week 9

what cranial nerves are involved in mastication?

5, 7, 9, 12

what are questions to ask if a pet presents with dysphagia?

exposure/ vaccines, recent surgery/ needs, activity related, how the pet eats, ptyalism

what should be included in your physical exam of a pet with dysphagia?

palpation of head and neck, lymph nodes, salivary glands, check for pain and perform CN exam, observe eating/ drinking in the room, sedated oral exam

what are common ddx for dysphagia?

infectious/ inflam: stomatitis, gingivitis, esophagitis

FB: string, bone, hook, grass awn

neoplastic: SCC

trauma: electrical burns, mandibular fractures

congential: stenosis/ malformation, cricopharyngeal achalasia, vascular ring anomaly

metabolic: uremic ulcers

vascular: lingual thrombus

nueromuscular

what are common conditions of the oral cavity?

tongue: granuloma, sialocele/ ranula

gums: POF, canine peripheral ameloblastomas

malignant tumors: SCC, melanoma, fibrosarcoma

what are common conditions of the salivary gland?

sialocele, masses, sioliths - tx: surgical correction

fistula, sialadenitis, sialadenosis

what are common conditions of cheek, gums?

infectious: FIV, FeLV

papilloma virus

what are common conditions of pharynx?

struct: rare- elongated soft palate

trauma: oropharyngeal penetrating trauma

nasopharyngeal polyps

nasopharyngeal stenosis

function: rabies, myasthenia gravis

congenital : CA

what are common conditions of esophagus?

obstruction: stricture, FB

anatomical: diverticula, fistula

inflammatory: esophagitis

functional: ME

what are common conditions of the larynx?

trauma, edema, paralysis

what are common causes of esophagitis?

FB, gastroesophageal, reflux, drugs (doxycycline), ingestion of irritatn, spirocerca lupi

what is the treatment for GERD?

H2 receptor antagonists, PPI, cisapride, metoclopramide, sucralfate

small frequent soft meals, low fat and fiber

what is the treatment of esophageal stricture?

balloon catheter dilation, bougienage, stents, surgical resection

what is the diagnostic gold standard for myasthenia gravis?

presence of serum autoantibodies vs ach receptors

what are CS of ME?

regurgitation, dysphagia, weight loss

how is ME diagnosed?

chest xrays, barium study, fluoroscopy

what is the tx for ME?

feeding adjustments, treat underlying disease, prokinetics, gastroprotectants, aspiration pneumonia

what are the 2 types of hiatal hernia?

1- sliding, axial

2- rolling/ para-esophageal

tx: pexy

what BW findings will you see with masticatory myositis?

hyperglobulinemia, anemia, CK inc

tx: immunosuppression

what are pros and cons to ventral midline approach to cervical esophagus?

p- accessible, superficial

c- exposure to carotid sheth, jugular, recurrent laryngeal nerve

what are pros and cons to right lateral thoracotomy approach to thoracic esophagus/ heart base?

p- access to area where most FB lodge

c- modified anesthesia due to risk of respiratory compromise, pain

where is the striated part of the esophagus?

upper 2/3

what is the most common CS of esophageal disease in horses?

ptyalism

what CN is involved in prehension in horses?

7

what CN is involved in mastication in horses?

5, 7, 12

what CN is involved in swallowing in horses?

9, 10

what can cause inflammation in the guttural pouch?

empyema, fungal mycosis, tympany

CS: nasal discharge, noisy breathing, swelling behind the jaw

what is the presenting sign of cleft palate in horses?

milk reflux from nostrils- rattle in trachea on auscultation

aspiration pneumonia- coughing, abnormal lung sounds, tachypnea, tachycardia, pyrexia

what are ddx for esophageal disease?

choke, esophagitis, esophageal perforation/ stricture/ diverticula, motility disorders

what are CS of choke in horses?

frothy nasal discharge, feed from nostrils and mouth, ptyalism, gagging/ retching, coughing

how is choke diagnosed?

sedation! head needs to be lower than point of shoulder

endoscopy if available

passage of NG tube

US

what drugs can be used to relax the esophagus in horses?

buscopan - N-butyl (bottom part of esophagus ((SMOOTH MUSCLE))

oxytocin- striated (top)

if choke is confirmed in a horse, what should you do next?

sedation + analgesia

pass NG tube

pump water in or use a funnel and gently apply pressure to the obstruction

keep head low to prevent aspiration of food material in trachea

what should you do if the choke is persistent in the horse?

place horse in stall , nothing per Os, IV fluids and electrolytes, sedatives and relax esophagus

what are refeeding considerations after choke in horses?

refeeding is a critical time, esophagus is inflamed, motility abnormal

when diet is not enough → esophagotomy

what is the tx for prolonged choke?

broad spectrum ABX, anti inflammatory therapy, sucralfate, reefing considerations

what are complications of choke?

aspiration pneumonia, esophageal stricture

esophageal rupture

what breed of horse is megaesophagus common in ?

fresians : muscular hypertrophy of caudal esophagus