Recurrent eye ulcers - never ending - fed up

[Reacher]

I posted last year about my mare (retired 23 year old TB) who has recurring eye ulcers in her right eye and needed surgery.

A trip to the eye hospital reveals hidden ulcer

In case this is interesting/ helpful to anyone, a couple of days ago I took Retired Mare to the eye hospital. She had surgery a few years ago for non healing ulcers in the same eye and recently has been having symptoms (slightly dribbly eye, not as wide open compared to the other eye). She...

forums.horseandhound.co.uk

A brief history is
Multiple eye ulcers pre 2019 treated with eye drops.

In 2019 a new ulcer occurred and I asked to be referred to the eye horsepital where the diagnosis of non healing ulcers was made and surgery performed (Keratectomy). The surgeon says she basically has a weakness in that eye and the layers aren’t “glued together” very well .

In August 2023 a new non healing ulcer occurred and she went back to the eye horsepital and had another Keratectomy.

In March 2024 she had a new ulcer. I rang the eye horsepital for advice also about the option of removal of the eye . The surgeon dismissed eye removal as an option and told me to treat with drops as a first option and then to refer back to him if non healing. The local vet who treated her also guilt tripped me for considering removing the eye.
I again treated with drops, apparently successfully but over the May bank holiday the ulcer reappeared in the same location. This is consistent with the previous times she was seen by the eye horsepital who thought that the ulcer has previously healed superficially but not right through the full depth so reoccurred.

i asked the local vet who came out over the bank holiday what he thought about removing the eye and he was supportive (the vet who came out in March wasn’t supportive of removal of the eye) so I contacted a referral vets where they have the facilities to do the surgery (not the eye horsepital) but he wasn’t keen to remove the eye as it has vision and can be (temporarily) cured by another op. Until the next ulcer occurs and we go through the cycle again. He is going to ring the eye surgeon today to discuss but I already know what he will say.

I don’t even know if my mare will get through another winter. She drops weight over winter. She stopped eating in late winter , (ETA she had blood tests which showed inflammation and anaemia) I changed her feed to ryegrass haylage to tempt her to eat and add calories/ protein and she rallied and is still getting 4 bucket feeds / day and haylage . (ETA at end of previous winter she was very ropey too, blood tests showed inflammation and kidney markers above normal. Surprisingly these were normal in most recent blood tests).

I’m completely fed up with the eye, it is costing a fortune, she is fed up of having it poked and prodded though she is extremely well behaved (my other horse wound think he was being murdered if I tried to give eye drops).

To be clear my issue with having another op done (at £2K a go) is that it won’t be the last one - how many more will there be.

To add to my logistical issues they are due to go to holiday livery soon.

Sorry for the whinge, I don’t feel the vets are listening to me, I am not hard enough to go against their advice and DEMAND they remove the eye.

 

[paddy555]

I posted last year about my mare (retired 23 year old TB) who has recurring eye ulcers in her right eye and needed surgery.

A trip to the eye hospital reveals hidden ulcer

In case this is interesting/ helpful to anyone, a couple of days ago I took Retired Mare to the eye hospital. She had surgery a few years ago for non healing ulcers in the same eye and recently has been having symptoms (slightly dribbly eye, not as wide open compared to the other eye). She...

forums.horseandhound.co.uk

A brief history is
Multiple eye ulcers pre 2019 treated with eye drops.

In 2019 a new ulcer occurred and I asked to be referred to the eye horsepital where the diagnosis of non healing ulcers was made and surgery performed (Keratectomy). The surgeon says she basically has a weakness in that eye and the layers aren’t “glued together” very well .

In August 2023 a new non healing ulcer occurred and she went back to the eye horsepital and had another Keratectomy.

