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EQUINE VETERINARY EDUCATION
Equine vet. Educ. (2018) 30 (2) 94-99 doi: 10.1111/eve.12703
Original Article Oesophageal disorders in horses: Retrospective study of 39 cases
B. Bezdekova†* and P. Janalik‡ †Equine Medical Centre, Skalice nad Svitavou; and ‡Veterinarni Klinika Kadera, Uherske Hradiste, Czech Republic. *Corresponding author email:
barabezdekova@gmail.com
Keywords: horse; oesophagus; choke; oesophageal impaction; oesophageal stricture; oesophagitis
Summary Oesophageal diseases are less frequently reported in equine veterinary practice in comparison with other alimentary pathologies. This paper describes the prevalence, age, breed and sex distribution, the duration of clinical presentation before admission, the diagnosis, aetiology, treatment course, complications, length of hospitalisation, and the short-term and long-term survival of 39 cases with equine oesophageal disorders at a referral clinic. Prevalence of oesophageal disorders was significantly higher in the group of horses up to 4 years of age in comparison with other age groups. The most common oesophageal disorder was simple obstruction represented by 22/39 cases (56.41%). The common complications of the oesophageal disorder were oesophagitis (16/39, 41.02%) and aspiration pneumonia (11/39, 28.20%); 31/39 (79.49%) of all oesophageal cases survived up to clinical discharge. Long-term survival was 65.78% in this group of cases.
Introduction
Various disorders can develop in the equine oesophagus. Oesophageal obstruction is the most common condition (Craig et al. 1989; Feige et al. 2000; Duncanson 2006). The other various oesophageal disorders are less focused in published studies but clinically significant. Obstruction can be represented by a simple oesophageal obstruction, where the prognosis is better than in oesophageal obstructions due to functional or morphological abnormalities (Craig et al. 1989; Stick 2006; Breuer et al. 2011). Previous retrospective studies described clinical features and complications of a population of horses presented to a referral institution as well as a nonreferred group of equids with oesophageal diseases (Craig et al. 1989; Feige et al. 2000; Duncanson 2006; Chiavaccini and Hassel 2010). The goal of our study was to describe the prevalence, breed, sex and age distribution, the duration of clinical presentation before admission, the diagnosis, aetiology, treatment course (surgical, medical), complications, length of hospitalisation, and the short-term and long-term survival of patients with equine oesophageal
disorders at a referral clinic in the Czech Republic. This is the first study of equine oesophageal diseases in our region and it provides an overview of referred oesophageal disorders among the equine population.
Materials and methods
Patients presented to a university referral clinic in the Czech Republic in 2004–2009 were included in the retrospective study. Records of horses diagnosed with oesophageal disorders were analysed. Horses referred with simple
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oesophageal obstruction without development of complications such as stricture or oesophagitis, which resolved prior to admission to the clinic, were excluded from the study. Variables included breed, sex and age, the duration of
clinical presentation before admission, the diagnosis, aetiology, treatment course (surgical, nonsurgical), complications attributable to the primary oesophageal condition, average length of hospitalisation in treated individuals, and short-term and long-termsurvival. Full history was taken. Diagnostics included results of
physical examination at the time of admission in all cases. Physical examination was performed according to a standard protocol. Additional diagnostic procedures, surgical and post-mortem examination in selected cases were analysed. Additional diagnostic procedures included passage of a naso-oesophageal tube, upper airway and oesophageal endoscopy, gastroscopy, native and contrast x-ray of the neck and thorax, and ultrasound examination of the neck and thoracic cavity. Short-term survival was defined as survival to the time of
discharge from the clinic. Long-term survival was obtained by telephone interview at least 6 months after discharge. Individual long-term survival length was not evaluated. Data were analysed using descriptive statistics and are
reported as median and range. Risk factors were tested using Fisher exact test. All levels of significance were set to P<0.05. The number of cases, breed and age distribution were compared to the general referral population. The different age groups were analysed in the group of all oesophageal disorders. The other variables have been analysed within the group of simple oesophageal obstruction cases only because of the low number of cases in the other groups of oesophageal disorders.
Results
The number of cases admitted to the clinic in the monitored period was 6917. This included 39 cases of oesophageal disorders in 38 patients (one horse was presented twice with simple oesophageal obstruction in an 8-month period). This represents 0.56% of all admissions. The group included 14 mares (37%), 13 intact males (34%)
and 11 geldings (29%). Eighteen breeds were presented (Fig 1). The age ranged from 4 months to 30 years (median 4.5 years). This breed and age distribution did not differ significantly from the hospital population over the same time period. For statistical purposes, the group of cases was divided into six subgroups by age (0–4 years; 5–8 years; 9– 12 years; 13–16 years; 17–20 years; >20 years). The age group distribution is shown in Fig 2. Prevalence of oesophageal
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