FACIAL NERVE PARALYSIS

[Bron1994]

Hi Everyone! I need advice about this condition!

My girl Rosie is 28 years old and the right side of her face has suddenly gone paralysed. Her ear droops, she can’t blink and her eye waters on both sides and her right side of mouth is drooping too. She is still eating and acting ‘normal’ but she is very head shy especially around her ears.
The vet has been out to see her and our only option realistically is to book her in for an endoscope to look into the guttural pouches which we are going to do. In the mean time I’m going to apply eye drops to her eye and she is going on oral steroids. From what my vet has said if it’s not the guttural pouches (which we can hopefully treat) then it could be the hyoid bone. Which unfortunately isn’t an option for us to treat.
Is there anything else it could be? That could be an option for us to look into?
Or anything I can do to help? Like massage? I don’t know what to do and it’s breaking my heart.
Thank you!
Bronwyn x

 

[nagblagger]

Hi, i had a donkey like this (about 15 years ago) and told the vet i think she had Bell's palsy, we weren't sure of the cause but i wanted steroids as that what we used in humans. As steroids increase the risk of laminitis i had to gather data to prove that they actually worked. The data showed in humans they would work if they were given within 5 days of onset of symptoms. Donkey was started on steroids and I used to do physio daily - massaging ear and trying to make her blink. She recovered 99%.
However at 28 years of age there may be other things causing pressure on her facial nerve including a tumour.


Edit the equine vet had never seen anything like it before.

 

[Bron1994]

Hi, i had a donkey like this (about 15 years ago) and told the vet i think she had Bell's palsy, we weren't sure of the cause but i wanted steroids as that what we used in humans. As steroids increase the risk of laminitis i had to gather data to prove that they actually worked. The data showed in humans they would work if they were given within 5 days of onset of symptoms. Donkey was started on steroids and I used to do physio daily - massaging ear and trying to make her blink. She recovered 99%.
However at 28 years of age there may be other things causing pressure on her facial nerve including a tumour.


Edit the equine vet had never seen anything like it before.

Thank you for this! She started steroids yesterday and we are seeing slight improvements from when it first happened (Tuesday) Only really small, hardly noticeable really, but hopefully in the right direction. She’s still not fully blinking but there seems to be more little blinks. And I will start some physio with her. Going to see how she gets on for the weekend before we book the endoscopy.

Yeah that’s my fear, realistically I can only do the endoscope and then anything else that I’ve read about is looking hard to diagnose, expensive and not treatable.

Yeah my vets haven’t seen it or atleast dealt with this issue before either

 

[nagblagger]

I only thought about it because i' m a nurse.and had seen it in humans To get the eye to try and blink I waved my hand in front of it, make sure the eye doesn't become dry/sore. It could have been an injury, hitting her head at an awkward angle. Good luck and keep us updated.

 

[Bron1994]

Thank you! I will keep you updated.

I’m applying eye drops twice a day, it’s all I can do with working full time. Her eye doesn’t look dry at the moment. Both her eyes do look red but they’re constantly weeping and look wet.

 

[Bron1994]

Also, she is eating but I don’t think she’s eating enough. I give her ad lib hay (lots of chewed up hay around) and she’s been getting spillers senior mash. A big bucket morning and evening but I’m scared she’s not eating enough. Should I just make up a feed only diet for her whilst she’s struggling? Making it like mash?

 

[nagblagger]

Mine did lose a bit of weight but she had a lot of grass available and her normal mix feed.
She obviously is not choking but she will eat slower so will need more time and that she doesn't feel hurried to eat The steroids may increase her appetite so weight watching, for loss and gain, and laminitis risk would be the main concerns.
Has she got a shelter she can go into if the sun is too bright for her eyes, and the flies.

 

[Birker2020]

Hi Everyone! I need advice about this condition!