In March 2024 she had a new ulcer. I rang the eye horsepital for advice also about the option of removal of the eye . The surgeon dismissed eye removal as an option and told me to treat with drops as a first option and then to refer back to him if non healing. The local vet who treated her also guilt tripped me for considering removing the eye.
I again treated with drops, apparently successfully but over the May bank holiday the ulcer reappeared in the same location. This is consistent with the previous times she was seen by the eye horsepital who thought that the ulcer has previously healed superficially but not right through the full depth so reoccurred.

i asked the local vet who came out over the bank holiday what he thought about removing the eye and he was supportive (the vet who came out in March wasn’t supportive of removal of the eye) so I contacted a referral vets where they have the facilities to do the surgery (not the eye horsepital) but he wasn’t keen to remove the eye as it has vision and can be (temporarily) cured by another op. Until the next ulcer occurs and we go through the cycle again. He is going to ring the eye surgeon today to discuss but I already know what he will say.

I don’t even know if my mare will get through another winter. She drops weight over winter. She stopped eating in late winter , (ETA she had blood tests which showed inflammation and anaemia) I changed her feed to ryegrass haylage to tempt her to eat and add calories/ protein and she rallied and is still getting 4 bucket feeds / day and haylage . (ETA at end of previous winter she was very ropey too, blood tests showed inflammation and kidney markers above normal. Surprisingly these were normal in most recent blood tests).

I’m completely fed up with the eye, it is costing a fortune, she is fed up of having it poked and prodded though she is extremely well behaved (my other horse wound think he was being murdered if I tried to give eye drops).

To be clear my issue with having another op done (at £2K a go) is that it won’t be the last one - how many more will there be.

To add to my logistical issues they are due to go to holiday livery soon.

Sorry for the whinge, I don’t feel the vets are listening to me, I am not hard enough to go against their advice and DEMAND they remove the eye.

I'm sorry, it is a horrible position to be in.

you make no mention of the other eye. Does it have vision? If not that would alter the decision.

you have a 23yo horse who may or may not have other problems, is retired, whose lifespan you can't determine.

eye drops are presumably steroids, operations involve more drugs and all for what??????

is your horse in pain? it is difficult to tell with eye problems how much internal pain there is.

if you are completely fed up with the eye I wonder how the horse feels. I would stop considering how the vet and eye hospital feel and consider how the mare feels.

I did DEMAND. It was done at home and 3 hours later the horse told me I had made the best decision for him.

 

[Reacher]

I'm sorry, it is a horrible position to be in.

you make no mention of the other eye. Does it have vision? If not that would alter the decision.

you have a 23yo horse who may or may not have other problems, is retired, whose lifespan you can't determine.

eye drops are presumably steroids, operations involve more drugs and all for what??????

is your horse in pain? it is difficult to tell with eye problems how much internal pain there is.

if you are completely fed up with the eye I wonder how the horse feels. I would stop considering how the vet and eye hospital feel and consider how the mare feels.

I did DEMAND. It was done at home and 3 hours later the horse told me I had made the best decision for him.

Hi Paddy
Thanks for your reply, it’s appreciated.
Vision in left eye is fine, it certainly has never had any ulcers in the last 5 years, we believe the ulcers prior to 2019 were all in the right eye but my and the vet records aren’t sufficiently good to be 100% sure.

Since the vet came out over the BH she has been on drops and bute and is now comfortable in the short term, however without treatment it will flare up again quickly from previous experience . Carrying on with the drops won’t fix the correct ulcer, having the keterectomy will fix it in the short term but another is likely to occur at sone point going on past experience.

I have used the argument that removing the eye fixes the problem and she no longer has pain but the vets are ignoring this argument and raise the issue of what if the other eye starts having issues .

The trouble is as the vets are guilt tripping me I lose my resolve that removing the eye is the correct opinion

 

[Pearlsacarolsinger]

Presumably if the other eye gets an unfixable ulcer you will pts. That is what you need to tell the next vet that brings this up. In fact if I were in your position, I would say " if you won't remove the eye of my retired horse, you need to.pts. This poor animal has had enough". I have had eye ulcers myself and know that they are extremely painful, I wouldn't want my horse to suffer recurrent eye ulcers.

