Equine Recurrent Uveitis

We interrupt the recount of the Horse Fair with a report of today’s events at the ISU Vet Hospital.  You may recall that when I went to look at Howdy on December 23rd, 2016, I noticed that he was holding his left eye just a little funny.  If you look closely at this picture, you can see that his eyelashes on his left eye are at a different angle from his right.  He is holding his left a bit closed.

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I was able to pick him up on January 8th, and by that time, his pupil had closed.

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The part that is green in the picture above is supposed to be a large oval, like this:

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This is a picture of his eye after his first visit to ISU Ophthalmology and treatment with a  lot of good drugs, including atropine to dilate that pupil.  Yay, we were on the right track by the second visit.  He had a few non-vision-affecting cataracts, but not a big concern.

Then I went in for the third ophthalmology appointment and the eye was worse again, though I could not tell by looking at it.  The cataracts were stable, but he had had “a flare,” and this time it included a little inflammation in the right eye too.  I started reading about Equine Recurrent Uveitis, though the doc had only mentioned it, not given it as a diagnosis.

The fourth checkup was today and since I could still see just a hint of inflammation in that left eye, I was pretty sure they were going to definitively diagnose him with ERU.

ERU is much more common in appaloosas than all other breeds combined, but it is not unheard of in tbs.  It just so happens that I had an appaloosa who had it when I was a 4-H-er and he went blind, despite my best teen-aged efforts at treating it.  The only treatments at that time were topical and keeping a mask on the horse.  I was pretty good with it, but it wasn’t enough and Johnnie went painfully blind by 20 years old.  I cried a lot over that.

So ERU scares me silly and makes me feel like that helpless teenager again, watching my good friend hurting and losing his sight with me only able to wring my hands.  And what I do when I am scared and a little torqued at the injustice of it all is RESEARCH.  Knowledge is power and research is what got me to the other side of My Journey Through MS.  If I did it once, I had a good shot to do it again.

So, I cranked up Google and the first thing I learned is that it is an autoimmune or immune-modulated disease.  When I hear that, it makes me think microbiome, primarily because the microbiome is so important in the treatment of MS, and it is an autoimmune disease.  That may be a little simplistic, but there it is.

Then I ran across this scholarly article that said ERU is not an autoimmune disease, it is an intraocular leptospirosis infection.  The research was done in Germany and those doctors recommend vitrectomy and replacement of the intraocular fluid with a gel.  Yikes.

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But the leptospirosis idea made sense to me when I learned about cyclosporine implants deep in the eye.  These little beauties were developed at NC State University and have a pretty good track record for stopping or slowing the inflammation process.  Cyclosporin is effective at suppressing T-Lymphocytes, the most common infiltrating cell in the ERU eye.  So yay, that’s a very good potential tool.

The T-Lymphocytes apparently come from the gut.  There are some problems with the idea of the gut microbiota being involved in inflammation in the eye, the major of which is that the eye has a pretty good wall between it and the rest of the body that keeps things that are “other” out.  But then I ran across this article, which, unless you are pretty hardcore into science you might choose to skip.  But their premise is that some T cells from the huge number of microbials that live in the gut can, under special circumstances, acquire the key protein needed to cross the blood/retina barrier and then get in and cause inflammation in the eye.

Yikes, no bueno.  And totally weird, friends, totally weird.

So maybe a horse gets acute leptospirosis, recovers from it, but there are still some reservoirs of it in the gut that fester and occasionally from that reservoir some of these activated T-cells are let loose into the blood stream and they attack the eye.  That seems to be what all this is pointing to.

So that’s just what I am thinking as I lead Howdy into the stocks at ISU.  I am very dubious about my ideas because I am fully aware that I know just enough about it to be dangerous.  Vets are way more educated than me on these topics, so even though (and maybe because) I have my own thoughts on ERU, I am planning on doing a lot more listening than talking.  I put the horse in the stocks, tell them what meds he is on and how he’s been doing and literally step out of the room to let them loose to do their exam.

IMG_9551I got back before they were done and there was a pall over the room that wasn’t there when I left.

They tell me the inflammation in the left eye has improved but remains.  The right eye is inflammation-free. The cataracts have grown slightly.  They are not wanting to say ERU, so I asked them if this meant we had a diagnosis of ERU and they said yes.  Ok, say I, is there anything that can be done about it?  The first thing we talk about is cyclosporine implants, which I am not averse to.  In fact, I’m damned glad it is an option.  I’ve read that there are limiting factors regarding which horses it is recommended for, so I’m glad that is still on the table.  The cost is $2,500 for one eye, $3,500 for two.  Yes, yikes, but could be worse.  I’d have to give up some things for sure, but if it meant he doesn’t have to give up his eyesight, I can deal.  I’m very pleased this option exists, but not enamored of it because it feels to me like treating the symptoms rather than getting to the bottom of the disease.  Treating the symptoms is a Good Thing, absolutely, but addressing the cause is THE Thing.

