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Enucleation Questions

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  • Enucleation Questions

    Can someone tell me about their experience with enucleation? My 29 year old horse needs to have his eye out, but I am really concerned about anesthesia and taking him to the clinic. Can it ever be done at the farm? Has anyone had it done standing?

    The ophthalmologist has said they do it at the clinic under general. She is strongly suggesting removal over the injection. I am looking for other suggestions and info on how they recover from this. Thanks!

  • #2
    I spent about 3 yrs working at a surgical clinic where horses underwent general anesthesia as part of many procedures. I'm no expert by any means, but I've never heard of standing enucleation.

    The dangers of anesthesia aren't so much from being under itself... if the respirator breaks, the anesthetist will breathe the horse manually. Blood levels are monitored regularly as is heart beat & blood pressure.

    The dangerous part of putting them under IME is the recovery stall. Fat, out of shape horses can break a leg if they get 'stuck' between a wall and the floor mat. And yes, they're under constant supervision, and it's not preventable. When a fat one gets stuck and tries to force himself up, he might break a leg high.

    Also, radial nerve paralysis is relatively common. They go deeper than anticipated and, despite our best efforts, stay down longer than what's wanted. Drafties, and again, larger/ fat horses seem to be most susceptible.

    If you're very VERY very concerned, you can ask about having the doctors give extra fluids prior to induction. I can't recall if there's something else given to help reduce the chance of RNP... speak with your vet.

    Frankly, his age would not bother me as much as it would if he's large and out of shape to the point of fat and REALLY unfit.

    I don't know what type of injection you're referring to, but I've seen about 7 enucleations, or at least rounded the horse before then again the next day and they are universally more comfortable and calmer after the enucleation.

    Comment


    • #3
      We have a vet here in Colorado that does standing enucleation. She performed this on my coach's 25/26 year-old-retiree. He came out of the surgery just fine, though they can do strange things while adjusting to having only one eye.

      The horse in question ran through a fenceline and tore the fence up pretty bad. No damage to Himself, though. Surely in Kentucky there is a vet who can do a standing enucleation. Ask around.

      Comment


      • #4
        Had my 21 yo old have his eye removed last year, at a clinic, standing. I was not there so he stayed at the clinic for an extra day or two until my husband could pick him up and bring him home. He has been fine, returned to his normal Mr. Crabbypants of the Pasture and has been right back to bullying the others. He does stick pretty close to his best friend but the standing operation went just fine. Good luck to you adn your boy, wil try to find my thread on this exact topic!

        Comment


        • #5
          Wanted to add my coach was also concerned about the general anesthesia, so was happy to find a vet who'd do the surgery standing.

          I know my cousin used to have eyes removed from cows with cancer eye -- done all the time at the vet's clinic standing in a stanchion -- didn't see any reason why it couldn't be done on a horse.

          Comment


          • #6
            Search function didn't work so I had to go through the posts! But here is my thread http://www.chronofhorse.com/forum/sh...removal-issues on this issue. Did mine standing with local! It was very comforting to find others who had beenthrough it! and he is still doing fine!

            Comment

            • Original Poster

              #7
              Thanks! The injection is gentamicin, which is injected into the eye and "kills" the eye. There can be complications, though, where as removing the eye will most likely take care of it.

              He no longer has vision in the eye, and he has adjusted to his loss of sight better than I thought he would so I would really like to give him a chance if I could. He is really very sound for his age, but he gets stressed so easily and I think if standing is an option, I'd like to explore it.

              Comment


              • #8
                You may have to find another person who will do it standing. Some regular vets will do an enucleation; you don't necessarily need an optho.
                Is the eye causing problems?
                Jingles for your guy.
                As Peter, Paul, and Mary say, a dragon lives forever.

                Comment

                • Original Poster

                  #9
                  Originally posted by lilitiger2 View Post
                  Search function didn't work so I had to go through the posts! But here is my thread http://www.chronofhorse.com/forum/sh...removal-issues on this issue. Did mine standing with local! It was very comforting to find others who had beenthrough it! and he is still doing fine!
                  Thanks for sharing that!

                  Comment

                  • Original Poster

                    #10
                    Originally posted by CrowneDragon View Post
                    You may have to find another person who will do it standing. Some regular vets will do an enucleation; you don't necessarily need an optho.
                    Is the eye causing problems?
                    Jingles for your guy.
                    He has glaucoma. He does not appear to be in pain, but I have heard from several vets now that the pressure is like having a migraine. The eye no longer has sight so there is no reason not to remove it. I'll have to check with the other clinics. Since Rood and Riddle is the best, I would like to go with them, but I just don't think general anesthesia is worth the risk if it is possible to do it standing.

                    Comment


                    • #11
                      Originally posted by caryledee View Post
                      He has glaucoma. He does not appear to be in pain, but I have heard from several vets now that the pressure is like having a migraine. The eye no longer has sight so there is no reason not to remove it. I'll have to check with the other clinics. Since Rood and Riddle is the best, I would like to go with them, but I just don't think general anesthesia is worth the risk if it is possible to do it standing.
                      I do know of someone who recently had to have an eye with glaucoma injected to "kill it". It went smoothly for him. I will see if I can get more info. Not sure if they used gentamicin as you mentioned, or something else.
                      As Peter, Paul, and Mary say, a dragon lives forever.