 

[Reacher]

This was the eye in March. Very small ulcer near the corner. After a week’s treatment with drops there was nothing to see. I continued the drops until the bottles were finished.
I bought some more of the non prescription drips (Remend) and continued using them twice a day as a preventative.

This was the eye over last weekend . It’s in the same place which is why I am convinced that yet again it healed superficially but not full depth

 

[Gloi]

I'm sorry but I would be considering PTS, especially if she will also struggle next winter.

 

[Reacher]

Presumably if the other eye gets an unfixable ulcer you will pts. That is what you need to tell the next vet that brings this up. In fact if I were in your position, I would say " if you won't remove the eye of my retired horse, you need to.pts. This poor animal has had enough". I have had eye ulcers myself and know that they are extremely painful, I wouldn't want my horse to suffer recurrent eye ulcers.

Thankyou - I have considered this - or threatening that I will call knackerman if they won’t remove the eye.
I couldn’t decide if I was being selfish / unreasonable, especially as now the bute and drops have kicked in she appears comfortable

 

[Reacher]

I'm sorry but I would be considering PTS, especially if she will also struggle next winter.

Thankyou , from the conversations with the vets I think I would have to ring the knacker man as I don’t think vets would support PTS

 

[Gloi]

Thankyou , from the conversations with the vets I think I would have to ring the knacker man as I don’t think vets would support PTS

I'm sure vets sometimes just think of their loss of income. It's a horrible decision when you have to make it but with all our animals we have to decide what their quality of life is. I'm not trying to push you any way here though, of course it is 100% your choice.

 

[AmyMay]

I'm sorry but I would be considering PTS, especially if she will also struggle next winter.

This. I agree.

 

[ihatework]

I’m sorry to hear about the struggles. Irrespective of whether you go surgery / treatment / pts there are a couple of things to consider (if you haven’t already - I’m sure vets have these bases covered already!)

Cushings - I knew one horse with recurrent uveitis who, once treated for their cushings, resolved for good.

Leptospirosis - a known link apparently- LEC on here is one to ask

 

[moorhillhorses]

I posted last year about my mare (retired 23 year old TB) who has recurring eye ulcers in her right eye and needed surgery.

A trip to the eye hospital reveals hidden ulcer

In case this is interesting/ helpful to anyone, a couple of days ago I took Retired Mare to the eye hospital. She had surgery a few years ago for non healing ulcers in the same eye and recently has been having symptoms (slightly dribbly eye, not as wide open compared to the other eye). She...

forums.horseandhound.co.uk

A brief history is
Multiple eye ulcers pre 2019 treated with eye drops.

In 2019 a new ulcer occurred and I asked to be referred to the eye horsepital where the diagnosis of non healing ulcers was made and surgery performed (Keratectomy). The surgeon says she basically has a weakness in that eye and the layers aren’t “glued together” very well .

In August 2023 a new non healing ulcer occurred and she went back to the eye horsepital and had another Keratectomy.

In March 2024 she had a new ulcer. I rang the eye horsepital for advice also about the option of removal of the eye . The surgeon dismissed eye removal as an option and told me to treat with drops as a first option and then to refer back to him if non healing. The local vet who treated her also guilt tripped me for considering removing the eye.
I again treated with drops, apparently successfully but over the May bank holiday the ulcer reappeared in the same location. This is consistent with the previous times she was seen by the eye horsepital who thought that the ulcer has previously healed superficially but not right through the full depth so reoccurred.

i asked the local vet who came out over the bank holiday what he thought about removing the eye and he was supportive (the vet who came out in March wasn’t supportive of removal of the eye) so I contacted a referral vets where they have the facilities to do the surgery (not the eye horsepital) but he wasn’t keen to remove the eye as it has vision and can be (temporarily) cured by another op. Until the next ulcer occurs and we go through the cycle again. He is going to ring the eye surgeon today to discuss but I already know what he will say.

