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Year 3 MOD > Equine Dentistry and Diseases of the Head > Flashcards

Equine Dentistry and Diseases of the Head Flashcards

1
Q

What can dental disease result in for horses?

A
  • Oral pain and discomfort
  • Weight loss
  • Predisposition for certain colics
  • Secondary disease process- sinusitis
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2
Q

What type of teeth do horses have?

A

Hypsodont- long crowned

Erupt 2mm/year

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3
Q

What is a horses deciduous and permanent dental formula?

A

Deciduous- [I 3/3, C 0/0, M 3/3] x2 = 24

Permanent- [I3/3, C1/1 or 0/0, PM 3/3 or 4/4, M3/3] x2 = 36-44

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4
Q

Which first number of 1, 2, 3 or 4 identifited which quadrant of a horse mouth with the triadan system?

A

100- upper right /5

200- upper left/ 6

300- lower left/ 7

400- lower right/ 8

/ deciduous

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5
Q

When do horses deciduous and permanent incisors erupt and show wear?

A

Deciduous Incisors-
Central- 1 week
Middle- 6 weeks
Corner- 6-9 months

Central permanent- 2.5 years, in wear 3 years
Middle permanent- 3.5 years, in wear 4 years
Corner permanent- 4.5 years, in wear 5 years

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6
Q

When do canines and wolf teeth erupt in horses?

A

Canine-
No deciduous precursor
Erupt- 5 years
Males- occasionally females

Wolf teeth-
No deciduous
Erupt- 1 year

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7
Q

When do horses premolars and molars erupt?

A

Premolars 06, 07 and 08 present at birth no deciduous molars

06- 2.5 years
07- 3.5 years
08- 4 years
09- 1 year
10- 2 years
11- 3.5 years

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8
Q

What anatomical differences can be identified on different age of horses?

A

The infundibulum

Secondary dentine

Amount and presence depends on age

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9
Q

What are each of the arrows pointing too?

How do maxillary and mandibular cheek teeth differ?

A

Arrows-
Top left- enamel
Top right- peripheral cementum
Bottom left- primary dentine
Bottom right- irregular secondary dentine/regular secondary dentine

Maxillary CT- 2 infundibulae, wide ‘square’

Mandibular CT- no infundibulae, narrow ‘rectangular’

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10
Q

What are pulp horns?

How many does each cheek tooth have at least, which have more?

A

Pulp horns are an area of pigmented secondary dentine on the occlusal surface, protects underlying pulp

Every cheek tooth have at least 5
06s- have extra rostrally
11s- extra 1-2 caudally

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11
Q

How many roots do maxillary/mandibular cheek teeth have?

Where are the roots found?

What happens if the teeth become infected?

A

Maxillary- 3 roots- 2 lateral, 1 palatal
Mandibular- 2- rostral and caudal

06, 07- root end in maxillary bone
08, 09- rostral maxillary sinus
10, 11- caudal maxillary sinus

Teeth infection- facial swelling/draining tracts, malodorous smell/ nasal discharge

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12
Q

What is anisognathia?

A

Differing upper and lower jaw width

Maxillary cheek teeth are further apart then mandibular

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13
Q

What are some normal anatomical variations of horses dentistry?

A

Curvature of the maxilla- widest 08-10
Implications- tack, removing buccal overgrowths

Curve of spee- more prononced in Arabs, care removing caudal 11 overgrowths

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14
Q

What is needed for a equine dental examination?

A

Appropriate area

+/- sedation

Dental equipment

Gloves

recording sheets

+/- head stand

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15
Q

What should be done in an initial examination of a horse?

A
  • Thorough history- recent weight loss, colic
  • Watch horse eat- normal sounds, both sides, time
  • Clinical exam- underlying disease, swellings, halitosis, nasal discharge
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16
Q

What dental equipment is needed for oral examination?

A

Gag
Light source
Dental mirror
Dental syringe
Pulpar explorer
Periodontal probe
Diastema forceps
Rasps- motorised tools

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17
Q

What should be checked for on an incisor then canines and wolf examination?

A

Incisors- without gag

  • Check for abnormal masses/ fractured teeth
  • Check occlusion from side and front
  • Count the teeth

Canines- calculus, fractures, apical infection

Wolf- displacment, blindly erupted, mandibular wolf

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18
Q

When palpating cheek teeth during a oral examination how should it be done?

What are you feeling for?

