Introduction and purpose
Polyneuritis equi (PNE) is an uncommon neurological disease of mature horses and ponies. Historically, PNE is recognized as untreatable. Unfortunately, veterinarians aren’t trained to consider the possibility polyneuritis equi underlies the clinical signs seen in horses before untreatable disease manifests. Our purpose is to present a set of white papers to inform and educate those interested in PNE. Eventually, we will combine the papers into an eBook.
If you are interested in polyneuritis equi, you probably have an afflicted horse or know a person that has a horse suffering from the disease. Polyneuritis equi is rare, less than 50, 000 horses a year are diagnosed with PNE. That means there isn’t much information out there on this orphan disease and there are few groups conducting studies that will solve problems associated with PNE.
We collected information from published literature and studies that we conduct to write these white papers. Some of our studies were conducted under the most rigorous conditions, blinded and placebo controlled. Some studies used cases from field veterinarians. Some field cases could not be used, there just wasn’t enough documentation. More often, case reports and collaboration allowed us to generalize, statistically evaluate parameters, and the body of data moved our work forward. Reports in the literature are for one or several cases and statistical analysis just isn’t possible.
It is our goal to share our knowledge, bring awareness to this disease in horses and license treatments that can control the clinicals signs of PNE.
Our view is that polyneuritis equi isn’t recognized early in the course of disease, when it is treatable. The current dogma surrounding PNE leaves no option other than humane euthanasia because clinical signs attributed to this disease relate to end-stage pathology. However, polyneuritis equi can have an insidious onset, horses present with subtle clinical signs that can be transient and they are progressive. We believe these signs are treatable. Frustratingly, these early signs can accompany other diseases and that makes diagnosis difficult. Scientists are looking at the cellular and molecular aspects of PNE and that gives us hope that we can achieve our goals.
This book is organized into ten stand-alone sections. An extremely brief but relevant overview of the nervous system forms the basis of understanding PNE. The section Relating clinical signs of PNE to pathology explains the underlying pathophysiology of disease. The Case Reports section is from the few reported cases in literature and current cases we follow. The discussion is approached using a standard scoring system for PNE. Clinical Scoring system for PNE highlights what may be relevant to evaluating field cases. The section on Considerations for a Differential Diagnosis of PNE explores the current thinking about diseases with similar signs. This section will highlight the relationship between etiology and pathophysiology of disease. Research Past and Present is a roadmap to current thinking about PNE. Diagnostic Testing for PNE is written to help alleviate the frustration with using inclusionary and exclusionary diagnostics to get to the root of disease. Treatment and a molecular based approach to treatment gets to our fundamental understanding: PNE is an inflammatory problem. The last sections Summary and How you can be involved in PNE research contains links to important support for the owners of horses with PNE.