Dysphagia describes clinical signs of pathology in the horse’s oral cavity, pharynx, or esophagus, which can potentially carry serious consequences. Many differential diagnoses can cause dysphagia. Therefore, understanding its prevalence in hospitalized horses and the distribution of etiologies and clinical outcomes could inform diagnosis, treatment, and prognosis. A retrospective case series aimed to describe the incidence, signalment, history, etiology, treatment, and outcome of horses presenting to a referral hospital for dysphagia.
Research on Dysphagia in Hospitalized Horses
Researchers screened referral hospital cases over a 12-year period and included them in the analysis for patients > 6 months of age with at least one clinical sign of dysphagia and an etiological diagnosis. They partitioned cases into one or more etiological categories of dysphagia (oral, pharyngeal, esophageal, and neurogenic) based on recorded diagnosis. Treatment, survival, and resolution of dysphagia were reported.
Dysphagia was recorded in 1.1% of all cases. Inclusion criteria were met for 182 cases. Nasal discharge was more common in patients with esophageal dysphagia (41/64; 64%), while slow mastication/dropping feed was more common with oral dysphagia (18/30; 60%), and coughing while eating was more common in pharyngeal dysphagia patients (15/18; 83%). Esophageal dysphagia was most observed in this population (77/182; 42%), while oral, pharyngeal, and neurogenic dysphagia were diagnosed in 19%, 20%, and 20% of cases, respectively.
Resolution of clinical signs for oral, pharyngeal, and esophageal etiologies of dysphagia was > 80%, while recovery of neurogenic dysphagia was 46%. Aspiration pneumonia was a common sequela of dysphagia and was observed in 27% (49/182) of cases. Aspiration pneumonia was most frequently diagnosed in esophageal dysphagia cases; 49% of these cases had aspiration pneumonia secondary to dysphagia. Of the 19 cases that did not survive to discharge, eight (42%) died or were euthanized due to complications arising from aspiration pneumonia.
Bottom Line
Dysphagia is an uncommon condition in hospitalized patients. Prognosis is good for most etiologies, but resolution of dysphagia of neurogenic origin occurs less frequently than the other causes of dysphagia.
https://beva.onlinelibrary.wiley.com/doi/10.1111/evj.14512
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