Trust
Published in modified form in "Equus"

The statuesque white horse lowered his head and snuffled my hand, then the bucket that held vaccinations, swabs and a weight tape. He almost shrugged as if to say that all was well in his world. Life had been good for many years.

Eva Iwicki bought a semi truck load of hay for a down-on-his luck horse trainer near Palm Springs, California, twenty-five years ago and in exchange he gave her a three-year-old strawberry roan Appaloosa with a white blanket named Go Native Go. She never planned to keep the young horse, but he represented a challenge. She kept him in training and he showed successfully in western pleasure at national Del Mar and Los Angeles, California shows. Between training and showing GoGo was a steadfast traveler on the desert trails and Eva was pleased that he never shied. Eva found a buyer within a year, but before the buyer showed up, money in hand, Eva realized that GoGo was the trustworthy partner she needed. She knew then that she would have him for life, a partner for the paths ahead. She began to realize what an incredible bond she already had with the horse.

Eva and her husband moved GoGo to the high country of Southern California and GoGo traced the granite ridges of the Sierras on the Pacific Crest Trail, from Running Springs to Big Bear, even camping on the trail. “I’ll take boring any day,” Eva told me, describing GoGo’s demeanor on the rocky trails. Perhaps he would stumble more than the average horse, and Eva noticed that sometimes he made bad decisions about which rock ledge to step on. I asked Eva if she had ever been scared while riding GoGo, but she only chuckled when she described GoGo’s tripping between two huge boulders and said they had almost “done a face plant”—I wondered how far down a ridge they would have fallen, but Eva really always felt safe.

After ten years of trail rides without serious injury Eva discovered why GoGo never shied. GoGo was blind. “Well, it wasn’t until I finally had the luxury of boarding my horses at home that I finally figured out GoGo was blind. …I was messing around with him one evening when I noticed that deep in his eyes, looking through his pupils, his lenses were really light or foggy looking, which only seemed apparent in the dark. I knew this couldn’t be good, and by this time, I’m sure a few other circumstances were starting to add up which made me think he may have a vision problem, so I called my vet. My veterinarian had seen GoGo before, and in fact we had ridden together, but she had never checked out his eyes. She told me she didn’t think GoGo could see anything. I was flabbergasted!!”

Eva took GoGo to Dr. Alan MacMillan, an ophthalmologist who worked with horses at San Luis Rey Equine Hospital near San Diego. He confirmed that GoGo had bilateral, complete, immature cataracts and could only discern light and dark. Cataracts are any opacity of any size involving the lens or its capsule. They are classified according to location and degree of lens affected: light cannot go through them. An immature cataract involves the entire lens but the fundus, the back of the eye, may still be visible, like looking through a shower curtain. Immature cataracts may be removed by “phacoemulsion”- cracked into pieces and suctioned out. Mature cataracts involve the entire lens, are completely opaque, and would have to be removed intact through a relatively large incision. “Well, I was really in shock on the way home from that exam,” Eva reminisced. “I have to say that it was pretty weird getting back on and riding GoGo again. But I did and of course nothing had changed—he was still the same great horse!”

It is estimated that some form of lens opacity is present in 5-7% of horses with otherwise normal eyes. A cataract is any opacity or change in the clear structure of the lens and may be localized in one area of the lens where the cataract may not impair vision. But complete cataracts cause significant visual disability. Congenital (present at birth) cataracts are most commonly bilateral. The most common cause for acquired cataract formation in the horse is Equine Recurrent Uveitis (ERU), inflammation inside the eye that not only can cause a cataract, but also makes the horse ineligible for surgery. Horses can have an inherited cataract and some of these are present at birth (congenital) and some may develop later in life. Cataracts may also be caused by trauma, toxins and nutritional abnormalities. GoGo did not have ERU—no squinting, no tearing, and he was in perfect health.

Eva scheduled GoGo for surgery at Texas A&M and he was admitted January 20, 1995, at the age of 13. Dr. Joan Dziezyc , Associate Professor and Diplomate ACVO, removed the right lens and a week later the left. Gogo’s cataractous lenses were removed by a procedure called phacofragmentation, or phacoemulsion, that involves the ultrasonic disruption of the crystal-like lens until it shatters, then irrigation and aspiration through a small suction catheter placed through an incision in the sclera of the eye just outside the cornea. Phaco has been the surgical treatment of choice for cataract removal for at least 15 years. Dr. Dziezyc and Dr. Nicholas J. Millichamp reported in 2000 that cataract surgeries in 51 eyes of 36 horses treated since 1985 restored vision in 30 horses. One year post-op, more than half still had vision and several were still used as working horses. The biggest problem immediately after surgery was corneal ulceration—perhaps because these horses became far sighted (difficulty focusing close up) without a lens and didn’t protect their eyes as well. An unpredictable problem after surgery is inflammation.

