Esophageal Disease Flashcards
(13 cards)
Differentials for hypersalivation
Inability to swallow (pharyngeal disease, neuromuscular disease)
Esophageal obstruction (choke)
Oral disease (ulcers)
Others (toxins - blister beetles)
What are the clinical signs associated with esophageal disease?
Dysphagia
Frequent swallowing
Coughing
Hypersalivation (ptyalism)
Regurgitation of feed
Respiratory signs secondary to aspiration
Anxiety, neck stretching
Swelling, emphysema
How is the esophagus examined?
NG tube (typically first) - if difficult to relieve, follow up with endoscopy
Endoscope
Radiographs
What are we looking for with endoscopic exam?
Motility
Integrity (diverticula)
Shape
Mucosa
What is the importance of sedation with esophageal disease?
Sufficient sedation to cause lowering of head –> decreases change of aspiration
Relaxation of esophageal muscles
Best sedation for horses
A2 agonists (xylazine, detomidine)
Acepromaxine
Buscopan
Methocarbamol
Lidocains
Atropine not useful because only distal 1/3 is smooth mm
What clinically important structures are adjacent to the esophagus?
Vagosympathetic trunk
Recurrent laryngeal nerve
Carotid artery
What does the muscle look like in the esophagus?
Proximal 2/3: no serosal layer, striated mm (serosa = increased healing)
Distal 1/3: smooth muscle
Locations of choke
High choke - cervical (most common)
Low choke - thoracic inlet
Intrathoracic choke (rare)
What are predisposing factors of choke?
Poor dental conformation
Pelleted feed
Whole apples, corn
Allowing sedated horses to eat
How is choke diagnosed?
Hx, clinical signs
NG tube +/- palpation
Endoscopy
Radiography
How is choke treated?
Sedation/muscle relaxation
Lavage
Drugs (NSAIDs, ABX)
Support
General anesthesia
Do NOT use lubricating agents
Megaesophagus
May follow choke
Weight loss
Regurgitation
Recurrent choke
Recurrent bloat
Idiopathic most common
Oganophosphates, myasthenia??