I don’t even know if my mare will get through another winter. She drops weight over winter. She stopped eating in late winter , (ETA she had blood tests which showed inflammation and anaemia) I changed her feed to ryegrass haylage to tempt her to eat and add calories/ protein and she rallied and is still getting 4 bucket feeds / day and haylage . (ETA at end of previous winter she was very ropey too, blood tests showed inflammation and kidney markers above normal. Surprisingly these were normal in most recent blood tests).

I’m completely fed up with the eye, it is costing a fortune, she is fed up of having it poked and prodded though she is extremely well behaved (my other horse wound think he was being murdered if I tried to give eye drops).

To be clear my issue with having another op done (at £2K a go) is that it won’t be the last one - how many more will there be.

To add to my logistical issues they are due to go to holiday livery soon.

Sorry for the whinge, I don’t feel the vets are listening to me, I am not hard enough to go against their advice and DEMAND they remove the eye.

Definitely not a whinge! You no what is best for your horse

 

[Reacher]

I’m sorry to hear about the struggles. Irrespective of whether you go surgery / treatment / pts there are a couple of things to consider (if you haven’t already - I’m sure vets have these bases covered already!)

Cushings - I knew one horse with recurrent uveitis who, once treated for their cushings, resolved for good.

Leptospirosis - a known link apparently- LEC on here is one to ask

Thanks
I mentioned Cushings to the surgeon and he didn’t think it was a factor, however it is worth considering.

I’ve not heard of Leptospirosis - will look that up

 

[ihatework]

Thanks
I mentioned Cushings to the surgeon and he didn’t think it was a factor, however it is worth considering.

I’ve not heard of Leptospirosis - will look that up

I personally think, given her age (and potential weight loss?) cushings testing would be a very good idea, irrespective of the uveitis.

 

[paddy555]

Hi Paddy
Thanks for your reply, it’s appreciated.
Vision in left eye is fine, it certainly has never had any ulcers in the last 5 years, we believe the ulcers prior to 2019 were all in the right eye but my and the vet records aren’t sufficiently good to be 100% sure.

Since the vet came out over the BH she has been on drops and bute and is now comfortable in the short term, however without treatment it will flare up again quickly from previous experience . Carrying on with the drops won’t fix the correct ulcer, having the keterectomy will fix it in the short term but another is likely to occur at sone point going on past experience.

I have used the argument that removing the eye fixes the problem and she no longer has pain but the vets are ignoring this argument and raise the issue of what if the other eye starts having issues .

The trouble is as the vets are guilt tripping me I lose my resolve that removing the eye is the correct opinion

I haven't yet read the other replies.

She could lose the other eye, however she could also break her leg tomorrow, get colic, walk under a double decker bus or a million other things which would end her life. If the other eye has problems then at that stage you could consider PTS. It may not happen for a reasonable amount of time or it may not happen at all (taking into account her more limited lifespan due to age)

eye drops are not without consequences. I couldn't understand why I kept getting rings around my horses feet. Surely after 20 years trimming I could balance a foot. Then it dawned on me. It was the steroids. (non cushings horse)

I know and appreciate the exact situation you are in.
I'm sorry to say it but to me (having been there, done that and got the T shirt) the vets arguments are ridiculous especially for that age of mare.

I don't mean to be rude to you, really don't, but I think it is time to stop raising arguments with vets and to give them instructions as to what is going to happen.

 

[paddy555]

I'm sure vets sometimes just think of their loss of income. It's a horrible decision when you have to make it but with all our animals we have to decide what their quality of life is. I'm not trying to push you any way here though, of course it is 100% your choice.

I'm sorry but I would be considering PTS, especially if she will also struggle next winter.

I cannot see any reason to PTS when there is a reasonable solution to try iro the eye

as for your first quote then I think the first sentence is very very true.

looking at horses in similar eye situations there are endless things you can do. More and more treatments that may work initially but then you are on to the next treatment. Funny how many only find success with enucleation.

