Equis ISSN 2398-2977

Epiglottis: epiglottitis - acute

Synonym(s): Epiglottiditis

Contributor(s): Safia Barakzai, Jean-Pierre Lavoie

Introduction

  • Inflammation of the epiglottic cartilage   →   respiratory problems   →    medical emergency. 
  • Cause: unknown.
  • Signs: most horses present with exercise intolerance, abnormal respiratory noises and/or coughing.
  • Diagnosis: made using endoscopy where mucosal ulceration and thickening of the epiglottic cartilage can be seen.
  • Treatment: medical treatment is usually successful.
  • Prognosis: 50% of affected horses may experience performance limiting complications such as epiglottic deformities, epiglottic entrapment, septic epiglottic chondritis with abscessation, granuloma formation and intermittent or persistent DDSP.

Pathogenesis

Etiology

  • Unknown.

Predisposing factors

General
  • None certain but thought to include:
    • Pharyngeal inflammation from respiratory tract infection or inhaled allergens, eg dirt tracks.
    • Intermittent dorsal displacement of the soft palate   Soft palate: dorsal displacement      Soft palate: dorsal displacement 02 - endoscopy  .
    • Epiglottic entrapment   Larynx: epiglottic entrapment      Epiglottis: entrapment 02 - endoscopy  ulceration  .
    • Trauma from ingested foreign bodies.

Pathophysiology

  • Edema, hyperemia of mucosa    Epiglottis: epiglottitis 01 - endoscopy    Epiglottis: epiglottitis 02 - endoscopy  .
  • Chondritis of the epiglottic cartilage.
  • Granulation tissue formation.
  • Epiglottic inflammation and dorsal elevation of epiglottic axis may be severe enough to cause partial respiratory obstruction    Epiglottis: epiglottitis 01 - endoscopy    Epiglottis: epiglottitis 02 - endoscopy  .

Timecourse

  • Most commonly sub-acute (racehorses) taking weeks to develop clinical signs.
  • Occasionally acute, eg after trauma from foreign bodies hours to days before clinical signs noted.

Diagnosis

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Infernuso T, Watts A E & Ducharme N G (2006) Septic epiglottic chondritis with abscessation in 2 young Thoroughbred racehorses. Can Vet J 47, 1007-1010 PubMed.
  • Dacre K J, Pirie R S & Prince D R (2004) Primary epiglottitis with associated dysphagia in a foal. Equine Vet Educ 16 (6), 296-301 VetMedResource.
  • Dixon P M & Collins N (2004) The equine epiglottis. Equine Vet Educ 16 (6), 299-301 VetMedResource.
  • Davenport-Goodall C & Parente E J (2003) Disorders of the larynx. Vet Clin North Am Eq Pract 19, 169-187 PubMed.
  • Hawkins J F & Tulleners E P (1994) Epiglottitis in horses: 20 cases (1988-1993). JAVMA 205 (11), 1577-1580 PubMed.

Other sources of information

  • Dixon P M (2006) Miscellaneous Disorders of the Larynx and Epiglottis. In: Equine Respiratory Medicine & Surgery. Eds: McGorum B C, Robinson N E, Schumacher J & Dixon P M. Elsevier, UK. ISBN: 0702027596.


ADDED