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  1. #1
    Join Date
    Apr. 5, 2004
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    Default Cyclosporine implant? (Uveitis) Anyone?

    I did a search and PM'd a few people regarding the cyclosporine implant for horses that have been diagnosed with ERU (uveitis).

    I want to know what the cost was like, the experience for their horse, where they had it done, what sort of horses are considered candidates, etc.

    From what I've read, it looks so promising but as it's not FDA approved yet I highly doubt my insurance would cover it. If it's some ridiculously expensive operation then there is basically no point in my even contacting a vet hospital about it!

    (Although, I've already contacted my local vet hospital about it via my vet. Still waiting to hear back.)

    Any experiences?

    I found on on Horse Advice.com (or something like that) in which the woman posted her results over a year....it started out so promising but after a year the eye had to be removed because he was completely blind in that eye.
    Horses - if God made anything more beautiful, he kept it for himself.

    Check out My Horse Chat!



  2. #2
    Join Date
    Jan. 23, 2007
    Location
    Hampshire, IL
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    779

    Default

    I called a local equine opthamologist about getting this done. the price I was quoted was $1200 /eye.



  3. #3
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    Apr. 5, 2004
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    Canada
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    Default

    Really? That doesn't seem so bad. I've heard some stories about great success and others who ended up having the eye enucleated. (Not sure if that term is right.)

    I wonder if it so inexpensive (relatively speaking) why more people aren't having it done?
    Horses - if God made anything more beautiful, he kept it for himself.

    Check out My Horse Chat!



  4. #4
    coachlora Guest

    Default cyclosporin implant

    I am in this same dilemma. I would love to hear from others about their experiences and outcomes. I am scheduled to take my horse to the University of Missouri Columbia on the 28th and they quoted me $2500. Thankfully only one eye is affected. I have found the Guardian Mask and am awaiting it's arrival. I have read some success stories on their website. Seems to be some sort of UV light correlation - not sure on it all.



  5. #5
    Join Date
    Aug. 16, 2008
    Posts
    23

    Default

    My mare received the cyclosporine implant in May 2007, and knock on wood, her eye is as healthy as ever.

    I don't have the cost in front of me, but will get the price and post it. I do know that our insurance covered the cost of the implant and treatment before and for a year after the procedure. This included stabling fees, exams, the surgery, and prescription drugs for a year.

    The procedure was done by Dr. Udder at New Bolton. We took her up there the day before the surgery, Dr. Udder did an exam to make sure she was not in a flare up, and did the surgery the next morning. Fancy was put under complete anesthesia, her shoes were pulled, the surgery was done, and she woke up without a problem. She stayed overnight, and we picked her up the next morning.

    She was on prescription drugs for several days, eye ointments, and in a stall for 24/7 for 3 days, and then kicked back out to the field. She wears her Guardian mask anytime the sun is out, and follows a strict regiment of banamine the day before, of, and after vaccines or dewormer.

    Since the surgery, she has not had a flare up. Her retina, which was detaching and curling before the surgery, smoothed out and reattached. Dr. Udder believes she has not significant visual impairment due to uveitis. The procedure was performed 6 months after her initial diagnosis, and very little damage to the eye was done. I don't know if this is what made her a candidate, but regardless I would ask the vet. Uveitis is a degenerative disease and is very painful, anything we can do medically offers horses some relief.

    Hope this is helpful, and I will let you know how much the surgery cost.



  6. #6
    Join Date
    Apr. 5, 2004
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    Canada
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    Default

    Thank you for the information everyone, it is much appreciated.

    I am worried that my insurance will hold out on paying for a procedure that is not standard protocol for this disease. Nevertheless it seems (for the most part, but not in every case) that people have seen good results with proper management and provided the disease is not aggressive.

    Another concern is that if I do want the surgery (and insurance agrees to foot the bill) that I have to get the approval ASAP. His insurance provider has told me I only have a certain amount of time to make a claim for this issue (November, when the policy is up for renewal). As this is my horse's first flare up, I'm worried he might not be considered a good candidate for the surgery (because he's had 1 versus 3+ episodes) yet. It's sort of "now or never" connundrum.

    My guy has been on meds for two weeks now after his initial diagnosis. Although his eye looks much better, you can still see him squint here and there as his eye is still not 100%. The vet said by now it SHOULD be basically back to normal, however I should expect another flare up in 6-8 weeks.

    Horses - if God made anything more beautiful, he kept it for himself.

    Check out My Horse Chat!



