Equine emergency upper airway management

Respiratory distress due to acute upper respiratory tract obstruction is an uncommon emergency in equine practice. However, clinicians should be confident with the approach to this truly life-threatening scenario. Clinical signs are obvious at rest and include increased respiratory effort, loud respiratory noise and recumbency as asphyxiation progresses. Many cases of upper respiratory tract obstruction involve the pharynx or larynx, though obstruction in other regions of the upper respiratory tract and other causes of respiratory distress should be considered. Generally, the obstruction can be bypassed by placing a nasotracheal tube under endoscopic guidance or by making a temporary tracheotomy to ensure a patent airway. Following this stabilisation, further investigation into the cause of airway obstruction can be performed. Endoscopy is usually the most valuable diagnostic tool, though other imaging modalities can be useful. Further empirical treatment is often required, though the specific management will vary depending on the pathology present

Surgical management of recurrent laryngeal neuropathy

Recurrent laryngeal neuropathy (RLN, laryngeal hemiplegia, laryngeal paralysis, 'roaring') is common in the equine industry with a prevalence ranging from 2.6-11% in light breeds (Raphel 1982; Lane 1987; Morris and Seeherman 1990) up to 38% in draught breeds (Brakenhoff 2006; Perkins 2009). There are a number of different surgical treatments currently available and more being developed. This article aims to discuss factors affecting choice of treatment and then provide an evidence-based approach to describe surgical approaches, success rates and morbidity. Specific details of surgical methods are not given as they are readily available in surgical textbooks (Stick 2006; McGorum 2007)

Comparison of two approaches to performing an inferior alveolar nerve block in the horse

Objectives To compare two approaches to performing the inferior alveolar nerve block in the horse and to evaluate the consistency of described topographical landmarks. Design Experimental cadaver model. Methods Eleven cadaver heads were positioned to mimic a standing sedated horse and the position of the mandibular foramen approximated. The vertical approach to the approximate location of the mandibular foramen was undertaken and red dye was deposited. The angled approach was then undertaken and blue ink was used to identify it. The heads were then dissected to determine the location of the dye. Placement was categorised as a hit or a miss for each technique for each side of the head. The distance of the dye from the nerve was recorded. Straight lateral radiographs of the sectioned heads were taken to evaluate the topographical landmarks for performing this nerve block. Results Each method was performed 22 times. A hit was achieved 16 times (73%) for the angled approach and 13 times (59%) for the vertical approach. There was no significant difference between the two approaches (P = 0.34). Radiographs revealed that the topographical landmarks used to approximate the mandibular foramen were relatively accurate. Conclusion Both methods were found to be equivalently accurate. The previously reported topographic landmarks for locating the approximate position of the mandibular foramen on the medial aspect of the mandible were found to be accurate, but currently recommended doses of local anaesthetic may be excessive

Use of tongue ties in thoroughbred racehorses in the United Kingdom, and its association with surgery for dorsal displacement of the soft palate

The prevalence of the use of tongue ties, calculated from 60 randomly selected race meetings held in the UK during 2001 to 2003, was 5·0 per cent. After its first use on an individual horse a tongue tie was used in an average of 77 per cent of its races during the first 12 months, but after this time period, in only 55 per cent of its races. Thirty-nine per cent of horses that underwent surgery for dorsal displacement of the soft palate raced with a tongue tie preoperatively, and 41 per cent of these surgical cases raced with a tongue tie postoperatively

Cognitive and behavioural processes in health anxiety

SIGLEAvailable from British Library Document Supply Centre-DSC:D193147 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Quadrilateral suspensory and straight sesamoidean ligament calcifying desmopathy in an Arabian mare

A 5-year-old Arabian mare was referred for the investigation of recent behavioural change, generalised stiffness, and owner-reported polyuria and polydipsia. Clinical examination revealed severe pain associated with palpation along the entire length of the suspensory ligament (SL) and palmar soft tissues of the pastern regions of both forelimbs. Radiographs of the distal forelimbs demonstrated marked radiopaque striations within the straight sesamoidean ligaments (SSL), and less severe but similar changes in the regions of the SL branches. Ultrasonography of both distal forelimbs revealed multifocal, hyperechoic lesions within the SSLs. The SL bodies and branches were enlarged and had mixed echogenicity on ultrasound scan. The horse was euthanased at the owner’s request and submitted for post-mortem examination. Relevant gross findings were restricted to the SLs and SSLs of all four limbs, all of which contained severe mineralisation and irregularly arranged fibres. Histological examination revealed severe, multifocal to coalescing, dystrophic mineralization with cartilaginous and osseous metaplasia, which suggested a primary calcifying desmopathy affecting all four SLs and SSLs. Clinical findings in the case reported here were similar to that of degenerative suspensory ligament desmitis (DSLD) previously reported by many authors, but diagnostic imaging and histopathological findings were significantly different

Quadrilateral suspensory and straight sesamoidean ligament calcifying desmopathy in an Arabian mare

A 5-year-old Arabian mare was referred for the investigation of recent behavioural change, generalised stiffness, and owner-reported polyuria and polydipsia. Clinical examination revealed severe pain associated with palpation along the entire length of the suspensory ligament (SL) and palmar soft tissues of the pastern regions of both forelimbs. Radiographs of the distal forelimbs demonstrated marked radiopaque striations within the straight sesamoidean ligaments (SSL), and less severe but similar changes in the regions of the SL branches. Ultrasonography of both distal forelimbs revealed multifocal, hyperechoic lesions within the SSLs. The SL bodies and branches were enlarged and had mixed echogenicity on ultrasound scan. The horse was euthanased at the owner’s request and submitted for post-mortem examination. Relevant gross findings were restricted to the SLs and SSLs of all four limbs, all of which contained severe mineralisation and irregularly arranged fibres. Histological examination revealed severe, multifocal to coalescing, dystrophic mineralization with cartilaginous and osseous metaplasia, which suggested a primary calcifying desmopathy affecting all four SLs and SSLs. Clinical findings in the case reported here were similar to that of degenerative suspensory ligament desmitis (DSLD) previously reported by many authors, but diagnostic imaging and histopathological findings were significantly different

Historical and clinical features of 200 cases of equine sinus disease

The historical and clinical findings in 200 referred cases of equine sinus disease were reviewed retrospectively. Univariable and multivariable analyses were performed to detect significant differences in historical or clinical features between various categories of sinus disease. The causes of sinus disease were classified as subacute primary (less than two months duration) (n=52), chronic primary (more than two months duration) (n=37), dental (n=40), sinus cyst (n=26), traumatic (n=13) or mycotic sinusitis (n=7), sinus neoplasia (n=10), dental-related oromaxillary fistula (n=8) and intrasinus progressive ethmoid haematoma (n=7). The majority of sinus disorders were of chronic duration at the time of referral and most (including 97 per cent of chronic primary sinusitis cases) had not responded to previous antibiotic therapy and/or sinus lavage in some cases. Clinical signs included unilateral nasal discharge in most cases, including purulent or mucopurulent discharge in all horses with primary, dental and mycotic sinusitis. Haemorrhagic nasal discharge was a feature of traumatic sinusitis and intrasinus progressive ethmoid haematomas. Firm facial swellings and nasal airflow obstruction were features of sinus cysts and neoplasms. Ipsilateral lymphadenitis was a more prominent feature of sinus disease with active infections such as primary, dental or mycotic sinusiti