I ask about whether we should do a blood draw for leptospirosis (yes) and ask a few more questions and I think for a bit about whether I should bring out the short, scientific articles I brought for them.  I decided that yes, if I was respectful, it was a reasonable thing to do.  So, I showed them the research I’ve come across and asked them what they think about going after the ERU with massive probiotics for a few months while I  monitor the progress with the help of the ophthalmologists.  They listen respectfully and are thoughtful and amenable to this and think it could be a sound course especially since it is early in the disease process and if it doesn’t work we have other options.  They also suggest that we could do a gentamicin injection into the eyes (yikes!) which has been shown to quiet ERU.  This I had not found in my googling. One of the problems with using the eye-injected gentamicin, they say, is that the process by which gentamicin works in this application is not known.  (Aside: which makes me wonder who was the first person who said, “Hey, let’s inject gentamicin into his eyes and see if it helps!”) Scientists and doctors aren’t ok with not knowing the basic science of why and how things work, but when I am considering my horse, I’m ok with not knowing how it works as long as it does.  Though I’m as curious as the next non-pro scientist, when it is your horse or your kid or your life, it isn’t how it works, it is that it works.

So we had a plan.  Then the docs tried to actually inject the gentamicin into his eye and Howdy was a ‘No’ about that.  Even under sedation.  The doc explained that the problem was probably that they had sedated him for exam and he came half out of it while we were talking, and then they put him back in sedation again and that just doesn’t work as well.  So we have an appointment next Tuesday to try again.

Meanwhile, I am sent home with a bunch of drugs again.  Every time I whine to myself about having to treat him again, I remind myself that I am dang lucky to have ISU with several ophthalmologists less than 15 minutes up the road and that the medications are nearly miraculous and that, with the benevolence of my husband Jay and giving up a few things here or there, we can afford them without too much trouble, for which I am also grateful. Plus Howdy is a very easy horse to treat.  Very sweet and relaxed.  He seems to know I am on his side even when I come at him with more stuff to put in his eyes.

So on to the probiotics!  The ISU ophthalmologists are going to talk to the internists about what they would recommend in the coming week.  Meanwhile, I’m like a dog with a bone on researching it.  And lookee here:

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I kid you not.  We’re starting with Bovine Colostrum.  It has more good stuff in it than you can shake a stick at, and cows are universal donors for colostrum.  By the way, the calves don’t suffer.  Cows make a LOT of colostrum, enough for two calves, and they usually only have one.  I read this article and I am convinced bovine colostrum can not hurt and should help.  I ordered six doses from Valley Vet and that should be here by Thursday.

And tonight he got his first dose of kefir mixed with molasses for palatability.  I mix it together and send it down his throat with a dosing syringe, like dewormer.  I make my own kefir, which is simple.  Contrary to common belief, you can feed kefir to horses even though adult horses are lactose intolerant.  The kefir grains consume effectively all the lactose, so it is not a problem.  Also, kefir contains Bacillus subtilis which has bactericidal action against the agents of leptospirosis, which happens to be exactly what we want.  And “lysis” is my new favorite word.  It means disintegration of a cell due to rupture of the cell wall, and that is what B. subtilis in suspension does to leptospirosis.Kefir-Probiotic-Facts

Go Science.  🙂

The Iowa Horse Fair Adventure

On Thursday morning I was greeted by this on the dashboard of our truck (with a trailer on and three horses on board):

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I did not want to deal with that the whole weekend of driving back and forth from the Horse Fair in Des Moines, so I cranked up the air compressor and pumped up the tire, then put in a call to Trickle’s in Ames, who are awesome by the way.  They said, “Sure, we can get you in,” and by the time I drove the 20 minutes to get there, they had a mechanic freed up and got me in immediately.  They found this in the tire:

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A self-tapping phillips-headed screw! Excellent.  Not really, not really.  But what was excellent is that they were able to patch the tire and I was in and out in less than 35 minutes (just enough time to walk next door to McDonald’s and have hotcakes and sausage which I have not done since I was about 12 years old, and, incidentally, it is still a sugary, fat-loaded festival of nutrient-void deliciousness [that I will probably have again about 12 years from now, because unless I am killing time waiting for a tire to get fixed or something similar, a sit-down breakfast at Mickey D’s is a No, just no.  But I digress.])

The horses (Howdy, Bravado and Sammy) waited patiently on the trailer while the tire was fixed and I got my hotcakes fix, and then we were off to Stagecoach Stables in Ames where they were kind enough to allow me to bathe all three horses in their fabulously huge and neat-as-a-pin wash rack.  It can be completely closed, so with three horses in it and warm water in use, it got toasty fast.

