Strangles

Strangles

Streptococcus equi (S. Equi), also known as Equine Distemper, is a highly contagious, debilitating disease.  It has the ability to quickly pass through a stable or farm and the after effects can be long withstanding.

Because strangles is so contagious, it is important for horse owners to understand mechanisms of this disease so it may be diagnosed and treated before passing through an entire herd.

S. Equi bacteria can survive an unknown length of time and is spread via pus, draining lymph nodes, coughing, direct nose-to-nose contact and even by flies. It has the ability to survive an unknown length of time.

While infection most commonly occurs in horses which travel frequently or in large herds with a high rate of new horses rotating in and out, it can be picked up by a single trip off the farm at any place horses congregate such as a weekend trail ride or small playday.

Once the horse picks up the bacteria, it enters into regional lymph nodes. Lymph nodes become enlarged and can lead to the trachea or pharynx becoming compressed, causing labored breathing, thus the term “strangles.” Swallowing also becomes painful.

There is a three to eight day incubation period in which the abscesses form. Once the abscesses rupture and drain, there is a two to three week recovery period. Typically, the horse will remain infective for weeks, and a small number can be infectious for years.

The most common signs include fever, nasal discharge (which may be green, yellow or white), loss of appetite, anorexia, depression, cough and swellings, usually on the underside of the jaw. This swelling is the result of abscess formations on the lymph nodes due to pus accumulation.

Abscesses on lymph nodes in the throat area can burst into the guttural pouches, resulting in the nasal discharge. This pus, which is thick and yellow, is contaminated and spreads the disease.

The horse may stretch out his head and neck to relieve pressure caused by the swollen lymph nodes.

There are additional forms of strangles which can afflict the horse. When lymph nodes outside the head and neck are affected (i.e. chest or abdomen), the form is referred to as metastatic or “bastard” strangles. This may be seen in horses which have an abbreviated illness, have partial immunity to this disease, or if a less virulent strain has been contracted (catarrhal form), with minor or no lymph node abscesses seen. 

In addition, strangles can also cause immune complexes which can lead to blood vessel damage (called purpura hemorrhagica). Horses with this may have limb and head swelling, circulatory failure and death.

Severe cases of S. Equi may result in death or require euthanasia. It should be noted that while death from strangles is rare, higher incidences of death are seen in horses with cases of bastard strangles.

All ages are susceptible, however, foals and yearlings are most likely to be affected due to a developing immune response. Not all horses which are exposed become infected. This depends on the amount of bacteria the horse comes in contact with, his immune status and other conditions (stress, nutrition, pre-existing illnesses).

If strangles is suspected, call your vet. The sooner diagnosed, the sooner measures may be taken to prevent further spread through the herd. Diagnosis is made via clinical presentation and culturing the pus. Horses which chronically shed the bacteria are more difficult to diagnose.

The vet will tailor a treatment plan specific to the individual horse. Treatment consists of Bute or Banamine for fever, antibiotics, flushing the abscess with Betadine solution, and keeping the area clean. The abscesses may be lanced or a tracheostomy performed to facilitate better breathing. Guttaral pouches may be flushed to promote drainage of the pus.

Prevention is, of course, key. Do not allow your horse to nose or come in contact with horses outside of his normal herd. Incoming horses should be isolated 2-3 weeks before introducing into the herd. Temperatures should be taken at least once daily. Vaccinations are available, but there are pros and cons for their use. Infected horses should be isolated for six to eight weeks.

Most horses recover within seven to 10 days from onset. There are usually no long term after effects. Complications can occur, and they include myocarditis (inflammation of the heart muscle), cellulitis, roaring, anemia, and pus filled guttural pouches.

Management is crucial to control the effects of S. Equi. Stringent protocols should be implemented to prevent cross-contamination of tack, buckets, water troughs, brushes and bedding. If possible, affected horses should be housed in a stall with concrete walls and floor for easier disinfecting. Keep in mind S. Equi can survive for several weeks and ultraviolet light can kill S. Equi bacterium.

There is a test available to determine carriers of strangles. 

