Great Expectations

or “My Life in Blog Sounds Much Cooler Than It Really Is”

A bad eye day…

Posted by mandyhuckins on May 21, 2009

Unfortunately, my beautiful, sweet, lovely, wonderful mare Dancer suffers from a horrible medical problem.  It is called Equine Recurrent Uveitis (ERU).  It is the leading cause of blindness in horses, but is unfortunately not very well understood.  They don’t always know what causes it or why some horses have it and others don’t.  They don’t know if it is hereditary, although there are some breeds that tend to be more susceptible to it than others (appaloosas and warmbloods, for instance).  Basically, it is condition that causes the eye to attack itself.  It also causes the pupil to spasm and contract and that is very painful for the horse.  When there is a build up of white blood cells in the eye – it causes a lot of other problems.  Raised pressure within the eyeball damages the sensitive inner structures located there and can develop into secondary glaucoma.

When I started leasing her 4 years ago, people at the stable started telling me that she had trouble with her eyes.  But, because these people were Germans and I didn’t always understand them, I didn’t really understand what kind of problem this was.  I knew that we had to turn her out with a fly mask on and I knew that her eyes were sensitive, but I leased her for a year without a single tear coming from either of her eyes.  When she came up for sale, my friends, knowing I wanted to buy her, re-doubled their efforts to warn me about her eyes.  I paid more attention and started doing some research.  I learned how devastating ERU is.  I had two separate vets that had treated Dancer in the past come out to look at her eyes and talk to me about the problem.  One vet told me that she didn’t have ERU.  He said that he treated her for an eye infection one time, but it cleared up with medicine and was not ERU.  The other vet said that he had seen her a few years earlier when she definitely did have ERU and he treated her for multiple flare-ups.  What to do?  Who to believe? 

I loved this mare so much, but I felt that it would be stupid to take on a horse that already had a major medical problem with a high likelihood that she would go blind in one or both eyes eventually.  I cried every day.  The owner found some buyers in another country (none of us were sure that they knew about the eye problem).  I cried even harder as I thought about what would happen to Dancer if they didn’t care for her the way she needed to be cared for.  I just felt such a special bond with her and it was killing me.  My husband saw this pain and went to the owner and asked if it was too late for us to buy her and he made arrangements in secret.  Then, he presented me with her as an anniversary gift.  The weekend before I thought the new owners were coming to pick her up.  She was mine!

I read what I could about Uveitis.  I bought a Guardian Mask and used it.  I only road her in the indoor arena when it was at all sunny outside.  I looked into her eyes every day.   In other words, I tried to protect her eyes as much as possible.  We went on blissfully for 18 months.  Then, one fateful February day in 2008, when I came to the stables, I saw a tear-track coming out of Dancer’s right eye.  There was a grey cloudy area inside her eyeball.  I called the vet right away, but it was a Sunday afternoon, so he didn’t come see her until Monday morning.  He gave her a shot and gave me ointment.  After about a week, it looked better.  No more discharge, no more cloudiness.  I called and asked him how long to continue putting the medicine in her eye.  He said for another few days.  A week after I stopped, it came back.  The vet came back.  We started over again with the shot and the ointment.  It didn’t go away.  He said we should put her in total darkness.  So, a friend and I hung sheets over the bars of her stall to keep the natural light from coming in.  She was already in the only stall without a window.  She also lived in her mask.  Everyday, I hoped to come out and see some improvement, but it was always the same.  Dancer got very depressed.  I got very depressed.  A few weeks into it, the vet told me that Dancer’s left eye was already “dead” and “blind” from a previous ERU attack (this was the first time he ever mentioned it to me – even when I hired him to talk with me about her eyes during the pre-purchase phase).  So, he thought that the right eye was her only seeing eye.  I didn’t believe that, but it definitely scared me.  I tried to get him to do something else for her or try a different medicine since what we had wasn’t working.  He didn’t know what else to do.  What I read about Uveitis online made me believe that hitting it hard was necessary, so own my own, I upped the frequency of her medicine.  I tried to get another vet to come out to see her, but there were “politics” involved.  The vet I was using was the brother of the owner of the barn and this was his “territory” the vet from the neighboring town didn’t feel comfortable stealing a patient.

