equine nasal discharge

Question 1

what is the source of unilateral and bilateral nasal discharge?

Answer 1

• Unilateral usually = rostral to the nasal septum (nasal passages and sinuses)
• Bilateral usually = caudal to the nasal septum (guttural pouch, pharynx, larynx, trachea, bronchi and lungs), but sometimes these can present as unilateral discharge

Question 2

what ‘other’ (eg non resp) clinical signs do you need to think about when deling with nasal discharge and why are they significant?

Answer 2

• abortion and neurological disease with Herpes,
• peripheral oedema with Equine Viral Arteritis,
• cranial nerve neuropathies with guttural pouch disease

Question 3

what are the diagnostic techniques of the URT?

Answer 3

◦ Oral/dental examination
◦ Head radiography
◦ Endoscopy (resting and exercising, sinoscopy)
◦ Computed tomography
◦ Haematology and Biochemistry
◦ Infectious disease tests (culture, PCR, ELISA)

Question 4

what are the diagnostic techniques of the LRT?

Answer 4

◦ Endoscopy
◦ Tracheal wash (culture and cytology)
◦ Bronchioalveolar lavage (culture and cytology)
◦ Ultrasonography
◦ Radiography
◦ Haematology and Biochemistry
◦ Specific tests for infectious diseases (Serology, ELISA)

Question 5

what are the signs of URT disease?

Answer 5

• Unilateral or bilateral discharge
• Localising signs to head/pharyngeal region
  ◦ Submandibular or retropharyngeal lymph node enlargement
  ◦ Guttural pouch swelling
  ◦ Draining tracts
  ◦ Dental abnormalities
  ◦ Respiratory noise
• +/- Cough
• +/- Systemic signs (Strangles, neoplasia)

Question 6

what are the clinical signs of LRT disease?

Answer 6

• Cough
• Increased respiratory rate
• Increased respiratory effort
• Increased respiratory noise on auscultation
• Stance and demeanour (pneumonia)
• Exercise intolerance
• +/- Systemic signs (Herpes, EVA, pleuropneumonia, neoplasia)

Question 7

what does haemorrhagic/epistaxis discharge say about the cause of the nasal discharge?

Answer 7

◦ Trauma (injury, foreign body)
◦ Vascular damage (ethmoid haematoma, exercise-induced pulmonary haemorrhage)
◦ Erosive conditions (neoplasia, mycosis)

Question 8

what does mucoid or serous discharge say about the cause of the nasal discharge?

Answer 8

◦ Viral infection, non-infectious inflammatory disease (asthma)

Question 9

what does purulent no odour discharge say about the cause of the nasal discharge?

Answer 9

◦ Bacterial (usually strep equi or strep zooepidemicus)
+/- viral infection

Question 10

what does purulent foul odour discharge say about the cause of the nasal discharge?

Answer 10

sually mixed bacteria with anaerobes – check for underlying cause (dental disease, neoplasia, mycosis, foreign body)

Question 11

what does food material discharge say about the cause of the nasal discharge?

Answer 11

◦ Breakdown of pharyngeal anatomy (cleft palate, oral fistula, dental disease)
◦ Choke
◦ Grass sickness

Question 12

what are the sites that can be involved in unilateral nasal discharge?

Answer 12

• nasal passages
• **sinuses **(including teeth) - most common
• pharynx and larynx (including lymph nodes and laryngeal cartilages)
• **guttural pouch **- most common
• (trachea)
• (oral cavity)