Jingles and Indolent Corneal Ulcer success stories STILL IN THE TRENCHES

[HunterJumperGin]

**End of the year update: We still have both eyes. We suffered through an infection and almost a month at Auburn, but we are ACTUALLY healing now. He’s still got an SPL in and has been treated at home 4x a day since coming back on Dec 14th with lots and lots of hand walking and grazing and praying and wishing and waiting. We go back for a re check on Jan 4th and I REALLY really hope we get some light at the end of the tunnel news. We had one colic scare that sent us back to Auburn, but ultimately was categorized as a gas colic mystery with no action taken. I hate this whole process. I’m so thankful he’s doing well but I will be THRILLED the day I can put his hairy butt in a pasture and take a breath.

Original Post: So at the same time the beautiful horse in my avatar was rapidly declining and ultimately let go two weeks ago, my other horse was diagnosed with a corneal ulcer and has spent the better part of two weeks at Auburn University under the care of their wonderful ophthalmology team. He is coming home tomorrow with a lavage system and in overall good spirits (considering he is a lively thoroughbred on stall rest). He is 17, which they said can sometimes lead to a slower healing time in itself, but I would REALLY love to hear some success stories from folks. He has no infection (fungal or bacterial) and no signs of infiltrate. They did two debridements of the epithelium, one with cotton swab and then later with the diamond tip. The only hiccup since has been some corneal edema, which is being treated with topical Sodium Chloride. He is getting atropine, vorconazole (SP - it’s an antifungal? ), and ofloxacin 4x daily through the lavage system, and is tolerating this very well.

He will come home tomorrow (YAY) where he will remain on stall rest with limited supervision outside and I will continue to treat through the spl. He will go back to Auburn for a recheck in 7 days to see progress. Could REALLY use some jingles for healing. I’m mentally trying to process the loss of my horse of 15 years, and I just really really do not want to drag this other horse through a healing process of months and months - although I know these can be a b**** and take that long to heal completely. If it comes to that point, I know that enucleation would be a very real option. Not near there yet, but I’m trying to remain realistic for his best interests.

Sigh. Horses.

[caryledee]

I’m sorry, I know how devastating corneal ulcers are firsthand. One of mine gets frequent corneal ulcers. The first one he had lasted seven weeks and the next one went 5-6 months. Neither was infected and he was only 6 at the time so age was not a factor with him. I tried everything out there…debridement, serum, EDTA, keratatomy, etc. As his would start to heal, the edges would fragment and not be able to close completely. Then it would open up again and the process would start basically from scratch. He was not a candidate for enucleation because he had issues with both eyes.

What I eventually found worked for him was adequan drops directly to his eye. Once I started this, the indolent ulcer healed within a week and every ulcer he has had since then has healed within 10 days. Hopefully yours will heal just fine but it might be something to keep in mind or ask vets about if it shows signs of not healing. Since it is an off label use for adequan a lot of vets don’t use it.

Sending big jingles for a quick recovery! Hang in there!

[HunterJumperGin]

@caryledee as in the drug that is normally injected for joint health and older horses? I read that somewhere else but I thought it was a typo for atropine. I will definitely inquire about that. Very interesting. As of right now we are only two weeks in and the edges are looking good so my fingers are crossed that a few more weeks of treatment can clear it up. Thanks for the encouragement! Thankfully we are only dealing with one eye at this time

[caryledee]

Yes! I just buy one vial of regular Adequan and use about 0.1 cc three times a day. One vial lasts about a week. I’ve heard some people say they dilute it with saline but I have always used it full strength. My friend works on one of the big TB breeding farms and she is the one who told me about it. They use it on the babies when they get corneal ulcers.

It sounds like you are on the right track. Hopefully when you go back for a recheck they will give you good news!

[cayuse]

Sending lots of jingles. I went through something similar a few years back with my pony. Oddly, she was diagnosed with it about 10 days after we lost my husbands mare so I can relate. It was a long emotional haul, for us and the pony, but we all got through it. Hang in there!

[HunterJumperGin]

Update: he’s home! I’m so happy to have him back. We will go for a recheck in 7 days and continue all treatments with the lavage system. I’m PRAYING he stays as much of a gentleman about this as he has been. Hell, at least I’ll burn mad calories hand walking and worrying.

[mpsbarnmanager]

Ugh, That’s such a pain in the @ss to treat. Is he a candidate for the cyclosporin implant?

[Skeezix]

We just survived one with a boarder. 20 year old who was not fond of being in his stall much to begin with. We had to devise all kinds of buddy systems to keep him calm and then round the clock medications through the labrage system. All told took about four months. He has just recently gone back to normal turnout and work. Sending lots of jingles and well-wishes your way for a good outcome!!!

[HunterJumperGin]

Thanks guys! It’s encouraging to know that a LONG recovery doesn’t mean NO recovery. He’s doing really great and I’m just trying to handwalk as much as humanly possible, especially on the weekend when I have more time. The ulcer is clearly visible, but he is holding the eye more comfortably. I’ll be curious to see what that looks like when/if we step down the banamine a bit. He is on 10 ml orally 2x a day currently. I’m nervous of ANY med long term. Praying he continues to be his happy go lucky self pooping and peeing as great as he does now.