A
  1. Occlusal surface of every tooth
  2. Edges of teeth- buccal maxillary, lingual mandibular
  3. Every inter-dental space
  4. Buccal mucosa
  5. Tongue adjacent to teeth
  • Dental overgrowths- sharp points, soft tissue trauma
  • Diastemata
  • Dental fractures
  • Displacment
  • Supernumary teeth
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19
Q

When doing a visual oral examination what should be done?

A

Look- wihout mirror-
Count, overgrowths, soft tissue trauma, fractures

Look with mirror-
count again, all surfaces, interdigital spaces

Probe- pulp horns, assess depth of diastemata

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20
Q

What does oral endoscopy allow?

What is routine floating?

A

Better evaluation of occlusal surface, diastema and periodontium

Hand rasping- 3-4 hand rasps, full examinatino, sedation

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21
Q

What further diagnostic imaging can be used for equine dentistry?

A

Radiograph

Sinoscope

Computed tomography

Schintigraphy

MRI

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22
Q

What are the two equine dental paraprofessionals and what is the difference?

A

BAEDT- passed BEVA exam, CAT 1 and 2 procedures

Others- Attended a course but not examined- only CAT 1

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23
Q

What are CAT 1 procecures?

A
  • Examinations
  • Removal or sharp points with manual rasps
  • Removal of small dental overgrowths- manual rasps
  • Rostral profiling of first cheek teeth
  • Removal of loose deciduous caps
  • Removal of supragingival calculuc
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24
Q

What are CAT 2 procedures?

A
  • Examinatino, evaluation and recording of dental abnormalities
  • Removal of loose teeth/fragments- negligible periodontal attachments
  • Removal of erupted, non-displaced wolf teeth under vet supervision
  • Palliative rasping of fractures and adjacent teeth
  • Motorised dental insturments to reduce overgrowths and sharp enamel points only
  • Horses sedated unless safe without, consent from owner
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25
Q

Who can perform category 3 procedures?

A

Qualified veterinary surgeons

Diastemata widening

Unerrupted wolf tooth removal

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26
Q

What is the consequence of brachygnathism and prognathism in horses?

A

Brachygnathism-

Ulceration behind upper incisors

Maxillary rostral 06 overgrowths and mandibular 11 overgrowths which will need lifelong attention

Prognathism-

Fewer incisor problems, overgrowths of lower 06 and upper 11 overgrowths

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27
Q

What is campylorrhinus lateralis?

A

‘wry nose’

Deviation of the entire maxilla, invilving incisive region, nasal septum and nasal bones

Varying degree of severity- from minor occlusal problems to severe and breathing problems

Surgical correction can be attempted but complex

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28
Q

What is malocclusion secondary to?

What is slant mouth?

A

Secondary to problems involving the cheek teeth

Slant mouth or diagonal bite is indicative that the horse is eating predominantely one one side

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29
Q

1) How does retained deciduous teeth in horses ususally present?
2) How is it treated?
3) What is done with supernumerary incisors?

A

1) Usually rostral to permanent tooth
2) Treatment- loose: remove with forceps, firmly attached: remove with dental elevators
3) usually cause little problem, often best not to remove

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30
Q

What can cause incisor fractures?

What indicates extraction?

A

Trauma, caught on objects, cribbiting

Determine if pulp affected- extraction required

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31
Q

What is incisor diastemata?

What is valve diastemata?

What should be done?

A

Spaces between adjacent teeth

Valve- narrower at occlusal aspect, wider at gingival margin, traps food near gingiva

Food should be removed from the spaces with a toothbrush on a twice weekly basis

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32
Q

What is Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH)?

How is it managed?

A

Swelling and/or draining tracts over multiple mandibular and maxillary incisors- pain

Diagnosis- visual, radiograpy

Extraction of the loose incisiors is curative
Disease is progressive in some cases spreading from tooth to tooth
May have to remove incisors- horses cope well

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33
Q

How is equine oral neoplasia classified?

A

According to the tissue of origin
Dental
Bone
Soft tissue

According to behaviour- benign/malignant

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34
Q

What oral neoplasias are from dental tissue origin?

A

Ameloblastoma- older horses, mandibles, causes bony swelling
Benign- surgical excision

Cementoma

Odontoma

Temporal teratoma

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35
Q

What equine oral neoplasias are of soft tissue origin?

