Uveitis

[BigMama1]

So my boy has been diagnosed with uveitis. In the past he has been prone to minor eye infections and we always act on them immediately. Usually the initial dose of Tobrex seems to work miracles and he’s good as new very quickly.

This time things were different. The first night he presented with a slightly puffy and funny eye I put in the Tobrex and expected to find him much improved in the morning. He wasn’t. Eye was very swollen and tearing and he was quite obviously in pain. Vet did a quick exam and thought he could see a small ulcer. Switched to a different antibiotic ointment and Banamine. Next day eye was dramatically better. Continued treatment over the weekend but the light sensitivity grew worse so called the vet back. Sedated for a full exam and concluded no ulcer or scratch, but uveitis.

So now it’s been 5 days since that dx. Treated with Atropine, Banamine and a steroid / antibiotic ointment. Has been kept in his dark stall and we put the UV mask on when lungeing or walking in the arena. Eye looks almost normal. Very little swelling or tearing. Eye checked again yesterday and said it looks good but the pupil still isn’t opening, so to continue with the Atropine for another few days.

He says to turn out and ride as normal using the Guardian mask and just to keep a super close eye out for any future flare ups. Of course I have millions of questions for others who have experienced this.

1. Is it ever just a single bout or does it always become recurrent?
2. If the pupil isn’t opening and he’s still in Atropine, does the mask really work well enough to keep him comfortable in bright light?
3. Is it ok to ride / work him as normal or would that be stressful?

Any tips, advice, or support are much appreciated

[theresak]

So my horse had what the vet called “traumatic uveitis” after he whacked his head on something. We think he bruised the eye pretty good and the skin below the eye (eventually sloughed off). We did the uveitis treatment protocol and he recovered.

He does have one chronically runny eye that I treat with ointment when it’s windy and he’s been prone to ulcers in the past.

[csaper58]

You might have a veterinary opthamologist check the horse for glaucoma. It can occur secondary to uveitis.

Glaucoma is quite painful and causes the horse to rub it’s eye. This leads to a swollen eye and corneal ulcers.

www.thehorse.com/articles/29896/diagnosing-and-treating-equine-glaucoma

[vineyridge]

You should also have the horse tested for leptospirosis, which is a common cause of recurrent uveitis in the South. If you have access to the vaccine and he is not already infected with lepto, I’d have the vaccine given as a precaution.

[Trails]

Had a mare at my barn with uveitis. She wore a UV fly mask ( Equine Sun Visor - blocks 99.5% ) all the time while outside. Her stall had a window so UV screening was put up. We also checked her eyes once a week using a flashlight. We always had an ointment on hand so if there was a flare up we could act quickly. Once the flare-up was under control the owner then rode regularly.

[cherham]

Have a friend with a lovely hunter show horse that was diagnosed with recurrent uveitis 2 years ago. The first flare up was bad but was quickly under control under Vet’s guidance. The second was much less but caught early enough that it did not require a Vet’s attendance as all the necessary medications were already on hand. If the barn staff are familiar and know how to deal with any re-occurrences it can be handled. This horse always wears the Guardian mask outside and a lighter mask under his bridle when being ridden. Even inside the arena. He has shown in the mask and has pinned relatively well despite this additional equipment. It does not seem to affect his eyesight to see the jumps etc and has both her Vet’s and the show stewards permission to continue to show him. He is not sale-able at this point of course but she is OK with that. He is her “forever” horse.

[BigMama1]

It’s been about 10 days and his pupils both seem equal now when I shine a flashlight on them. Wearing the Guardian mask outside all the time and will forever. I rode him in the indoor yesterday without the mask and he seemed fine - no swelling or tearing at all.

I know it’s unlikely but I’m still keeping my fingers crossed that this is a one-off infection and doesn’t become recurrent uveitis.

[EmilyM]

I just experienced this with my horse in February. He had a bout of uveitits that I couldn’t explain. Never had so much as a tear before. Because I was in Ocala I got to see the nation leading opthamalogist, Dr. Brooks. I just want you to know that even though my horse looks perfect to me, he suggested that I continue to treat it. So i’m over the 2 month mark, still treating it and will see a specialist next week at NBC now that I’m back in PA. I am using diclofenac (which is basically Surpass for the eye) every 2 days so it’s easy treatment, but i guess uveitis is a bugger. I have been slowly tapering to this level of treatment starting with 2-3x/day of 3 meds: antibiotic, atropine and diclofenac. Also, they advised that around vaccines to treat w NSAID of choice 24 hours in advance (banamine is preferred, but mine gets Equioxx due to predisposition for ulcers) and 3 days after. I also amped up the diclofenac around vaccination time. I guess the immune response created by vaccines can cause a flare up. When he was acute, the systemic NSAID was very important.

I hope this is not recurrent for your guy. I’m hoping the same for mine!!!

[beau159]

@BigMama1

So my boy has been diagnosed with uveitis. In the past he has been prone to minor eye infections and we always act on them immediately. Usually the initial dose of Tobrex seems to work miracles and he’s good as new very quickly.

This time things were different. The first night he presented with a slightly puffy and funny eye I put in the Tobrex and expected to find him much improved in the morning. He wasn’t.

Tobramycin is just an anti-biotic and will do nothing for inflammation, which is what uveitis is.

@BigMama1

So now it’s been 5 days since that dx. Treated with Atropine, Banamine and a steroid / antibiotic ointment.

Banamine will help bring down the inflammation, but topical steriods are really beneficial.

Of course with horses, you do have to be very careful with steriods if any corneal compromise (abrasion) is involved – which sounded not the case for your guy.

@BigMama1

Eye checked again yesterday and said it looks good but the pupil still isn’t opening, so to continue with the Atropine for another few days.