Muscle Problems

Tying Up

Tying Up has been plaguing horse owners for centuries. Known also as azoturia, Monday Morning Sickness, extertional rhabdomyolysis (ER) and myoglobin, this syndrome occurs when a horse suddenly becomes stiff, sweaty and reluctant to move. He may have pain which originates in the back, pelvis and hind limbs. ER is not one disease; rather it is several different diseases with similar signs and different causes.

There are many causes and it is quite misunderstood as to the exact reason horses contract ER. It used to be believed lactic acid caused it but further research is necessary before a specific cause is pinpointed. What is known is that there is a defect in calcium regulation and how it is pumped back and forth into the intercellular storage.

ER can be either sporadic or chronic in nature, and often can be seen in horses which have a diet lacking selenium and Vitamin E.

Cases seen sporadically are usually due to exercise overload, electrolyte depletion or nutritional imbalances. Sporadic episodes respond well to rest, a balanced diet and a gradual return to training.

For others, ER is a chronic issue.

All breeds can be afflicted, but Thoroughbred and Quarter Horses tend to have a higher percentage of cases. There is a common belief ER in Thoroughbreds initiates in the way calcium is regulated by membrane systems in skeletal muscles.

Mares and fillies are most commonly affected, mainly due to their nervous and high strung nature. Your vet may recommend a progesterone regimen to control her heat cycles and offset some of the nervousness.  

This disease may be dormant until the regulatory system malfunction is triggered by any number of causes – stress, excitement, lameness, diets high in grain, and an excess amount of speed while exercising.

An episode of ER may find the horse with pain originating in the back, pelvis and hind limbs. The horse may be in so much pain he refuses to walk. He may exhibit signs similar to that of colic like sweating, and increased heart and respiration rates. Dark red urine is also indicative of tying up, as protein is released from damaged muscle cells and excreted in the urine.

Diagnosis is determined through clinical presentation and also through routine bloodwork. An elevated level of creatine kinase (levels five times above normal) is a good indicator of a horse with ER.  

It is vital to determine the horse whether or not the horse tied up. It may be mistaken for a fracture, laminitis, neurological conditions, poisoning or plant toxicity.

Mild cases can often be difficult to diagnose because the horse may only seem stiff or off. Serious cases need to be diagnosed immediately because massive amounts of muscle damage can cause kidney failure and even death, though rare.

Treatment consists of Acepromazine, Bute, IV DMSO and other fluids.

Dantrium is often prescribed for horses which chronically tie-up. It should be administered prior to exercise.

If you suspect your horse is tying up, immediately stop exercise and move him to a stall. Don’t force him to walk. Call the vet. If it is cool, blanket him. Offer small sips of water if the horse is dehydrated due to sweating. Administer Acepromazine as directed by your vet to relieve any anxiety or pain. Remove feed and give hay until signs subside.

It is a good idea to keep the horse confined in the stall for a few days after the episode. Handwalk daily and turnout once the stiffness is alleviated.

Your vet should work to determine the cause of the ER as an aid to the future. This will be a process done over time, with careful monitoring of exercise, diet and tests such as muscle biopsy.

To keep episodes of tying up at bay, try to minimize stress and excitement in the horse. Adjust his diet to minimize carbohydrates (less than five pounds per day of sweet feed), and add fat.

Commercial feeds such as ADM Senior Glo or ADM Grostrong Ultra Fiber can benefit horses which need a low carb, high fat diet. Balance this type of diet with good quality hay and a vitamin/mineral supplement. All of these work to decrease muscle damage with exercise.

In nervous horses, it will be especially important to establish a routine and gradually increase exercise. These horses may benefit from daily phenytoin (Dilantin  – an anti-epiliptic) or Dantrium. Not all horses which tie up are candidates for prophylactic treatment, however. Your vet will determine if this type of therapy will be beneficial to yours.

You vet can also help create a preventive management plan for horses who chronically tie up. Regular exercise and gradual increases in training, minimizing stress, establishing a daily habitual routine, special diet, and medication can all aid in management of this disease.