A

Squamous cell carcinoma
Sarcoid
Epulis
Melanoma
Oral papilloma
Ossifying fibroma
Fibroma
Myxoma/myxosarcoma

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36
Q

What canine abnormalities can affect horses?

A

Rarely cause problems

Calculus around lower canines most common- remove with dental forceps, owner can clean periodontal pockets

Apical infection/fracture- endodontic treatment, removal can be challenging- long and curved roots

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37
Q

Why are wolf teeth commonly removed?

When is removal indicated?

A

Due to owner/trainer preference/tradition

Do not cause problems with normal shape, position- is removal justified?

Indications- biting problems/ulceration, blindly erupted

May become molarised- look like a molar, always radiograph

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38
Q

What is used for wolf teeth removal?

What are the potential complications?

A
  • Specialised kits do exist, alternatively a long handled elevator or small animal tooth luxator and forcep
  • Standing sedation and speculum
  • Local anaesthesia- infra-orbital/maxillary
  • Blindly erupted- incise gingiva over top with no 11/15 scalpel
  • Remove once loose with forceps
  • 2 weeks bit rest

Complications:
Fracture of tooth
Fracture of bone
Trauma to palatine artery

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39
Q

When should dental checks be done for horses?

A

Ideally examine cheek teeth briefly in first week- check for cleft palate

Yearly checks as the cheek teeth begin to erupt

The earlier you begin working on a horses mouth the more tolerant it will be

It is usuaul to have to perform any routine rasping before 2 yo

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40
Q
A
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41
Q

What are retained caps?

A

Remnants of deciduous teeth- normally shed during eruption

Loose/retained caps can cause oral pain

Usually attached to gingiva in one place- causes pain
Easily removed with forceps

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42
Q

What can cause cheek teeth displacments?

What problems can it lead to

A

Overcrowding during eruption- often bilateral

Can lead to rotation and trauma

Diastemata can lead to periodontal disease

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43
Q

What is developmental diastemata?

What can it lead to?

A

Opposing angulation causes the compression of occlusal sufaces of the teeth together in rostro-caudal direction- should

If this doesnt haeppen teeth develop too far appart

Leads to-
Spaces developing
Food accumulating
Fermentation
Periodontal disease

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44
Q

What is done if there is a supernumerary cheek tooth?

A

May result in periodontal disease- extraction indicated

If they occlude normally with the other teeth can be left in situ but may require regular rasping

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45
Q

What causes enamel overgrowths and where are they found?

When are they more pronounced?

What can exacerbate the problem?

What are the clinical signs?

How are they managed?

A

Anisognathism- leads to enamel points- buccal of upper, lingual of lower

More pronounced where horses fed more concentrated

Tack can exacerbate the problem

Clinical signs- quidding, pain when eating

Rasp on routine dental

46
Q

What are some disorders of wear?

When are they more commonly seen?

A

Wavemouth- marked undulation to occlusal surface, dominant areas can be sequentially reduced

Strepmouth- may occur when a focal overgrowth occurs, can be reduced in stages

More commonly seen in horses without regular dental care

47
Q

What is shear mouth?

What causes it?

How is it managed?

A

Increased occlusal angle of entire cheek tooth row

Usually secondary ro diastemata formation/dental fracture
If bilateral suspect temporomandibular joint arthropathy

Managment-
Treat primary problem
Gradual reduction of the angle

48
Q

What does this image show?

What is done to treat this?

A

Exaggerated transverse ridges- large overgrowth

Hand or power rasp in stages
Excessive can lead to pulp exposure, thermal damage and risk apical infection

High risk sites- rostral 06 and caudal 11s

49
Q

What is ‘bit seating’

A

Rostral profiling- to prevent bit impingment- misconception

Uneccessary can cause pulp horn exposure

50
Q

What are dental caries when does it occur?

A

Caries can affect the peripheral cementum of the maxillary and mandibular cheek teeth and the infundibulae of the maxillary cheek teeth

Occurs when food material becomes stagnated in pits in the peripheral cementum:
Fermentation, drop in pH of the environment, demineralisation, pits bigger and blackening

Cementum becomes eroded first, may spread to peripheral enamel

51
Q

What are the two types of caries in horses?

What causes them?

How can they be managed?

