Horse Eye Problems

Horse Eye Problems

Tuesdays with Tony

By now you already have it marked on your calendar to attend this month’s meet and greet with yours truly. Of course, if you don’t, here is your friendly reminder that this Thursday, May 2nd, 2019 at 6:30pm I will be hosting the world-famous ophthalmologist, Dr. Dennis Brooks. So when you come, you not only get to meet the world’s most famous cat, me, you also get to meet him and ask him all your burning questions about eyes. And I’m here to prep you with a quick tidbit about all the eye problems your horse may, and likely will, encounter during his lifetime.

 

Superficial Corneal Ulcers

 

Probably the most common eye condition my docs see in horses is superficial corneal ulcers. What does that mean, you ask? Well, that means that your horse probably did a silly horse thing like scratch his face in a bush, or roll in dirt and then rub his eye on his leg. When he did that, he caused damage to the epithelium (thin tissue layer) of the cornea leaving the layers below exposed to the elements. Luckily, most horses are giant wimps and will let you know right away that they have hurt their eye. You may notice your horse squinting more, tearing, or even some swelling of the eye lids.

 

Once you call my docs and they come out, they will perform a full ophthalmologic examination of your horse’s eye. This will likely include sedation as well as nerve blocks to make the eyelid less difficult to open. They will then use an ophthalmoscope to examine the surface of the eye as well as the back of the eye.  Then they will stain the surface of the eye with fluorescein stain and that is when you will see it, the dreaded yellow spot on the surface of the eye indicating that there is a defect in the corneal epithelium and thus a superficial corneal ulcer has formed.

Springhill Equine Veterinary Clinic

Once my docs see this, they will prescribe certain topical medications as well as systemic NSAIDs. That’s where your job begins. You’re going to be very diligent and apply medications twice a day, if not more, depending on what my docs tell you. If you are lucky, the ulcer will be healed within a week and your job will be done. Unfortunately, that is not always the case, and some ulcers just do not heal no matter how diligent owners are. That is where I come in. The docs are going to recommend you bring your horse into me at the clinic where I will oversee the docs placing a subpalpebral lavage system in your horse’s eyelid which will allow for more frequent application of topical medications without having to manipulate your horse’s eyelid. I will also ensure that my staff is administering medications to your horse every 2 hours while he is hospitalized. This is great for me, as I get treats and pets every time someone comes in to treat your horse.

 

On occasion, even with increased medications and the SPL, ulcers may not heal and my docs will have to deride the cornea.  I am a bit of a squeamish cat so I usually find a nice warm place to nap when this happens, but from what I have heard around the clinic, this is when the docs take cotton swabs and try to remove corneal epithelium that is not healing and preventing the ulcer from healing.

 

If, after debridement the cornea has not healed, my docs will probably call in the experts like Dr. Brooks or Dr. Mangan. Everyone at the clinic always gets so excited when the ophthalmologists are coming, though I have yet to figure out why. When the experts come, they will assess the eye and tweak my doc’s plans. They may perform other diagnostics and adjust your horse’s medications. I even heard that horses may sometimes require contacts. I have perfect 20-20 cat vision so I wouldn’t know what it is like to have contacts. My docs tell me a horse having a contact is not the same as humans, but instead the contact acts as a protective barrier on the cornea to encourage ulcer healing. As you can see thus far, eyes can be a giant pain in my kitty rear-end, so remember, if you notice your horse showing signs of eye problems, call the clinic ASAP and get my docs on the job.

 

Stromal Abscess

We all live in Florida for a reason, the warmth! There is nothing better than laying on the hood of the doc’s trucks and taking a warm sun bath, ahhhhh I love Florida! Unfortunately, horse eyes do not have the same love for Florida that I do.  The heat and humidity here make for an excellent breeding ground of fungi and bacteria, which also means that your horse’s eyes are at an increased risk for developing stromal abscesses. This is when the fungi or bacteria find a tiny little defect in the cornea and work themselves into the deeper layers of the cornea. The defect heals without you even noticing any problems and then a few days later you come out and see that your horse is squinting, has a lot of tearing from his eye and is very, very painful.

 

You’ll call my docs out and they will perform their usual ophthalmologic examination. Except this time they will not find an ulcer. Instead, they will see a white dot somewhere below the corneal surface. This is the result of the body trying to combat the fungi or bacteria that has gotten into a place it shouldn’t be. Stromal abscesses are even more difficult to treat, and my docs will almost certainly place an SPL and start your horse on multiple medications including anti-fungal medications. You will probably decide that you want to bring your horse in to me for treatment so that you are not having to get up at all hours of the night to treat your horse. Of course, I will always oblige and love to have the company, the more the merrier, right?