  7. #7
    Join Date
    Sep. 7, 2008
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    56

    Default

    A woman at my barn had it done on her gelding in August. It was done at Moore and Company vets in Calgary. I don't know what the costs were, you could call them if you really want to know(I see you're in Canada). Horse was at clinic for a couple of days, then stall rest for a week, if I remember correctly. Huge improvement initially, horse not squinting like he normally does. However, I think progress is not as good as they want, because she delayed an out of town trip because she was still medicating him, with eye ointment (a skill she's got, but the barn staff not so much). But that might be a mistaken impression on my part. She's away on her trip at the moment and the horse is on a decreasing course of bute. The vet is coming to recheck him next week. When she gets back from her trip next month, I'll see if I can get her to post her information directly. I think overall, she's happy she had it done, so far, and is hoping to get long term (5-10) years of improved comfort for her horse out of it.



  8. #8
    Join Date
    Aug. 16, 2005
    Posts
    538

    Default Alternatives...

    WW Queen, this is a timely thread for me as well. I have been managing uveitis flare ups with one of my TB's since he came off the track last August. He had an eye injury which the vet at the track at the time felt it would heal without issue. Well, he continued to have flare ups every 6-8 weeks...then from late April until about a week ago he was good.

    Well, the flare up he got last week went south really fast and he has a fibrin on his right eye, and then he started to tear and get inflammation in his left eye. So Monday I took him to an ophthamologist, and it's likely he has lost vision in the right eye. We are treating this flare up very aggressively with dex, atropine, and banamine. Anyway, I asked about these implants and right now the doctor does not think my horse is a candidate - we have to wait and see what type of damage this current flare up has done. But she felt too much damage was done to help.

    I also ordered a guardian mask - hope it arrives today.

    This disease is so frustrating and devastating, I am looking into all options b/c this horse is likely my "once in a lifetime horse", he's just amazing and we've only just begun our relationship.

    Have you looked into acupuncture? I had my horse treated last night, and the relief was nearly immediate, and his eyes do look better today. But with the meds, it is hard to tell for sure. But he definitely seems more comfortable. The vet is also using a light treatment - the name of the machine is LACER. It energizes the cells to help the healing. I am trying to get more information and then I can share it.

    Anyway, I am just trying to offer some other alternatives to look into until you make a decision on the cyclosporine implant.

    Good luck with your horse.



  9. #9
    Join Date
    Aug. 16, 2008
    Posts
    23

    Default

    I went back into my records to see what I could find on the cost of the cyclosporine implant. In my case, the implant itself was donated from NC State vet school. U Penn at New Bolton charged around $1800 for the anesthesia, board for 3 days, and to perform the procedure.

    I addition I use Great American Equine Insurance, and they did cover everything.


    It never hurts to ask your vet about the procedure. Fancy only had 2 flare ups before the surgery, so I don't know if all places go by the 3+ flare up rule.

    Hope this helps.

    PS
    Also for those who are getting flare ups every 6-8 weeks, is it at all around the time (within a week) of deworming? I was told that deworming can trigger flare ups.



  10. #10
    Join Date
    Jan. 23, 2007
    Location
    Hampshire, IL
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    Default

    I'm sorry I did forget to mention that the $1200/eye price was at a teaching / university clinic.



  11. #11
    Join Date
    Nov. 9, 2005
    Location
    uk
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    15,268

    Default

    Quote Originally Posted by WW_Queen View Post
    Thank you for the information everyone, it is much appreciated.

    I am worried that my insurance will hold out on paying for a procedure that is not standard protocol for this disease. Nevertheless it seems (for the most part, but not in every case) that people have seen good results with proper management and provided the disease is not aggressive.

    Another concern is that if I do want the surgery (and insurance agrees to foot the bill) that I have to get the approval ASAP. His insurance provider has told me I only have a certain amount of time to make a claim for this issue (November, when the policy is up for renewal). As this is my horse's first flare up, I'm worried he might not be considered a good candidate for the surgery (because he's had 1 versus 3+ episodes) yet. It's sort of "now or never" connundrum.

    My guy has been on meds for two weeks now after his initial diagnosis. Although his eye looks much better, you can still see him squint here and there as his eye is still not 100%. The vet said by now it SHOULD be basically back to normal, however I should expect another flare up in 6-8 weeks.