A

Infundibular caries

  • Common- grade 1-4
  • Developmental predisposition- cemental hypoplasia, food acumulated in infundibulum, fermentation- decay
  • Progressive, irriversible, predisposes to fracture
  • Can be managed with infundibular restoration

Peripheral caries

  • Common
  • Increased sugars- haylage
  • Managment- palliative rasping of the roughened cementum, removal of excess sugars
52
Q

How does diastemata treatment vary?

A

Depends on severity of periodontal disease

Without PD
Cleaned out completelt- pick then lavage
Remove ETRs on opposite arcade
Pack with impression material

With PD
Widen with burr- lidocaine
Pack with impression material
Dietary managment- short fibre

53
Q

What are the three main types of cheek teeth fractures?

A

Buccal slab
Midline saggital- through infundibulum
Occlusal fissure

54
Q

What is smooth mouth?

A

Senile change- cheek teeth and enamel largely worn away

Softer dentine and cementum become smooth

Dietary manage- feedings chopped forage

55
Q

How does the presentation of buccal slab fractures vary?

A

May be incidental
Quidding behaviour- slab can damage gingiva

Usually not associated with apical infection, pulp horn seals off, extraction may be required

56
Q

What teeth most commonly have midline sagittal fractures?

What can it result in?

A

Most common 109 and 209

Pathologoical fracture through infundibulum

Results in apical infection- with or without sinusitis, extraction required

57
Q

What do the clinical signs of an apical infection depend on?

Give examples

A

Depends on which teeth are involved
Location in relation to paranasal sinuses

Facial swelling +/- draining tract- Maxillary 06, 07, occasionally 8

Unilateral nasal discharge- maxillary 09, 10, 11

Bony mandibular swelling- all mandibular cheek teeth

58
Q

What are the causes of apical infections?

What is the pathogenesis?

A

Causes-
Anachoresis
Fracture
Periodontal spread
Pulpar exposure

Path-
Pulpitis- pulpar oedema, vascular occlusion, necrosis

59
Q

How is apical infection diagnosed?

A

Clinical signs

Oral examination- fracture, pulpar exposure

Imaging-
radiograph- poor sensitivity
CT- gold standard

60
Q

What are the methods of cheek tooth extraction?

A

Oral extraction

Modified transbuccal extraction

Lateral buccotomy

Repulsion

61
Q

What are the steps to oral teeth extraction?

A
  1. Interdental spreading- placed in the interdental space infront and behind, closed gradually to stretch peridontal ligament- can cause further fracture
  2. Molar forcep application- wiggling- lateral strain- different types
  3. Apply fulcrum- lever the tooth out
62
Q

What instrument are these?

A

Interdental spreaders

63
Q

What are these instruments?

A

Molar forceps

Different depending on the tooth shape

64
Q

When is minimially invasive transbuccal extraction indicated?

A

Used when crown fractures
specialist equipment

Chisels to breakdown ligament, reserve crown drilles, hole tapped, extraction screw inserted

Preserves alveolar bone

65
Q

What is repulsion?

A

Blunt instrument to drive tooth into mouth

High potential for complications

66
Q

What is lateral buccotomy?

A

Incision through cheek, removal of lateral alveolar bone

Often GA

Potential damage to facial nerve and parotid duct

High morbidity rate- iatrogenic trauma, wound breakdown

67
Q

What are the 7 functions of the URT in a horse?

A
  1. Conduit- air to and from lung
  2. Filtering- mucus
  3. Protection
  4. Olfaction
  5. Phonation- vocalising
  6. Swallowing
  7. Thermoregulation
68
Q

At rest what is the normal respiratory rate, tidal volume and therefore minute ventilation of a 500kg horse?

What is the increase of minute ventilation at excercise?

How is it coupled with gait?

A

At rest- 15 breaths per minute
1L per 100kg- 5L
Minute ventilation- 75L

Excercise- 20x increase- 1500L

Coupled with gait at when FL hit the ground pressure from abdominal organs moving forwards helps breath out, HL hit ground and abdomen pressure backwards, breath in

69
Q

Why is URT function very important in horses?

A

Horses cannot switch to mouth breathing

Anything that narrows airway of lumen- increases airflow resistance, increases negative pressure, causes unsuported structure collapse, URT obstruction leading to noise and reduced O2 delivery

URT disease is common and can be life threatening and cause poor performance

70
Q

What are the clinical signs of URT disease?

A
  • Respiratory noise/distress
  • Dysphagia
  • Coughing
  • Excercise intollerance
  • Nasal discharge- blood, purulent material, ingesta
  • Facial deformity
  • Neurological signs
71
Q

What histrory should be taken from a horse with suspected URT disease?