             

Seasonal ER

Tying up also is a seasonal affliction. Referred to as pasture myopathy, this non-exercise induced form of ER is believed to be caused by a toxin found in white snakeroot. It is often seen in the fall after inclement weather, as the change in the weather causes plants to store both nutrients and toxins in higher concentrations as a defense mechanism against the elements. The toxin causes an undesirable taste but in a scarce food situation, some horses may consume it.

Seasonal tying-up episodes can progress rapidly, and without aggressive diagnosis and treatment, can be deadly. It is important to supplement with hay once the availability of grass becomes limited to aid in prevention of this disease. 

Cribbing in Horses

Equine vices are a battle for stable managers and horse owners alike. Thoroughbreds in particular seen to be prone to cribbing and as much as 10-15% of domesticated equines may exhibit these obsessive compulsive disorders, of which cribbing heads the list.

Annoying, financially and aesthetically destructive, and hazardous to the horse’s health, cribbing (aerophagia), also referred to as “wind sucking”, can be caused by boredom, anxiety or stress and can be seen in horses confined for long periods at a stretch.

During the act of cribbing, the horse grasps the surface of choice with his front teeth, flexes his neck and draws air into the throat.  A grunt will be heard. It is commonly seen in stalls and fencing but anything at chest height can be targeted. It is a different syndrome than wood chewing (in which no air is sucked), and the horse may actually spend more time cribbing than eating.

It is thought a lack of social interaction or lack of grazing/turnout may contribute to cribbing. Some have considered it directly related to bad training practices, but that theory has been denounced. Recent reports in The Horse indicate this is probably not a learned behavior at all. New research has indicated cribbing may be inherited, and Thoroughbreds seen to be more predisposed.

The horse may discover cribbing can create a drug-like high, releasing endorphins. Endorphins are natural painkillers and stress relievers and if a horse cribs due to stress, he may find these endorphins make him feel better, leading to increased cribbing.

Health hazards associated with cribbing include excess wear or chipping of the teeth, often resulting in a noticeable gap between top and bottom front teeth when the jaw is closed. Splinters may also impale the lips, and cribbing has a history of leading to weight loss (secondary to tooth wear), and equine motor neuron disease.

Multiple studies have also found a link between cribbing and an increased type of surgical colic called epiploic entrapment (EPE), in which the small intestine herinates into the epiploic foraman. There appears to be an unusually high percentage of horses with EPE that are cribbers. Researchers speculate this may occur due to this part of the intestine altering shape during cribbing and possible due to abdominal pressure as well. They are unsure if the ingested gases have any effect.

There is no cure-all for the cribber. Thus, prevention is key. Cribbing is not seen in wild horse herds and there is thought that constant grazing and a consistently full stomach may ward off this bad habit. Therefore, horses should be given plenty of turnout time in a grassy setting. Those that must remain stalled should ideally be fed throughout the day rather than one or two large meals daily. Toys or a buddy should be provided. Ensuring the horse does not remain idle or bored will lessen stress, and as a result, lessen the chance of cribbing.

Try to combat the problem soon after discovery, ideally, within the first 30-60 days. The sooner cribbing is detected, the better chance for it not to become a long term problem.

If, however, the problem continues, owners have several options. Changing the horse’s environment may be helpful to deal with cribbing (or any stable vice). Primarily, the best option is a cribbing collar, which constricts lower neck muscles. Some collars have a tack strip in it to cause discomfort anytime the horse sucks air. There is debate whether painting wood surfaces will discourage cribbing (it may discourage chewing, however). You may also choose to bed your horse on straw, so he has to pick out wisps of hay, similar to as if he were grazing.

Further solutions include shock collars (similar to bark collars used in dogs) and antidepressant therapy, which provides an artificial means of endorphin release. There has been no long term evaluation on safe or effective antidepressant therapy.

If all other options fail, it may be best to just give the horse something safe TO crib on, such as an old tire or rubber coating on the stalls.

For horses with an extreme problem, surgery or cribbing rings may be the answer.

