Disease Du Jour: Upper Airway Disorders in Horses

In this episode of the Disease Du Jour podcast, Kaycie Hatcher, DVM, discussed upper respiratory disorders in horses. She talked about common disorders she encounters in practice, her approach to building a differential diagnosis list, treatment and management strategies, and more.

This episode of Disease Du Jour is brought to you by Equithrive.

Common Upper Airway Disorders in Horses

Hatcher said one of the most common disorders she sees is a tooth root abscess that becomes sinusitis. Other upper airway disorders she encounters include ethmoid hematomas, epidermal inclusion cysts, cancerous masses in the sinuses, and disorders associated with the palate and the larynx.

“There are a massive amount of diseases that can exist within [the palate and the larynx],” said Hatcher. “For me specifically, I see a lot of palatal instability, so things like dorsal displacement of the soft palate, whether that’s persistent or intermittent. I also see things that are wrong with the larynx, like recurrent laryngeal paralysis.”

Hatcher practices in Florida, where veterinarians also frequently encounter generalized inflammation of the upper airways.

Clinical Signs

Clinical signs that raise suspicion for an upper airway disorder include nasal discharge (especially if it’s malodorous or bloody), poor performance, respiratory noise, and behavioral changes.

“We do actually seem to see a behavioral change associated with these horses outside of their performance level, where they are increasingly more anxious to enter the box [at a competition], they’re increasingly more reluctant,” Hatcher said. “They are experiencing things that are happening while they’re performing that are causing anxiety and giving them negative biofeedback.”

Building a Differential Diagnosis List

When building a differential diagnosis list, Hatcher investigates what the owner is doing with the horse: What does work look like? How often are they competing? Where are they competing?

She also asks owners to describe specifically what they are seeing and when they are seeing it. Does the horse make a noise when cantering? Is he cantering specifically to the left? Is he cantering on the buckle or in a frame? She asks owners to describe or physically replicate the noise they are hearing. She also likes to watch the horse work under saddle if possible.

“The history will lead you into a particular thought of, ‘Is this infectious? Is this inflammation? Is this congenital?'” she said.

Creating a Treatment Plan

Treatment pathways depend on whether the airway disorder is infectious, inflammatory, or congenital. Hatcher often has success in managing inflammatory conditions with a combination of steroids and environmental changes. “If I’m suspicious that I have something like a recurrent laryngeal nerve paralysis, I’m going to probably send that horse a whole lot faster for a surgical workup than I would for the horse that I might potentially be able to manage,” she said.

She is also quick to refer horses with suspected guttural pouch mycosis or guttural pouch empyema, which have the potential to become catastrophic if the horse ruptures an artery.

Listen to the podcast episode to learn more. In the episode, Hatcher discusses diagnostic tools, factors that influence prognosis, upper airway emergencies, emerging treatments and diagnostic techniques, and more.

About Dr. Kaycie Hatcher

Born and raised in Panama City, Florida, Kaycie Hatcher, DVM, is a true Floridian native. Growing up in the panhandle, she had the unique pleasure of riding everything under the sun.

Beginning her equine career at a young age on hunter horses, she slowly found her way to the Western performance horse world and settled into a niche of barrel horses before attending college. During this evolution, she also found a secondary love in production animal medicine and became heavily involved in the cattle industry. Collegiately, she attended the University of Florida for both her undergraduate and veterinary schooling.

Hatcher owns Iron Horse Veterinary Services in Florida. Given her background, she has a special interest in performance horses. Furthermore, she has a large professional interest in upper airways and gastrointestinal systems.

Related Reading

• The Ethics of Airway Surgery in Equine Athletes
• Research Spotlight: Managing Equine Asthma
• Disease Du Jour: Equine Asthma and EIPH

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