A

General- signalment, use, duration of ownership, general health, duration, managment, dental prophylaxis, any other horses, eating/drinking

Specific-

  • Nasal discharge
  • Respiratory noise
  • Excercise intollerance
  • Cough
  • Bilateral nasal airflow
  • Previous medical treatment
72
Q

What should be noted about a nasal discharge?

A

Bilateral- behind nasal septum- guttural pouch, larynx, pharynx
Unilateral- rostral to nasal septum- sinus/nasal passage

Duration

Nature- serous, blood, putulent, food

Evidence of trauma

73
Q

What history of respiratory noise should be obtained?

A
  • Severity of obstruction- noise
  • When- rest, excercise
  • Inspiratory/Expiratory
  • What does the noise sound like- whistle, roar, gurgle, snoring
  • Continuous/intermittent
  • Performance effects- does the horse stop/slow
74
Q

How is the respiratory system examined at rest?

A

Look, listen palpate

General physical examination​- all systems, concurrent disease, RR and character, Nostril flare, Auscultation of thorax/trachea, rebreating- bag over heat

Assess other causes of poor performance- lameness, cardiac disease

75
Q

What should be examined about a horses head?

A

Symmetry
Nasal/occular discharge
Airflow from both nostrils
Percussion of sinuses
Palpation of larynx
Previous surgical scars

76
Q

What noises at excercise are normal?

What should be noted about abnormal sounds?

A

Snorting, ‘high blowing’, Sheath noise, Thick wind

When- throughout/pushed/tired
Quality/pitch
Stride phase

77
Q

What diagnostic imaging can be used for the head?

A
  • Endoscopy
  • Radiography
  • Sinoscopy
  • CT
  • Ultrasonography
  • MRI
  • Scintigraphy- less so
  • Sound analysis- spectral analysis
78
Q

What are the advantages of resting endscopy for URT disease?

When is it indicated?

A

Widely available, affordable
Minimally invasive
Directly visualise regions
Options for treatment- laser removal or fenestration

Indications-
Nasal discharge/malodour
Respiratory noise
Dysphagia

79
Q

Why is excercising endoscopy useful?

What can be identified here that cannot be elsewhere?

What are the advantages of dynamic respiratory endoscopy?

A

Important for assessment of poor performance at excercise- more accurate assessment of dynamic airway function at excercise

Many cases of URT obstruction only occur at excercise and can only be identified here

DRE- Affordable and widespread, unqique design, attaches to bridle, wireless pictures, real time examination

80
Q

What is head radiography traditionally the gold standard for?

What are its Adv and Dis?

What are the standard and additional radiographic views?

A

Traditionally the gold standard for assessing bony/dental structures

Adv- Images can be obtained with portable machines, easy to perform standard views
Dis- complex anatomy, 2D image

Standard- Latero-lateral, Lateral-oblique, Dorso-ventral
Additional- Intra-oral, open mouth oblique, tangenital views

81
Q

What are the following views useful for assessing?:

Latero- lateral view

Lateral oblique

Dorso-ventral

Intra-oral

A

Latero-lateral- good for assessing paranasal sinused, guttural pouches, pharynx. Cassette on affected side

Lateral- oblique- assess the periapical regions of cheek teeth for evidence of infection. 30 degree angulation maxillary arcades, 45 degree angulation mandibular arcades

Dorso-ventral- assessment of paranasal sinuses, nasal septum and teeth. Helps to determine if lesions uni/bilateral

Intra-oral- assessment of incisor teeth and associate bone, fractures of incisor teeth/associated bone EORTH

82
Q

How we doing big man?

This seems useful to have a general look at but doesn’t seem worrying about

A

Keep it up.
Remember be the best person you can.

83
Q

What are the Adv and Dis to sinoscopy?

A

Adv- minimally invasive means of visualizing the paranasal sinuses, enables surgical treatmenr and ongoing monitoring of sinuses

Dis- more invasive than routine endoscopy- standing sedation with local

84
Q

What limits head ultrasonography?

What are some important uses?

A

Bony skill limits its use in assessment of some areas of the head

Some important uses:

  • Opthalmic
  • Soft tissue swellings
  • Assessment of skull bones
  • Larynx
85
Q

What are the advantages of CT?

When is it indicated?

