Pharynx: foreign body in Horses (Equis) | Vetlexicon
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Pharynx: foreign body

ISSN 2398-2977


Introduction

  • Inhaled foreign bodies are rare in the horse.
  • Cause: thorns, twigs and brush bristles most common; large objects less so.
  • Signs: dependent on site:
    • Nasal foreign body → unilateral acute nasal discharge and/or epistaxis, snorting and head-shyness/shaking → chronic discharge and halitosis.
    • Large pharyngeal foreign body → peracute respiratory dyspnea and acute dysphagia.

    A life-threatening respiratory obstruction may occur if a large foreign body becomes firmly lodged.

    • Small, sharp pharyngeal foreign bodies → dysphagia, nasal regurgitation, squealing and arching of neck.
  • Diagnosis: direct endoscopic visualization.
  • Treatment: removal, and antimicrobial and anti-inflammatory therapy.
  • Prognosis: generally good.

Presenting signs

Nasal foreign bodies
  • Unilateral nasal discharge Nose: nasal discharge and/or epistaxis .
  • Snorting/sneezing.
  • Discomfort.
  • Chronic cases develop halitosis.
Small pharyngeal foreign bodies
  • Acute onset dysphagia.
  • Nasal regurgitation and distress when eating/drinking.
Large pharyngeal foreign bodies
  • Peracute inspiratory dyspnea.

If firmly lodged → life-threatening respiratory obstruction.

Geographic incidence

  • Worldwide.

Cost considerations

  • Cost of treatment.

Special risks

  • Animals with large pharyngeal foreign bodies should not be anesthetized.

Pathogenesis

Etiology

  • Foreign body is accidentally inhaled and becomes lodged in either the nasal passages or the pharynx depending on size.

Predisposing factors

General

Pathophysiology

  • The physical presence of the foreign body causes an obstruction and irritation.

Timecourse

  • Large foreign bodies will cause acute onset clinical signs.
  • Smaller foreign bodies may result in more chronic duration of clinical signs.

Diagnosis

Presenting problems

Client history

Clinical signs

Nasal foreign bodies
  • Nasal discharge (usually unilateral) Nose: discharge 03 - purulent Nose: discharge 02 - froth.
  • Epistaxis Nose: epistaxis - bleeding.
  • Snorting/sneezing.
  • Halitosis.
Small pharyngeal foreign bodies
  • Dysphagia.
  • Nasal regurgitation Nose: discharge 01 - food Nose: discharge 04 - milk    Nose: discharge 05 - food.
  • Distress.
Large pharyngeal foreign bodies
  • Peracute inspiratory respiratory distress.
  • Dyspnea.
  • Dysphagia.

Diagnostic investigation

Endoscopy
  • See Respiratory endoscopy Respiratory: endoscopy Pharynx: dorsopharyngeal cyst - endoscopy.
  • Allows direct visualization of the foreign body and therefore identification of its nature and location.
Radiography

Confirmation of diagnosis

Discriminatory diagnostic features

Definitive diagnostic features

Differential diagnosis

Treatment

Standard treatment

Monitoring

  • Monitor for resolution of clinical signs.

Prevention

Control

  • Prevent crib biting, etc.

Outcomes

Prognosis

  • Good.

Expected response to treatment

  • Resolution of clinical signs.

Reasons for treatment failure

  • Failure to remove foreign body.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Kiper M L et al (1992) Metallic foreign bodies in the mouth or pharynx of horses; seven cases (1983-1989). JAVMA 200 (1), 91-93 PubMed.
  • French D A et al (1989) Removal of a retropharyngeals foreign body in a horse, with the aid of ultrasonography during surgery. JAVMA 194 (9), 1315-1316 PubMed.
  • Bayly W M et al (1982) Epistaxis caused by foreign body penetration of a guttural pouch. JAVMA 180 (10), 1232-1234 PubMed.