@mpsbarnmanager I don’t know about the implant. I will ask about it!

[PushersBlue]

My gelding had an ulcer and an abscess on top of things because he’s special like that. Very painful eye and infection in there, but I think we caught it within hours. I now realize we lucked out since I was able to treat with systemic antibiotics plus eye ointment over the course of 5 or 6 weeks. He was an excellent patient though and shockingly came to me for his treatment 4 or 5 times a day at all hours for weeks.

Pain control is quite important though we found. We removed the banamine too early and he flared up something awful literally within hours since they try to rub. I would recommend working with the vets to step things down very very slowly and watch for how he does. We switched to bute and eased down over the course of a week or more.

From the stories I read and hear, we got off easy, but every horse is difference in terms of pain tolerance and healing speed. The affected eye is partially blue so it was easy to see the healing and the edges. There was brief talk of debriding, but it thankfully came together. We believe there is a spot in his line of sight but he doesn’t act differently due to it verus before.

It does take a long time to heal. It sounds like you have a good patient which is a giant plus in your column.

[HunterJumperGin]

Ugh back at Auburn. We made it home for 6 days and then last night it started to look a bit angry so I took him back for his recheck a day early. They did a keratectomy today as nothing was really healing and he will be at the hospital for about a week. This is after a diamond burr treatment last time. Which was after an initial cotton swab debridement. I am willing to give it more time and throw all the meds at it at home for however long it takes but this is the last treatment and hospital stay I can afford. Praying this works

[TXJumper]

I am so sorry - this whole eye thing is so frustrating and discouraging! I so completely get it. I am dealing with an eye issue as well that we can’t seem to figure out. So my question is, what were his symptoms? Mine is just teary, squinty and obviously it bothers him. Had a vet out and he stained, but didn’t see anything. Well, after he left, I watched some videos of eye exams and realized he didn’t do half the proceedures he should have. So I am just wondering if he maybe missed an ulcer (he never looked at it under a light). He just said it was angry and gave me ointment. Well, ointment didn’t work, and it’s been 3 weeks. I switched over to colloidal silver because I was concerned that the ointment (which contained steroid) was going to make things worse IF he did have an undiagnosed ulcer (which I felt was totally possible given that he didn’t block, take culture, or get a really good look at it!). Well, it’s not worse - no discoloration or anything. But it’s not better really either. It’s better than a several days ago but has been status quo for about 3 days with the colloidal silver. I’m just wondering if, given the experience you have, does that sound similar to yours? I think I may need to take him into an ophthalmologist but the one that I was referred to doesn’t have an appt until December!!! And I have lost faith in my vet…looking for some answers.

[Corky]

Wow, how big was it to start OP?

My mare is 5 weeks into her corneal ulcer. She had two ulcers actually, total effected area was 50% of her cornea when diagnosed in October. We started on Banamine 2X daily, atropine for 2 days, cefazolyn, and serum 6 times a day. Cultures were clean, no bacterial or fungal. Both ulcers were shallow but huge. We were very concerned about the two ulcers melting into one which would have likely resulted in detached retina and eye removal. Thank god they didn’t grow larger after diagnoses.
She was not progressing with healing and no development of blood vessels at first, so she had the scratchy thing done on her eyeball to trigger healing, we added Tobramycin and upped strength on the Cefazolyn. Downgraded drops to 4X day on day 4. She stayed indoors with arena turnout only for 4-5 days.
Signs of blood vessels, but ulcers didn’t start to shrink until about 2 weeks I think.
Added ‘blackout’ section to a flymask and turned her out, continued 4X day drops and vet visits every 3 days to checkup and draw blood for serum. She was getting some adema, added Muro drops 2X day for adema.
She came off banamine on day 8 or 9 I think, but she wasn’t opening it all the way indoors so we added banamine back but 1 dose daily for another 5 days, then stayed off when she could hold both eyes evenly open in low light with no banamine.
Now shes had the scratchy procedure done 2, maybe 3 times total, shes off serum and off muro now, off banamine and down to Tobramycin and Cefazolyn drops 2X day, still wears mask on day turnout, off indoors at night. She can go out in low light with no mask, so last hour of the day I usually take it off at dusk if I can so she has some time outdoors with it off. Will be taking off tape so shes just in a mask before taking it off totally, probably won’t be for a week or two yet.

Both ulcers are now shrinking and have excellent blood supply. Last procedure was a week past today when she had a developing ridge scraped off, then a check up monday. She will be checked again today. Hoping one will be nearly gone by now.

We never installed a lavage system because I immediately did treat + eyedrops so she wasn’t horrible, and has remained generally agreeable about drops. If she had been throwing me around the stall over the drops we would have had a different outcome. My vet is also near my place often enough she could check the eye every three days, draw blood and either deliver serum or I’d meet her on her route when needed to pick up. With a less awesome, less local vet I would have had to put her in clinic, or she would have lost her eye. I also had to move her farms because she was supposed to be living out and there was no stall for her on Nov 1 so I moved her to a friends place down the road where she could still come in every night. If we had to put her back on outdoor board, my vet was going to sew her eye shut for protection. I freaked, and moved her. Thank god for accommodating friends!

