Tower Equine

Veterinary Surgeons


Managing Liver Disease - December 2012

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Taken from Horse Magazine, November 2012:

"When one family was told their new pony may be seriously ill, they were keen to continue with the sale and restore his health", says vet Holly Applewhite.

"My first encounter with Ringo was during a two-stage pre-purchase examination in April. Potential buyer Jennie Atkinson had requested I look at Ringo to check his suitability as a first pony for her daughter, Holly. Vets perform many pre-purchase examinations which are designed to assess the animal's health, soundness and overall ability to meet the future owner's expectations. When I saw Ringo I was concerned he was thin and had poor muscle development. His coat had patches of hair loss and was quite itchy. I was worried there could be an underlying reason for his condition rather than just poor nutrition.

When performing a trot-up, he showed no signs of lameness but was very weak - I was almost able to push him over. I expressed my concerns to Jennie. First, Ringo was weak and in a poor way, and therefore unrideable; second, there might be a more long-term, detrimental reason why he was in this condition. I advised blood tests to investigate the cause.

The test results showed that Ringo had raised liver enzymes, which is evidence of liver disease. The function of the organ was also compromised. The blood test did not prove the exact cause of liver disease, but the laboratory gave a guarded prognosis for a pony of his age.

I discussed this with Jennie and advised her against the purchase, as I could not say for certain whether the liver disease would resolve. I was mainly worried that he was not suitable for Holly because it was possible she would not be able to ride her first pony for a long time and it would cost the family large amounts of money to get him right.

Despite my recommendations, Holly and the family had fallen in love with Ringo. They decided to keep him, give him a loving home and hope his liver condition improved with the help of supplements and the nutrition he needed to help the liver recover. Gradually, over the next few months, Ringo put on weight and started to look like a normal pony.

When my colleague visited Ringo a few months later, he had gained lots of weight and looked great. Repeat blood tests showed the liver was recovering well and Holly was given the all-clear to start riding him.

The underlying cause of the liver disease will never be determined. Ragwort poisoning cannot be ruled out, but usually with this type of poisoning the liver enzymes do not improve so quickly. In Ringo's case it seems normal liver function has been restored. The likelihood is that Ringo suffered from a transient viral hepatitis (inflammation of the liver caused by a short-lived virus) that with good management and rest his immune system managed to overcome.

Due to his speedy recovery, the long-term outlook for Ringo is much brighter, although he should be monitored for any similar signs returning, such as poor coat and weight loss. For now, though, the Atkinson family can treat him as a normal, four year old pony.

This case shows that with the right care and attention, liver disease can, in some cases, resolve. The family were brave to give Ringo a chance, but their patience and commitment paid off."