 

Stromal abscesses take what seems like forever to heal and sometimes even require surgical intervention. My docs do not perform corneal surgery; that’s when they call in the experts again. Even after surgery, stromal abscesses take a lot of care and time, but in the end they are rewarding when all your hard work has paid off and you horse’s eye has been saved.

 

Equine Recurrent Uveitis

Equine Recurrent Uveitis an immune mediated disease. I have diabetes, but that’s not an immune mediated disease, that’s just because I used to be a fat cat.  Immune mediated means that the horse’s body is attacking its own cells, in the case of ERU, the horse’s body is attacking its eyes. Eeek!

 

ERU is a common cause of blindness in horses and is a painful disease. You will notice that your horse’s pupil is very small at all times, even in the dark, they will likely be squinting, and may have tearing. You may also notice that your horse’s eye appears to be smaller. ERU can affect one or both eyes and is most common in Appaloosas but can occur in any breed of horse. If ERU is left untreated, your horse’s retina may become detached or a cataract may form in the lens of the eye.

 

My docs will assess your horse’s eye and usually will see that his eye is smaller, they may notice that there are blood vessels surrounding the cornea and the eye may be cloudy.  They will recommend treatment that will include immunosuppressants topically and sometimes systemically. They will also put your horse on systemic NSAIDs for pain control. Some horses require lifelong treatment and may require surgery to place an implant that releases immunosuppressants slowly over time. The goal with treatment is to decrease the number of times medications are administered to the fewest times possible while maintaining your horse’s comfort.

 

By now, you’ve listened to me, and you’ve listened to my docs and you know that if you notice any of these signs or symptoms, you will call the clinic or emergency line because, remember, eye problems are always an emergency!

 

These are by no means the only eye problems that horses have. In fact, I’ve only just begun to scratch the surface of problems. But I have been up for more than 5 minutes now and must nap before I prepare for my next nap. So, if you want to hear more about eyes from the expert, come out to see me on Thursday night. Remember you can always watch the seminar on Facebook live or later on my YouTube channel.

Until next week,

~Tony

P.S. If you want to know more about equine eyes, make sure you check out the podcast my docs put out. It’s called Straight from the Horse Doctor’s Mouth. The episode on eyes is ah-mazing 😉

Tuesdays with Tony is the official blog of Tony the Clinic Cat at Springhill Equine Veterinary Clinic in Newberry, Florida. If you liked this blog, please subscribe below, and share it with your friends on social media! For more information, please call us at (352) 472-1620, visit our website at SpringhillEquine.com, or follow us on Facebook!

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The Curse Of Knowledge

The Curse Of Knowledge

Tuesdays with Tony

My humans have been worrying about the future a lot this week. The weather people say it’s going to get cold (no one seems to remember how often they’re wrong), and with cold weather comes colicky horses. That got me thinking, so this week I asked Kayla, Nancy, Beth, and MJ what they worry about more now that they’ve worked here and seen all the things horses really can do to themselves. After all, they see hundreds of horse problems every year, so they have plenty to worry about with their own horses. We call that the Curse of Knowledge. Here’s their Top 5 list.

#1 Eye ulcers

Maybe you’ve had the Docs come out and put some of that fluorescent green dye in the eye. Then they tell you to use a few ointments 4 times per day, give some Bute or Banamine, and they come back out to check it again in a few days. Lots of eyes heal perfectly well this way. The ones that don’t, however, are the ones my team worries about. My minions have all had the joy of treating ulcers in eyes. They say what makes this one Number 1 on their list is that everything can be done absolutely perfectly, and things can still go bad. These ulcers are also very expensive and extremely time consuming. Treatment very quickly goes into the thousands of dollars, and is a minimum of 4 weeks. My minions also agree eye problems are a great reason to have major medical insurance on your horse!

#2 Very specific lacerations

Last year we had a weanling come in with a very small cut over her hock. She was an extremely well-bred barrel horse. Turns out that small cut went into the hock joint. It looked like no big deal, but because of the location, it was life-threatening. That’s right: life-threatening. Wounds in joints can very easily lead to infections in joints, and infections in joints are extremely difficult to clear in horses. Luckily, with about $5,000 in treatments, my Docs were able to get this one cleared up. MJ was horrified at how small the wound was, how easy it was to overlook, and how bad it all could have ended up. She says she’ll never take a wound for granted again! We all know horses are incredibly fragile, but MJ was amazed to see it action. Also, yet another reason to have major medical insurance on these crazy horses.

