There are some medical conditions that can cause apparent self-mutilation behavior, and practitioners are always encouraged
to perform a complete physical examination on suspected horses. Squamous cell carcinoma of the urethra has been diagnosed
in a number of such cases, and allergies and skin conditions were found to be responsible for self-mutilation in others. The
vast majority of cases, however, will have no medical cause and should be treated as behavioral in nature.
Dr. Nicholas Dodman and colleagues at the Tufts University School of Veterinary Medicine have investigated the use of various
agents for the treatment of ESMS. They found significant reduction in this behavior after the administration of various drugs,
such as acepromazine, detomidine, naltrexone and buspirone. These dopamine blockers, alpha-2 antagonists, opium-receptor antagonists
and serotonin agonists provide evidence of a neurophysiologic basis for ESMS and further support the link between ESMS and
Tourette's syndrome. Though these drugs reduce the unwanted behaviors seen in these diseases, the duration of action is not
long enough to make such treatment a practical reality. Treatment of ESMS still should be directed at altering the horse's
environment and the situations that brought about the clinical syndrome. Reduction in stress is important and can involve
a change in stabling, turn-out, work schedules and so forth.
Increased activity almost always reduces mutilation behavior, so training and play time should be altered accordingly. Increased
social contact, when possible, is also beneficial, and goats, sheep and many other companion species have been used with success.
The affected horse's diet also should be modified to reduce carbohydrates and increase the percentage of roughage. While ESMS
is difficult to cure completely, it can be controlled in many cases, and continuing research into this condition and Tourette's
syndrome eventually might yield a practical medical treatment program.
Horses that lose their vision can present another challenging situation to the equine practitioner. Initially, clients will
need assistance with the trauma or particular medical condition that causes blindness. It is estimated that 1 to 2 percent
of horses will lose sight in one or both eyes during their lifetime. Dr. Ann Dwyer, a veterinary ophthalmologist practicing
in New York, has written a chapter on the practical management of blind horses in the 2005 edition of Equine Ophthalmology. She lists recurrent uveitis as the most common cause of blindness in horses with corneal damage. Trauma and tissue degeneration
are other possible reasons for vision impairment.
And of course, clients have problems of their own when trying to care for a blind horse. This is the area where veterinary
expertise is requested and where, according to Steve Smith, many practitioners let their clients down. Smith runs a sanctuary
farm that caters to the needs of blind horses and oversees
http://BlindHorses.org/, which provides information, resources and help to owners faced with caring for a blind horse.
"Many veterinarians are unfortunately unaware of some of the methods of dealing with blind horses and consequently do not
offer clients all the options following a situation that has produced or will soon produce a blind horse," Smith says.
Many clients are told that their horses are in pain or will not tolerate an unsighted life and are encouraged to euthanize
by some practitioners. But each blind horse must be treated and evaluated as an individual because most can adapt to eventually
lead a good quality of life.
Once the initial medical management of the blindness is set, veterinarians can help clients and their horse transition to
sightlessness by offering a few simple guidelines. First, allow owners and animals to adjust to this new situation. Reassurance
is simple and effective. Most blind horses adjust to their new condition faster than owners. Since blind horses depend greatly
on hearing, owners must learn to constantly talk or whistle around their horses. Verbal clues also can be taught through repetition,
and blind horses can learn to follow, stand, back, step up and step down. Not all horses are good natural learners, but if
you think of all the physical clues that a dressage horse learns or all the visual clues that a roping horse learns, then
it is not unrealistic to believe that a blind horse can learn many commands and verbal clues that can greatly enhance its
ability to interact with humans and its environment. Teaching a blind horse to step up into and out of a trailer is also very
important, and though it might take a while, it can be done. Many references are available for owners wanting to learn these
techniques, and Dr. Dwyer's chapter is a must-read for veterinarians seeking to help their clients.