Cribbing surgery (Forssells or Modified Forssells procedure) removes a portion of the muscles which control throat movement in addition to a portion of the spinal accessory nerve. The surgery is fairly common and enjoys a favorable success rate of 60%, provided the horse is less than two years of age and has been cribbing for a no longer than six months. While the muscles are not entirely clipped, they are cut down to the point of restriction. (Caveat: the longer a horse has been a cribber, the more muscle he has built up and therefore, still may be able to crib to an extent.)

In a simple procedure under sedation, small cribbing rings are inserted into the gums between the upper incisors and then clamped with pliers. The process takes about ten minutes and the rings generally stay on 3-6 weeks. The rings put pressure on the gums, making cribbing uncomfortable. There are no side effects to the gums or teeth and they do not interfere with eating or wearing a bit. The horse will not crib while the rings are in place and they begin to work shortly after they are put in. Cribbing rings are 80% successful in halting this habit.

Stabled horses are better candidates for rings, as they can come out with grazing. Be aware they horse may return to cribbing after the rings come out.

Another downfall of owning a cribber many may not be aware of is insuring the horse. Some carriers will turn down cribbers, due to the health risks. Some large auction companies require cribbers be disclosed prior to sale in the ring. If the horse is not listed as a cribber, and it turns out that he is, the purchaser has the right to return the horse to the consignor.

While it is nearly impossible to completely eliminate the problem of cribbing in a horse, care should be exercised to provide the horse with an environment that prevents the problem before it starts. Changing up his routine, eliminating stress factors, and providing the horse with ample turnout time can prevent him from picking up this ugly habit. If you own a serious cribber and are ready for a change, ask your vet if he would be a candidate for intensive therapy such as surgery. 

Equine Fractures

Equine Fractures

                               

Equine fracture diagnosis and repair has seen marked improvement in recent decades. Thanks to advances in surgical techniques, casting procedures and owner education, horses with broken bones, once deemed useless and euthanasia candidates, can (in many cases) go on to lead productive and useful lives.

Pre-hospital care and quick diagnoses are paramount to a successful treatment. Without proper emergency field care, a horse with a simple fracture may sustain irreparable damage. All horse owners should be aware of signs and first aid for broken bones, because, although a rare occurrence, this knowledge is critical to your horse’s survival.

There are three types of fractures:

·         Incomplete (including hairline and stress fractures)

·         Complete – simple or comminuted

o    Simple: broke in two pieces

o    Comminuted: broke in more than two pieces

·         Compund – a complete fracture with bone fragments poking out of the skin

In some cases, fracture may be obvious; in the case of an incomplete fracture only mild lameness may be seen and it may take days or weeks for a fracture to show. Less obvious breaks are seen mostly within small bones, as in the case of hock, knee, and foot fractures, and with hairline fractures in larger bones. Bone may also fragment (“chip”) off in a knee or ankle.  

Equine fractures are often complicated by extensive soft tissue damage, which decreases blood supply to the area and also by the need for immediate weight bearing on the affected limb.

Suspect a fracture when the horse is totally unable to use the leg, a loud crack is heard immediately prior to the lameness, the limb is unstable or at an unusual angle, and the horse is in extreme pain. The horse may attempt to move on three legs; any movement should be immediately halted and your vet should be summoned at once.

First Aid

When the fracture is initially suspected, the main goal is to stabilize the fracture site and to ensure further separation remains at bay. Once the limb is stabilized, usually through use of a splint, the horse’s anxiety level decreases and the horse may rest the leg rather than use it for support. The splint is used to take weight off the broken leg and hold the joints in a straight line. Generally, a vet should put on a splint, but if a vet is unavailable, the owner will have to.

Splints consist of wood, halved PVC pipe, boards, or tool handles and should be placed over a bandage of layered roll cotton, gauze and elastic bandaging. The bandage’s diameter should be three times that of the limb diameter. Any thicker and the bandage may bunch or shift.

Stabilize the joint above and below the fracture and secure the splint with a non-elastic bandage. (An exception to this would be fractures located above the stifle, as there is sufficient muscle coverage to act as a splint.) The splints should be applied at a 90^o angle to prevent bending.

Keep the horse from flailing around while trying to bear weight on the unaffected leg. Not only could this cause further soft tissue damage, but the handler could be severely injured in the process.

