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Eye for danger
Tuesday, April 19, 2011 - by Kimberly French

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When Box Car Billie’s right eye first became inflamed, his conditioner wasn’t very concerned. The then 5-year-old had just finished fifth in a $19,500 non-winners contest at Yonkers Raceway on Dec. 4, 2010, and in the nearly three decades Robbie Siegelman has been involved with the sport, it wasn’t something he hadn’t seen pop up before.

“I would say one out of every 100 times you race, you see a horse with a little trouble in one eye,” explained the 57-year-old Rosyln Heights, N.Y., resident. “Honestly, 99 percent of the time some dirt irritated or aggravated it and I’ve always had it go away simply by keeping it clean or maybe putting a little ointment in it.

 
Photo courtesy of Dr. Patty Hogan
Boxcar Billie's cornea was "melting" due to a bacterial infection.

But Box Car Billie was the one exception.

“We watched him and instead of being better 24 to 36 hours after the race, it actually went the other way,” Siegelman said. “As soon as my vet (Dr. Joseph DeLeo) at the Meadowlands saw his eye, he said, ‘I want to send this horse to (Dr.) Patty Hogan right away.’”

Box Car Billie, a son of Rambaran and Helen O’ Grace, who has earned more than $200,000 from 100 career pacing miles and is owned by Richard Calogero, Jerry Alampi and Richard Mole, was admitted to Hogan Equine on Dec. 6 with an ulcer that was permeating the corneal lens of his eye.

Immediately, Dr. Hogan realized the infection in his eye was so serious, it was very possible he might not ever see out of it again.

“He came very close to losing the eye,” she said. “The cornea was obviously melting on arrival and within a few hours of his admission, the process was so aggressive that it had resulted in a perforation/hole through the cornea. The eye is under pressure and any hole in the eye results in a potential loss of pressure – sort of like letting the air out of a balloon. If you cannot plug the hole properly, all the inner fluids will leak out and the eye is lost.

 
Photo courtesy of Dr. Patty Hogan
Boxcar Billie wears protective goggles to shield him from bright lights and debris.

“Fortunately, the iris of the eye (the pigmented portion) plugged the hole immediately. Because we were able to arrest the aggressive melting process, the destruction ceased, and the plug remained stable in the hole. Once we were able to eliminate the destructive bacteria and stop the damage, it was a matter of time, intensive care and a lot of luck in getting the eye on the road to healing itself without it rupturing completely.”

Shortly after Box Car Billie came to the clinic, he was outfitted with a catheter under his eyelid to dispense various medications directly to his eye every 60 minutes. Although he wore this apparatus for nearly three weeks, his eye responded to this form of treatment within 12 hours.

“He had a bacterial infection,” Hogan said. “In fact, the culture grew two types of bacteria that are known for their ability to produce enzymes that actually “melt” the tissue of the cornea. I see approximately 15-20 cases of corneal ulcers a year with more than half being the aggressive, “melting,” type. They are considered to be true emergencies because you can actually lose the eye within a couple of hours.

“The eye had been treated daily at the racetrack prior to admission with the appropriate medications and he seemed to be responding well. But on the morning of admission, Dr. DeLeo reported a dramatic change overnight and referred the horse immediately. I suspect that was due to the two very aggressive bacteria being able to set up shop and join forces to destroy the cornea. One of them was completely resistant to the antibiotics used at the track. Usually it is primarily just one strain that colonizes a cornea, but both bacteria together was a bit unusual.”

Box Car Billie returned to Siegelman’s shedrow on Dec. 22, but he wasn’t cleared to return to the track.

“That’s when we took over with our treatment,” Siegelman said. “He was in his stall, which we kept dark for quite a while, and we kept it covered. As always, I followed Patty’s instructions to a T and she wouldn’t let me move him for a while. I believe we kept giving him Atrophine for at least 30 days after he was discharged.”

Hogan recommended for Box Car Billie to be hand-walked for a week and even after he returned to jogging, it should only be in the early morning hours before the light was too bright. The gelding could not be introduced to more intense sunlight until two weeks after the Atrophine was discontinued.

“This horse was treated very appropriately at the racetrack for what appeared to be a very minor corneal scratch or injury,” Hogan said. “The take-home message is that diligent daily care of an eye injury is very important as the situation can change very quickly and in very dramatic fashion.

“Never take a simple scratch or ulcer for granted. Always involve your veterinarian in the process. Dr. DeLeo noticed a change on the morning of the referral and sent the horse immediately. If there had been any more delay the horse would have definitely lost the eye. Not only were we lucky enough to save the eye, but most of Billie’s vision as well.”

Box Car Billie qualified on Feb. 4, 2011, at Yonkers and has competed five times since his return.

“He qualified really good for us and we put a nice pair of green goggles on him every time we take him out,” Siegelman said. “It’s kind of like if you hurt your eyes and you put some dark sunglasses on, like Ray-Bans, every day. When we race him we put a pair of goggles on him.

“He hasn’t seemed to race as well with the goggles, but there are so many other factors. I think it’s the faster times they are going now and I think it’s because they added an extra sixteenth of a mile at Yonkers. I have a pretty good feel for all my horses and he shows me no indication of favoring the eye. He doesn’t shy away from anything on that side and he doesn’t seem to throw his head. I think it bothers us a lot more than it bothers him.”


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