Eye Injuries

Those big soft eyes; whether they’re brown or even blue, we all love to stare into them. However, being so large has its disadvantages, as our horses’ eyes can be prone to injury. Whether it’s to get that last little nibble of grass on the other side of the fence, or while out riding and hacking, traumatic or penetrating injuries can occur and sometimes without us noticing it straight away.

The most common and obvious to the “naked eye” include eyelid lacerations.
Usually the upper lid is most involved, but all lacerations are extremely important to repair without delay to avoid further damage to the eye itself. Depending on the extent of injury, your veterinarian will most likely need to stitch the eyelid.

Another evident injury is blunt trauma to the eye. Your horse may present with just a swollen eyelid, but the key is not to panic! Call your vet to have them examine the extent of injury through the layers of the eye.

Other injuries may not be so apparent. Scratches or damage to the surface of the eyes can easily become infected and create corneal ulcers, which in turn can progress to severe scarring or rupture.

Signs to look out for painful eyes include:
• Avoiding bright light (standing at the back of the stable for example),
or excessive squinting
• Closed eyes, with tear production
• Discolouration of the eye
• Swelling or redness of the eye
• White to yellow discharge from the eye

Your vet will want to examine the eye in a dark stable, with a calm and well-restrained patient, therefore sedation may be heavily indicated. Nerve blocks may also be required to relax the eyelids and allow for a more thorough examination. In addition, a special dye called fluorescein can be used to search for damage to the surface layer of the eye, by staining them in bright green.

Treatment can range from daily management routines to immediate referral for further diagnostics and/or surgery. Medical treatment will usually consist of anti-inflammatory drugs to help reduce the pain, as well as eye drops to administer multiple times a day. Atropine eye drops will help to dilate your horse’s pupil and therefore help with pain relief. Antibiotic drops or ointment may be required to fight off any infections. Although it may be onerous, it is very important to stick to the regular daily administration of these medications. Finally, horses should be kept in a dark stable, preferably in a low-dust environment.

With a combination of early recognition, rapid assessment and the appropriate treatment, eye injuries can have very successful outcomes. Communicating with your vet is key, and soon enough you’ll both be back cantering head on into the sunset!

Castration

Castration is a routine procedure most commonly performed in young colts in order to prevent unwanted breeding and aid management.

There are three main methods of castration, the decision as to which is most
appropriate should be discussed with your vet as the choice is dependent upon a number of factors including age and size of animal, temperament and previous history:
• Open castration which is usually performed standing with the incisions left open.
• Open castration which is performed under a short acting general anaesthetic in a field setting. (This is usually reserved for smaller ponies or unhandled colts who cannot be castrated standing.)
• Closed castration under general anaesthetic which is performed in an operating theatre.

Open Castration

Open castration is the most commonly performed method of castration and can be performed either standing, under heavy sedation and local anaesthetic, or under a short general anaesthetic.
Standing castration is only possible in quiet, well handled horses, and is not safe to undertake in small ponies or horses that are difficult to handle. Guddling around between the hind limbs of a colt who is reluctant to give up his manhood can be quite a dangerous job!
Open castration under general anaesthesia is most commonly undertaken in ponies. Although all anaesthetics carry a small risk, this is minimal in healthy horses.
In most cases two incisions are made, one over each testicle, and these are left open post operatively. This allows free drainage of blood and serum that normally forms at the surgery site.

Closed Castration

This involves a general anaesthetic and the procedure can only be performed under sterile conditions in our operating theatre. The skin incisions are closed (stitched) following surgery. This method is generally recommended in older horses whose testicles and cord are more mature/larger. The closed method reduces the risk of haemorrhage.
As the incisions are sutured closed they are unable to drain as well as open castrations and as a result these horses often develop significant swelling of the castration site.

Tetanus prevention

If the horse has not already been vaccinated for tetanus, he will need to be given temporary cover at the time of the castration. Check with the vet before the operation is performed as to what is required.

Paperwork

It is helpful if you have your horse’s passport or breeding papers available at the time of castration, so that they can be modified to confirm that he has been gelded.

Aftercare

Exercise:
Gentle exercise should be encouraged to promote drainage and prevent swelling of the scrotum. Ideally, this should be achieved by turning the horse/pony out into a small dry paddock where he can move around quietly for at least a week. If your horse/pony is stabled then he should be walked out at least 3-4 times daily for 10-15 minutes to decrease swelling and improve drainage.

Woundcare:
With open castrations, the wound will be left open to allow drainage. Dripping of blood from the wound is normal, and this may continue for several hours after surgery. The legs should be washed or hosed down as necessary but it is usually not necessary to clean the wounds themselves. If blood streams from the wound or there is bleeding for more than 24 hours please contact us. The scrotum may remain swollen for up to a week; again this is normal and the swelling should start to decrease after this time.