My girl Rosie is 28 years old and the right side of her face has suddenly gone paralysed. Her ear droops, she can’t blink and her eye waters on both sides and her right side of mouth is drooping too. She is still eating and acting ‘normal’ but she is very head shy especially around her ears.
The vet has been out to see her and our only option realistically is to book her in for an endoscope to look into the guttural pouches which we are going to do. In the mean time I’m going to apply eye drops to her eye and she is going on oral steroids. From what my vet has said if it’s not the guttural pouches (which we can hopefully treat) then it could be the hyoid bone. Which unfortunately isn’t an option for us to treat.
Is there anything else it could be? That could be an option for us to look into?
Or anything I can do to help? Like massage? I don’t know what to do and it’s breaking my heart.
Thank you!
Bronwyn x

Ive heard about Horners syndrome, its a palsy that starts from the gutteral pouch and can cause the symptoms you describe. Maybe that's why they want to look in the pouches. They did that with a previous horse of mine that kept getting nosebleeds.

 

[Bron1994]

Mine did lose a bit of weight but she had a lot of grass available and her normal mix feed.
She obviously is not choking but she will eat slower so will need more time and that she doesn't feel hurried to eat The steroids may increase her appetite so weight watching, for loss and gain, and laminitis risk would be the main concerns.
Has she got a shelter she can go into if the sun is too bright for her eyes, and the flies.

Thank you! Yeah she does have a field shelter x

 

[skinnydipper]

If you are unable to administer the eye drops frequently try using an ointment lubricant like Xailin night, Hylo night or Hycosan night. They lubricate the eye for a longer period than drops or gel.

ETA. If she is not blinking, close and massage the lid if you can to ensure the ointment covers the eye.

 

[Bron1994]

Thank you! I’ll look into the ointments x

Yeah she isn’t blinking fully, only little eyelid flutters.

 

[Bron1994]

Ive heard about Horners syndrome, its a palsy that starts from the gutteral pouch and can cause the symptoms you describe. Maybe that's why they want to look in the pouches. They did that with a previous horse of mine that kept getting nosebleeds.

Thank you! Yeah I think best case scenario there is something going on in the pouches that we can hopefully treat

 

[nagblagger]

Mine recovered after high dose steroids and had no further issues.

 

[Bron1994]

Mine recovered after high dose steroids and had no further issues.

She is on steroids and today will be her third day. So far no improvement and her eye looks worse tonight. The corner (the pink bit) looks inflamed and has increased in size.

 

[nagblagger]

is she on a higher than normal dose of steroids, after a 'discussion' with my vet about the high dose steroid treatment, providing human data as evidence it works, he agreed to prescribe them but had to be very careful with the laminitis side effect. i took full responsibility.
Does she wear a fly mask to protect the eyes, like they use for uveitis? You definitely need eye cream.

 

[skinnydipper]

You definitely need eye cream.

^this^

If her eyelid isn't blinking/closing properly this will lead to dry eye. The eye needs adequate lubrication to prevent ulcers and corneal scarring.

 

[Bron1994]

is she on a higher than normal dose of steroids, after a 'discussion' with my vet about the high dose steroid treatment, providing human data as evidence it works, he agreed to prescribe them but had to be very careful with the laminitis side effect. i took full responsibility.
Does she wear a fly mask to protect the eyes, like they use for uveitis? You definitely need eye cream.

She’s on 5 tablets a day. I’ll have to check the brand of steroid, I don’t know it off the top of my head.
She has a fly mask and what eye cream would you recommend?

 

[nagblagger]

I used chloramphenicol eye drops, not sure if optrex is any good to lubricate until you discuss with vet. My donkey was on more than 5 steroids a day, but like I said, a higher than normal dose for the animal. I presume the steroids are prednisolone 5mg so 25mg a day. It's a shame it's bank holiday tomorrow or else I could get all the accurate details for you.

 

[Bron1994]

I do have chloramphenicol cream off the vets which I’ve been using. She’s not the easiest to get these things into her eyes, but I’m doing my best. And I have optrex eye drops but I’m going to get some of the ointment that was recommended ^^^ Hylo night.

