It started back in late December. You might remember when I went to look at Howdy and talk to his owner about buying him, Howdy looked at me like this. If you look carefully, his left eyelashes are pointing a little more down than his right – he was having some pain in that eye. I picked him up the first week in January and his eye looked like this:
That is no bueno. The grey is water/inflammation on the eye, and the pupil is totally closed. An open pupil looks like this:
You can read much more about the journey of his ERU diagnosis and the protocol we followed here, but the gist of it is that the brilliant ophthalmologists at ISU helped diagnose and work with me on a treatment protocol. They took a fluid draw from his eye and his leptospirosis titer was 1600! Very high. We treated him with intraocular gentamicin, and systemic baytril and doxycycline. The eye looked good after that, but we couldn’t tell what was going on with any objective measure. I wanted to do another eye fluid draw to see what the titer was after the treatment. They said we had to wait three weeks for all the antibiotics to totally clear. Three weeks after the last antibiotic treatment was last week, so in he went for a checkup and to have another fluid draw from his eye to check his leptospirosis titer.
First, his eye exam went well. In fact, this well:
That thar is some great news.
So for the eye fluid draw, first they had to sedate Howdy. He stands beautifully for his eye exams (he’s certainly done enough now), but he needs to be stock still for the fluid draw from his eye. I mean we’re talking about literally “stick a needle in my eye” stuff of childhood nightmares. Moving during that process would be a Bad Thing.
So first the drugs:
Getting dozy here and yes, that is a crutch underneath his chin because horse heads are heavy!
Then anesthetizing the spot where the needle will go in. Just like your dentist does before she gives you the shot of novocaine.
Then put the nasty metal spreader underneath his lids to keep them open. This process made me wince. Thank goodness Howdy had pretty much left the building mentally:
The syringe is a half cc and they drew out that much. The volume of fluid in a horse eye is 6.5 ccs. Afterwards they gave him a shot of banamine for the pain the needle caused. They submitted the fluid to the lab and I learned the results today.
Dr. Foote told me that the results had come in last night but that she needed to discuss it with her colleagues. My heart sank. If it needed several ophthalmologists to discuss it before disclosing to the client, I was sure it was going to be a bad thing. Then she said that his titer was 200. I had completely forgotten all my science and I thought we were looking for zero and I was a little disappointed. She explained that 200 is a normal titer for a horse that has had leptospirosis. The titer is the level of antibodies in the fluid. It is good to have some antibodies to ward off any future attack. Two hundred is in the normal range. This is great news!
The downside is that they are still recommending his twice daily diclofenac eye treatments and twice monthly atropine. The diclofenac may be for the rest of his life. But he tolerates the treatments well, they apparently work, and they are not prohibitively expensive, so I am grateful for that. Next check up is in two months.
Meanwhile we’ve been jumping and working on Ranch Horse skills. More details on that in future installments soon. Here’s a picture of the team, with Howdy still half in the bag and me with a new haircut and the freakishly long fingers of my left hand accidentally doing Spock’s “Live Long and Prosper” sign. Dr. Foote on the left, Dr. Sebbag on the right, vet tech and students in the middle. They are really delighted with Howdy’s progress. It takes a village to get Howdy well again and on the road to the RRP. I love my village.
Wow, you certainly have gone the extra mile with Howdy. And successfully. And this is all because of Leptospirosis? I was going to phone you today to see what you have been up to but now I know. I have a column due today for the SCA Bulletin and have no idea what I will write about. But the morning chores are finished so I can sit down and get to it.
Yes, he had a systemic leptospirosis infection at some point in his life. His body cleared it all, except in his left eye. The body goes nuts trying to clear the infection but can’t get it done sometimes, which results in ERU. It seems at this point that the antibiotics have gotten it under control and they eye is settling down. We are not completely out of the woods yet, but indications are positive.
Maybe you should interview a canine ophthalmologist and talk to them about advances in dog eye disease. I think of this because, remember, Johnnie had ERU when I was a kid, and he eventually went blind to it. ERU treatment in horses is still difficult, but it is becoming more effective. I bet the same is true for canine eye disease and people always want to read good news. Good luck!
Awesome read! Can’t wait to see you and Howdy again, but we hope for another stable check up and no surprise visits in between!