Equine head endoscopy

Question 1

What methods of restraint are available for equine head endoscopy?

Answer 1

Chemical –> sedation (could induce DDSP
- a-2 agonists: Detomidine, Xylazine, Romifidine
- Butorphanole

Physical
- nose twitch

Question 2

How should the endoscope be introduced?

Answer 2

Insert first 20cm quickly ventromedially into ventral meatus (VM)

Avoid ethmoid (bleeds easily)

Question 3

What structures should be assessed during endoscopy?

Answer 3

1. Nasal passages
   - Nasomaxillary opening (sinus drainage angle)
   - Ethmoid turbinates
2. Pharynx
   - Guttural pouch ostia
   - Nasopharyngeal recess
   - Soft palate
3. Larynx
   - Arytenoid cartilages
   - Epiglottis
   - Vocal chords
   - Ventricles
   - Aryepiglottic folds

Question 4

Identify the structures in the nasal passages

Answer 4

A. Nasomaxillary opening (Aka sinus drainage angle)
B. Ethmoid turbinates

Question 5

Identify the structures in the larynx

Answer 5

a. Arythenoid cartilages
b. Epiglottis
c. Vocal Chords
d. Ventricles
e. Aryepiglottic folds

Question 6

Answer 6

Lymphoid Hyperplasia

Very common & usually regarded as of no clinical significance, particularly in younger animals

Question 7

This is taken from a 2yo TB presenting for poor performance.

What is your diagnosis?

Could sedation cause this??

What do you think is the timing of the respiratory noise produced during exercise?

Can this be treated? How?

Answer 7

Laryngeal Hemiplegia

Sedation doesn’t induce hemiplegia but other conditions such as DDSP may occur with sedation

Inspiratory mostly

There are several treatments (including tie back or ventriculo-cordectomy) but may not be necessary unless it affects performance

Question 8

Picture taken from 3yo TB presenting poor performance

What is your diagnosis?

What do you think is the timing of respiratory noise produced during exercise?

Can this be treated & if so how?

Answer 8

Dorsal Displacement of Soft Palate

Mainly an expiratory noise

There are several treatments, tie forward regarded as most effective, though less invasive procedures (Cornell collar etc) can also be effective

Question 9

18mo Cob with mucopurulent nasal discharge and lymphadenopathy

What diagnosis should you rule out in this case?

What sample would you collect?

What treatment options do you think are possible in this case?

(picture in guttural pouch)

Answer 9

Common presentation of guttural pouch empyema (aka pus in GP)

May be consequence of Streptococcus equi equi (“Strangles”) infection
- Very infectious condition & in horse with this presentation must be ruled out

Should perform GP lavage & submit sample for testing (bacterial culture & PCR)

Best treatment is simply to turn horse out in ”isolation paddock” until resolution of clinical signs & retest 3 weeks after that