Exam 1 - Equine Nasal Discharge

Question 1

what are 8 differentials for an adult horse presenting with epistaxis? for each differential, what are 2 characteristics that would help you arrive at that particular differential?

Answer 1

1. trauma - history & unilateral bleeding
2. guttural pouch mycosis - severe severe bleeding seen!!!!! & usually unilateral
3. ethmoid hematoma - usually unilateral with mild bleeding & mucoid discharge
4. neoplasia/nasal polyps - upper: unilateral & facial deformity, lower: bilateral & dyspnea/distress
5. coagulopathy - bleeding from multiple locations & petechiations/ecchymoses
6. exercise induced pulmonary hemorrhage - bleeding occurs during strenuous exercise & bilateral bleeding
7. pleuropneumonia - cough, pleurodynia, auscultation, & ultrasound
8. rectus/longus capitus rupture - horse is seen falling over backwards & swelling present behind the jaw/throat latch

Question 2

what are 6 differentials for an adult horse presenting with purulent nasal discharge? for each differential, what are 2 characteristics that would help you arrive at that particular differential?

Answer 2

1. sinusitis - unilateral & stinky
2. guttural pouch empyema - discharge when the head is lowered & several horses are concurrently sick
3. cicatrix - respiratory noise & the horse is kept in pasture
4. pneumonia - cough, fever, & sick
5. asthma - seasonal/timing, worse in certain environments, chronic, cough, & increased respiratory effort
6. neoplasia - weight loss & respiratory effort

Question 3

what are 4 differentials for an adult horse presenting with nasal discharge with feed in it? for each differential, what are 2 characteristics that would help you arrive at that particular differential?

Answer 3

1. esophageal obstruction - signs of choke, retching, & cough
2. dysphagia - neurologic signs/components & no evidence of pain
3. external obstruction - visible swelling & fever
4. oronasal fistula - prior maxillary tooth removal, history of trauma

Question 4

what is the mainstay of equine upper airway diagnostics?

Answer 4

endoscopy

Question 5

where is the nasomaxillary opening located in the horse?

Answer 5

rostral to the ethmoids & most caudal aspect of the middle nasal meatus

Question 6

disease in the guttural pouches of horses is associated with what differentials?

Answer 6

strangles, guttural pouch mycosis, temporohyoid osteoarthropathy

Question 7

how do you enter the guttural pouches in an endoscopic exam of a horse?

Answer 7

get through the plica salpingopharyngeus