Medication:
All horses are given a dose of antibiotics and pain relief for the procedure. Your vet may or may not consider it necessary to prescribe a longer course of antibiotics. Further painkillers (usually ‘bute’ powders) can be beneficial to help the horse or pony feel better after the operation, and move more freely; these may be prescribed by the vet who performs the surgery for a few days.

Complications

Castration (gelding) is one of the most common operations we perform and like any surgical procedure, complications may occur in spite of the procedure going smoothly.

Bleeding
This is the most immediate and common complication and can be life-threatening depending on the extent and duration of bleeding. Bleeding after surgery is often minimal with intermittent drops of blood which spontaneously stop within minutes. However, if the drops cannot be counted then prompt veterinary attention should be sought. The bleeding may come from the testicular artery (which may have been ligated during the castration procedure) or from one of the blood vessels in the scrotum which are not ligated during surgery. Depending
upon the level of haemorrhage, either the scrotum will be packed with sterile swabs or the bleeding blood vessel will require ligating (tying off).

Swelling
A degree of post operative swelling is normal and is not considered a complication however excessive swelling accompanied with stiffness
should arouse suspicion of infection. We normally recommend a course of anti-inflammatories (bute) which would help to control post operative swelling and pain. Modest exercise in the form of paddock turnout will help to minimise swelling post operatively. Excessive swelling or stiffness may indicate infection (see below).

Infection
Open castration is often termed a clean rather than sterile procedure as it is performed in field conditions where it is hard to reproduce the
sterility of an operating theatre. Antibiotics are commonly administered following castration to reduce the risk of infection. The placement of a
ligature (stitch) around the testicular artery during surgery has the advantage of reducing the likelihood of haemorrhage but this does increase the infection risk due to the presence of a foreign material within the body which can act as a focus for infection. Infection causes swelling and discharge from the surgical site and a stiff gait indicative of pain. The temperature may be raised and appetite may be reduced. For minor infections, antibiotics combined with manual opening of the incisions usually resolves the infection. More serious infections can need a further surgical procedure to remove infected tissues.

Hydrocoele
Occasionally a soft, fluid swelling may be noticed within the scrotum of a gelding which is termed a Hydrocoele. This is essentially an accumulation of fluid within the vaginal tunic (the membrane that covered the testicle) which is more common following open castration.
These do not normally cause any problems but can be corrected surgically if desired. Hydrocoeles may be detected at pre-purchase examinations when a blood test may be required to confirm that no testicular tissue remains.

Herniation/Eventration
Occasionally a small amount of fascia/fat may protrude from the incision particularly if there is post operative swelling. Unless the amount of tissue is very small, this will probably need trimming under sedation. The more serious form of herniation occurs if small intestine is able to pass through the inguinal ring (a small gap in the body wall through which the testicle descended). This normally occurs following a standing castration and is associated with an abnormally large inguinal ring. Treatment of this is an emergency and involves replacing the intestines within the abdomen within an operating theatre. Correction of this problem can be diffcult and may prove fatal but thankfully is rare.

Lymphangitis

This disease is recognised by the swelling of the legs, usually hind, that pits when pressed with a finger. There are two causes with very different implications for the horse.

The first reason for this type of swelling is known as Sporadic Lymphangitis. The swelling usually affects both hind limbs but can affect all four legs and can be considerable. The cause is simple and it is brought on by an unusually lengthy period of box rest in a horse that doesn’t usually rest for long periods. If your horse is stabled for most of the time anyway then swelling of the lower limb is likely to be due to a genuine injury rather than this disease. This sporadic form can easily be differentiated from the more sinister form as it resolves to a completely normal looking leg with a short period of exercise. There is no underlying disease process and there are no long-term effects to the affected horse. As the colloquial term “Monday morning disease” suggests, it is commonly seen in horses that work hard through the week and are stabled over the weekend, presenting with swollen back legs on Monday morning when they are brought out to work again.

The other form of the disease – Ulcerative Lymphangitis – is a completely different disease. This presents similarly to Sporadic Lymphangitis with massive swelling of, usually, one hind limb but it is much more painful and you will often see discharge through the skin of the affected leg. It is caused by infection with bacteria either through an existing wound or in a limb affected by mud rash. The swelling is caused by a combination of inflammation and blocked drainage of the leg by small clots wedged in the vessels that would normally carry the oedematous fluid away. The affected horse will also often be non weight bearing, show a high temperature, reduced or absent appetite, sweating, increased respiratory rate and sometimes, mild colic symptoms due to the significant pain.
Treatment is always necessary and should be rapid and aggressive as these cases are difficult and challenging to treat successfully and unfortunately often results in a permanently swollen leg.