Euthanasia vs. Eye removal

My uveitis horse is not doing so good. I had been maintaining him on eye drops daily and oral dexamethasone. He had a flare up.

I treated aggressively for 24 hours doing drops every 3 hours. Then tapered to 4x daily for the last 3 days. Went to check this evening and his eye is swollen shut and full of pus. He doesn’t want anything to do with eye meds and is fighting me tooth and nail.

I can’t decide if I want to proceed with eye removal or just give up. He’s not a good patient. He hates stall rest. He is good til about 5 pm when he starts pacing and wanting out. I decided to just turn him out with a blinker hood on so he can’t rub it. His halter goes on over it so he can’t (hopefully) rub off the hood.

But the thought of putting him through surgery and fighting with him for aftercare is a bit overwhelming. I don’t like this horse that much. He was a rescue and has had 3 mostly good years here. Still a young horse, with high energy levels.

Everything is a negotiation with him, lots of fear issues, nervousness, equine ptsd. Training was a professional job and there were times where I questioned my sanity in even getting on his back- nearly ran me into a fence at one point. He had so many phobias and fear issues. Most of this has been overcome and he is actually a nice riding horse, most of the time. But I still worry about what happens if someone shoots a gun off or he has a ptsd moment, as he still has a big panic in him. That fear never totally leaves and his panic reaction is to run off. He spooked at my map while I was sitting at a picnic table and bolted off in a random direction. Somehow he left state park lands and didn’t stop until he reached the highway (the police were called).

I can’t imagine supporting him for another 20 years either. I’m really not certain I want to continue. Maybe I can get him through this flare up, but what about the next one? And do I want invest money for eye removal surgery when the disease can jump to other eye?

I have not taken him to see a specialist. My local vet clinic has been treating him (3 vets looked at him at some point). So far his good eye appears okay, but they aren’t specialists either. It could be his good eye is going to go bad today, tomorrow, or next year… Maybe it is already starting to go bad, just not obviously flared.

I am attached to this horse. He has come so so far, compared to where we started. I’m just exhausted. Defeated. And tired of arguing with him over eye meds. He is really starting to trust me… Just not when his eye is hurting.

If you have had eye removal done, how difficult was the aftercare? Perhaps it won’t be as difficult as I think. I just don’t know.

If I was certain the other eye was affected it would be a simple choice to euthanize. He will not do well as a blind horse. Way too flighty and nervous.

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Oh my! I can’t even begin to imagine how difficult it is to deal with this horse. I have dealt with some special cases. Never ever feel guilty for putting a horse down, he sounds like he would never find another good home and it can be a kind thing to do. he sounds like he is in pain, with his eye. Truly sometimes the kindest thing is to let them go. I think you are looking for permission or affirmation to do this.

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I had an eye removed in a horse due to long term issues, and the relief he found from the pain changed his personality. He was always sweet, but grumpy and fearful - the surgery made all the difference and our last years together were wonderful. The recovery was very easy … not difficult for him (or me) at all. (The only thing that happened during surgery was the vet disregarded my advice on his tolerance for sedation, and he got up part way through and then fell on the barn owner’s husband. Ooops.)

I would probably give it a try and see if the long term discomfort didn’t have something to do with his behavior. But, I have also been in your position where I had a horse I just didn’t get on with, who was remarkably difficult and we never ever ever clicked. It was zero fun to ride him, and to own him. I did eventually euthanize him because of canker in all 4 feet, but my vet and I had many discussions along the way about euthanizing a horse that just wasn’t happy and wasn’t useful. I was okay with the idea, and still am, but I did feel like I should at least try to manage his discomfort and see where we got.

Anyhow, my two cents.

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What a difficult decision OP —you sound like a wonderful horse owner with a challenging horse! I would support the idea of going ahead and having the eye removed, then give the horse and yourself a reasonable amount of time to see if the relationship improves. If you decide to have the horse put down, you will know you have tried everything. You are a kinder person than I am —and far more patient. I’ve had two horses in my 50 years of horse ownership that were problematic --one may have had mental issues, and one that was untrustworthy around kids (bite/kick). After two years of trying everything --I found them more suitable homes than a farm with kids running around. At the time I felt like a failure --but in both cases the open stall was filled with a wonderful horse, far more suitable and enjoyable than the one that left --sorry you are in this situation.