I squeegied them and wrapped them in wool coolers and loaded them on the trailer and drove south to the State Fairgrounds.  I set up the stalls and settled them in.  Then it was time to hack around.  It was a pretty surreal to have the fairgrounds pretty much to myself.  I got on and rode Howdy to the Stock Pavilion.

He walked around fairly relaxed and continued with some pretty decent trot and canter work.  He walked flat-footed around the park other than a few reasonable shies at manhole covers.  Pretty good!

Then it was Bravado’s turn, and unfortunately for his peace of mind, a lot of people and animals arrived while I untacked Howdy and tacked Bravado. Bravado’s ride included trailers driving everywhere on the way to the Pavilion, and children running up and down the bleachers in the grandstand of the pavilion, which he actually dealt with pretty well.  Then there was a racket outside of the Pavilion – of trucks, and hooves on aluminum ramps.  Rodeo stock?

Almost.  When we left the arena, we were greeted by these two beauties, members of The Rawhide and Dusty Show.  They were in a paddock and they were being pretty sedate.  I really wondered what Bravado would do when I asked him to walk by them, and he surprised me by doing pretty much nothing.  He gave them a glance then walked right by them.  What?  Good man!

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Then we continued on:

These are pictures of the Pulver East Arena, which is a spectacular venue.  I actually prefer it to the Pavilion.  It has arguably better footing and a vastly better sound system.

Then it was Sammy’s turn.  Sammy is 15 years old and has a lot of experience.  sammyyellow

I rode him in the pavilion and he was spot on.  He was moving beautifully and on the aids.  Then I petted him and let him walk on a long rein and he was looking around and finally allowed himself to enjoy this:

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Stick horse race practice!  What a fun way to end the day!

That was day one of the Horse Fair Experience, and there were three more days of the Horse Fair.  The days were entirely too long for me to write anything sensible in the blog.  I’ll do installments on them in the upcoming days.  Stay tuned.

Bending Right

Last time I rode Howdy, I noted to myself that standing still was not really his thing.   So today, I sat on him while I taught a lesson.

IMG_9421We stood still a while, then walked in circles a lot and did some more halting and did some bending.  Actually, I wasn’t paying that much attention to him.  I was mostly focusing on Jean and Sammy as they worked on cavaletti and transitions.  This morning I read this very nice blog post about Will Faudree and young horses on the USEA site and it got me to thinking about bending in general and the inside leg to outside rein connection and I was just fooling around with it.

Meanwhile, Jean and Sammy had some nice canter work:

Toward the end of Jean’s lesson, Howdy figured out how to bend right.  All of a sudden he noticed he could shorten the right side of his body and lengthen the left half.  I should mention that I’m actually quite stoked about this.  As you may know, Howdy has a slight club foot on his right front and often horses are not as handy at bending toward their club foot side.  Knowing this, I was prepared for it to be a long, slow process.  Turns out, to get a good start on it, it took about an hour of just playing around and allowing it to happen.  Huh.  There’s a nice surprise.

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Well, its not a right bend, but its kinda cute anyway.

The Cheeky Monkey

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Howdy in a cheeky moment

The Iowa Horse Fair is next weekend and I am going to present several sessions whose topics will be jumping, eventing and foxhunting.  Fun flyer.  I’ve presented jumping seminars before and I’ve learned that while it is interesting for people to watch an example of very good jumping, they are fascinated, entertained and amused if you present them with an imperfect horse and show them how to react to mistakes and how to train the horses.

And so Howdy and Bravado are going to the Horse Fair to learn how to jump, in public.  Both horses were racing at Prairie Meadows last summer and Bravado has started the very basics of jumping.  Here’s his big accomplishment for today:

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Yep, those are 1′ jumps with placing poles.  Wheeeee!

I spent a pleasant hour today helping him to learn how to navigate these jumps in a relaxed manner, and at the end we were both grinning.  Now mind you, plenty left to learn at the Horse Fair.  We never were balanced enough to do two jumps in a row.

Meanwhile, Howdy and I yesterday started with simple poles on the ground between standards.  We started out walking over them and the first few times were actually quite dramatic, with crookedness and a bit of balking and then some over-exuberance.  By the end he was trotting over them in a relaxed manner, about which I was very pleased.  I untacked him and left him loose in the sandy indoor to roll.  I came back from putting his tack away and he was on the other side of the arena.  He was just shaking off from a roll and when he saw me he put his ears up and started cantering to me.  I thought that was charming, of course, anybody would.  But he won my heart, the cheeky thing, when he altered his course so that he would canter right over one of the poles on the ground on his way to me – ears up with a “look what I can do” expression.  This one’s gonna be fun.

Back to our regularly-scheduled Thoroughbred

Howdy had his fourth eye appointment at ISU (wheeeee!) and needed to have more eye treatments, three times a day.  We decided to take him with us to the Flint Hills of Kansas where we were joint meeting with several other Midwest foxhunts.  Foxhunting is always very serious business.