#3 Colic

This one had to be on the list. However, my minions said they view colic very differently than they did before working here. All colics used to scare them. Now it’s the colics that don’t respond quickly to drugs. Then they go into full on panic. You see, most colics get some sedation and a little pain relief, a whole lot of water and electrolytes, and off they go. It’s the ones that get painful again very quickly that scare my minions. Too often those are surgical colics. Even if they aren’t surgical, they do require lots of fluids, pain meds, and care. These colics are always touch and go for a bit. And yet another reason to insure horses!

PS on this one: coastal hay is the number one cause of colics. You can feed coastal to your horse, but please, please, please also feed some alfalfa or peanut hay!!

#4 Tendon Injuries

You pick up the trot one day and something doesn’t feel quite right. You wait a day or two and try again: still not right. My Docs come out and do a lameness evaluation, put some novocaine in different parts of the leg until the lameness goes away, and then do an ultrasound. You know you should be worried when the Doc gets “that look” on her face. She tells you it’s a proximal suspensory tear. Why do my minions fear this diagnosis so much? They know it’s a minimum of 6 months of rehab work before we even know if things are going to be back to normal. They know with some of these small tendons and ligaments (like the oblique sesamoidean) that it is nearly impossible to get the horses back to normal. They also know that the best shot for healing comes with extremely diligent physical therapy work, and most people don’t do so well at that part.

#5 Lay Tooth Floaters

I saved this one for last, but it should probably be higher on the list. There are lots of people out there who will “do your horse’s teeth” for not a lot of money. You get what you pay for. Unfortunately you also often get much, much less than you pay for. My minions have seen broken teeth, missed tumors, infections caused or made worse, and, simply put, really bad floats done. Even worse, many lay floaters sedate horses which is AGAINST THE LAW. My Docs went to school for a really long time to know all the things that can go wrong when they sedate a horse. They drive around with a truck full of stuff to manage problems if things do go wrong. My Docs have the knowledge to understand how that little thing they see can be an indicator of BIG problems. I can’t be any clearer: Lay floaters are not a good answer for your horse’s health. Dentistry should be done with bright lights, sedation, a speculum, and a doctor.

Want to know how to keep your horse safe in a scary world? Communicate! My Docs and minions are here to help you. Send pictures, call, email in questions. From abscesses to zoonoses, they’ve got you covered. Now I’m headed for a long winter’s nap.

Tuesdays with Tony is the official blog of Tony the Clinic Cat at Springhill Equine Veterinary Clinic in Newberry, Florida. If you liked this blog, please subscribe below, and share it with your friends on social media! For more information, please call us at (352) 472-1620, visit our website at SpringhillEquine.com, or follow us on Facebook!

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Eye Injuries

Eye Injuries

Tuesdays with Tony

As we get into the Christmas spirit, it seems horses can sense the strain on your wallet from all that shopping. As a cat I’m a little more conscientious about such things, of course, but horses get some sort of evil pleasure from making their owners squirm.

 Every Eye Injury is an Emergency

If you are a horse, one easy way to rack up a big vet bill in a short amount of time is by poking something in your eye. Remember that eye injuries are always an emergency, and the more time that passes before the right medication is initiated, the more expensive they can be to treat.

Corneal Ulcer

This is the most common eye injury in horses, but it can be just the tip of the iceberg. The cornea is the clear outermost layer of the eye that you see through. Puncture wounds, abrasions, and other forms of trauma can cause a break in this layer. Usually these “simple” ulcers will heal just with a few days of triple antibiotic ointment. However, any break in this protective outer layer creates the opportunity for infection. Uh-oh.

Stromal Abscess

When a corneal ulcer gets infected by any of the bacteria or fungus that exists in our lovely Florida soil, it becomes a ‘complicated’ ulcer. What often happens at this stage is the outer layer of cornea heals over, trapping the infection beneath. This is called a stromal abscess, which takes on average 8 weeks of medicating the eye 4 times a day to heal! No fun. A Stromal abscess can often be prevented by early treatment of a Corneal Ulcer. That’s why all eye injuries are an emergency! That, and….

 Iris Prolapse

Certain types of fungus that can infect corneal ulcers actually cause the cornea to ‘melt.’ The fancy medical term for this is keratomalacia, which would be great to use in a game of Scrabble! Melting corneal ulcers are the worst of the worst. If left untreated, they can cause iris prolapse, or rupture of the eye. It is every bit as gross as it sounds. Basically, the ooey gooey insides of the eye leak out through the hole in the cornea, until the iris (the part that gives the eye it’s color) blocks the hole. This requires emergency conjunctival graft surgery or enucleation (removal of the eye) to treat. This is definitely not something you want to make your horse endure due to your inaction.

