Diseases of the oral cavity and oesophagus Flashcards
(22 cards)
How is physical examination of the oral cavity conducted on a non-sedated horse?
it is limited
can inspect the mouth while the tongue is pulled out
external examination while the cheeks are pulled out
mouth gag
Physical examination of a sedated horse
detailed, relaxed examination
can see everything
Mention some clinical signs of oral disease
- inappetance
- Painful chewing and swallowing
- Swollen face
- Salivation, discharge from the oral cavity
- Halitosis
- Weight loss
- Quidding (dropping food)
- Nasal discharge
- Fistula
- Problems with riding (bit)
- Headshaking
Prepharyngeal dysphagia CS
Quidding
reluctance to chew
Pharyngeal dysphagia CS
cough
nasal discharge
gaggin
neck extension
Postpharyngeal dysphagia (oesophgeal)
- Cough, nasal discharge (saliva, food), gagging, neck extension
Management of dysphagia
Specific treatment of cause
Feeding dry hay is not recommended
Slurries made from complete pelleted feeds
- Nasogastric intubation in severe cases
- Extraoral route if necessary (oesophagostomy)
NaCl and KCl supplementation if salivation is severe
Short term parenteral feeding is possible
What can cause stomatitis and glossitis
foreign bodies: barely, grass awns, metallic
phenylbutazone overdosing (ulcers)
vesicular stomatitis
Actinobacillosis, rhabdovirus
Which salivary gland is the biggest one in horse?
parotid
What causes swelling of parotid gland in grazing horses?
slaframine-fungal toxin
primary vs secondary sialodenitis
primary is unusual while secondary is more common (trauma)
what bacteria can cause infectious sialodenitis?
corynebacterium psudotuberculosis
Congenital oesophagela diseases, occurence and reasons
rare
oesophageal duplication cyst
persistent right aortic arch
idiopathic megaesophagus
congenital stenosis
aquired oesophageal diseases, occurence and reasons
Frequent
Obstruction (most common)
Foreign body
Compression
Gastrooesophageal reflux disease
Stricture
Diverticula (congenital and acquired)
Trauma, perforation
Megaoesophagus - innervation
Granulation tissue
Scar tissue
Neoplasia
What should be done prior to removing a oesophageal obstruction?
Always check the trachea first to show the presence of aspiration pneumonia before you start
The oesophagus may rupture – need to tell the owner
It can help with aspiration pneumonia if you put a tube into trachea and inflate it
Types of oesophageal obstruction
Intraluminal (foreign body, e.g. carrot, apple, feed)
Extramural (tumour, e.g. squamous cell carcinoma, lymphoma)
Intramural (abscess, granuloma, tumour, cyst, stenosis)
Functional disorders (exhaustion, dehydration, primary megaoesophagus, neuropathy)
Where would you expect to find an oesophageal obstruction?
Cervical part
Thoracic inlet
Base of heart
Gastric cardia
Clinical signs of oesophageal obstruction
Signs of dysphagia
Anxiousness
Extended neck
Coughing
Gagging
Bilateral, frothy nasal discharge (saliva, water, feed)
Salivation
Odynophagia (painful swallowing)
Distention in the jugular furrow
Signs of aspiration pneumonia
Signs of oesophageal rupture
- Cervical region: cellulitis, signs of systemic inflammation
- Thoracic region: pleuritis
Treatment of oesophageal disease
Buscopan inj.
Acepromazine inj. (0.05 mg/kg IV)
Oxytocin inj. (0.11-0.22 IU/kg IV)
Sedation (xylazine, +/- butorphanol)
Nasogastric tubing
Careful lavage while the head is lowered
Lavage under general anaesthesia
- Tilted surgical table
- Carefully inflated intratracheal tube
Infrequently oesophagotomy
Parenteral antibiotics, flunixin meglumine
Oesophagitis is often
ulcerative
What is reflux oesophagitis?
- Repeated regurgitation of gastric fluid
- May occur along with gastric ulcers
- Motility disorders
- Decreased tone of cardia
- Gastric outflow obstruction
treatment of oesophagitis
Control of gastric acidity
- Omeprazole, ranitidine, sucralfate
Delayed gastric outflow (rule out physical obstruction)
- Metoclopramide
- Betanechol
Diet
- Frequent, soaked, small portions
- Fasting for days in severe cases (parenteral feeding)