    w queen dont be surprize if it doesnt flare up with proper management it can be control
    and you sure can help it alot if you know when and where your horse needs extra help
    ie dont put him out in direct sunlight or windy weather as that makes eyes run which makes them sore so always have a fly mask and fly sheet
    dont stable him next to door or anywhere in the yard thats a dust trap ie blowing straw or hay or bits around
    alway have him on shavings and feed on the floor with hay or buy a hay bar so the hay is contained and not hung up and then going to drop bits in his eyes
    alwsy water spray the air before you bring him in or when you mucking out so the dust paritcals settle same to with having him next door to one on a straw bed when they roll it puuffs up and over or into the next stable so so spray the air in the stable with a water bottlle spray gun type dampen feeds and hay,
    do go anywhere where the areana arnt well mantianed and harrowed and dampened regualar- simple things can prevent and control the eyes with out medications
    also make sure the ailes are clear dont want you triping nor the horse with junk in the way and make sure you keep things in the same place in the field and in the stable each attack damages the eye or eyes
    alway make sure you worm regualar, and also have to say it depends on the horse as to how many attacks he gets some get attacks often some do not
    you cant judge this one and say as your vet did that he will get another attack in 6- 8 weeks as might not



  12. #12
    coachlora Guest

    Smile chronic uveitis

    I put his Guardian mask on today and chuckle as I write this - he tends to get his fly mask off, I hope he keeps this on without much fight. I may have to glue velcro tape to him - hahahahahahahaha - kidding of course!
    I have been conversing with a woman from horseadvice.com about the implant surgery. Her horse is two years out and no flare ups post surgery. I am leaning on getting this done as we are scheduled to on Thursday of next week. I will keep all of you posted. The fee I have been quoted is $2500 for the affected eye and boarding. I will let you know final price as the vet said that is approximate. We are going to University of Missouri Veterinary School. I must ask about gentocin injection with the implant as i am hearing some things about that as well. Keep posting with information everyone. I enjoy any info I can get my eyeballs on!



  13. #13
    Join Date
    Mar. 4, 2008
    Location
    Birmingham, AL
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    1,631

    Default

    Quote Originally Posted by WW_Queen View Post
    The vet said by now it SHOULD be basically back to normal, however I should expect another flare up in 6-8 weeks.

    Really?! My horses go years without flare-ups. But maybe it is the predisposing factor that caused it in the first place. If it is due to lepto or other parasites then I would understand the flare ups being at the time of deworming, depending on the dewormer. So much is still unknown about the cause of uveitis so I wonder if the implants are equally effective on a variety of horses who may have uveitis for a reason other than lepto.

    Guardian Masks will alleviate pain and help prevent future flare ups because they block UV light, wind, dust/debris and insects. That is what we use here with all 3 of our ERU horses. One of mine has a hard time keeping his on just because he has tiny ears. I recommend tying it to a breakaway turn out halter to help keep it on if you have that problem. Your horse should wear that mask 365 days a year, regardless of sun/clouds/rain. And you'll have to consider that he is exposed to wind, dust/debris and insects at night and how will you protect his eyes?

    The fewer the flare ups the slower his vision loss will be.
    Altamont Sport Horses
    Trakehners * Knabstruppers * Appaloosa Sport Horses
    Home of stallions: Ambrosius af Asgard "Atlantis" & Hollywood Hot Spot
    Birmingham, AL



  14. #14
    Join Date
    Aug. 16, 2008
    Posts
    23

    Default

    We had the implant done for my mare, and she was lepto negative. Her uveitis is purely autoimmune caused, however, worming and vaccines especially caused her second flare up, as it over loading her immune response.



  15. #15
    Join Date
    Mar. 4, 2008
    Location
    Birmingham, AL
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    Default

    Quote Originally Posted by EventChic88 View Post
    We had the implant done for my mare, and she was lepto negative. Her uveitis is purely autoimmune caused, however, worming and vaccines especially caused her second flare up, as it over loading her immune response.
    Is your mare an Appaloosa?
    Altamont Sport Horses
    Trakehners * Knabstruppers * Appaloosa Sport Horses
    Home of stallions: Ambrosius af Asgard "Atlantis" & Hollywood Hot Spot
    Birmingham, AL



  16. #16
    Join Date
    Aug. 16, 2008
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    23

    Default

    Quote Originally Posted by Altamont Sport Horses View Post
    Is your mare an Appaloosa?
    No she is an OTTB, she was diagnosed when she was 6 almost 7; Just my luck. I had an Appaloosa before her, but he didn't get it.



  17. #17
    Kavania Guest

    Default

    My horse Rosie had this done, i'm pretty sure that the price was about 1,500$ where I live... But i'm not quite sure I haven't looked into that really, it was 2 years ago that she had that done i'll edit this if I find out for sure!



  18. #18
    Join Date
    Nov. 9, 2005
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    uk
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    15,268

    Default

    Quote Originally Posted by Altamont Sport Horses View Post
    Really?! My horses go years without flare-ups. But maybe it is the predisposing factor that caused it in the first place. If it is due to lepto or other parasites then I would understand the flare ups being at the time of deworming, depending on the dewormer. So much is still unknown about the cause of uveitis so I wonder if the implants are equally effective on a variety of horses who may have uveitis for a reason other than lepto.

