performed incorrectly, there is risk for rupture of the tear duct. 

If your veterinarian suspects that your horses tear duct is obstructed, they will sedate your horse, as most horses HATE this process. They will then insert a small tube into a tiny hole in your horse’s nostril and flush a solution of saline and usually steroid up the tear duct to dislodge any mucous that has accumulated. I find it to be utterly disgusting, but for some reason the docs and techs love to do this. They say it’s rewarding. Humans.

Antihistamines are often prescribed if your horse has an overall allergic appearance. You know what I’m talking about, the itchy mane with hair missing and the crusty tail, those guys really need antihistamines. As a cat with allergies, I can tell you how important it is to control the itchiness before it results in a skin or eye infection. An easy way to help protect your horse’s eyes from external environmental factors is placement of fly mask. Some horses really just don’t know what’s good for them and often like to remove their fly masks. Don’t be afraid to ask my docs about the fly masks out there that are significantly more difficult for horses to remove.

Stromal Abscesses

Probably one of the most frustrating eye problems a horse can get is a stromal abscess. This is when bacteria or fungus gets trapped within the layers of the cornea and the top layer of the cornea heals, allowing the organism to reproduce and grown within the deeper layers of the cornea with no way out. Abscesses are extremely painful for your horse and result in extreme squinting and copious tearing, often with mucoid discharge present as well. These horses tend to be head shy and do not want anything or anyone near their eyes.

An abscess within the cornea is usually easily diagnosed by a yellow-white circular infiltrate surrounded by edema, and occasionally blood vessels. Recognizing an abscess early is extremely important when it comes to successful treatment. Also, recognizing that treatment will be long, intense, and likely expensive is very important. You as an owner must be upfront and open with your veterinarian about your willingness to be involved in treatment and your budget.

Treatment almost always includes placement of a subpalpebral lavage, along with every 2-hour administration of 4-6 eye medications around the clock for several weeks. These things are exhausting, let me tell you. When we have one here at the clinic, I literally get no sleep, which is saying something for a cat. Neither does the horse or my minions. This is a lot to take on at home, so think hard about your willingness to get up at midnight, and 2 am, and 4 am, etc. to go give your horse more eye meds. It will take over your life, so that’s why we encourage you to let us handle it for you. We have more people to share the load. 

One of the most important goals of treating an abscess is to control the inflammation. Once the inflammation is under control, the abscess has a chance to heal. Sometimes, medications will be injected directly into the conjunctiva or abscess itself to facilitate die-off of the organism and allow for healing to occur. These things can take 6 weeks or longer to heal. It’s a long hard road but, if it caught early and treated aggressively, they can heal, and sight can be normal.

If an abscess does not heal despite intense treatment, or if it’s been left too long without treatment, enucleation may be recommended. This is when the entire globe of the eye is removed. Sometimes enucleations are the best option for the horse and the owner, and sometimes it’s the only option.  

Lacerations

If you have ever owned a horse, then you’ve probably had a horse who has sliced his eye lid almost clean off. They find the most random places to do this too: screw eyes, bucket handles and hooks, double ended snaps, tree branches, horse trailers, fences, literally just about anywhere you can think of, a horse has lacerated his eye lid on it. You can be the most cautious owner in the world and your horse will still find a way to lacerate his eye lid. 

Looking at the lacerated eyelid, it might seem like a simple fix to just finish off the job and trim the flap off. Please, for the love of cats, do not do this! Your horse needs his eyelids! Their eyelids protect them from when they stick their heads in places they shouldn’t, they act as a lubricating system to the eye, and protect them from UV rays from the sun. Horses need their eyelids. Do not, I repeat, do not cut off their eyelids.

Always call your veterinarian if you notice a lacerated eyelid. The sooner they come out to fix it, the better. After a while, the flap will start to lose blood supply, and once that happens, fixing it may not be an option. When your veterinarian comes out, they will assess the damage, which 9 times out of 10 looks significantly worse than it is. They will sedate your horse, clean up the eyelid, and put it back together with sutures. They will also examine the eye itself to make sure there was no damage done to the eye. You will likely have instructions to apply topical antibiotic and administer anti-inflammatories daily. Sutures have to be removed after several days, as they can cause trauma to the eye if left in longer than directed. The best part about eye lid lacerations is, after your horse looks like he has been in a bar fight for a couple of days, you’ll barely notice anything ever happened and they heal up fantastically.

Eyes are the window to the world and your horse needs them just as much as you do. So, who are you going to call when your horse has an eye problem? YOUR VETERINARIAN! This cat could go on and on about eyes, so if you have any questions, please do not hesitate to call the clinic.

Until next week,

~Tony

P.S. If you want to really get deep into horse eyes, you should listen to the podcast the humans do. It’s called Straight from the Horse Doctor’s Mouth, and they have several in-depth episodes on eyes. You can find them here on the Podcast Page, or subscribe wherever you get your podcasts. Every horse owner should be listening to this fantastic free resource! In addition to reading my cat wisdoms, of course. Goes without saying.

When you’re the supervising feline of a veterinary clinic, you know the amazing lifesaving things that antibiotics can do. You also know what a CATastrophe it would be if we didn’t have them. Plenty of things make a cat grumpy, but few things ruffle my fur quite like misuse of antibiotics that might lead to antibiotic resistance!

Let me explain how antibiotic resistance works and how we can avoid it. Antibiotic resistance doesn’t mean that your horse’s body becomes resistant to antibiotics, it means that the bacteria no longer respond to the antibiotics designed to kill them. They ignore the antibiotic treatment and continue to grow and reproduce, making your horse’s infection worse. When the bacteria become resistant, the antibiotics don’t work anymore, and your vet is left with few options to treat your horse’s infection. Infections caused by resistant bacteria are difficult or even impossible to treat.

