10. Examine the oral cavity, pharynx, and oesophagus of the horse, and summarise the findings. Interpret the gastroscopic findings of the horse Flashcards
Signs of disease:
- Inappetence & weight loss
- Painful chewing & swallowing
- Swollen face
- Salivation
- Nasal discharge
- Head shaking
- Quidding = horse stores bolus of food inside mouth or drops it after a few bites
Physical examination of oral cavity, without sedation:
Limited possibilities.
1. External palpation through cheeks
2. Inspection with tongue hanging out
3. Mouth gag can be used
Physical examination of oral cavity, with sedation:
- Less stressfull for horse
- More detailed examination
- Mouth rinse recommended
- Endoscopy: pharynx, oesophagus, guttural pouch
- Nasogastric tubing and gastroscopy: Stomach
What to examine in the oral cavity:
- Mucous membranes
- Look for abnormal odor & saliva
- Teeth
- Tongue
- Salivary glands: Parotis, Mandibular gland, Sublingual gland, Buccal gland
- Pharynx
- Oesophagus
Name some oral cavity diseases:
- Dysphagia = difficulties with swallowing and/or eating
- Stomatitis: inflammation of oral mucous membrane
- Glossitis: Inflammation of the tongue
Pharyngeal diseases:
- Pharyngeal collapse
- Pharyngeal cyst
- Congenital defects: Choana atresia feks
Oesophageal diseases, congenital:
- Oesophageal duplication cyst
- Persistent right aortic arch
- Idiopathic megaoesophagus
- Congenital stenosis
Oesophageal diseases, acquired:
- Obstruction (most common)
- Foreign body
- Compression
- Gastroesophageal reflux
- Stricture
- Diverticula
- Trauma, perforation
- Granulation tissue
- Neoplasia
- Megaoesophagus
Name the salivary glands of a horse:
- Parotid
- Mandibular gland
- Sublingual gland
- Buccal gland
Examination of salivary glands:
- Inspection: sweeling etc
- Palpation
- Ultrasound
- Needle aspiration (cytology, culture)
Diseases of salivary glands:
- Salivary gland laceration
- Sialadenitis = inflammation of the salivary gland
- Sialolithiasis = salivary stones -> obstruction
- Neoplasia = melanoma in grey horses especially
Examination of pharynx:
- Inspection
- Videoendoscopy during treadmill
- Ultrasound
Diseases of pharynx:
- DDSP (Dorsal Displacement Soft Palate) = the caudal free margin of the soft palate moves
dorsal to the epiglottis, creating a functional obstruction within the airway. Clinical signs: breathing through mouth, vibrating noise during expiration - Pharyngeal lymphoid hyperplasia.
- Pharyngeal collapse
Pharyngeal collapse:
Rostral: upper respiratory expiratory noise, because of rostral soft palate billowing
Dorsal/Lateral: respiratory inspiratory noise
Choana Atresia:
- Seldom malformation
- Persistent buccopharyngeal membrane
- Associated with failure to resorb the bucconasal membrane during embryonic development
- 2 forms:
* Unilateral: - Can be asymptomatic at rest and Surgical intervention at age 1-2 years
* bilateral: - Tracheotomy, then laser-resection & stenting
Examination of oesophagus:
- Palpation, eg. Check for foreign bodies
- Nasogastric tubing
- Endoscopy
- Radiography (plain, contrast)
- Ultrasound
- Blood chemistry (in case of rupture): hyponatraemia, hypochloraemia, hypokalaemia (due to ptyalism) leukocytosis, left shift…
Predilection site of disease/problem with the esophagus:
- Cervical part
- Thoracic inlet
- Base of heart
- Gastric cardia
Types of diseases/problems with esophagus:
- Intraluminal - eg. Foreign bodies
- Extraluminal - eg. tumours
- intramural (within the oesophagus wall) - eg.
abscess, granuloma, tumour, cyst, stenosis
Name disease/problems with esophagus:
- Obstruction
- Oesophagitis
3.
Obstruction of oesophagus:
- Most common oesophageal problem
- Caused by feed impaction
- Treatment: seadative, nasogastric tube, oesophageal lavage,
Oesophagitis:
= inflammation of the oesophagus
Caused by: trauma, reflux, mural abscess
Treatment: omeprazole feks, diet
Preparations for gastroscopy:
- 12hrs fasting prior to examination
- Sedatives
- restraint
- inflate stomach with air to facilitate the examination - decompress after!!
Anatomical structures of stomach:
- Volume: 5-15L
- Location: left side, intrathoracic area
- Blind sac
- Major curvature
- Minor curvature
- Pylorus
Blind sac of stomach:
= pars non-glandularis
* Located in the cardiac region
* Covered in non-glandular epithelium
* This area rarely contains ulcers
Major curvature of stomach:
- Covered by white non-glandular mucosa (pars non-glandularis) dorsally and pink glandular mucosa (pars glandularis) ventrally, separated by the Margo plicatus
- Gastric ulcers are most commonly found at the margo plicatus
Minor curvature of the stomach:
- Once you can see the endoscope exiting the esophageal opening, the curvatura minor
can be viewed - Pay close attention to the area under the lip of the lesser curvature, gastric ulcers may
be present in this region
Pylorus of the stomach:
- May be difficult to find, due to presence of feed material & gastric fluid
- Proximal duodenum can also be examined
Pathological findings of the stomach:
- Hyperkeratosis
- Hyperaemia
- Ulcerations
- Larvae
- Fibrin
- Neoplasia
Hyperkeratosis of stomach:
- Reddening or yellowing of the mucosa
- Irregular changes in the thickness of the mucosa
Hyperaemia of stomach:
- Reddening of the mucosa
Ulcerations of stomach:
Caused by stress, NSAIDs
