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Experience with/Treatment for Uveitis?

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  • Experience with/Treatment for Uveitis?

    I bought my gelding in November of 2009, thinking I was getting a great deal. We had worked together before the sale and formed a bond, and we just worked really well together. I knew he had uveitis in his left eye, but that is was under control with daily doses of diclofenac solution, thrice weekly dexamethasone tablets, and twice weekly phenylbutazone. We have had no issues for two years.

    I did some research on uveitis, because of course I want to protect his eyes, but apparently I didn't do enough. In November of 2011, his right eye swelled up, and was all red and puffy, with a cloudy spot near the front corner. We had our vet out, he gave us antibiotic ointment, and said he'd come back if that didn't work. But it cleared up. Then, First week of February, it shows up again, this time worse. We called our vet, but of course he is on vacation. We called around and finally got ahold of a local clinic. The vet diagnosed it as uveitis, and I felt incredibly dumb. I should have known, right? $250 later, the horse's eye is all doctored up and we have instructions for at least the next ten days. He gave us atropine ointment, diclofenac solution, and off brand banamine for the pain. He said my diclofenac ointment was better, because we have a prescription from Rood & Riddle, but told me to use his anyway. I go home and get into my extra meds kit and find atropine and banamine in a stash. And feel incredibly stupid again.

    He is only ten years old! We can't afford the surgeries.

    Do you have any tips or tricks for keeping flare-ups away? Is there anything I should be doing differently?

  • #2
    Daily aspirin therapy is recommended. http://www.merckvetmanual.com/mvm/in...m/bc/30300.htm

    It really made the difference for my late app mare. I fed her Tums along with it to reduce the gastric issues.

    Also invest in a Guardian Mask... much better light protection than a traditional fly mask.
    <>< Sorrow Looks Back. Worry Looks Around. Faith Looks Up! -- Being negative only makes a difficult journey more difficult. You may be given a cactus, but you don't have to sit on it.


    • #3
      If he lives outside, you may want to consider putting him in a barn stall during the day and turning him out at night.

      I had a mare with uveitis, so I sympathize. It's very painful for the horse.

      ETA that I gave the mare away to the woman who had been leasing her. I would not have tried to sell her with that unsoundness. Also, I second the Guardian mask.
      Last edited by TheHorseProblem; Feb. 13, 2012, 02:19 PM.
      2012 goal: learn to ride like a Barn Rat

      A helmet saved my life.


      • Original Poster

        He is turned out during the day weather permitting, as the temperature drops pretty low at night. He has a fly mask he wears in the summer anytime he is outside. He is stalled when it is too hot or too cold to be outside. Should I ask my vet if we should reconsider his medication? The last time he saw the opthamologist in Lexington was six months before I bought him.


        • Original Poster

          Also, is the Guardian Mask something specific, or can I make a homemade one with fabric?


          • #6
            This might be old technology - but I had a mare with uveitis, and at some point we started doing steroid drops in her eyes daily (I think only during the spring/summer). That seemed to manage the outbreaks very effectively.

            I don't recall the name of the steroid that we administered... I'll see if I have any records of it.


            • #7
              Originally posted by autumnthompson View Post
              Also, is the Guardian Mask something specific, or can I make a homemade one with fabric?
              There is no substitute - they are VERY specific: http://www.horsemask.com/
              <>< Sorrow Looks Back. Worry Looks Around. Faith Looks Up! -- Being negative only makes a difficult journey more difficult. You may be given a cactus, but you don't have to sit on it.


              • #8
                Been there, done that...

                The Guardian mask is very specific, and it's a godsend. My AQH gelding had uveitis in his left eye. Without the mask, he'd have been a vampire, living in the dark and only going out at night.

                Pal apparently contracted uveitis at a very young age, maybe even in utero or at birth. His mother had a late-term miscarriage of a foal before she was pregnant with Pal (a sign of leptospirosis infection), and she lost an eye to (what was thought to be) glaucoma. We now suspect it was also uveitis.

                Pal's first flare came at about age 15 months, nobody really thought anything of it. Everybody (including vet) thought it was just a youngster being silly and bonking his eye.

                Next flare came when he was around 3 years old. Attributed to the same thing - silly horse bonked his eye. Disease then laid dormant for a a very long time.

                Then when he was about 15, he started having flares. The first came in January of that year. We didn't know that it was anything other than the result of the horse bonking his eye. Had the vet out, we used antibiotic goo, and it went away in pretty short order.

                Eight weeks later it was back, and this time the vet tested for leptospirosis, and the test returned a high level for the species associated with uveitis. So now we knew what was happening and how to treat accordingly. We did a regimen of prednisolone drops and atropine, and banamine for the first couple of days. We also used the triple-antibiotic eye goo. After two weeks of treatment, everything seemed OK.

                Six weeks later, it was back. Same regimen as above, but we went a full 30 days. Also got the Guardian mask. Flare subsided, and the condition stayed quiet until the fall. Flared up again, and this time we did subconjunctival injections of prednisolone. At that point, the condition went quiet for a year.

