Equine Oral + Esophageal Disorders Flashcards
What clinical signs should warrant an oral exam in an equine patient?
abnormal chewing, quidding: chewing up hay and spitting it out, weight loss, recurrent impactions: d/t improperly chewed + swallowed hay, recurrent choke, sinusitis (unilateral nasal discharge- think tooth root abscess), facial swelling and head shaking
What is a dental malocclusion?
a normal tooth that is out of occlusion with an abnormality (diseased, damaged, misplaced or missing tooth) in the opposite arcade
What are examples of malocclusions?
anything that creates an unlevel arcade. dental crown elongations such as: hooks, ramps, waves, steps, and transverse ridges
What are some dental changes that are consistent with aging?
wave mouth, smooth mouth
move patient to a pelleted complete feed
When performing a float, what is the maximum amount that you want to grind down + why?
4 mm at a time- remember teeth are live tissue
What is Equine odontoclastic tooth resorption and hypercementosis? (EOTRH)
a progressive dental condition involving the incisors, canines, and premolars of aged horses internal and external resorption of dental structures and production of irregular cementum
What are some clinical signs that may indicate a patient has EOTRH?
sensitivity in the mouth to any manipulation, head shyness, periodic inappetence, weight loss, decreased use of incisors for grasping or grazing, gingival secession, calculus deposition and firm bulbous enlargement of the incisive bone over incisor reserve crowns
What is the treatment for EOTRH?
remove the teeth! EXCEPT if it involves the cheek teeth
What are some indications that teeth need to be extracted?
severe periodontal disease leading to bone loss and tooth mobility, fractured teeth, servere endodontic disease leading to apical infection (tooth root abscess), EOTRH
What are some CBC/chem values that would align with a differential of choke?
stress leukogram, dehydration,
increase in wbcs with neutrophilia and lymphopenia
What is the etiology of choke?
esophageal intraluminal obstruction, sedation, dental dz, neuromuscular problem, esophageal abnormality, competition via herd dynamic, etc
Describe how you would go about diagnosing choke
look for associated clinical signs such as feed coming out of nose, palpate the neck to see if you can feel the mass, If I try to pass a stomach tube and am unable to, take rads and endoscopy
What is the treatment for choke?
After I correct a choke, what are my next treatment steps?
When educating a client on choke prevention, what should I recommend?
soft feed, dental care, slow down p eating, in a horse with no effective teeth, eliminate hay from diet, a special diet for horses with esophageal abnormalities
What causes esophageal stricture?
circumferential ulcers due to choke or esophagitis - usually form within 4 to 8 weeks after the primary lesion
this can lead to recurrent choke or megaesophagus
How do I diagnose esophageal stricture?
endoscopy and a barium swallow
What is the treatment for esophageal stricture?
soft feed diet, bougienage (balloon dilation) or sx
What can cause an esophageal rupture?
external trauma, rupture of the diverticulum, NGT
What is the treatment of esophageal rupture?
conversion of closed perforations to open perforations if possible, extensive debridement + lavage of tissues, antibiotics, tetanus prophylaxis and esophageal rest
What is the prognosis of an esophageal rupture?
poor
What clinical signs are associated with an esophageal diverticulum?
recurrent choke
How do I diagnose an esophageal diverticulum?
barium swallow
What are causes of megaesophagus in horses?
chronic obstruction- ex. choke, stricture, hiatial hernia), vagal nerve dysfunction, myopathy such as botulism
What are some clinical signs of megaesophagus?
excessive salivation, bulge or fluid-wave in neck, nasal reflux, regurgitation, poor growth or weight loss
How do I diagnose megaesophagus in horses?
x-rays are best! esophagram (barium study), clincial signs
How do I tx megaesophagus?
tx underlying disorder, dietary management- soaked pelleted feed given elevated, humane euth
What are clinical signs of esophagitis?
gagging or discomfort while swallowing, bruxism, hypersalivation
What are causes of esophagitis
trauma, infection ex. mural abscess, chemical inj.-acidic medicines, cantharidin- beetle, gastric acid/reflux
How to dx esophagitis?
endoscopy
How do I treat esophagitis?
sucralfate, pain meds and soft feed
