Big ol' complication! long one ppl, sorry!

ashcass

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Ok so this is a long story. My 23 year old Shetland was diagnosed with a really rare (and by really rare I mean less than 10 horses worldwide and the vets know little about it) immune disease over the summer. This basically has almost completely knocked out his immune system and affects the growth of skin and horn. His skin in certain areas is thin and flaky, he has no chestnuts and ergots anymore what does grow in those places tends to break off after a week or so but the majority of this problem has focussed on the coronet band. his hoof growth while at a normal rate is rather uneven and is prone to cracks. He regularly gets inflamation of the coronet band and was very painful for him. Three weeks ago he was put onto steroids which has helped no end, he's much more comfortable and to a degree, teamed with aloe vera baths, has improved his skin. The major problem is that if he cuts himself etc it just takes ages to heal. a graze on his nose literally took nearly amonth to repair. Now just after he started on his steroids he got an absess on his coronet band which promptly split a horse shoe shape, less than an inch wide covering the cornet band and down onto the hoof, leaving a middle fleshy section. The crack was cleaned out by the vet and weve been polticing his hoof and used magnesium paste to draw out the puss. but while the majority of the puss has gone, still a tiny bit, the thing just will not heal and is still quite sore for the poor thing. My vet, who trust me is consulting everyone about the whole condition my pony is infact becoming something of a case study, says this is one of the side effects of the condition and there are likely to be more absess in the future. The major problem is because of his other medication he isnt allowed bute or finadin pain relief. So if anyone has any ideas that mite help with healing and repair and herbal pain relief other than 'No Bute' which doesnt seem to have any effect, I would be really grateful to hear them. I cant tell you what a nightmare the whole thing has been, knowing that the vetinary world knows little about the condition either. Sleepless nights are an understatement, its soul destroying but the vet is convinced hes a tough cookie (this is the first in a long line of ailments hes had) and its all worth persevering with which is something I guess. Sorry that was so long!
 
Is your pony suffering from pemphigus or something else?
Has your pony been referred to an equine specialist? This may be a worthwhile next step as they could try more novel approaches to getting his condition under control using drugs that might not be accessible/familiar to your own vet.

Treating autoimmune diseases can be incredibly difficult, as you have to strike a balance between switching the pony's immune system off enough that it does not attack itself, but not so much that it cannot effectively protect the pony against infection and affects healing. Often it takes a while to stabilise these cases, but it may be worth discussing slowly reducing the steroid dose he is on and perhaps considering topical steroids.

Hope that is some use - I know how frustrating these kind of cases can be.
 
Its a condition called Neutropenia. Yes we are with an equine specialist at Liverpool as well as our regular vet but as you said these cases take time, its a nightmare.
 
If Liverpool are looking after him then I don't think there is much else you can do, they will know what is best for him! Is Prof Knottenbelt taking care of him? The medicine vets there are really good.

Best of luck, hope you have a breakthrough soon.
 
Good luck, if you are at Liverpool I am sure you are getting the very best treatment possible.
As I am sure the vets have explained to you, neutropenia is a fancy name for low levels of neutrophils in the blood, a type of cell that helps to fight infection.
I don't know much about equine neutropenia, but in humans neutropenia can be seen for a variety of reasons. Genetic / Cancer / Drug Induced to name a few.
What I suppose I'm trying to ask is have the vets given you a reason behind why your horse is neutropenic?
When dealing with cancer patients I have often seen G-CSF prescibed by consultants, I wonder if there is a shetland version?!
 
What a sad thing to have happened OP. Sorry to raise this, but I wonder what kind of quality of life your little chap is having? I know we all want to do the very very best for our ponies and it is utterly heartbreaking when they are so poorly.

I really hope that a cure can be found.
 
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