 

[AandK]

I am surprised that the vets are so against removal of the eye, your poor mare sounds like she is fed up, as do you, so sorry they are not being more supportive.
My late gelding had one eye (left eye removed due to cancer) and of course there is a risk of something happening with the one left but it's worth taking if it means the horse is pain free, if something had happened to his remaining eye I would have PTS. I have heard of horses with the eye removed due to recurring ulcers being so much happier once it is done.
You also have the other issues to contend with, which is tricky. It is a tough place to be in. Can you find another vet to get a second opinion re removal? I also think investigating cushings is a good idea.

 

[slimjim86]

I had a friend go through similar recently, horse seemed fine once under treatment but was very unhappy at the start of each new flare up, she put herself on hunger strike she was so fed up, led to semi regular colics and decision was made that pts was in her best interests. She did test borderline for cushings but was essentially screaming that she'd had enough by the time this was diagnosed and owner chose to call it a day rather than see if prascend made any difference which I think in am elderly horse now prone to colic is sensible. Oddly enough a vet friend of hers had a real go at her for not just continuing the endless cycle of treatment every month or so! In your shoes I'd tell the vet in no uncertain terms that you want the eye removed or will be requesting pts as the horse has been through enough x

 

[Reacher]

I haven't yet read the other replies.

She could lose the other eye, however she could also break her leg tomorrow, get colic, walk under a double decker bus or a million other things which would end her life. If the other eye has problems then at that stage you could consider PTS. It may not happen for a reasonable amount of time or it may not happen at all (taking into account her more limited lifespan due to age)

eye drops are not without consequences. I couldn't understand why I kept getting rings around my horses feet. Surely after 20 years trimming I could balance a foot. Then it dawned on me. It was the steroids. (non cushings horse)

I know and appreciate the exact situation you are in.
I'm sorry to say it but to me (having been there, done that and got the T shirt) the vets arguments are ridiculous especially for that age of mare.

I don't mean to be rude to you, really don't, but I think it is time to stop raising arguments with vets and to give them instructions as to what is going to happen.

Sorry for the delay in replying.

I appreciate your replies and don’t find them rude at all. Your comments are reassuring in that from the way the vets were arguing against it I felt I was being selfish by asking for removal of the eye

 

[Reacher]

I am surprised that the vets are so against removal of the eye, your poor mare sounds like she is fed up, as do you, so sorry they are not being more supportive.
My late gelding had one eye (left eye removed due to cancer) and of course there is a risk of something happening with the one left but it's worth taking if it means the horse is pain free, if something had happened to his remaining eye I would have PTS. I have heard of horses with the eye removed due to recurring ulcers being so much happier once it is done.
You also have the other issues to contend with, which is tricky. It is a tough place to be in. Can you find another vet to get a second opinion re removal? I also think investigating cushings is a good idea.

Thanks, I think re second opinion I’d have to ask my local vets to contact a 2nd referral vet - which may be possible

 

[Reacher]

I personally think, given her age (and potential weight loss?) cushings testing would be a very good idea, irrespective of the uveitis.

Thanks , I can discuss that again with the local vet.

 

[paddy555]

Sorry for the delay in replying.

I appreciate your replies and don’t find them rude at all. Your comments are reassuring in that from the way the vets were arguing against it I felt I was being selfish by asking for removal of the eye

that's OK then I really do know what you are going through.

 

[maya2008]

If it was just the eye, I would do everything possible to find someone who would support the removal. But...the horse is a 23yo and you don't think they'll make it through another winter. The worsening situation with the eye ulcers is presumably representative of general old age. You have blood tests suggesting her organs aren't managing well, weight issues, eye issues. In my experience, once they get to a certain point it's indicative of general old age and it's just one thing after another. You can spend thousands, but their body is failing in general and the end result is the same. I would PTS - local knackerman will not ask questions and will do a kind, calm job.

The vets just seem to be suggesting surgery after surgery on an already old horse with questionable blood tests - more stress and pain on an already ailing body. How is that ethical??

