Dysphagia is characterized by a difficulty or inability to swallow. In horses, dysphagia is a symptom caused by a vast range of diseases and conditions.
• In general, it is caused by difficulty getting food into the mouth, chewing it, or moving feed from the mouth into the stomach
• Horses with dysphagia require prompt veterinary attention, as some of the causes of dysphagia require early diagnosis and treatment to improve chances of a good outcome
• Diagnostic tools include physical examination, bloodwork, nasogastric intubation, and endoscopy
• Treatments depend on underlying conditions, and may include NSAIDs, antibiotics, supportive care, and in rare cases, surgery
• Horses with difficulty swallowing must be kept off feed until they have been examined by a veterinarian in order to prevent choking
Dysphagia is common in horses. Horses with trouble swallowing require immediate veterinary attention to determine which of the many potential conditions that cause this symptom is present. Dysphagia can be potentially life-threatening, as improperly swallowed feed may enter the lungs and cause aspiration pneumonia.
Note: Horses with dysphagia tend to regurgitate undigested materials through the nose, not the mouth. Horses with feed coming out of the nose require immediate veterinary attention.
There are many potential conditions that result in difficulty swallowing. In general, dysphagia relates to one of three possible causes: the inability to get food into the mouth properly, the inability to chew it properly once it is there, or the inability to move it from the mouth to the stomach once it is chewed.
Difficulties getting the food into the mouth usually occur because of issues with the lips and, to a lesser degree, the tongue and incisor teeth. These conditions include:
• Snake bites, or other sores on the lips
• Fractures to the upper or lower jaw
• Neurological diseases that affect the lips such as facial nerve paralysis
• Ingestion of toxic plants, such as yellow star thistle
• Tongue injury
Difficulties with chewing usually occur due to issues with the teeth or gums, including:
• Broken or rotten teeth
• Gum disease
• Arthritis in the jaw joints
Difficulties with moving the food from the mouth to the stomach usually involve the tongue, larynx (voice box), pharynx (tube that leads from the mouth to the esophagus), or esophagus, including:
• Congenital issues, like a cleft palate or malformed larynx
• Space-occupying lesions of the pharynx, including foreign bodies, tumors, polyps, or abscesses from strangles
• Neurological diseases affecting swallowing
• Blockage of the esophagus by an accumulation of food, commonly known as choke
The severity of dysphagia depends on the underlying cause, the length of time it goes untreated, and the associated conditions that develop as a result.
Dysphagia occurring in foals is commonly due to congenital malformations, such as cleft palate. Conditions such as choke or neurological disorders more commonly affect older horses.
In cases where dysphagia goes unchecked, weight loss and loss of body condition are likely to occur.
As a result of dysphagia, horses may develop aspiration pneumonia, a dangerous condition in which material is inhaled into the lungs.
Diagnostic tools to identify the underlying cause of dysphagia include:
• Physical examination, including watching the horse attempt to eat and drink
• Nasogastric intubation (a tube fed through the nostril into the stomach)
• Endoscopy (a camera passed into the esophagus through the mouth)
• Bacterial cultures
• Nasal swabs
Note: nasogastric intubation should only be performed by a veterinarian. There is no safe way to intubate a horse at home.
Treatment depends on the underlying cause. Surgery is rarely necessary. Treatments may include:
• Anti-inflammatory medications
• Laser therapy
• Esophageal lavage
• Pain medication
During the treatment period, horses must be kept off feed. Supportive care while the horse cannot eat includes:
• IV fluids
• Nutritional support
Since the mucus and material that is regurgitated due to dysphagia flows from the nostrils, difficulty swallowing is sometimes mistaken for the mucus production associated with upper respiratory tract infection.
Symptoms often associated with dysphagia depend on the underlying cause.
If the dysphagia is related to a respiratory condition, symptoms may include
• Swollen lymph nodes
• Rapid breathing
• Sweet, off-smelling breath
In the case of neurological disorders, symptoms include:
• Incoordination of limbs (ataxia)
• Pressing the head against walls or other objects
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