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Retrospective Analysis of Dysphagia in an Equine Referral Hospital, 182 cases
  • Kevin Connolly,
  • Krista Estell
Kevin Connolly
Virginia-Maryland College of Veterinary Medicine
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Krista Estell
Virginia-Maryland College of Veterinary Medicine

Corresponding Author:[email protected]

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Abstract

Background: Dysphagia, (dysfunctional prehension, mastication, or deglutition) describes a comorbidity of pathologies of the oral cavity, pharynx, and esophagus that carries potentially serious health consequences for horses. Given the diversity of differential diagnoses that may result in dysphagia, an understanding of the prevalence of dysphagia in hospitalized patients, the distribution of etiologies and relative clinical outcomes could inform diagnosis, treatment, and prognosis. Objectives: We hypothesize that clinical outcomes would vary between dysphagia of different etiological origins, and that neurogenic dysphagia would carry the lowest probability of recovery. Study design: Retrospective cross-sectional study. Methods: Referral hospital cases were screened and included in the analysis for patients > 6 months of age with at least one clinical sign of dysphagia and an etiological diagnosis for these clinical signs. Cases were partitioned into one or more etiological categories of dysphagia (oral, pharyngeal, esophageal, neurogenic) based on recorded diagnosis. Associations between etiologies, predisposing factors, treatments, and outcomes were evaluated by statistical analysis. Results: Inclusion criteria was met for 182 cases. Resolution of clinical signs for oral pharyngeal, and esophageal etiologies of dysphagia was >80%, There were reduced odds of recovery for dysphagia of neurogenic origin (OR 0.24, 95% CI 0.10-0.56, p < 0.001). Patient age at presentation and use of antibiotic and anti-inflammatory therapy was positively associated with patient outcome across all dysphagia etiologies. Aspiration pneumonia was a common sequela of dysphagia across all etiologies; but had no effect dysphagia resolution. Main limitations: The retrospective nature of the study was limited by the reliability and completeness of the historical and clinical information. Observations in this study population (referral hospital cases) may not be representative of all dysphagia cases. Conclusions: Dysphagia is an uncommon comorbidity in hospitalized patients. Prognosis is good for most etiologies, but positive outcomes for dysphagia of neurogenic origin are reduced.
20 May 2024Submitted to Equine Veterinary Journal
24 Jun 2024Review(s) Completed, Editorial Evaluation Pending
28 Jun 2024Editorial Decision: Revise Minor
10 Sep 20241st Revision Received
11 Sep 2024Submission Checks Completed
11 Sep 2024Assigned to Editor
11 Sep 2024Review(s) Completed, Editorial Evaluation Pending
19 Sep 2024Reviewer(s) Assigned
26 Sep 2024Editorial Decision: Revise Minor