Melting eye ulcers - want your experiences

Discussion in 'Horse Management' started by Ebza, Aug 20, 2014.

  1. Ebza

    Ebza Active Member

    I haven't posted on here in years! But I'm desperate to find someone who has had experience with these nasty eye ulcers. My horse has been being treated since Friday but isn't responding to the antibiotic drops we have been using. My options now are:

    1) surgery to put grafts in - VERY expensive! But I would like to know how people's horses recovered and the results. She is expected to lose up to 40% vision if we do this.

    2) let the eye rupture and continue treatment. This is going to take a long time (1-3 months). Apparently the eye can heal itself and providing there are no further problems this can be done. If she is in too much pain or not healing then eye will have to be removed. My concern is having to put my poor old girl through the pain and prolonged treatment - she's not happy being locked up and would be looking at weekly vet trips (this costs approx half as much as the surgery to fix it IF it heals within a month, continual treatment means continual cost. Also similar cost for one month treatment as to remove the eye).

    3) remove the eye (half the cost of surgery to fix it and same price as one months treatment).

    What would you do? I would love to hear the good and bad about either surgeries. My horse is 21yrs and already sour about being treated and locked up.

    Any advice appreciated.
     
  2. Satins mine

    Satins mine New Member

    I have been out of vet nursing for ten years so there are probably different ways of treating things now. But back then treatment for awful eye ulcers could include stitching the third eyelid across and then stitching the main eyelid closed. Additionally a lacrimal cannula can be put in place to ensure the best delivery of top notch drugs to the eye.

    I don't know if these things have been tried.

    Personally I think you need to research all you can and make the decision you need to make. If she is going stir crazy already you want to get her out of that stable as soon as you can.

    I don't envy you the choices you have to make
     
  3. Ebza

    Ebza Active Member

    Thank you. I'm not sure - there has not been any mention of stitching the eye shut... She has a lavage (think that's what it's called - the tube in her eyelid) to help with the administering of meds - thank god as she has been on 2 hourly antibiotics since Friday there's no way I would have been able to do it without it!

    The only thing I'm thinking is maybe that isn't an option as it is not responding (actually continued to get worse) to antibiotics.

    I must say I wouldn't with this upon my worst enemy! Probably one of the hardest decisions of my life and the last thing I want to do is remove the eye of a horse that can be fixed but then so far I haven't heard great things about the surgery to fix it. And I was something done ASAP as she's in pain (even on painkillers seems uncomfortable). I am taking her for walks 3 times a day but can't risk her rubbing or catching the tube on something.

    Thanks again I appreciate the response :)
     
  4. irisis

    irisis New Member

    A girl I agist with had this very same problem with her gelding this year. She ended up having the eye removed and they haven't looked back.
    She rides him out on trails and is starting to do dressage on him too. He's recovered so well and you wouldn't even think he was missing an eye.
     
  5. kp

    kp Well-known Member

    Nothing wrong with a second opinion in these circumstances. Who is the current vet?
     
  6. Satins mine

    Satins mine New Member

    Get a second opinion and ask about stitching the eye shut. There may be reasons they don't do this now but the old vet I used to work for saved many an eye doing it. It was explained to me that every time the horse blinks it rubs off a layer of cells on the cornea. By stitching the eye shut it prevents this and saves the eye. It also eases the pain.

    Please do ask about it. It's such a simple low cost procedure and I have seen it work in my nursing days.

    good luck
     
  7. Ebza

    Ebza Active Member

    Thank you.

    I will question it at the vet tomorrow.

    Current vet is Valley Equine Clinic. She has been seen by 2 of there vets and a specialist all have said the same :(

    At this stage she is going to the vet tomorrow and more than likely having the eye removed tomorrow. I can't stand seeing her in so much pain - even on pain killers she's not doing well! Was really looking for anyone that has done the surgery to fix it.

    Thanks again! Appreciate the advice everyone
     
  8. Satins mine

    Satins mine New Member

    Ok sounds like you have experienced people but do still ask. Questions never hurt and sometimes help a lot. Good luck for tomorrow.

    I worked at a stud with a one eyed horse many years ago. She had a nanny ( gelding ) who looked after her but she was pretty independent. You just had to be careful approaching from her blind side by making sure you talked to her
     
  9. horse girl Jess

    horse girl Jess Well-known Member

    It is generally not recommended any more because you cannot see the response to treatment with the eye closed and we now have better options (e.g. the grafting).

    If you don't have any concerns about cosmesis then an eye oblation provides immediate relief, ulcers are horrible, painful things in the eye :( I think the options that the 2 vets and the specialist have given you are all good options and it sounds like they've been proactive at trying to treat it aggressively with medical means first before recommending surgery.

    Best of luck with your choice :)
     
  10. Angimac

    Angimac Well-known Member

    Ebza hope everything went well with your horse.
    It is probably too late but I did a quick google and got a snapshot from some USA websites.

    Vetlearn.com "if keratomalcia (melting) is observed anticollagenase/antiprotease therapy, such as autologous serum".

    The Horse.com magazine "Anti-Melting Therapy
    Prevention of collagen breakdown and ulcer progression is also important in ulcer therapy. Enzymes derived from white blood cells in the tears can be powerful forces in the destruction of the corneal stroma, and can cause rapid deepening of ulcers. Topical corticosteroids increase this damaging enzyme activity and should not be used in the treatment of corneal ulcers.

    Serum from the blood of the horse contains proteins with anti-melting activity. Blood is drawn from the horse or foal, spun down, and the serum drawn off and stored in an eye dropper for use as medication. Serum can be placed in the eye hourly for melting ulcers in horses. Ethylenediaminetetraacetic acic (EDTA, a chelating agent and anticoagulant at 0.2%) can also be administered several times a day as eye medication to reduce corneal melting. Acetylcysteine (5-10%) is used topically for its melting enzyme-inhibiting properties. It must be kept refrigerated and the horse treated every one to two hours."
     
  11. Satins mine

    Satins mine New Member

    Thanks horse girl Jess. Medical techniques do change with time and no doubt the newer treatments are well researched.
     

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