Long haul! We are not out of the woods yet, but I have a mare who still has two eyes so I’m still positive about it!

Oh, and we are doing all this with a 4 month foal at side.

[HunterJumperGin]

@TXJumper

Symptoms were tearing and holding the eye mostly shut. similar to you. My suggestion is to do whatEVER you can to escalate the situation yourself. Get him to a veterinary hospital with an optho team STAT. They can help work with your budget and come up with a plan that you can do or at least be realistic with what your options are. These things are SO HARD to see unless they are sedated and under light, etc. And it’s important that you have the right antibiotics and/or antifungals on board asap. I would have never known the level we were dealing with without an expert. Sorry I’m just now reading this but GO anywhere you can. Be pushy. Get an appt or see if a local vet can refer you. Eyes can go downhill so so quickly despite your best efforts. Keep me posted!

[HunterJumperGin]

Damnit. Vet just called and the keratectomy site is looking infected. They are upping the antibiotics and doing them every 4 hours tonight. We will see what it looks like in the morning and do some cytology to see if this is worth continuing to fight or can be fought. I KNOW there are a lot of great one eyed horses out there - I was just really hoping we would not be close to that decision. We are at 1 month of fighting this damn thing and I fully understand that is not that long of a time when it comes to eyes. But at the end of the day he is 17 years old and we are not going to ever be doing a grand prix or running prelim. Part of me just wants to give him his life back and enjoy the years we have left - even if that is with one eye.

[TXJumper]

I am so sorry! What is going on now? Im praying it got better since your post? I’m still battling this too. Things are looking a lot better - eye is open and getting better. But, today I’m looking at it and I swear I see some blue haze. It’s got me freaking out. Had a new vet out Tuesday and he said it was fungus and healing well. Said to keep using the colloidal silver as it seemed to be working. Gave me something else for the pain. But now I’m really worried. I’ll see how things look tomorrow and I’m trying to put it in more frequently. Why don’t people tell you about eye issues!! I wish I had known a month ago what I know now!!!

[GAHORSE]

Don’t give up! I’ve treated three separate cases at my barn, all ended up clearing up. The last one was the worst, terrible melting ulcer…I was on the verge of giving up but once it finally started healing it cleared quickly! I had the levage system on two and used it and the eye saver mask on last one. It was a lifesaver for me. Good luck!

[katenreno]

I agree, don’t give up yet. I know you’re at the end of your financial means, and I get that. But talk to them about culturing it; both aerobic/anaerobic and fungal cultures. Make sure you’re on the right drugs. Oflox and voriconazole through the lavage are pretty much the best you can get, but sometimes the culture surprises you. Ask your ophtho if he’s a candidate for a conjunctival graft. If you at all have the means to give it one more go before enucleation, that’s your hail mary. It won’t look pretty for several months, but he will still have an eye and partial vision. If it’s getting infected, you literally need drugs at least every 2 hours, if not hourly. Constantly keep that cornea bathed in some kind of antimicrobial. Horses live in a filthy environment. I’m sure he is, but if he’s not wearing an eye saver, he needs to be. Even if you’re sure he isn’t rubbing the eye, he is. Lastly, we had some good success with a nasty non-healing graft sight that we ended up putting on vigamox. I am more than sure your ophtho’s know what they’re doing. Just throwing out a couple suggestions that my doctors and I do when the going gets tough (I work for a veterinary ophtho). Good luck and many jingles!!

[FraggleRock]

My mare had two corneal ulcers in her right eye from hay stuck through the fly mask. It happened on her first day allowed back outside in daylight (bugs) from a bad kick(s) that had resulted in stitches in one spot and eventually opening up a huge hole in her hind end to let the fluid drai
** Not sure where the rest of my post went???**

[Ruth0552]

Last summer (2016) I spent 2-3 months treating my retired OTTB for a fungal eye infection. It SUCKED. It took a long time, and he had a lavage system in for most of the summer, but by the end of the summer he was better. He has a large white patch of scar tissue in that eye and I assume he has some vision loss but managed to beat the odds.

My cat had eye issues this summer. After seeing my regular vet who was farting around I made an appointment with an ophthalmologist who diagnosed uveitis, an indolent corneal ulcer, and glaucoma. Once we got the glaucoma under control we were hoping the ulcer would heal but it wouldn’t. Opth. wanted to do a keratectomy but after talking with my new regular vet (I switched regular vets due to the farting around) we decided to take the eye out instead. Both of us were heading out on vacation for a couple days so we made an appointment for when we were back. I get home from vacation and would you freaking believe it the cat’s eye healed while we were away. Took the cat to regular vet to check- no ulcer. Went back to opth. who was amazed eye had finally healed but it did, it just took a long time. Then we started treating for the uveitis, which is now under control and doing well.

It’s weird to me that corneal ulcer become non-healing on there own. I thought most of the time this happened there was another underlying condition, like my cat with uveitis.

I hope you get some good news soon! Stay positive- he’ll do fine with 1 eye and right now he probably doesn’t want it anyways!