Tough to Swallow

Q. My 3-year-old pony mare developed a purulent (discharging pus) head infection last summer and was subsequently diagnosed with a stenotic (narrowing) left guttural pouch, which required two laser surgeries to correct. Surgeons constructed an opening to allow the infection to drain. The infection cleared up, but she now ends up inhaling feed and water when she eats and drinks.

The vets say that the laser surgery might have paralyzed the nerves leading to the pharynx and, consequently, her throat doesn't close properly when she swallows. She is understandably depressed and, unless the condition corrects itself, doesn't have much of a future. She is also at risk of pneumonia if she gets foreign material into her lungs. Have you ever seen anything like this, and do you think time will help correct the swallowing/nasal problem? Is this a congenital condition?

via e-mail

A. This is, indeed, a very sad problem, but it can happen. Although your veterinarian says the laser surgery has caused the swallowing problem, the original infection itself can also contribute. Regardless, recovery, if it happens, will be slow and could require months of feeding by other methods (for example, by stomach tube or esophagostomy tube--an artificial opening into the esophagus).

A congenital (existing at birth) stenosis is possible, but the infection itself can cause stenosis and considerable tissue distortion.

You did not state how long the pony had problems swallowing, but this is important. If recent, treatment with anti-inflammatory drugs (flunixin meglumine, or Banamine) and time could help. The prognosis will be determined by the severity of nerve damage, which could range from superficial injury and inflammation to complete nerve disruption. Lack of signs of recovery over time would be consistent with the latter. Let us hope that it is the former. Unfortunately, we do not have a useful way of determining the extent of nerve damage and have to rely on clinical guidance for this.

About the Author

David E. Freeman, MVB, PhD, Dipl. ACVS

David E. Freeman, MVB, PhD, Dipl. ACVS, is Professor and Interim Chair of Large Animal Clinical Sciences, of the University of Florida's College of Veterinary Medicine.

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