                      Comment


                      • #12
                        Absolutely find a clinic that will do it standing. I had an Appaloosa years ago that had both eyes removed standing by my non-opthomologist (albeit board certified surgeon) vet. There were no complications either time, in fact the horse shipped home the same day. I will say that it may be wise to leave the horse in a clinic setting for a few days post op if it's especially buggy where you are--my vet's biggest concern was timing the surgery during non-fly season. Best of luck to you--removing my horse's eyes was the best decision I ever made for him. FYI the two surgeries were done when he was 33 and 35 years old.
                        Originally posted by EquineImagined
                        My subconscious is a wretched insufferable beotch.

                        Comment

                        • Original Poster

                          #13
                          Originally posted by CrowneDragon View Post
                          I do know of someone who recently had to have an eye with glaucoma injected to "kill it". It went smoothly for him. I will see if I can get more info. Not sure if they used gentamicin as you mentioned, or something else.
                          Please do find out! I think she said it is a combination of drugs. She said it was an option but she did not do enough of them to say how likely it is that there will be complications.

                          Comment

                          • Original Poster

                            #14
                            Originally posted by Herbie19 View Post
                            Absolutely find a clinic that will do it standing. I had an Appaloosa years ago that had both eyes removed standing by my non-opthomologist (albeit board certified surgeon) vet. There were no complications either time, in fact the horse shipped home the same day. I will say that it may be wise to leave the horse in a clinic setting for a few days post op if it's especially buggy where you are--my vet's biggest concern was timing the surgery during non-fly season. Best of luck to you--removing my horse's eyes was the best decision I ever made for him. FYI the two surgeries were done when he was 33 and 35 years old.
                            Thanks! That is very helpful!

                            Comment


                            • #15
                              When my mare needed her eye removed, I really wanted it done standing, but unfortunately she was already at a vet hospital because I decided to have a conjunctival graft done to try and save her eye, and it failed. The hospital she was at refused to do a standing enucleation (when I asked why, the only answer I could get was that it was "messy"). She was already pretty stressed and uncomfortable, so I had to weigh the risks of transporting her to another clinic in her condition (she'd also had a mild colic while there, and she was still recovering from a hoof abscess as well. Oy.), against the risks of general, and I opted to leave her where she was and have it done under general. It went fine, thankfully. But I did a ton of research at the time, and if I knew I was going to go with enucleation, personally I'd absolutely find a clinic that would do it standing.
                              "In order to really enjoy a dog, one doesn’t merely train him to be semi-human. The point of it is to open oneself to the possibility of becoming part dog."
                              -Edward Hoagland

                              Comment


                              • #16
                                Originally posted by caryledee View Post
                                Please do find out! I think she said it is a combination of drugs. She said it was an option but she did not do enough of them to say how likely it is that there will be complications.
                                I'll send you a PM when I get the info. I'm also trying to get the name of the vet; perhaps they could speak to your vet
                                I believe this was done in the field, by one of the clinicians from UC Davis.
                                As Peter, Paul, and Mary say, a dragon lives forever.

                                Comment


                                • #17
                                  My 28 year old mare had it done under general anesthesia and did well. I trusted my vets advice. I don't know about the Gent injection to kill it. If you think it hurts now, it can't feel good while it is dying from a chemical overdose.....but I may be wrong.
                                  "Punch him in the wiener. Then leave." AffirmedHope

                                  Comment


                                  • #18
                                    My appy had her eye removed at my vet clinic - in the back yard! My vets were mostly small animal and not set up for equine surgery, but we figuted it would be better to do the surgery there if there were problems. Waking up was not fun and since my girl was totally blind I was worried.
                                    She was a trouper, hopped on the trailer, and went back to her life at home. The relief was immediate. Both of us were glad the eye was gone - she didn't have any more pain and I didn' t have to buy and instill drops every 4 hours!
                                    Good luck!
                                    Y'all ain't right!

                                    Comment


                                    • #19
                                      Most vets prefer to take the eye out under a general anesth. because of the risk of hemorrhage, and infection. I have seen it done standing by a very experienced vet.
                                      First the animal was sedated, then the area scrubbed and draped. Nerves around the eye where blocked with anesthetic, and then alowed to become numb. Then the eye was removed, and the eyelids trimmed and sewn together. This vet recommended against placing a prosthetic in the eye socket, saying he felt there were less complications if the socket was left empty.
                                      As the horse recovered, she was given pain meds as needed and antibiotics. She was much more comfortable after she healed. She wears a fly mask when turned- out to protect her remaining eye.
                                      Be sure the vet you select has done this sugery STANDING many times. IMO this is a proceedure that requires experience. Make sure that sterile field is used.
                                      This is not the place for dust or germs. Jingles for your boy!

                                      Comment

                                      • Original Poster

                                        #20
                                        Thanks everyone! I called Hagyard and they will do it standing so that is probably where we will end up.

                                        Comment

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