                I started to think we were out of the woods at that point, but the following September, it flared again (conveniently while I was on my honeymoon). We did another round of the subconjunctival injections (triamcinoline this time), but at this time, the condition seemed to become more aggressive. I think from then on, we never went more than 8-12 weeks between flares. We also did a course of Doxycycline.

                It was very frustrating. I couldn't keep him in consistent work, and there was really no cure. Eventually we did the clyclosporine implant surgery. That provided some relief, but we were never able to totally wean Pal off the prednisolone drops. By about 2 years following the surgery, he had lost his vision in that eye.

                The good news was that once Pal actually lost the vision in the affected eye, he became much less spooky. Although he retired from jumping, he has a nice "semi-retirement" doing low-level dressage. Very mercifully, the right eye was never affected.

                Do you have access to an equine ophthalmologist? Has the horse been tested for leptospirosis? Maybe a course of doxycycline wouldn't hurt. Sometimes that helps quiet things down.
                Why do I like most horses better than most people?


                • Original Poster

                  He has been to see an ophthalmologist twice to my knowledge- Dr. Claire Latimer in Lexington. However, we are located in central Ohio and do not have a trailer, nor the funds required to haul him down again. The surgeries themselves are expensive as well. And since he has uveitis in both eyes, he is not a candidate for removing the eye. I don't want to splurge on an implant surgery if it might not help. I just want to make him comfortable and hopefully figure out what causes his flare ups so that I can stop them. We moved him to a stable in October, and I have a feeling that is the problem. It is very dusty and stressful when you are the lowest in the pecking order. Before this barn, he was in a pasture with a twenty by twenty run in shed for a barn and shelter. When we lost our house we had to board him. I will ask for a Guardian Mask for my birthday in May, but until then he will hopefully be a little more comfortable if I put fabric on his current flymask to prevent irritation and hopefully catch some of the dust.

                  How often do you have the mask on?


                  • #10
                    The Guardian Fly Mask. We had an old polo pony here for one summer and she suffered from uveitis. It really helped quite a bit. It's really not that expensive...much less than vet calls. He should wear it when he's exposed to light. Otherwise he should be in a fairly dark stall.

                    When the pony was having a flare-up, I brought her in before dawn and turned her out after dusk...thankfully, it was the summer. I often wonder what happened to her...she was a sweet old thing.

                    You want to be careful with steroid drops...you might set her up for a fungal infection.
                    Last edited by LauraKY; Feb. 13, 2012, 07:25 PM.


                    • #11
                      If you decide to enucleate, here's my horse's story:


                      My horse recovered 100% but other soundness issues have turned him into a light riding horse.

                      Spiker wasn't a candidate for the cyclosporine implant, however others have had great success with it. Guardian Mask is really good, worth the money. Definitely buy one. Give banamine before worming.

                      Good luck!
                      A quick tutorial on interval training: Conditioning your horse for eventing


                      • #12
                        Originally posted by autumnthompson View Post
                        . . . ask for a Guardian Mask for my birthday in May . . .
                        This is one time where you need that birthday present early. Please consider asking for it right away.
                        Courageous Weenie Eventer Wannabe
                        Incredible Invisible


                        • #13
                          My old horse developed several bouts of uveitis, and like typical ERU cases they increased in frequency and severity, although they were all managed by prompt use of banamine.

                          At one point I added MSM to his diet for a variety of other reasons, although I had read of potential benefits with MSM (all anecdotal, not one proven). It was about a year later I realized we had not had one more ERU attack from that point forward. We are going on 11 years, knock on wood.

                          That's a highly unproven n=1 and I wouldn't begin to suggest that MSM is some sort of miracle cure. However just to be on the safe side, I've never discontinued it either! 10-20mg/day, 365 days a year. Just to be safe, you understand.

                          And for a n=2, bensmom had a pony that she was at her wits end with, as in banamine, etc. wasn't managing pain and he had already lost one eye, so the stakes were high. She also saw improvement/decrease in symptoms after th epony was put on MSM.

                          So again, with all the caveats in place, MSM is insanely cheap (Select the Best is super cheap), safe and has been proven to help reduce muscle soreness post workout, so it's a lot of good reasons to put a horse on it and if your horse makes it an n=3 for reduced severity of symptoms, we still won't call it a trend.
                          Your crazy is showing. You might want to tuck that back in.


                          • #14
                            Dr Xie in Reddick FL

                            makes an herbal supplement called Ming Mu Di Huang. Your vet has to order it.

                            I have a pony with uveitis. the only time it flares up is when I say to myself " yeah, some kind of Chinese powder is going to keep this under control" and I quit giving it to her. Bingo, she has a flare up. Lesson learned - i keep her on it all the time!

                            I have also heard uveitis can be related to allergies and some horses that are on allergy shots have fewer outbreaks of uveitis, which kinda makes sense. maybe you should have your horse tested for allergies. Not so much that uveitis is an allergy, but that horses with allergies could spend a lot of time rubbing their faces and eyes, which stirs up the infection in the eye.