A
  • Gold standard
  • Affordable and cost effective- not sure personally
  • Cross sectional images, superior resolution, tissue density measurement

Indications-

  • Dental disease
  • Masses withing paranasal sinuses/ nasal passages
  • Trauma
86
Q

What are the two CT sytems used for horses?

What are the advantages of each?

How is CT interpretated?

A

GA- less movement from patient (better images)

Standing sedation- avoids GA, stabilise patient prior to surgery, pre-surgical planning

Using hounsfield unit tissues have different values (density)- higher density higher number- enamel, bone… air

87
Q

Why are equine head MRIs rarely performed?

A

Limited to only a few facilities
Requires GA
Expensive
Time

Uncommonly indicates- brain lesions, neoplasia

88
Q

What are the indications for scintigraphy?

What has superseded it?

A

Indications-
differentiation between primary/secondary sinusitis
Identification of correct tooth
Suspected TMJ disease

Superseded by CT

89
Q
  1. What does the soft palate separate?
  2. What allows pharyngeal collapse?
  3. What are the 3 functions of the pharynx?
A
  1. Nasopharynx and oropharynx
  2. Lacks rigid support by bone/cartilage
  3. Passage of air- to larynx and lower airways
    Passage of ingesta- oral cavity to oesophagus during swallowing
    Airway protection
90
Q

Describe the anatomy of the pharynx

A
  • Muscular tube
  • Relient on neuromuscular function for stability
  • Intrinsic/extrinsic musculature
  • Innervation- cranial nerves V, X, XI and cervical nerves

V- trigeminal

X- Vagus

XI- accessory

91
Q
  1. What are the main functions of the larynx?
  2. What cartilage structures are associated?
  3. When does abduction take place, muscle-insertion and innervation?
  4. When does adduction take place, muscle- insertion and innervation?
A
  1. Breathing, protect LRT, vocalisation
  2. Cricoid cartilage, thyroid cartilage, epiglottis, paired arytenoid cartilages
  3. Excercise, cricoidarytenoideus dorsalis muscle (CAD), cricoid cartilage to arytenoid cartilage, recurrent laryngeal nerve
  4. Closure- swallowing, cricoarytenoideus lateralis muscle (CAL), RLN innervation
92
Q
  1. What are the key presenting signs of larynx/pharnx disease?
  2. What should be clinically examined
A
  1. Respiratory noise, excercise intolerance, poor performance
  2. Palpation of the larynx- muscular process of arytenoid, cricothyroid articulation
    Observation during excercise
93
Q

What imaging modalities can be used for diagnosis of larynx and pharynx disease?

A
  • Endocsopy- rest, excercsie
  • Ultrasound
  • Radiography
  • CT
  • MRI
94
Q

What are the clinical signs of pharynx disease?

List the key disorders?

A

Clinical signs- poor performance, respiratory noise, dysphagia, respiratory distress, nasal discharge, coughing

Key disorders-
DDSP- intermittent, persistent
Naso-pharyngeal collapse
Pharyngeal lymphoid hyperplasia
Cleft palate
Foreign body
Pharyngeal mass

95
Q

What is iDDSP and persistent DDSP?

A

Intermittent dorsal displacment of the soft palate
Dynamic condition- during intense excercise
Soft palate displaces- expiratory obstruction, gurgling
Returns to normal on swallowing

Persistent DDSP-
Soft palate permanently displaced
Often secondary- epiglottic entrapment, sub-epiglottic ulcer/cyst
May have dysphagia

96
Q

What is the proposed pathogenesis of iDDSP?

A

Neuromuscular dysfunction
Thyroideus muscle pulls larynx forward into pharynx
Innervated by pharyngeal brach of vagus
Maybe caused by inflammation in guttural pouch or pharnx

Lower airway disease

Structural abnormalities

97
Q

How is DDSP diagnosed?

A

History and Clinical examination

  • Excercise intolerance
  • Gurgling
  • Rider reports
  • Dysphagia- permanent

Endoscopy

  • Resting- assess structural abnormalities, diagnostic pDDSP
  • Excercising- gold standard, replicate conditions when disease occurs
98
Q

How can DDSP be treated?

A

iDDSP- conservative:
Maturity- common in youngsters
Get fit- muscles that support pharynx
Change tack- keep mouth closed
Tongue tie- stop caudal movement
Treat inflammation
Throat support- cornell collar

Surgical-
Tie forwards- sutures between basihyoid and thryoid cartilage
Palatoplasty- thermal/laser or stiffen
Staphylectomy- questionable
Myectomy- rarely performed

99
Q

What is pharyngeal lymphoid hyperplasia?