    Guardian Masks will alleviate pain and help prevent future flare ups because they block UV light, wind, dust/debris and insects. That is what we use here with all 3 of our ERU horses. One of mine has a hard time keeping his on just because he has tiny ears. I recommend tying it to a breakaway turn out halter to help keep it on if you have that problem. Your horse should wear that mask 365 days a year, regardless of sun/clouds/rain. And you'll have to consider that he is exposed to wind, dust/debris and insects at night and how will you protect his eyes?

    The fewer the flare ups the slower his vision loss will be.
    ooh iam so gllad someone agree withme about the flare up thing and so second your opnion
    ossy is 17yrs old hes suffer wih uv since a foal before i got him due to worm infestations
    and since then his eyes have got worse but over along period of time as hes now 17yrs
    and although he has lost sight of one eye and lacks 100 vision in his other eye as it can transmit from one eye to the other hes had a good life and is still having a good life
    the mask is an absolute must from horse with uv and management seconded to none
    dust debris pollen sun clouds rain wind etc all paly a part huge part with horses with uv
    and the more you can keep him out of the way off-- the more chance you have of hiim being prevented with uv flare ups
    ossy is an old man now and like some horses he might not reach 20yrs or so but then so dont many others without uv, uv isnt an age thing it attacks any horse any age
    and the best thing you can do is to think---- what can i do to help this horse in the ways of my own management with him
    dont stable him in a ayrd that has constant windy parts that blow and spiral everywhere
    dont stable him next door to horses with straw as everytime the move the tiny spors puff up and into the boxes next door
    dont take him to dusty places when at shows or events if there areana's are well mantianed
    dont stable him next to crops ie rape seed etc
    dont stable near straw or hay storage areas

    dont put him in a field full of buttercups they are well know to be an irratant and cause mouth ulcers
    and face and muzzle issues cuase they are a toxic plant
    there lots of things you can do to improve his enviroment if you think logically and commonsense



  19. #19
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    Aug. 16, 2005
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    I had my follow up vet appointment today with my OTTB, and the prognosis on his right eye (the one that has been the issue) is at this point not good, his sight is cloudy at best. But the left eye looks great, and has responded well with the treatment. So the vets feel he would be a candidate to have the implant in his left eye.

    My question is - it's my understanding that the implants do not last forever. So for those of you that had the procedure, do you wait until there is a flare up to know that you have to go back for a new implant? Does the vet suggest you just do it every couple of years?

    These are questions I have into my vet, but just curious what you can share now.



  20. #20
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    Oct. 28, 1999
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    Mason, NH (where????)
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    Quote Originally Posted by EventChic88 View Post
    I went back into my records to see what I could find on the cost of the cyclosporine implant. In my case, the implant itself was donated from NC State vet school. U Penn at New Bolton charged around $1800 for the anesthesia, board for 3 days, and to perform the procedure.
    We had this procedure on our gelding about four years ago -- NC State donated the implant, and the equine opthalmalogist who is now at New Bolton did the surgery for us at a local vet clinic. I was actually prepared to bring the horse to NC State if need be.

    Pal's ERU was particularly aggressive. Following the surgery, he continued to have flares about every 8-12 weeks, but they were orders of magnitude less severe than before the surgery. The implant did clear up most of the cloudiness in the eye, and it was the first time that the opthalmologist got a good look at the inside of the eye. However, we never succeeded in weaning him off the steroid drops. He ultimately lost his vision in that eye about a year after the surgery.

    I don't recall what the cost was -- I think in the neighborhood of $3K. But then again, I had already spent thousands treating the condition over two years prior to the surgery.

    We do know that Pal was lepto-positive. He apparently had his first flare-up as a yearling, then another a year or so later, then the whole thing went dormant for 8 years. When it reappeared, he flared about every 8-12 weeks, with only two breaks. His dam lost an eye to (what was then believed to be) glaucoma, but we think in retrospect it was ERU. We think that he may have contracted lepto in utero -- something that happens in dogs but is not really documented in horses.

    It was next to impossible to keep him in work during this. We used the Guardian mask for him, which at least allowed him to be turned out like a normal horse. We eventually retired him. Damn shame.

    ERU is so frustrating, not the least because there is no cure. We had tried everything else, including repeated courses of doxycycline. What would work to stop one flare-up would usually not work a second time. The implant was really the last resort. Would I do it again? Yes, no question.



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