🩺 Vet’s 2025 Guide to Corneal Ulcer Care in Horses with Cushing’s Disease 🐎👁️

Equine eye injuries can escalate rapidly, and when a horse also suffers from Cushing’s Disease—formally known as Pituitary Pars Intermedia Dysfunction (PPID)—the stakes are even higher. Recent findings show that horses with Cushing’s produce higher levels of cortisol in their tears, directly impacting the eye’s ability to heal from infections or trauma. In this comprehensive 2025 veterinary guide, Dr. Duncan Houston explores why prompt and aggressive treatment is crucial for preserving vision in these horses. 👁️🧠

📘 Understanding PPID (Cushing’s Disease) in Horses

PPID affects up to 30% of horses over age 20. It involves a dysfunction in the pituitary gland that leads to excessive production of ACTH, stimulating the adrenal glands to release more cortisol—a stress hormone that affects immunity, metabolism, and healing. 🧬🧪

🔍 Common PPID Symptoms:

• 🧥 Long, non-shedding coat
• 💧 Increased thirst and urination
• 🔥 Higher risk of laminitis
• 😓 Excessive sweating
• 🧫 Heightened susceptibility to infection

These hormonal changes compromise a horse’s natural defenses, including those in delicate tissues like the eye. 👁️💥

⚠️ Why Cushing’s Affects Eye Healing

Recent studies show that horses with PPID have elevated cortisol levels in their tear fluid. This seemingly small detail has major implications for ocular health. 🧪💧

🧬 Effects of Cortisol on Eye Tissue:

• 🔻 Suppresses immune response on the eye’s surface
• 🚫 Slows down healing of minor abrasions or ulcers
• 🦠 Increases vulnerability to bacterial and fungal infections

In other words, what might be a minor corneal scratch in a healthy horse could turn into a serious sight-threatening ulcer in a horse with Cushing’s. ⏱️❗

👁️ What Is a Corneal Ulcer?

A corneal ulcer is an open sore or abrasion on the clear, outer surface of the eye (the cornea). It’s typically caused by trauma—like a branch scratch or dust—but can rapidly become infected. 🧫🌿

🧩 Key Symptoms of Corneal Ulcers:

• 😢 Excessive tearing
• 👀 Squinting or holding the eye shut
• 🔴 Redness and inflammation
• 🌫️ Cloudiness or visible spot on the eye

Corneal ulcers in PPID horses require faster intervention because these animals heal slower and are more prone to developing fungal infections—a significant risk in warm, humid environments like Texas or southern U.S. states. 🦠🌡️

🚑 Emergency Protocol for Eye Issues in PPID Horses

If your horse has Cushing’s and develops eye discomfort, don’t wait. Here’s what to do:

1. 📞 Call Your Vet Immediately

Eye problems can become irreversible in hours. Delay risks permanent damage or loss of the eye. ⏳👁️❌

2. 🔬 Diagnostic Testing

• 🔎 Fluorescein dye test to detect ulcers
• 🧫 Cytology and cultures if fungal involvement is suspected

3. 💊 Initiate Aggressive Treatment

Treatment regimens for PPID horses may include:

• 🧴 Topical antibiotics (e.g., gentamicin, ofloxacin)
• 🦠 Antifungal drops (e.g., voriconazole for fungal ulcers)
• ⏰ Medications administered every 1–2 hours initially
• 💉 Systemic anti-inflammatories and pain control

In some cases, a subpalpebral lavage system (a catheter for administering eye meds) may be recommended for easier application. 💉👁️

🌡️ Fungal Ulcers: The Texas Risk Factor

In regions like Texas, fungal ulcers are particularly aggressive and often resistant to common treatments. Warm, dry climates promote fungal spore growth—making prompt veterinary attention even more essential. 🌵☀️

Horses with Cushing’s in these climates should be monitored closely for eye injuries and managed with enhanced caution. 🛑🧴

🛡️ Preventive Tips for Owners of PPID Horses

Since prevention is far easier than treatment, follow these tips:

• 🧼 Keep paddocks free of sharp branches and foreign objects
• 🧽 Clean around the eyes regularly to remove debris
• 🧠 Be vigilant for signs of eye irritation
• 👀 Schedule regular ophthalmic exams for horses with PPID

📱 Use Technology to Stay Ahead

The Ask A Vet app offers features that make managing chronic conditions like PPID easier:

• 📅 Reminders for eye exams and medication
• 📷 Upload photos of eye injuries for rapid vet feedback
• 💬 Chat with a licensed vet anytime, anywhere

📲 Download the Ask A Vet app and stay ahead of PPID complications.

🧠 Final Thoughts: Don’t Delay Eye Care

Corneal ulcers are always an emergency, but in horses with Cushing’s Disease, they’re a potential disaster. With delayed healing and suppressed immunity due to high tear cortisol levels, these horses must be treated immediately and aggressively to avoid vision loss. 🧪🛑

If your older horse shows eye discomfort, assume the worst and act fast. Consult your equine vet or reach out through AskAVet.com for expert care advice. Your horse’s sight depends on it. 👁️🐴