Transporting

Unless the fracture occurs at your vet’s clinic, moving the horse will be necessary. If the horse is unable to be transported, it is probable that humane euthanasia will be or may be imminent. 

Bring the trailer as close to the animal as possible. Use a ramped trailer if possible. Utilize the chest and butt bars in supporting the horse and leave his head untied to aid in balancing. Provide him with a haybag to keep him busy.

A rule of thumb is to face backward with forelimb fractures and face forward with hindlimb fractures to help him balance during braking. Provide as smooth and straight a ride to the clinic as you can and unload as close to the exam area as possible.

Diagnosis

Complete fractures are obvious to diagnosis. With less obvious fractures, proper diagnosis can be hard, even in an extremely lame horse. The horse may be moderately to severely lame and it may take up to two weeks for the fracture to be seen. Depending on the suspect area, your vet may use hoof testers, nerve blocks, radiographs, or nuclear scintigraphy (bone scan).

Nuclear scintigraphy uses nuclear scanners that detect radioactive materials which have been intravenously injected. These materials accumulate in diseased or traumatized areas of the body and are very helpful in detecting hidden fractures.

Treatment

Fracture treatments vary, depending on severity and location of the problem, and may range from a few weeks of stall rest and some shoeing adjustments to surgery (or multiple surgeries), casting, use of a sling, long stays in the clinic, months of stall rest and a year or more off.

Treatment plans should be designed to minimize occurrence of laminitis or breakdown in the opposite leg.

Other factors contributing to a successful fracture heal are a competent farrier and the location of the fracture itself.

Surgery

The objective for a complete fracture is to bring the bones back into alignment. This is accomplished via intense surgery involving plates, screws, pins and casts.

Equine veterinarians have been repairing fractures with plates and screws for approximately forty years, utilizing the same technology human surgeons do. Generally, the horse is placed under general anesthesia and the bone is fixed in place with the surgeon’s choice of hardware. Depending on the nature of the fracture, an “arthrodesis” (fusion of bones of a joint) may be performed.

When using screws, one screw works to compress the fracture line, while a series of screws lock the bone onto the place. This provides a great degree of stability. The hardware may or may not be left in permanently.

Bone cement is also used to support internal fixations (plates/screws), to bond loose fragments, act as an antiseptic and to provide filler and support in new bone growth.

As with humans, a fiberglass cast will be applied for stability to the healing limb. Casts are changed roughly every six weeks in an adult horse, sooner in foals.

Techniques have improved to prevent reinjury to the leg during recovery. Anderson slings, hydraulic lifts, recovery pools (brought to national attention by New Bolton Center in Pennsylvania during Kentucky Derby winner Barbaro’s treatment), and redesigned locking screws have allowed increased survival rates from fracture repair surgery. However, it can still be an anxious time during the immediate recovery period, as the horse may refracture as he is attempting to rise.

Prior to consent to surgery, an owner should be well informed of the costs, risks and time considerations involved. While surgical repair is more expensive, complicated, and riskier than traditional casting, benefits include a quicker healing time and less of a chance for pressure sores and bony calluses to be formed (which may interfere with tendons sliding over the bone).

Complications

Aside from complications arising from anesthesia or the surgery itself, other complications which can present include joint infection, arthritis, ringbone, dejenerative joint disease, re-breaking, soft tissue injury, laminitis, diarrhea, and death.

Euthanasia

Euthanasia is imminent if any of the following occur:

·         Open fractures with bones sticking through the skin

·         Multiple long bone fractures

·         Complete fractures above the knees, and in the upper hind and forelimbs

·         Severe infections of the bone, joint, synovial sheath or bursa

·         Severe damage and loss of soft tissue

Splint Fractures

Splint bones occur on either side of the cannon and are long, narrow bones which start at the knee and taper down, ending in a small knob 2/3 of the way to the ankle. Splint fractures are not to be confused with “splints”, which is an injury to the periostium (tissue covering the bone). Splint fractures can be due to a kick from another horse, self-interference or from forces sustained during a race. Surgical removal may or may not be necessary. Splint fractures have, for the most part, a good prognosis.

