Close collaboration and facial reconstructive surgery save a thoroughbred’s eye

When Leroy, a 5-year-old thoroughbred gelding, was turned out in his paddock, he was viciously kicked in the face by another horse. The injury was discovered in the early morning at feeding time. 

Leroy, owned by Julia McElligott, from Hamilton, Virginia, was referred to the Marion duPont Scott Equine Medical Center by veterinarian Samantha Eder, from Total Equine Veterinary Associates, for emergency evaluation of left eye trauma. 

The Equine Medical Center in Leesburg is one of three animal healthcare facilities and teaching hospitals of the Virginia-Maryland College of Veterinary Medicine, which is based at Virginia Tech in Blacksburg.

When Leroy arrived at the hospital, he was quiet but alert. Initial evaluation by Elsa Ludwig, clinical assistant professor of equine surgery, identified significant swelling around his left eye, and the underlying bone was noted to be depressed and freely movable when pressed.  

Computed Tomography (CT) imaging at Virginia Equine Imaging (VEI) revealed a significant crushing injury to the area above and below Leroy’s left eye. The kick caused displacement of bone surrounding the eye, and the damage was significant enough that Ludwig was worried that if a surgical repair was not done, the eye could potentially be injured further, resulting in loss of vision in Leroy’s left eye. 

McElligott was willing to do anything for her much-loved horse, who she described as a “perfect saint” under saddle and a big part of her riding program.   

After reviewing the CT images, it was decided that surgery was warranted and necessary, and that normal frontal head bone surgical repair would not be sufficient. The bones would need metal plates, but because the fragments were so small, it would be necessary to use very small bone plates that were not readily available at an equine hospital. The LifeCentre, in Leesburg, Virginia came to the rescue at short notice, providing bone plates designed for small animals (dog and cat) bone repair. 

Surgery was scheduled for the following day. 

Leroy was placed under general anesthesia and Ludwig, assisted by surgery resident Bruno Malacarne, painstakingly reconstructed the bones in his face. Some small bone fragments had to be removed, as they were impinging the back of Leroy’s eye, but Ludwig was able to secure the plates in a way that held the bones in the appropriate location. The hope was that this procedure would provide Leroy’s eye with the necessary structural support. 

A lavage system was placed in the lower section of Leroy’s eye, so that Equine Medical Center staff could administer medication directly into the eye. After the surgical procedure was completed, it was difficult to visualize the eye as it was so swollen, and it was decided that it would be imperative to work on reducing the swelling surrounding Leroy’s left eye. 

Leroy recovered from surgery without complication, and at that point Equine Medical Center faculty and staff focused on keeping Leroy’s eye functional, an important attribute for a school horse! 

Ludwig collaborated with the Center’s medicine team. Elizabeth MacDonald, clinical instructor of equine medicine who monitored the eye closely, checking the rear of the eye, and over time the swelling surrounding the eye subsided. 

At this point Leroy was able to blink on his own, and in bright light his iris was appropriately constricting, all good signs of recovery which Ludwig and MacDonald were delighted to see. These signs of recovery meant that Leroy still had function and vision in his left eye. 

During treatment Leroy was fitted with eye protection – a clear plastic mask, to ensure that he didn’t rub his face, which would prove to be itchy. He remained in the hospital for just over a week, which enabled Equine Medical Center staff to consistently monitor his damaged eye, which required medication multiple times per day.  

When Ludwig and MacDonald felt that the eye was stable enough, Leroy was transported to To Win Again Farm, a rehabilitation center in Woodbine, Maryland, for continued care and monitoring.  A post-operative CT on the way to the rehabilitation center confirmed that Leroy was healing appropriately.  

Leroy stayed at the rehabilitation center until his eye and facial bones were healed enough to enable him to return to work.  

“Our gratitude is truly beyond words.” said McElligott “We’re absolutely thrilled with the incredible work the surgical team did. A huge thank-you to Dr. Ludwig at Virginia Tech’s Marion duPont Scott Equine Medical Center, and everyone at To Win Again Farm and Rehab.”