The choking horse Flashcards
define hypersalivation
big increase in saliva production
define ptyalism
drooling
more saliva coming out the mouth but no increase in production
when presented with a hypersalivation / ptyalism case, what is the first cause we want to rule out
Diet
List 2 things in the diet that could cause a horse to exhibit hypersalivation/ ptyalism
contaminated legymaes
OR
oral PBTZ with clembuterol
once diet has been ruled out of cause of hypersalivation/ ptyalism, we move on to …………….. causes
dental
Describe how to rule out dental causes of hypersalivation/ ptyalism
thorough exam of mouth using a speculum and strong light source
after dental causes of hypersalivation/ ptyalism have been ruled out, what do you look into next
morphological abnormalities: obstructive
Once obstruction has been ruled out as cause of hypersalivation/ptyalism, what do you look into next
morphological abnormalities: PAINFUL
List 5 painful morphological abnormalities might cause a horse to exhibit hypersalivation/ ptyalism
teeth: root abscess, fractures, abnormal wear
jaw fractures/trauma
stomatitis/glossitis
temporohyoid osteoarthritis
temporo-mandibular osteopathy
define glossitis
inflammation of the tongue
List 4 possible causes of stomatitis/ glossitis in horses
foreign body
ulcerations
vesicular stomatitis (viral)
bacterial (actinobacillus)
define stomatitis
inflammation of oral mucosa
once we have ruled out painful morphological abnormalities as a cause of hypersalivation/ptyalism, what will we look into next
functional abnormalities: NEUROLOGICAL
List 5 neurological abnormalities might cause hypersalivation/ptyalism
Infections
CNS trauma
CNS masses
Toxic
other: e.g. grass sickness
once we have ruled out neurological functional abnormalities, what will we look into next as the cause of hypersalivation/ptyalism
functional abnormalities: MUSCULAR
List 6 clinical signs of oesophageal obstruction
regurgitation of food, water and saliva
ptyalism
dysphagia
coughing
repeated head extensions or retching
anxiety
describe how to diagnose an oesophageal obstruction
general physical exam
palpate neck and thoracic inlet
oral exam
thoracic auscultation
NG intubation
clinical pathology: hydration status, CBC, electrolytes, acid base status
why is it important to do a thoracic auscultation on a horse with potential oesophageal obstruction
if obstruction has been there for a while, horse may have aspiration pneumonia
why is it important to do NG intubation on a horse with potential oesophageal obstruction
allows you to confirm diagnosis and lets you know how far in the obstruction is
List the parameters we look at on clinical pathology to assess the hydration status in the horse
PCV
TP
urea/ creatinine
why do we want to do a CBC on a horse with suspected oesophageal obstruction
detect presence or absence of systemic inflammation
typically, an oesophageal obstruction is caused by …
food
outline how we would use radiography in a case of oesophageal obstruction
help determine extent and location of obstruction
using contrast
can also tell us if we have further complications such as a rupture or aspiration pneumonia
Describe how would we medically manage an oesophageal obstruction if we were going for spontaneous resolution? (I.e. allow blockage to remove itself)
remove all feed and water- ideally horse in stable without bedding
IV fluids
NSAIDs
sedation- to relax the oesophagus
oxytocin- if proximal obstruction
how would we medically manage an oesophageal obstruction if we were going for assisted resolution?
oesophageal lavage and drainage (using sedation and keeping head below thoracic inlet)
may use GA if impaction is v hard to remove (aids in relaxation)
what should we do following removal of oesophageal obstruction
assess mucosal damage
small quantities of soft feed 48hrs post relief
provide electrolytes and fresh water
NSAIDs (don’t give oral and don’t give too much cause can -> ulceration)
broad spec antibiotics if obstruction has been there a while
Describe surgical management of horse with choke
longitudinal oesophagotomy
what are the most common complications of an oesophageal obstruction
aspiration pneumonia
ulcers
List 6 possible complications of oesophageal obstruction
aspiration pneumonia
ulcers
stricture
megaoesophagus
diverticula
rupture