If you were using atropine and the pupil WAS NEVER dilated, I would be concerned of a posterior synechiae (where the iris is “stuck” to the lens).

Did it eventually dilate? (meaning the synechiae was broken?) If it never did dilate with atropine, I’d be getting a second opinion immediately.

[BigMama1]

@beau159

Tobramycin is just an anti-biotic and will do nothing for inflammation, which is what uveitis is.

Banamine will help bring down the inflammation, but topical steriods are really beneficial.

Of course with horses, you do have to be very careful with steriods if any corneal compromise (abrasion) is involved – which sounded not the case for your guy.

If you were using atropine and the pupil WAS NEVER dilated, I would be concerned of a posterior synechiae (where the iris is “stuck” to the lens).

Did it eventually dilate? (meaning the synechiae was broken?) If it never did dilate with atropine, I’d be getting a second opinion immediately.

Yes, sorry should have been more clear. It was opening with the Atropine but not quite as much as the vet wanted so he suggested we keep using it for a few more days. Today was the first day without Atropine and the eye looks completely normal now to me and my trainer. Vet is coming back tomorrow for another check.

[Dee-Vee]

@vineyridge

You should also have the horse tested for leptospirosis, which is a common cause of recurrent uveitis in the South. If you have access to the vaccine and he is not already infected with lepto, I’d have the vaccine given as a precaution.

Please do not vaccinate your horse for lepto. There is no equine version of the vaccine and I have seen vaccinations with the bovine version bring on an attack of uveitis. For the record, there were a number of cases of uveitis on the property where I used to board, so I had bloodwork done to find out that my horse has been exposed Lepto a long time ago. She is fine. I watch her though because I have been through the heart ache of uveitis with my previous horse. So point being exposure to lepto does not equate to uveitis. It is just a correlation because the cause of uveitis is unknown.

Mama…best advice…talk to Guelph. There are so many new things that vets are doing for uveitis that can stave off attacks. I won’t comment on how your vet handled the situation other than to say that the approach is different from that used by some of the vets in my area who have updated themselves.

Best set of Luck!

[vineyridge]

Last year there was an announcement of an equine vaccine for Leptospirosis. Currently it is well accepted in vet circles that Lepto can lead to ERU.

However, Zoetis admits that the vaccine has not been shown to reduce ERU, abortion or renal failure due to lepto.

https://www.zoetisus.com/products/ho…tor/index.aspx

[Dee-Vee]

@vineyridge

Last year there was an announcement of an equine vaccine for Leptospirosis. Currently it is well accepted in vet circles that Lepto can lead to ERU.

However, Zoetis admits that the vaccine has not been shown to reduce ERU, abortion or renal failure due to lepto.

https://www.zoetisus.com/products/ho…tor/index.aspx

That may be the case, nonetheless I am coming from a place of personal experience. Because of this, I do not have faith in its efficacy or trust in outcomes. I know of one dog that was vaccinated for lepto and nearly died of the disease. Thus, I have had a number of conversations with my vet about vaccinating my dog and we have both decided not to.

While I agree that there is an acceptance in vet circles that there is correlation between uveitis and lepto, there is no definitive understanding of the cause of uveitis. My horse is case in point. While she has been exposed to lepto, she does not have uveitis. Uveitis can also be caused by a blow to the eye and some breeds of horses are genetically predisposed to it.

Given that this horse has had a flare up, and it has not been determined that the previous episodes of eye issues were not flare ups (as I have known uveitis to occur that way in some horses), I would suggest that money be better spent in treatment. All said, that is a discussion between the OP and her vet.

[BigMama1]

My small animal vet does not support vaccinating dogs for lepto - he feels the coverage of the vaccine is too low and the risks from the disease itself in our area aren’t high enough to justify ansomewhat ineffective vaccine with potential side effects.

its not something my horse vet is concerned about. We did draw blood just to make sure there’s no underlying inefection but 2 days off the Atropine and he’s really happy with how my horse’s eye looks. Pupils are equal size and equally reactive, no cloudiness, puffiness, tearing or oozing at all, no discomfort in bright light. We will continue the steroid / antiobiotic ointment for two weeks and gradually reduce the dose while keeping our fingers crossed.

[horseladi78]

My horse has been diagnosed as well recently. On April 8th I noticed his eye looked swollen and weepy. He is accident prone so we thought he just bumped his head. I put antibiotic ointment in it right away as a preventive. A week later no improvement so we called the vet out. She blocked the eye and determined he had uveitis. He was prescribed banamine, vetropolycin, surpass for the eye ( Diclofenac) and atropine. His eye cleared and then were told to stop the banamine. Two days later, eye is cloudy, weeping and swollen again. Mind you I have been putting ointment in his eye for almost a month now. I too am hoping this is a one time thing but already I am thinking I am not so lucky especially since we can not seem to clear it up enough to stop all treatments. I just want him better and not in pain. Hugs to you BigMama1. It seems to be a terrible thing to deal with.

[saberger]

My horse has intermittent bouts of uveitis now for about 4 years. When his eye starts to swell up, I treat with dex/antibiotic ointment and banamine…ususally resolves in about 3 - 4 days. We started him on Equioxx as a preventative last August…then took him off it in November. The vet thought he could be off the Equioxx for the winter when the days were short…well, he had a small bout December 15 - so now he is back on the Equioxx. It will be a lifelong management. I did test him for Lepto - and he came back as being exposed, but the levels were less than what they treat it with. I am tempted to push the vet to treat it (6 weeks of antibiotics) just to see if it will stop the immune response that triggers the uveitis. Every time I treat my horse with the banamine (1000# worth 2X a day for a few days then tapered down) he gets an ulcer, then I have to stock up on Ulcergard for a month. Whole thing is expensive and painful for my guy.