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I assisted when a friend had her horse’s eye removed after an accident. It was done standing in a clinic, though the vet would have done it in a field if necessary. The prep work, surgery, and wrapping up after took maybe two hours total. The after care was actually quite easy – leave the bandaging on for however many days, then a fly mask and monitoring afterwards. The horse was turned out with his herdmates the entire time and has adjusted to being one-eyed very well.

Whether or not this is a workable issue for you and this horse is a question only you can answer. I offer this info only to let you know that removing an eye is not a major production surgery these days.

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A friend of mine went through this a few months ago (although with an elderly horse that she loves and went to great lengths for). They removed the problematic eye and within a few weeks he developed uveitis in the other one and had to be euthed anyway.

From the sound of it, aftercare for the eye removal was easy, but there was one freak incident. Lightning struck at the farm and the horse panicked and fell down. Mud on the fly mask covered his good eye, so he panicked even more at suddenly being completely blind, and ran through a fence. This was a very calm 30±year-old horse, so it seems that having only one eye was causing him some uncharacteristic anxiety.

OP I don’t think either option would be wrong and that’s what makes it so difficult… finding him a good home would be very very tough and most likely would not happen.

Hugs to you… it’s so hard, but if you would decide to euth it would not be the wrong decision.

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I had my horses eye removed after he lost sight in it following a cross-tie accident and he kept getting ulcers in it. The aftercare is not much, and you get used to the empty socket pretty quickly. The empty socket does get dirty and itchy. My horse loved having me clean it with a wash cloth and itch it for him. He was much happier once the eye was taken out and really no different to ride, although I had to remember to ride his blind side so that I did not accidentally stear him into the fence or wall of the ring. He was happy and confdent out on the trails.
Unfortunately, he developed uncontrollable glaucoma in his remaining eye and I opted to have him euthanised as he was in so much pain from that.

I started with a happy confident horse that I had owned for many years and who trusted me completely which probably made things a lot easier.

Tough decision, OP. I’ve seen two horses have an eye removed and it was really no big deal at all. The bandages came off after a few days and the horse had to wear a fly mask for several weeks. Twice a day we wiped the area gently with a wet gauze pad. It was itchy as it healed and they really seemed to like it. In those cases though, there were injuries not diseases - no risk to the other eye. Both horses remained in work and did fine.

I have neighbors who like to target shoot and it drives him nuts (running the fence and dripping sweat, trembling). It’s not possible to continue if he goes blind. I can’t risk getting hurt fighting with him either.

I think I will turn him out with a mask and hood. He may pull out of this on his own. He put bad ulcers in it twice before during flares and we couldn’t treat with steroids obviously, and both times he recovered, although with some vision loss. I can do pain medication and just turn him out. There’s no ulcer this time.

I’ll see how he does over the next week. I don’t have to make a decision right now. I put a call into the vet to discuss things. See what she suggests…

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I support the OP in either decision, but I personally would be euthanizing. It sounds like it feels like managing this illness is alot of work and not alot of light at the end of the tunnel for the OP, and I see no down side to euthanizing, frankly. The OP has already given the horse love, training, and a job, so I feel that at this point, horse could be let go with a clear conscience. Just speaking for myself, I believe that being dead and not in pain, and not at risk for more pain or anxiety, is better than being alive with pain and risk for more pain and uncertainty. (Of course, every situation is different.) But I would euthanize, with love and treats, and give both horse and OP a rest.

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With all the details given, elective euthanasia is probably your best bet. If you can’t handle surgery after care, and you can’t guarantee his quality of life without it, then elective euth is a great option.

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It’s totally okay to euthanize in this situation. Enucleation is an easy procedure with an easy recovery, but this horse sounds difficult. I would say that most horses adapt very well to being blind on one side, but I have also seen horses that are blind on one side become a little “funny” about things on their blind side. So if this horse is prone to nervousness and panic, it’s possible that there will be behavioral issues post-enucleation. If you were my friend I would totally support you in your decision to euthanize a horse that is suffering, requires surgical intervention with an uncertain outcome, and that does not have a high likelihood of return to a useful purpose/happy life.