Stress Fractures

Stress fractures are overuse injuries seen in horses which are subject to high-demand repetitive activities. They are the result of long term stress that weakens the bone.

During these periods of overuse there is an accumulation of microdamage to the bone itself. The degree of this damage is related to the number and magnitude of the load cycles on the specific structure that is damaged.

This damage is repaired through bone remodeling, a process where damaged tissue is naturally removed and replaced. A stress fracture occurs when the resorptive phase of bone remodeling dominates the rebuilding process and the weakening can lead to complete fractures. Stress fractures are generally not visible radiographically, and need scintigraphy to diagnose.

The horse may be unstable, have painful lameness, and an incomplete fracture line will be visible on the radiographs. Radiographs will indicate new bone formation by bone increasing in size (a normal part of the remodeling process). A specific training history may aid in diagnosis of stress fractures. If stress fracture is suspected and other methods have been unable to diagnosis, nuclear scintigraphy will be recommended.

Prognosis is good for horses with stress fractures. Recommendations usually involve a course of rest-and-retrain, gradually working back up to previous levels to stimulate bone tissue building.

The ultimate goal of fracture repair is to return the horse to work. Treatments and surgeries can be a long and costly process and a horse that ends up only pasture sound may not be considered successfully treated.

Equine fractures are not as detrimental or fatal as they once were. Simple fractures may be healed in as little as 30 days in a stall and development of surgical techniques has vastly improved survival rates from a generation ago. Often the horse will return to the same activity level as he was previously. Prompt action and treatment on owners’ parts greatly increases the likelihood of survival and the ultimate goal of future use. 

Eye Injuries

Equine eye injuries require immediate veterinary attention. Even minor injuries may develop complications, including blindness, and it’s best to begin treatment as soon as possible.

Common injuries and diseases include corneal abrasion and ulcers, keratitis, conjunctivitis (tissue inflammation around the eye), uveitis (swelling and irritation of the middle layer of the eye), habronema (persistent conjunctivitis associated with eye worms), and keratoconjunctivitis sicca (dry eye syndrome – less tears are formed).

Signs of injury or disease include swelling, redness, or an abnormal amount of discharge. The eye may have a bluish-white tint or appear cloudy. Blood vessels will be seen across the surface of the eye, pulling this cloud with them and providing blood to repair the injury.

Your vet will utilize an ophthalmoscope and fluorescein dyes to diagnose any eye problems. Fluorescin will dye or stain the eye green to highlight injury or detect foreign bodies. It is placed under the lid via a slip of paper containing the stain or with a syringe. Stain will only be taken up when there is a break in the tissue and will differentiate which layer has been affected.

Treatment is based on how the stain is dispersed (i.e. one line, several small spots). If stain is present, the objective then becomes preventing infection in the surface wound.

If there is no stain uptake, treat the horse to prevent infection and lessen discomfort, clear up redness of conjunctivitis, and lubricate the eye to prevent irritation. Ophthalmologic triple antibiotic is commonly used. It is important you do not use an antibiotic made with steroids in place of the triple antibiotic ointment, as steroids can restrict blood flow to the eye, causing a slow healing process and can do more harm than good to the eye.

Discomfort may be caused by eye muscle contraction to the lens. A secondary eye medication may be required to relax these muscles.

Eye Infections

Eye infections, like all eye injuries, need to be treated carefully. If the infection is bad enough, the eye structure can actually erode and cause it to collapse.

Treat for an infection if you notice a cut, torn, or swollen eyelid, obvious damage to the eye, a white film is present, red or inflamed eye or tissue can be seen, tears running down the face, large amounts of eye discharge, eyelid tumors, or the eyelids of a foal are turned under.

If an injury or infection is suspected, flush the eye with a saline solution (contact lens solution will work), put a fly mask on the horse and keep him in a dim stall until your vet can address the situation.

Corneal Ulcers

Corneal Ulcers are disruptions of the corneal epithelium (outer layer of cells). They begin with corneal trauma, resulting in the removal of corneal epithelial cells, exposure of stroma (connective tissue), and can result with bacterial or fungal organisms invading the stroma. These ulcers can be directly seeded by branches brushing the eye.