By this point it was late April and we were scheduled to move back to America that summer.  Thanks to a tip from a friend, I discovered North Carolina State University’s equine ophthalmologist – the premier expert in the field of study of Uveitis – Dr. Brian Gilger.  I emailed and called Dr. Gilger and his staff.  They were exceedingly kind to speak to me about Dancer’s problems.  They even had an intern who spoke German call my vet to discuss Dancer’s condition.  We quickly ascertained that Dancer wasn’t getting the best care.  They really needed to have her in North Carolina.  I started making the plans to ship her.  She left Germany on June 1st, spent 3 days in New York in quarantine, was picked up and driven in a sealed trailer to North Carolina, established at NCSU’s quarantine facility and was seen by an ophthalmologist on June 11, 2008.  That is the day I learned that she was not blind in the left eye, but at some point during the treatment of the right eye, she had developed Glaucoma and had permanently lost sight in that eye.  The interocular pressure in that eye was over 50 (normal is around 15 +/-).  We started treating her with Glaucoma medicine to see if we could get the pressure down and make her more comfortable.

At first, it seemed like it might work.  But, the pressure went back up and it was time to make some hard decisions.  Dr. Gilger explained that horses don’t always respond to Glaucoma medicine (but, it had been worth a try).  I certainly didn’t want her to be in pain forever, so there were two courses of action: 1) I could have the eye removed, which would permanently solve the problem, but had an added risk of putting her under for surgery or 2) I could have the eyeball injected with Gentamicin – which would destroy the inner workings of the eye – preventing it from producing more fluid and hopefully reducing the pressure in that eye.  NCSU was also putting cyclosporin implants in horses’ eyes with some success in staving off and possibly preventing future Uveitis attacks.  Dr. Gilger and I discussed putting one of these implants in Dancer’s left eye.  But, he also told me I had an option there too – a Rapamycin injection – which was new and still experimental, but early results showed it had a similar effect to the implant.  I decided to go with that.  On July 10, 2008, Dancer had the Gentamicin injection in the right eye and the Rapamycin injection in the left eye. 

Unfortunately, the Genatamicin injection wasn’t the perfect cure to our pressure problem.  Working with my ophthalmologist in Alabama, we have found that she still needs twice daily a drop of Cosopt and a strip of Dexamethasone ointment to keep that eye controlled.  I was also continuing one strip of Dex in the left eye as a preventative every other day.  Things seemed to be fine.  Her last check was in February, when we decided that things were good and she didn’t need to be seen until May – right before I would take her to Kansas.

Well….I went out to the stables on Tuesday morning, took off her mask and was greeted with a left eye that was swollen shut, oozing and hot to the touch.  Naturally, I panicked and burst into tears.  Then, I wiped her eye, put Dex in it, and gave her some Banamine.  I put on a clean mask and started trying to call my ophtho.  We gave Dancer another dose of the Dex ointment a few hours later.  That afternoon, when I had her up at Auburn, the eye looked much better.  My ophthalmologist (whom I adore) gave her a good once over.  Her pressures were actually better in both eyes than they ever have been (left 11 and right 15!).  She thinks that my fast action in administering the right meds might have stopped this flare-up in its tracks.  I am going to continue the Dex in the left 4 times a day for a while and then start to taper back down.  One full day has passed and we are halfway into the second day, but the eye looks great.  It is hard to tell there was anything wrong with it two days ago.  I am so relieved!  But, I am still being vigilant and not counting my chickens yet.

Sometimes, I get tired of having to go to the stables twice every day – but now I realize that it is actually a blessing.  Because I am there, I can notice any change immediately and try to get the help she needs.  She was given to me because I truly believe I am the best one to care for her.  Horse ownership is difficult and there are many people out there struggling with horses who colic or dealing with lameness issues.  But, God doesn’t give us something we can’t handle.  And, I thank him every day for giving me Dancer.  She has caused me anxiety and worry and stress – but, the joy she brings me far, far exceeds any of the struggles.

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2 Responses to “A bad eye day…”

  1. Lori said

    I am SO glad you are Dancer’s mommy. You are right…you ARE the perfect person to care for her. I hope she continues to stay the course and enjoy the wonderful life I know you give her!

  2. Kirsten Dawes said

    Reading this made me cry. I was seaching equine uveitis and came across your blog. My horse was just diagnosed with uveitis and it is heartbreaking.

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