Anytime antibiotics are used, it can contribute to bacteria developing resistance. Usually, the benefits usually outweigh the risks when the antibiotics are used appropriately. But if used unnecessarily or incorrectly, it increases the chance of creating antibiotic resistance. These mistakes are really common, so be careful you aren’t making them. And this stuff applies not just to your pets’ antibiotics, but also for the ones your doctor prescribes for you. We need our antibiotics to keep working so my docs can keep saving lives!

Mistake Number 1

One of the most common mistakes many horse owners make is not finishing the entire course of antibiotics that their horse is prescribed. Here’s how it often happens… your horse is prescribed an antibiotic by a veterinarian, and you give it very diligently for several days. Then, you start noticing that he is improving, and you think, GREAT, the antibiotic is working and my horse is cured. Here is where the mistakes begin. 

It is extremely common for owners to see their horse improving and decide to discontinue antibiotics before they have finished the full course. DO NOT do this! Antibiotics are prescribed for a specific length of time. During this time the bacteria are being killed, which is why your horse begins to improve.

What happens when you stop antibiotics early is that some of the bacteria have not died yet, but they have been exposed to the antibiotic. When you stop the antibiotic, they start to reproduce again and the next thing you know, your horse is showing signs of infection again. When you see the signs return, you might try to start the antibiotic again. But this time, your horse does not improve. You call one of my docs out and they recommend a culture and sensitivity test which shows that the bacteria are now resistant to the antibiotic that previously worked on your horse’s infection. 

By discontinuing antibiotics before the full course was administered, antibiotic-resistant bacteria or “superbugs” are formed, and now the superbugs are reproducing. The superbugs recognize the first antibiotic and laugh at it when you try it again, as they have developed superpowers to prevent the antibiotics from killing them. Now we have a superbug that needs an even stronger antibiotic. Hopefully, this time, you have learned your lesson and give the entire course of prescribed medication. But sometimes it takes you humans more than once to learn your lessons! So you repeat the above scenario with stronger antibiotics, and a super-superbug forms. It isn’t long before there are no antibiotics left that the bug is susceptible to, and now your horse has a resistant infection that cannot be treated. 

Mistake Number 2

Mistake number two may be even more common than mistake number one. Do you have old leftover antibiotics lying around your barn somewhere? I bet if I cat-scanned your farm I would find some!

Here’s how it goes… You notice your horse has an infection and think, well, I have some of that old antibiotic in the tack room, I’m sure that it would be fine to treat my horse with that and I’ll save a little money. Never administer an antibiotic to your horse willy nilly! Even if it was once prescribed for him. ALWAYS call my docs first. You might think you’re going to save money, but this sort of thing often causes expensive and difficult problems that could have been avoided.

Different types of infections are caused by different types of bacteria. The bacteria causing your horse’s lung infection may be a different species than the ones that infect a skin wound. The antibiotic that will treat one kind of infection may not touch another. If you choose the wrong antibiotic, it not only wastes time and lets the infection get worse but is a great way of causing antibiotic resistance. Chances are you don’t know the right dose for that antibiotic either. So DON’T use what you have laying around the tack room, and DON’T buy something random at Tractor Supply. Don’t even get me started on expired antibiotics!

Mistake Number 3

Yeah, I know that it would be easier if you could just dump the antibiotic tablets in your horse’s grain and he would eat them all up. You don’t like giving them directly in his mouth, and neither does he. But what usually happens is that the horse picks through his grain and doesn’t like the taste, so he only eats part of the antibiotic dose. The bacteria are not killed when they are under-dosed – that only makes them stronger and more likely to become resistant.

The best way to make sure he gets the whole dose is to syringe it directly into your horse’s mouth. My docs will show you how and teach you tricks to get it done. Many of the common antibiotics they use can be dissolved in a little water inside a big plastic syringe and given just like a dewormer. You can even add flavorings like molasses to sweeten the deal. But your horse must receive his ENTIRE dose to avoid problems. If you find that you really can’t administer the antibiotics that were prescribed, my docs will find you another way to treat your horse and avoid antibiotic resistance.

Mistake Number 4

Sometimes people call asking for antibiotics to treat their horse and yet my docs have never even seen the horse. Not only is this illegal for my docs, it’s also very dangerous for your horse. If my docs prescribe your horse an antibiotic for an ailment that they have not examined your horse for, they are risking their veterinary license. Not to mention you are putting your horse at risk for developing antibiotic resistance. 

A common misconception is that all infections are treated the same. This could not be further from the truth. Some bacteria thrive in an environment without oxygen, some thrive in an environment with oxygen, others have super strong cell walls that require stronger antibiotics, and others are more easily treated. Even further, some infections are a mixed bag of multiple different bacteria. The only way for one of my docs to have any idea of what kind of infection your horse has is for them to see your horse. And did you know that viruses NEVER require antibiotics? Giving antibiotics for a viral infection just wastes money and creates antibiotic resistance.

I never want to find out what it would be like to live in a world without antibiotics, and neither should you. A lot of these problems we’ve talked about are avoidable simply by making sure you have a veterinarian examine your horse prior to treatment, following your vet’s orders, and calling them if you are having trouble with the prescribed treatment. The future of equine healthcare, cat healthcare, people healthcare, and every other kind of healthcare depends on it!

Until next week,

~Tony

P.S. Have you been to my YouTube Channel lately? I’ve got hours and hours of free horse knowledge waiting for you there. It’s way more beneficial than bingeing on Netflix, and easier to share with your friends: win-win!