My old horse (34 TB) developed an infected eyesocket two months ago, which was dealt with but did not improve even after 2 kg wide-spec antibiotics and a course of injectable anti-inflammatories. his appetite was poor, so he lost weight. I started him on daily penicillin / streptomycin injections (30 mg of Pen - Hista - Strep)and not my favourite occupation, which really did help to fight the infection, and he's been eating really well again. Nevertheless, he has developed a haematoma in a sinus (same side as the eye) and two or three under his cheek, which, during the penicillin course exploded exuding gelatinous gunk down his face and nostril. I seemed to be more appalled about it than he was, however! Today was his last injection, (10 days of them) and I'm scared the whole lot will swell up again? I don't really know what needs to be done about the haematomas....will they shrink of their own accord? i spoke to the French vet this morning, who seems to think extending the penicillin will not achieve much more at this point. What do you suggest? He's a very old man, but with a fierce will to live, and has a quality of life despite his eye problems.
Type of Animal: horse
Name of Horse: HARRY
Hi,Poor Harry he has been through it but it sounds as though you have been doing a great job with his care.Older horses have a weaker immune system and so infections can take hold more readily and be stubborn to sort out.Haematomas are collections of blood usually associated to previous trauma, I would want to confirm that this is what these new lumps are and not abscesses which may be related to the initial abscess around the eye socket.If it is likely to be an extension of the eye socket infection i.e. the infection is spreading/tracking to different areas of the face then it does need to be controlled and ideally resolved. Prolonged broad spectrum antibiotics can actually low down the development and eventual rupture of abscesses and sometimes can do more harm than good with developing infection. Antibiotics are certainly more effective once the discharge is able to drain away and a combination of effective antibiotic and wound/hole drainage can get things sorted but it can take time.If there is still discharge and it is not decreasing in volume I would be tempted to get your vet to take a swab of the discharge to grow the bacteria to make sure it isn't an unusual bacteria causing the issue and more refined less common antibiotics maybe needed. The results will be a bit skewed given the previous antibiotic treatment, but nevertheless would be worth doing.Another reason for infection not to resolve would be that if it were a result of a foreign body and as long as the foreign body is in place the bodies immune systems will continue to try to expel it through discharges and infection.Also it would be worth checking his teeth as older horses are notorious for getting tooth root abscesses and the roots of the molar teeth can be very long and so problems can reflect in the cheeks and eye areas.Horses have an amazing capacity to heal and I have seen some horrific wounds heal on their own without antibiotics, but I would just be a little cautions with Harry given his age.The most important thing is that he is bright alert and eating and drinking.I hope this answer is helpful and wish you good luckRegardsDr Dan Makin
Given Harry's great age, surgery is out of the picture, so what can be done about a foreign body? How in God's name did anything get in there? Harry always wears an excellent mask outside (summer and winter!) At the outset of the eye problem, the vet sedated the old boy and thoroughly washed out the eye. The "lumps" might well be abscesses, (they are soft, and if you press the ones under the cheek, the lump in the sinus inflates! Does the vet need to drain the things, and can it be done just under sedation?
Hi,I definitely agree surgery would not be a consideration with his age and a foreign body is only a possibility as to why the problem has been so protracted.The abscesses would be very easy to drain and probably a tiny amount of sedation would be sufficient, literally a small stab incision with a scalpel blade and thats it, you could then flush them daily with a big syringe of water and I would definitely get your vet to swab some of the goo that comes out when first lanced to make sure the correct antibiotic has or is being used.Good luckDan
Equine Veterinary Surgeon