When is it common?

A

Enlargment of lymphoid follicles on the walls and roof of nasopharynx

Common in young horses

little clinical significance

100
Q

What are the two types of nasopharyngeal collapse?

A

Nasopharyngeal dysfunction-
Neonates- dysphagia
Self-resolves

Dynamic pharyngeal collapse
Lateral or dorsal walls
Yearlings/2 yo- +/- other disease
Sport horses- exacerbated by neck flexion

101
Q

What is cleft palate?

What are its DDXs?

How is it diagnosed and treated?

A

Congenital defect

DDXs- pharyngeal dysfunction, guttural pouch tymphany

Diagnosis- oral examination/endoscopy

Surgical repair often not attempted

102
Q

What are the clinical signs of larynx disorders?

List the laryngeal disorders

A

Respiratory noise, Poor performance, Dysphagia, Coughing, Respiratory distress

  • Recurrent laryngeal neuropathy
  • Fourth branchial arch defect
  • Dynamic laryngeal disorders
  • Arytenoid chronditis
  • Epiglottic abnormalities
103
Q

What is recurrent laryngeal neuropathy?

Describe the pathophysiology

How is it diagnosed?

A

Left unilateral paresis/paralysis of the arytenoid cartilage

Pathophysiology- progressive loss of large myelinated nerve fibres of recurrent laryngeal nerve, neurogenic atrophy of intrinsic laryngeal muscles, loss of adduction/abduction

Diagnosis
History- abnormal inspiration noise at excercising, poort performance
Atrophy of CAD on palpation
Endoscopy

104
Q

When doing endoscopy for RLN what is assessed?

How is it graded?

How is it managed?

A

Gold standard- avoid sedation

Assessment- symmetry, synchrony, maintenance of abduction

Different grading systems-
Resting function- Havermeyer I-IV
Dynamic function- Havermeyer A, B or C

Managment depends on- findings, use of horse, age, degree, owner expectations, economic

  • Prosthetic laryngoplasty- standing/GA- ‘tie back’
  • Ventriculo-cordectomy
  • Laryngeal re-innervation- nerve graft
  • Arytenoidectomy
105
Q

What are the DDXs of laryngeal paralyis?

A

Unilateral-
Perivascular injection
Guttural pouch mycosis
Previous surgery

Bilateral-
Hepatic disease
Toxicity- organophosphate, lead
Post anaesthetic
Equine protoxoal myeloencephalitis- not UK

106
Q

What can cause laryngeal dysplasia?

A

Congenital- abnormal development of laryngeal cartilages

Laryngeal dysfunction- limited right arytenoid abduction, rostral displacement of palatopharyngeal arch, cricopharngeus muscle affected

107
Q

What can detect vocal cord collapse?

How does it present?

How is it treated?

A

Only detected by overground scope

Inspiratory whistle- produces lots of noise

Treatment- vocalcordectomy

108
Q

What is medial deviation of aryepiglottic folds?

How does is present?

What is it associated with?

How is it treated?

A

Collapse of the aryepiglottic folds

Inspiratory, thick noise

Associated with DDSP

Treatment- laser resection of folds

109
Q

What is epiglottic entrapment?

What are the clinical signs?

How is it diagnosed and treated?

A

Loose sub epiglottic tissue wraps over and entraps epiglottic cartilage- intermittent or persistent
Prevents normal function

Clinical signs- respiratory noise, coughing during eating, sometimes poor performance

Diagnosis- endoscopy

Treatment- laser resection

110
Q

What causes sub-epiglottic cysts?

What are the clinical signs?

Diagnosis and treatment?

A

Likely congenital

Clinical signs- respiratory noise, dysphagia, excercise intolerance

Diagnosis- endoscope

Treatment- laser or snare excision

111
Q

What is arytenoid chondritis?

What are the clinical signs?

How is it diagnosed and treated?

A

Inflammation/infection of arytenoid cartilage- mucosal ulceration, progressive and painful

Clinical signs- respiratory noise/obstruction, respiratory distress

Diagnosis- endoscope

Treatment-
topical and systemic AB
Patrial resectoin
Aryenoidectomy
Permanent tracheostomy

Year 3 MOD (42 decks)

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