Pytalism & Dysphagia Flashcards
List the differential diagnoses for excessive salivation in horses and the diagnostic test(s) that would be most appropriate to confirm each listed diagnosis.
Ptyalism - increased production of saliva
Saliva is high in potassium and bicarbonate
DFDX
- pain
- foreign body
- dental disease
- mucosal ulceration/irritation - awns, vesicular stomatitis virus
- “slobber factor” - slaframine, mycotoxin: Rhizoctonia leguminicola
- dysphagia
Confirm with thorough oral examination, radiography
Define dysphagia.
Difficulty, discomfort, or pain when swallowing
Understand the common causes of dysphagia based on the anatomical site of the primary pathology and the underlying pathophysiologic problem and diagnosis.
Oral/pharyngeal
- cleft palate
- pharyngeal or retropharyngeal abscess (strangles); guttural pouch empyema
- neuro CN 7-10, 12: guttural pouch dz, otitis media/interna, lead/mercury tox, EPM, yellow star thistle, botulism/rabies/tetanus
Esophageal
- obstruction
- motility disorder
DX
- history and physical exam
- endoscopic exam of larynx, pharynx, and esophagus
- neuro exam
- diagnostic imaging if needed
Describe the clinical signs of esophageal choke in horses, and outline a reasonable diagnostic and therapeutic plan for a horse with this problem.
Most common esophageal disorder in horses.
Clinical signs
- ptylalism
- feed-tinged nasal discharge
- swelling in neck
- anxiety
- retching
Diagnosis
- sedate and pass NG tube or endoscope
likely to get stuck distal to pharynx, thoracic inlet, base of heart, esophageal sphincter
- radiographs/ultrasound
Treatment
- xylazine/detomadine to sedate to counteract anxiety, relieve pain, lower head
- pass NG tube and gently see if obstruction can be dislodged
- IV fluids to maintain hydration if indicated
- limit oral intake with muzzle, stall without feed/water/bedding
Identify the breed of horse that is most likely to have esophageal disorders.
Friesians