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Um, ok, maybe not always serious…

I rode Bravado on the hunts during the weekend and he was great.

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Jay is riding Annie, the grey horse and I am to his left on Bravado.  Our friends MFH Monte Antisdel and HRH Diane Antisdel are to my left.

Meanwhile, Howdy hung out in his stall while we hunted.  He was completely unfazed by the other horses leaving their stalls and getting on the trailer.  He looked up from his hay, watched the other horses walk away, mumbled, “Have a good day at work, suckers!” and put his head back in the hay.

Much to his surprise, despite the fact that it was snowing when we got home from the hunt, it was his turn to go out for a hack.Howdy

It was a beautiful snow, with huge flakes and no wind.  We went out with our friend Holly Barrett and her horse.  They gave us several leads through creeks and Howdy did fine.  He led, he followed, he left the other horse, he stopped well, he went forward well and just didn’t have much of a problem with anything.  What a fun horse!

Our goal is the RRP in Kentucky in October, but the next outing is the Iowa Horse Fair next weekend.  I’m speaking there and he and Bravado will be demo horses.  Gonna be a good time.

Spring Fling Combined Driving Event

We’re having a little time out from the Howdy blog to cover a trip to Florida for the USEA Instructor Certification Seminar in Ocala Florida.  Since I was coming to Florida on Monday for that, I called my friend Denise Loewe to see if I could hangout with her in her big ol’ camper that is parked near Buck Davidson’s barn in Ocala.  “Absolutely,” she said, “and you should come down a few days early and groom and navigate for me at the Spring Fling Combined Driving Event.”  What fun, I’m in.

So I flew in to Orlando SFB late on Friday night, forgot which rental car agency I made reservations with through the airline, figured it out by playing it cool and just following a lot of other people on my flight to Alamo, (thank you God, that worked), got my luggage and car and drove two hours to Orlando and went straight to sleep when I got there.  (And if you believe that last part, about going straight to bed after seeing my friend again after almost a year hiatus, you are having a silly moment.  We might have stayed up talking and drinking wine until 1.  Might have happened.)

Up early on Saturday to walk the obstacles on marathon.  I was completely overwhelmed, to the point of losing my ability to speak because of these thoughts tangling in my brain:

  • How do people remember all these gates?
  • Do people know that these wooden objects will not move when hit with a carriage/horse/human?
  • And  wait, only time in the obstacles are penalties, the rest of it is basically working trot?

I was with Debbie Egan and Margaret Shenker and Denise walking the course.  Debbie and Margaret are very experienced combined drivers, Denise is moderately experienced, and on Friday I didn’t even know that drivers cantered (for god’s sake!) through the obstacles. Me walking the course with them reminded me of one of my favorite sketches on Sesame Street – one of these things is not like the other.

The learning curve was daunting as a cold, granite cliff face, and I was a babe wandering barefoot and sleeveless in the foothills.  My climb involved many questions after I recovered my ability of speech.  Some frantic Youtube searching, an important sheet of times for each section given to me by the benevolent Margaret, who saw my need before I even knew of its existence, and a little zen time alone with the obstacles completed my ascent to feeling somewhat prepared to navigate marathon for Denise.

The days were happy, long and exhausting  (and I didn’t have access to wifi, horrors!), so I didn’t make a blog entry Saturday and Sunday night, but I did make this video compilation that will give you a good idea of the gist of how the weekend went.  Crazy fun.  If you find an opportunity to go to/volunteer at/groom for/navigate at a combined driving event, do it! So fun!

Looking like a real horse and the Big Trip

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I leave for Florida tomorrow for a week to go to the USEA ICP Seminar, the Young Event Horse Symposium, the Retired Racehorse Project BBQ at the Ocala Jockey Club, to groom and navigate for my friend who is driving her horse in the Florida Spring Fling Driving Competition at the  Florida Horse Park, and to see my nieces who are riding with the big dawgs in Ocala.  This is gonna be fuuuuu-un, and I’ll share the highlights and the inevitable funny things that will happen as I stay with my friend who has a big camper that she parks at Buck Davidson’s winter complex.  Yes, I know.  Ridiculousness.

If you want to catch it all, you can subscribe to this blog by putting your email address in the box on the upper right of this page.

Meanwhile, I put a saddle and a bridle on Howdy who said, “Ho hum, I did this at the track.” I lunged him in loose side-reins and I’ll be darned, he looks like a real horse at times.  Here’s some video with our dogs occasionally barking in the distance.  If you listen carefully, you might hear a coyote howl.  Home on the range in dear old Iowa.  I am not vain enough to think you might be interested to see the whole 7 minutes of this video, but if you scan around a bit you can see all three gaits in both directions.  Should be good for comparison down the road.