GoGo did remarkably well, and seemed to have little inflammation after surgery. He stayed at Texas A&M for one month and was off all medications by the time he went home. He could see! He ran bucking and playing around his large paddock no longer afraid of obstacles and fences. He was still on R&R from surgery when he began to have discomfort in this right eye.

Within a week of returning home, Eva reported that GoGo had developed inflammation in his right eye, evidenced by squinting and increased tearing. Medication was prescribed for a few weeks. Eva applied atropine to the eye every other day to keep the pupil dilated away from the back of the eye as well as a steroid-antibiotic combination to reduce the reaction. Gogo took it all in stride and he seemed fine in a few days. In November, 1995, Dr. MacMillan reexamined GoGo. Both eyes were comfortable and there was no evidence of inflammation. But GoGo had developed posterior capsule sclerosis--a scar on the posterior lens capsule, which is normally just behind the lens--and a synechia in the right eye—scar tissue adhesions from the posterior lens capsule to the iris, the colored portion of the eye around the pupil. The iris controls the size of the pupil in response to the amount of light. No light could get through the scar to the optic nerve. GoGo did not have a blink reflex because he could not see, and he couldn’t move his pupil in response to bright light. In the left eye, the same type of scarring was developing. Once again, he could not respond to light because of the scar tissue, but the optic nerve was just visible through the opacity. GoGo was barely able to see. The sclerosis would progress over time until GoGo was once again blind.

Ophthalmologists today continue to feel that phacoemulsification is very successful in horses, though not as favorable as in humans or dogs, according to Dr. Millichamp. The short term success rate is above 80%, Dr. Dziezyc reported, but uncontrollable inflammation from uveitis can occur at any time after surgery. Inflammation can lead to posterior capsule sclerosis and synechia as in GoGo, or even to retinal detachment at the back of the eye. Ophthalmologists are now recommending post operative anti-inflammatory medication in an operated eye daily for months or for life. Horses do not tolerate daily medication in the eye as well as dogs and certainly that reluctance may limit the success of cataract surgery in the individual horses. Anatomical differences in the strength of the lens capsule may also predispose horses to tearing of the posterior capsule during or after surgery.

Over the last fifteen years, life has been pretty sweet for GoGo. Eva continued to ride him and as long as he had another horse along, he was steady and dependable. Because of his blindness, it seemed that GoGo developed increased sensitivity to sound, smell, and touch and his responses to Eva’s leg pressure would be the envy of any trainer. Eva tried a western saddle but felt that she was not close enough for leg contact and went back to her dressage tack, even in the mountains. But Eva couldn’t be with GoGo all the time and she knew he needed a sighted companion. Eva adopted Hobby, a paint mare who had fallen on hard times. Hobby became part of the team. Eva rode GoGo and ponied Hobby on the trails. At home, Hobby was GoGo’s seeing-eye horse.

Eva and her husband Jim moved to Colorado with GoGo and Hobby about 9 years ago. GoGo is now 28, and Hobby is 34 and significantly arthritic. The horses have a wonderful home and as long as GoGo can hear or smell Hobby, he is at peace in his stall or pasture. He only worries when Hobby is taking a nap—she doesn’t snore and GoGo doesn’t know where she is resting. In 2001, GoGo severely damaged the cornea of his left eye, leading to the replacement of the eye with a synthetic globe. Today, GoGo remains blind, happy, and comfortable.

The wonder of it all is that Eva still rides GoGo on the safer trails of the San Juan National Forest close to home, with a second pal, April, on lead, providing comfort and the occasional snorted warning of dangers ahead., but Hobby objects to the usurping of her trail duties. Over the years, Gogo has roaned out until he is all white, with only the mottling of skin around his muzzle advertising his appaloosa heritage.

Eva and GoGo have a longstanding partnership that is, in fact, a matter of trust, highly developed senses and a horse’s version of Braille. GoGo “sees” his world through Eva’s, Hobby’s, and April’s eyes, and it is good.