Texas Equine Veterinary Association

www.texasequineva.com • 7 may be necessary and IV anesthetics are recommended. Surgical approach should keep in mind important surrounding structures like nerve branches, salivary ducts and major blood vessels. Long reach instruments and intraoperative endoscopy become important assets for many situations. Lacerations, ulcers and necrotic tracts can be left to heal for second intention. Post-operative care includes consistent oral lavage, accompanied by suitable antibiotic therapy. Anti-inflammatory agents should be used for pain management, sometimes being necessary to rely on steroids to avoid excessive inflammation of laryngeal structures that may lead to respiratory distress. Gruel and soft feeding are indicated while the horse recovers its appetite and normal deglutition. Series Body APPROACHING OROPHARYNGEAL Foreign bodies Mindless eating habits of young or curious horses may lead to the ingestion of a wide variety of odd articles. At presentation, many of the clinical signs noticed by owners include partial or complete anorexia, ptyalism, halitosis, dysphagia, upper respiratory sounds or cough and local or diffuse often painful swelling on the face or retropharyngeal region. Such swelling may decrease when treated with antibiotics but comes back when treatment stops. A proper diagnosis should be able to identify the foreign body, the degree of affection to the surrounding structures and should allow the design of a suitable therapeutic plan. An accurate history and a thorough oropharyngeal examination are basic. Observation and palpation of the mouth should look for swellings, lacerations on the mucous membranes, painful areas, abscess points of drainage and even the foreign body itself. Imaging diagnostic tools become a valuable aid afterwards. Radiographies will help identify metallic elements; several views should be taken from different angles to create a good perception of depth and anatomic orientation. Open mouth views will help eliminate the radiodensity of teeth. Ultrasound through the intermandibular space or retromandibular region can also become useful when looking for objects that are not radiopaque enough such as wooden splints or plastic. Endoscopy should be used to assess structures beyond the clinician's ability to see on the regular oral exam. The combination of more than one imaging study helps determining accurately the best surgical approach for removal. The treatment goal is to successfully remove the foreign body avoiding unnecessary damage. Often times it can be achieved manually under sedation and using an oral speculum and a good light. Otherwise, surgery technique may have to be creative. If general anesthesia is required, avoiding endotracheal intubation 5 year old Appaloosa gelding presented to BVEH with history of coughing when eating, fever and nasal discharge. No significant findings on oral exam, but endoscopy and radiographs revealed multiple metallic foreign bodies in the larynx and trachea. Wires were extracted endoscopy assisted under short intravenous anesthesia. Quarter Horse yearling presented to BVEH after owners noticed her getting into fishing equipment. A fishhook was found on head radiograph and was successfully extracted under short general anesthesia. ABOUT THE AUTHOR Dr. Paul Vega was born and raised in the small, beautiful country of Ecuador. He graduated as a veterinarian on 2018 from Universidad San Francisco de Quito and found an internship position at Brazos Valley Equine Hospital in Navasota. Even though the Ecuadorian Andes are quite different from the Texas landscape, Paul is very happy to enjoy his time in Texas and its wonderful people. As he keeps going with his career, he would like to focus on regenerative therapy, sports medicine, poor performance and diagnostic imaging. Paul Vega, DVM

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