 

[Reacher]

If it was just the eye, I would do everything possible to find someone who would support the removal. But...the horse is a 23yo and you don't think they'll make it through another winter. The worsening situation with the eye ulcers is presumably representative of general old age. You have blood tests suggesting her organs aren't managing well, weight issues, eye issues. In my experience, once they get to a certain point it's indicative of general old age and it's just one thing after another. You can spend thousands, but their body is failing in general and the end result is the same. I would PTS - local knackerman will not ask questions and will do a kind, calm job.

The vets just seem to be suggesting surgery after surgery on an already old horse with questionable blood tests - more stress and pain on an already ailing body. How is that ethical??

Thankyou - it’s all food for thought.

If the eye was removed she could have the summer then reassess.

She is otherwise quite perky in herself. She is enjoying 4 meals a day and the other day charged down to the gate for her lunch, ate it then charged back up the paddock.

I’m waiting for the referral vet to ring back
having spoken to the eye surgeon. I will underline the other health concerns.

 

[Pearlsacarolsinger]

I hadn't linked Cushings with the eye ulcer my mare had until this thread but now I wonder. She had an ulcer which the vet thought must be caused by her poking herself in the eye on something. We treated it and it cleared up without recurrence but not so long after, she tested positive for Cushings and was started on Prascend.

 

[Gloi]

I hadn't linked Cushings with the eye ulcer my mare had until this thread but now I wonder. She had an ulcer which the vet thought must be caused by her poking herself in the eye on something. We treated it and it cleared up without recurrence but not so long after, she tested positive for Cushings and was started on Prascend.

Cushing's causes the strangest things

 

[Reacher]

Re PPID Are vets obliged to provide prescriptions?

I have a feeling I have asked local vet before and been fobbed off

 

[paddy555]

Re PPID Are vets obliged to provide prescriptions?

I have a feeling I have asked local vet before and been fobbed off

you may want to check prices with your vet first.
My mare has been on prascend for many years and because the vet couldn't match the online price anywhere near I got a prescription.

Price for prascend was around £1.09 online

Then a couple of weeks ago vet (horse practice) told me they were part of a buying syndicate for meds who negotiated with pharma and were now supplying pergoquin to their clients.
Prascend cost me c £1.09 (animed) plus prescription c £20

pergoquin direct from vet and no pres. is £1.01.

not often good things happen

 

[Reacher]

Just giving a quick update. I was waiting for various people to get back to me who were on leave.

Mare is booked in at the eye horsepital next week. Surgeon will examine and we will then decide what to do. Removing the eye is on the table as an option. So is another surgery.

His opinion is she has a genetic weakness in the eye which means the cornea isn’t stuck down very well. At the sites of the previous surgeries the scar tissue anchors the cornea firmly which should reduce risk of further ulcers. The new ulcer is in a different location so another surgery would pin down the cornea at that location, and I think he said it’s in a location where the cornea is thick which is good. I have told him I can’t keep bringing her for a surgery every 6 months and have discussed her age and medical background which he took on board.

Thanks for everyone ‘s input, I am reflecting and noting all the points and will discuss further with local vet. Currently she is bright and well and enthusiastically hoovering up her meals and haylage.

 

[Pearlsacarolsinger]

Just giving a quick update. I was waiting for various people to get back to me who were on leave.

Mare is booked in at the eye horsepital next week. Surgeon will examine and we will then decide what to do. Removing the eye is on the table as an option. So is another surgery.

His opinion is she has a genetic weakness in the eye which means the cornea isn’t stuck down very well. At the sites of the previous surgeries the scar tissue anchors the cornea firmly which should reduce risk of further ulcers. The new ulcer is in a different location so another surgery would pin down the cornea at that location, and I think he said it’s in a location where the cornea is thick which is good. I have told him I can’t keep bringing her for a surgery every 6 months and have discussed her age and medical background which he took on board.

Thanks for everyone ‘s input, I am reflecting and noting all the points and will discuss further with local vet. Currently she is bright and well and enthusiastically hoovering up her meals and haylage.

Thanks for the update. It sounds as if you have a way forward now. You sound much more positive.