An Ounce of Prevention

You can’t really protect your horse 100% from everything, because they’re a lot like cats in their ability to find a way to cause mischief. However, you can go a long way towards preventing eye injuries (injuries in general, really) by doing a few simple things. First, make sure they don’t have something sharp to scratch on. Check your stalls and fences regularly for nails and broken boards. Broken tree branches are another favorite scratching point. Also, don’t put your horses out with things like rusted-out car bodies, tractor implements, falling-down structures, and things like that. Just because your neighbor’s horse made it in that type of environment for 20 years is no guarantee that yours will.

A quality fly mask can also prevent many eye injuries. Gnats and flies are a major cause of itchy eyes, so keeping them away is a huge help. The mask itself will also keep most scratching sessions from becoming eye injuries. It’s a lot cheaper to buy a new fly mask every year than it is to treat an eye injury. Do your horse (and yourself) a favor, and cover it up!

The moral of the story

If your horse has a squinty, tearing, swollen, or otherwise weird-looking eye, don’t waste any time getting one of our amazing docs to check it out! Quick treatment can make a huge difference in whether or not your horse loses an eye, and it can also be the difference between hundreds of dollars and thousands of dollars. I’m a professional risk-taking cat, and I’m here to tell you: Don’t take risks with your horse’s eyes! There’s nothing to gain, and everything to lose.

Until next week,

-Tony

 

Tuesdays with Tony is the official blog of Tony the Clinic Cat at Springhill Equine Veterinary Clinic in Newberry, Florida. If you liked this blog, please subscribe below, and share it with your friends on social media! For more information, please call us at (352) 472-1620, visit our website at SpringhillEquine.com, or follow us on Facebook!

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Tuesdays with Tony – Cancer Awareness

Tuesdays with Tony – Cancer Awareness

As I look forward to fall, I notice that October is Breast Cancer Awareness month, No-Shave November (Movember) is for Prostate Cancer, but what about the horses? Equine Cancer is a thing too, but I don’t see anybody giving horses their own cancer awareness month! What gives? Well I, the honorable Tony, am officially declaring August to be Equine Cancer Awareness month! And my first act to raise awareness is writing this blog.

 
Like other species, horses are susceptible to many different types of cancer. The most common in horses are melanoma, sarcoids, squamous cell carcinoma, and lymphoma. I’m a cat, so I like to keep things simple. Basically if you are a grey horse, you are going to get melanomas. If you are an Appaloosa or Paint horse with white around your eyes, you are likely to have squamous cell. If you are an unlucky horse of any other color, you could end up with a sarcoid or lymphoma.

 
If you own a grey horse, you probably already know what melanomas look like. They are usually firm, round grey nodules that commonly occur under the tail or around the external genitalia. Luckily I make it a point to spend at least 5 hours a day grooming my external genitalia, so I would be sure to notice a melanoma right away. Small melanomas are usually benign, but as they get bigger and the horse gets older, they are more likely to become malignant. But have no fear- there are new treatments becoming available!

Oncept, a vaccine that has shown promise against canine melanoma, is now being studied in horses. Now, why you would want to prolong a dog’s life is beyond me, but I guess not everyone can be a cat person. Oncept is going to cost you a pretty penny too: about $4,000 for the initial course of treatment. In addition to Oncept there is an autologous vaccine (that’s a vaccine made from the horse’s own cells–aren’t you impressed I knew that?) in clinical trials.

 
Sarcoids come in many forms. They can be flat, bumpy, warty, or a mixture. They can show up anywhere on the body. Depending on their location, they usually don’t pose much of a threat, just more of a nuisance. Kind of like me lying in the doorway so everybody has to step over me when they walk through the door. However, the smaller they are, the easier to treat. One treatment for these pesky tumors is a cream called Aldara (aka Imiquimod- say that 5 times fast!) There is also an herbal cream called Xxterra that has shown success in shrinking sarcoids.

 
Squamous cell carcinoma is not as friendly. As mentioned, it tends to occur on and around the eyes and eyelids of light-skinned horses, and sometimes on their private parts too. This form of cancer is aggressive and difficult to treat. Chemotherapy with 5-Fluorouracil or Cisplatin, radiation, and enucleation (removal of the eye) are the most common treatment modalities. Boy, I can’t wait to play cat Scrabble with Teanie this weekend. Fluorouracil, how many points is that?!

