My comment is now too old to edit but another poster has provided some good insight
I'm not entirely sure... I know it worked in 2K, but didn't work for Win9x line, so I'm pretty sure it was in 2K/NT APIs, and not the 3.x/9x/me line. I don't think it was used by any of MS's internal themes until XP though.
(I say "pretty sure" because I once wrong a program to create a second mouse cursor but which was controlled via a game controller. The logic being I could multi-task my GUI operations. Obviously the logic was flawed and that application proved dumb but it was a fun development exercise none-the-less. Anyhow, I think I drew the cursor directly to screen by reading and writing pixels using some Win32 API; but I'm not super confident of that memory).