Fungal Ulcers

Fungi are found in hay, grass, shavings, straw and dust. They can live with bacteria on the surface of the cornea and conjunctiva. Fungi cause the severe corneal disease keratomycosis (in which you will see ulcers, abscesses and iris prolapses) following corneal trauma or inappropriate treatment for corneal ulcers.

Fungal ulcers are commonly seen in warm, humid regions.

Keratomycosis

Signs of keratomycosis include corneal swelling, droopy upper eyelids, small pupils, squinting, and increased tearing. Diagnosis is based on a cellular exam of a corneal scraping, culturing the corneal lesion or a surgical biopsy. A downside to diagnosis of keratomycosis is that if the fungus has worked its way deep into the cornea, a false negative result can be seen.

Uveitis, or iridocyclitis (inflammation of the iris and cilary body) are always found too.

As few as fifty percent of eyes with keratomycosis may retain vision. Half of keratomycosis-infected eyes may become blind or need to be removed. The high rate of failure may be due to a lack of aggressive treatment early on. If discovered and treated early, there is a positive probability for both vision and eye survival – nearly 90%, but treatment will be prolonged, expensive and corneal scarring may occur.

Your vet will recommend a plan to treat the fungi as well as the inflammation. This may require an extended period of treatment as anti-fungals tend to slow growth rather than kill fungus quickly. Anti-fungals include miconazole, itraconazole, silvadine, and fluconazole. Antibiotics will be recommended because bacterial infection commonly runs concurrent with fungal infections.

Treatment of Eye Injury/Disease

Most common, a therapy of triple antibiotic eye ointment will be recommended. However, topical antibiotics are not always the answer, as they can suppress certain bacterial strains and allow multiplication of resistant organisms.

Acetylcysteine is used as a last resort to decrease enzyme activity in the tears of horses with melting corneal ulcers (due to psuedomanas or matrix mecalloproteinase). Drawbacks to this medication include eye irritation, costs (it is quite expensive), a foul odor and the need for refrigeration.

There also is a therapy involving use of blood serum enzymes to speed corneal healing.

Your vet may suggest you treat the horse with atropine sulfate drops to dilate the pupil and Banamine to ease eye pain associated with ulcers.

As previously mentioned, be aware that use of ophthalmologic steroids can worsen eye diseases, suppress immune protection so microbes can more easily cause disease and predispose the cornea to fungal infection, and decrease effectiveness of antifungal agents, thus furthering the infections.

Surgery may be necessary if the ulcers are deep, and do not respond (or worsen) during treatment. Up to 50% of horses might require a combination of traditional treatment along with a conjunctival graft or a full-thickness corneal transplantation (taken from a donor horse).

For major eye injuries, medication is administered via an eye pump. This pump is attached to tubing which is threaded directly to the eye. A disk containing several medications continuously delivers treatment to the affected area. These pumps are an expensive but necessary therapy.

Use any medications prescribed for the full course, even if the horse appears to be more comfortable. Keep the horse in a dust free, dim environment and cover any sharp edges or nails he may be tempted to scratch on. Always be aware of his blind side when working around him.

Preventing and Handling Eye Injuries

Keep in mind that eye injuries and disease are not uncommon. Owners should take precautions to keep the horse in as safe an environment possible, free of protruding nails and sharp edges. The area should be as dust free as possible.

Contact your vet immediately if you discover or suspect any injury to the eye. If the eye is lacerated, clean with a saline solution of ¼ teaspoon salt to 1 cup of lukewarm water (contact lens solution will work also). If a foreign object is in the eye try to remove it – easy if it is in the eyelid but if the eyeball itself is involved, do not attempt it. Keep your horse quiet until the vet can arrive.

Keep the horse’s face covered with a fly mask during the summer months and avoid bright light. Follow all courses of medication as directed and remember, the horse may have some obscured vision and be spookier than usual.

With proper care, minor eye injuries may heal in as little as one week – much faster than skin injuries. 

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