 
Last but not least, horses can get lymphoma too. Just when you thought colic and laminitis were the only things horses could die from. Lymphoma is sneaky. It is usually impossible to diagnose until a large tumor has already grown internally and spread to other parts of the body. Weight loss and lethargy are often the first sign. Bloodwork usually doesn’t show any striking abnormalities. Sometimes a mass is identified by ultrasound or rectal exam, but most often it is a diagnosis made via the process of elimination.

Lymphoma is sad because it is usually fatal within a few weeks to months. Treatment with steroids and chemotherapy is being studied at UC Davis vet school, but it is going to cost you a lot of Meow Mix for that big of an animal. Hence why we need to raise Equine Cancer Awareness to fund new research!
So class, what have we learned from exceedingly wise, supremely intelligent, impressively well-educated Tony today? Cancer in horses does happen! It doesn’t always carry a poor prognosis for a long and happy life, but treatment options are few and very costly. We need to raise awareness of equine cancer in order to further research into new treatments for this malady!

 
Now that I’ve exhausted myself with all this knowledge, I must get back to my nap!

Until next week,
– Tony

Tony in bed

Tuesdays with Teannie – Eyes

OK, I have had enough of Tony this and Tony that.  I’m taking over this week.  Welcome to Tuesdays with Teannie.  That’s right, I’m the cuter and smarter cat at Springhill Equine, and this week I’m writing about eyes.  I should point out I don’t have any, but that story is what makes me qualified to write this week’s blog.

I started life with two normal eyes.  Along the way I got infected with a Herpes virus.   Herpes is the same virus that causes rhinopneumonitis in horses.  In horses and cats this usually presents as a bit of a cold.  Sometimes it goes elsewhere and causes all kinds of problems.  In horses, it can also cause abortions in pregnant mares and a neurologic disease.  In cats, it can cause the immune system to attack the eyes.  This is what happened to me.  It took years and years, and Dr. Lacher tried pretty much every treatment available, but eventually they couldn’t save my eyes.  Along the way I have become an expert in eyes.

I’m going to start with the obvious.  If there is redness, swelling, or a lot of tears, call Springhill Equine.  These are pretty good indicators of a problem, and the earlier a problem is addressed, the better the outcome (I lived on the streets for a while just trying to keep a roof over my head, so don’t judge me that I didn’t get proper care).  To start, our Docs are going to use a special device called an ophthalmoscope to look in the eye.  They claim this is to get good light and magnification.  Personally, I think they like shining a bright light in my eye to torture me.  I get back at them by standing in front of computer screens and stepping on keyboards.  Next a special stain called flourescein is put in the eye.  This stain shows if any of the surface layer of cells is gone.  You want a negative flourescein result.  Negative here means all is good.  Positive means you have long nights and days, or your horse has an all-expense-paid trip to Springhill Equine.

With their big bug eyes set on the side of their heads and their propensity to stick their heads where they don’t belong and then get scared, horses are very prone to ulcers.  So that’s problem number one with horse eyes.  Next, we live in Florida and we grow fungus here.  Put bug eyes and fungus together and chaos follows.  This is why if you call with a question about an eye, our Docs freak out a little bit and move the Earth to get you on the schedule that day.  All eyes get treated like they have a bacterial and fungal infection, no matter what.  They also get a wee bit obsessive-compulsive about rechecking the eye to make sure it’s going to the right direction.   Treatments are sometimes done every hour!

Sometimes horses, and let’s be honest, cats, are… umm…  difficult to treat.  Eye treatments sting! The Docs have a few tricks up their sleeves to help.  They always give horses (and this cat) treats with EVERY eye medication.  They also have a device called a sub-palpebral lavage system.  Using a really, really big needle, they put a long tube through the eyelid which lets you stand at the withers to inject medications which are then delivered to the eye.

If the worst happens and the eye can’t be saved, then a procedure called an enucleation is performed.  This is the fancy word our Docs use for taking the eye out.  Here’s where my experience comes in.  Please do not worry about your horse missing an eye.  I lost my left eye first and certainly didn’t miss it a lick.  In fact, without the constant pain, I was loving life.  I would run around and attack Tony, chase my tail, and knock papers off the desk.  When my right eye began hurting, I was back to moping around the clinic.  Dr. Lacher decided to let me slowly go fully blind so I could better adjust to life with no eyes.  Once they removed my right eye, I was right back to running this joint.  I still stalk Tony, I still stand directly in front of the computer screen, I know exactly where the escape key is on the keyboard, and I am loving life as the smart cat at Springhill Equine.  Moral of this story:  if you think something is wrong with your horse’s eye, call Springhill Equine!