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Can you get a consult with an Opthamologist? Their input might help you to be more comfortable with whatever decision you make. If you PTS or remove the eye, I don’t think either is a wrong choice. I know it’s a hard choice, though. I had a mare who nearly lost her eye and had surgery to graft the area and she was never quite right afterwards. I sometimes wish I had her euthed at the time (she also had a few other issues that required maintenance). I hear you about the exhaustion and defeat. I’m sorry that you and you horse are going through this. Sending Jingles.

For those of us who have dealt with a horse with Uveitis and the constant , horrible, flair ups and how difficult it can be in administering the needed meds-- all I can say is whatever decision you decide on is the right one.

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With a horse that does not give you joy on his best days, I think euthanizing makes a lot of sense.

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Horses I have known who have lost an eye were fine with some precautions BUT they were fine, sensible and easy to work with BEFORE they lost their vision on one side. They trusted their humans and were not overreactive.

Posted before, one of these trustworthy, sensible one eyed horses got surprised on its blind side after a demanding clinic on a hot day. My group of very experienced, older riders with equally experienced older horses, including one missing an eye , were hand grazing and chatting as they cooled and dried. Some stray kids were playing frisbee with a dog in the parking lot on the other side of the barn, frisbee hooked around the cornrr past the end of the barn and it and the dog, at a dead run, hit metal trash can very close and on the blind side of that horse. Really scared it so it jumped and spun to see, knocked his owner down slamming into another horse who jumped into my horse and I went tip over tea kettle down a small hill.

Now, true, we were also at fault, not paying attention, and I had changed into really cute backless clogs. But I broke my wrist needing surgery and hardware, missed 8 weeks of work (cant work in a cast). The cute, stupid shoes survived unscathed.

Point here being even though that horse was kind and trained to death, Id known it for years, even jumped it around a 3’ course, in a boarding barn, s#*t happens. You cant control everything or the actions of others or expect others to tailor their actions around a over reactive horse or even know about it in a busy environment. Thats a fact of life in even the best managed barns.

Sounds like OP horse is not kind and trusting, is difficult to handle, can over react even with sight in both eyes- if he goes nuts over pasture noises now, what happens when he loses sight in one eye? Doesn’t sound like OP keeps him privately but depends on others to manage him. There are things to consider here, not to mention Uveitis tends to occur in both eyes so spending on the surgery and wrestling with this horse for the aftercare might not solve anything long term.

It would be different if the horse liked or at least accepted being handled now and/or it was an injury to the eye, not a degenerative, often bilateral condition. Very possible his bad behavior is related to poor eyesight but removing an eye and all sight on that side isn’t going to create any new trust and acceptance on his part. I feel sorry for horses that never caught a break and OP had the best intentions but he’s a bit on the nasty side and liable to hurt her or a barn worker trying to flush out and medicate the socket. Some are just not good candidates for this surgery.

Most people I have been around for decades wont continue with Uveitis. They’ll medicate and manage them but when it advances past a certain point, they let them go rather then subject the horse to it and end up putting them down anyway when it very commonly worsens in the remaining eye.

OP is completely justified if she chooses to let him go, Sometimes we get them broken and they just cant be fixed and meanwhile continue to have poor quality of life. I dunno about spending to do the procedure just to see if it helps him knowing he will not tolerate the aftercare and chances it will worsen in the remaining eye are high. Doing him no favors on that.

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What a tough place to be. My heart goes out to you OP. Remember that horses do not look forward to tomorrow. They live in the moment. Whatever you decide will be the right choice.

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Agree with others in supporting whatever decision you make. Don’t dp the surgery out of some guilt or feeling like you ‘should.’ Do it if you really think it will improve his QOL, you have the finances to handle it witbout concern, and will accept whatever the after prognosis is. It sounds like he’s not living the best life now, not for your lack of trying. Sometimes euthanasia really is the kindest decision. Best of luck to you, whichever way you go.

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We removed my retired geldings bad eye after months of treatment, and he became a different horse after! It only took him a few short weeks to adjust, and has since been healthier than ever. We’ve made slight accommodations - we now lead him from the off side so that he can see us during handling, and he wears a fly mask no matter the weather (his preference - if we forget he will wait at the pasture gate for it).

This isn’t to say that you’ll have the same positive experience, but I am very thankful we did the surgery for my gelding when I debating between the same two options.