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NA S A L D I S C H A R G E
AUTUMN 2012 ISSUE
EQUINE MATTERS
14
Diagnosis:
In order for us to work out what is causing
the discharge we need to consider the
age of the horse, the breed and use of the
horse, the history of the problem and
perform a physical examination.
Age:
Certain conditions will only be
relevant in very young or new born foals
such as a cleft palate. Otherwise age can
give an indication as to the likelihood of
a condition but it is not set in stone. For
example, viral and bacterial respiratory
infections are more common in young
horses whereas nasal tumours are more
common in older horses.
Breed and use:
A thoroughbred race
horse is more likely to get exercise
induced pulmonary haemorrhage (EIPH)
post racing; a condition in which the
horse bleeds into the lungs during
galloping. In general competition horses
are more likely to come into contact with
viral infections.
Other signs:
The presence of other
signs will also assist with localising the
source of the discharge, for example
with infections the horse will often also
have a raised temperature and be
unwell whereas a horse with an allergic
condition will be physically well.
Conditions involving the sinuses often
result in facial swelling. A full physical
examination will examine the respiratory
tract and the mouth to identify
abnormalities.
Type of discharge:
The appearance
of the discharge can often give clues to
the cause. A clear mucus-like discharge
is often seen with a viral infection or in
allergic respiratory disease. A yellow
or green discharge suggests a bacterial
infection which could originate from
any site in the respiratory tract or be
secondary to another cause of
inflammation e.g. viral infection. A
one-sided discharge that is very smelly
often suggests a tooth root infection. A
bloody discharge can be associated with
EIPH, trauma or a tumour of the ethmoid
bones at the back of the nasal cavity.
Swallowing disorders can result in a nasal
discharge containing food material.
Some common causes of nasal discharge:
Sinusitis (infection/inflammation of
the sinuses)
Viral or bacterial respiratory infection
Tooth root infection/abscess
Allergic respiratory disease e.g. recurrent
airway obstruction (RAO)
Tumour
EIPH (Exercise induced pulmonary
haemorrhage)
Guttural pouch infections
Pharyngitis
Strangles
Pneumonia
Guttural pouch infections
Strangles
Unilateral
Bilateral
In some cases further diagnostic
procedures are required:
X-rays
- fluid lines present in the sinuses or
guttural pouch, changes around a tooth root,
or masses in the nasal chambers may help
indicate where or what the problem is.
Respiratory tract endoscopy
- by passing
a small camera up the horse's nose we can
visualise the nasal chambers, guttural
pouches, pharynx, larynx and upper airways
and we can also use this to take samples
from these structures if required.
Bacteriology
- this involves taking swabs and
or washes from potentially infected areas and
culturing the bacteria that may be present.
Blood sample
- haematology and
biochemistry can show us what the white
and red blood cells are doing which may
indicate a certain type of infection, blood
loss, or associated systemic disease.
Cytology
- involves looking at cells from
samples collected from the lungs or
windpipe, by washing sterile saline into the
airway then drawing it back. The resultant
fluid can be analysed to see what sort of
cells are present and therefore what sort
of problem may be present.
CT imaging of the skull
- gives a three
dimensional x-ray image of the skull which
can help diagnose more unusual conditions
such as tumours.
Treatment:
The treatment for nasal discharge will
depend on the cause. Viral conditions
may simply require rest and
anti-inflammatories, bacterial infections
will often additionally benefit from
antibiotic treatment and some sinus
conditions may require surgery and
flushing using an indwelling catheter.
Most conditions will benefit from some
management changes to assist the
resolution of the nasal discharge:
●
feed from the floor to assist natural
drainage of the respiratory tract
and sinuses;
●
turn out as much as possible;
●
stop ridden work;
●
if the horse is unwell keep it in
isolation to prevent the spread of
infectious disease;
●
use dust-free management to reduce
the irritants to the respiratory tract.
Grazing and feeding from the floor assists the
drainage of discharges from the sinuses and
respiratory tract
Please remember that in the majority
of cases nasal discharge is not a
serious problem. In most cases it
is likely to be a mild respiratory
infection but if you do see some
of the more serious symptoms such
as a unilateral, purulent, bloody,
smelly discharge or any other signs
of disease then it may warrant
earlier intervention by your XLVets
Equine practice.