                            I have the Guardian mask for her. Nice product and I wouldnt try to make it on my own. I have had to adapt it though as my pony developed rubs from it. I put a rim of fuzzy material around the eyes to keep it from rubbing her. She doesnt go out on really bright days - at leasst not during the brighest time of day. I never let shampoo or dust get in her eyes. When I put blankets on her I make sure the fabric doesnt touch her eyes.

                            This pony got dumped on me by an unscrupulous boarder. She probably had uvietis for a long time before she came to me. She is mostly blind in one eye and can probably see only shapes and movement in the other eye. She is in her late teens I think. She gets around just fine and generally knows exactly where she is.

                            Sounds like you are catching it early. Seriousy though, the Chinese herb really does seem to work. Let me know if your vet has trouble locating it if you want to order it.


                            • #15
                              My sympathies to you. Uveitis is one of the most frustrating equine conditions I've run into.

                              A woman who boarded her horse at our barn had me exercising him and looking after him. A wonderful sweet thing, but spooky. One day I got him out and noticed his eye had clouded over. Vet came, we started the eyedrops and other meds that have already been mentioned, as well as bute, fly masks, etc.

                              She had an equine opthamologist examine the horse. The horse was diagnosed with uveitis and secondary glaucoma. That horse had the implant operation. Its important to know that the implant used isn't going to save the eye necessarily. The idea is to help reduce the internal pressure within the eye over time. The horse may still lose its vision, but it won't be as painful for it.

                              The horse was going blind in that eye, that was obvious. The thing is, it will happen most likely, even if you are a real stickler about meds and keep the horse in the most optimal environment.

                              The good news is that horses can get along with one blind eye, and even blind horses can get along.

                              The whole episode was very sad and frustrating. I'm going to give you some links for further info on this disease.

                              How often do you have the mask on?
                              Certainly all during the daylight hours, but pretty much 24/7.




                              Best of luck with this difficult situation. Many jingles for your horse.


                              • #16
                                My mare was prone to uveitis, don't know what started it but it was persistent. Diclofenac ointment definitely helped and a fly mask. Then a friend did some research for me and discovered a link between it and ivermectin so I thought "nothing to lose.". I stopped using ivermectin and she's not had one flare now in over 4 years!!!! I use only fenbendazole when worming her (all my other still get ivermectin), do an occasional stool look with the vet to ensure her parasites are under control and all has been ok. It's been a lifesaver.

                                Good luck.
                                Fernhill Warmbloods


                                • Original Poster

                                  Originally posted by Starda01 View Post
                                  The idea is to help reduce the internal pressure within the eye over time.
                                  When the vet examined him, the pressures were normal, and his eye is not in danger as long as we keep the flare ups under control. He doesn't seem to even have any vision impairment.

                                  @WW Queen: Chance has uveitis in both eyes, and his right one is the only one that has had flare ups in the two years that I have had him, only recently starting in November. I was advised against enucleation. He is supposedly a good candidate for the cyclosporine implants but we would prefer not to go that route.


                                  • #18
                                    For a temporary fix you can always put duct tape over one side of a regular flymask.

                                    My retired horse has had ERU for over 15 years now. I've been able to manage him very well with daily aspririn and 24/7 flymasks.

                                    At one point I did consider enucleation, but we haven't had a flare in many years. He is completely blind in the worse eye, and it has atrophied a lot - but it doesn't seem to bother him anymore.

                                    Since he is ancient and retired I don't plan to take any extraordinary measures to fix it as long as he's not in pain.

                                    Good luck - it's a terrible thing to have to deal with, but not always career ending. My guy did just fine only seeing out of one eye and was fine under saddle for many years.


                                    • #19
                                      I have a mare that had extremely bad Uveitis. For about two years, she flared up frequently, I eventually found she usually did after worming and started worming by the fecal counts. But still she would flare randomly. And then it all of the sudden nearly stopped happening, unfortunately she lost most of her vision despite steroid drops, meds to dilate her pupils and banamine. It was awful but she is comfortable and has adjuated very well to her loss of vision. I tried aspirin daily for about six months with no change, now wishing I tried MSM from these posts! For me, this disease was devastating and I was aggressive about her treatment, I just wish I had done the implants right away.


                                      • #20
                                        Five years ago, the Guardian Mask didn't seem to fit my horse. The eye cups were stiff and spaced apart, but it seemed my horse's eyes were wider spaced and he'd get rubs from the mask cups sitting on him askew. I didn't trust him wearing it in my absence so I did make my own. I bought the darkest shade cloth I could from Home Depot/Nursery and sewed a patch on over his regular fly mask. It seemed as dark as the Guardian, but I don't know if the Guardian had UV protection that the shade cloth didn't.

                                        The Guardian was well made, and I think I could have probably called he mfgr and they would have special made something for me that would work, but the shade solution seemed easier.

                                        FWIW, my guy was completely blind in one eye and fully functional. He only had three flares in the 14 years I owned him (from 11 to 25). The first two times I didn't know, the third time I figured it out. In hindsight, I realize he must have had limited vision in the blind eye from the day I bought him. Best horse ever.

                                        There is a relationship between neck thread worms and ivermectin. I might have this wrong but I believe the wiermectin kills the larva and they migrate to the eye and die, causing a flare. The MSM connection is interesting...