 

[skinnydipper]

Leave 5 minutes after chloramphenicol eye drops before applying lubricant.

 

[Bron1994]

Update - her left eye is swollen now and shut and weeping. Mouth and ear seem fine.
Right side still the same, eye looking a lot better.

I honestly don’t know what to do because we have ongoing issues with ringbone too. She had a neurectomy to keep her field sound but it worked for 5 days then she went back lame; she’s been treated for neuromas and she’s still lame. I’m so overwhelmed and I don’t want to give up but I’m not sure what I can do. All nerve blocks and X-rays pointed to the ringbone being the issue too.

I was thinking about trauma being one of the causes tho.
She has a wooden hay crate that I fill, but she likes to throw her hay around and I have seen her hit her muzzle area a few times on the crate? Could that be a cause?

 

[nagblagger]

Vet for the eye i'm afraid if she was mine.

 

[meleeka]

Update - her left eye is swollen now and shut and weeping. Mouth and ear seem fine.
Right side still the same, eye looking a lot better.

I honestly don’t know what to do because we have ongoing issues with ringbone too. She had a neurectomy to keep her field sound but it worked for 5 days then she went back lame; she’s been treated for neuromas and she’s still lame. I’m so overwhelmed and I don’t want to give up but I’m not sure what I can do. All nerve blocks and X-rays pointed to the ringbone being the issue too.

I was thinking about trauma being one of the causes tho.
She has a wooden hay crate that I fill, but she likes to throw her hay around and I have seen her hit her muzzle area a few times on the crate? Could that be a cause?

I think have a chat with your vet. If it’s trauma is it likely to improve? Is there swelling somewhere and how long would that take to resolve? The eye could well be infected so I’d ask the vet about that too.

Perhaps you’d feel better to put a time limit on it, with the guidance from your vet. Say, if there’s no improvement in 4 weeks there’s unlikely to be any improvement, so decision made, or something like that. It doesn’t sound like shes suffering at the moment, but long term it’s probably not fair to keep her going, with her other problems.

 

[Bron1994]

Thank you, I am in constant contact with the vet everyday (bet he’s sick of me now ) and I will get him to come have another look at her. I’m trying to attach files but they’re too big. To show you guys what she’s looking like.

It’s just heartbreaking to see her like this and know what the right thing to do is. I think at the age of 28 things are most likely only going to get worse with health issues. But I want to try my best for her.

 

[nagblagger]

You sound like you are doing the best, but being realistic and will make the right decision if needed. That's the best kind of animal owner.

 

[Bron1994]

You sound like you are doing the best, but being realistic and will make the right decision if needed. That's the best kind of animal owner.

Yeah I think I need to be realistic about her and make that hard but right decision for her x

 

[Zuzzie]

Also, she is eating but I don’t think she’s eating enough. I give her ad lib hay (lots of chewed up hay around) and she’s been getting spillers senior mash. A big bucket morning and evening but I’m scared she’s not eating enough. Should I just make up a feed only diet for her whilst she’s struggling? Making it like mash?

Lots of chewed up hay around sounds like she isn't able to chew as she did when young. My gelding is 29 - last year the vet came to do his teeth but said he has lost some teeth and also the grinding surface has diminished so that he can't really chew hay. Not being able to chew it properly means he could get impacted colic so she recommended a hay replacer. I have put him on Spillers Happy Hoof unmolassed which is basically a short fibre feed and he loves it (he has 2 scoops for breakfast, 2 for dinner and 4 for bedtime) I also feed Top Spec Fibre Plus Cubes and Dengie Alpha A (soaked) as a breakfast, lunch and dinner. It is expensive but my horse looks great - like a 5 year old!

 

[Bron1994]

Hi everyone! Update on Rosie.

She’s still here and we’ve had our first proper full blinks today! And her ear is showing a bit of movement too! I’m hoping these improvements continue
She has dropped weight, but I have plenty of long grass that she is doing good on and she’s been getting plenty of feed! Fingers crossed!

 

[rextherobber]

Fantastic news!