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  Discussion on Difficult breathing
Author Message
Member:
clauee

Posted on Wednesday, Jan 2, 2019 - 9:40 am:

Hi dr.O
I have a question about a yearling, there is a noise during inspiration and expiration every time he breathes. The sound is like snoring but very mild, it seems like he has difficulty taking in and out his air or like if there was mild congestion, but there is no sign of infection, no nasal discharge. His respiratory rate seems normal and it is not worse during exercise, he eats normally and seems overall in good condition despite the condition has been going on for months: no weight loss, good quality hair and hooves, normal growth and he is interested in his environment/ interacting normally. What would be the possible causes for this, and diagnosis protocol? Can you point me out to some articles referring to these symptoms? thank you
Moderator:
DrO

Posted on Wednesday, Jan 2, 2019 - 2:23 pm:

Hello Clauee,
You will find a list of possible causes in the introduction to the article associated with this discussion. As you can see there are many possibilities and the article discusses probabilities and diagnostic protocol. Has this yearling had this problem from birth?
DrO
Member:
lsweeney

Posted on Wednesday, Jan 2, 2019 - 2:47 pm:

You would think with a blockage of the airways that exercise would exacerbate the problem. Also, it is interesting that there is no sign of congestion.

In addition to Dr. O's articles, I found this one with some additional ideas:
https://equimed.com/health-centers/first-aid/articles/recognizing-and-dealing-wi th-respiratory-distress
Member:
clauee

Posted on Wednesday, Jan 2, 2019 - 5:47 pm:

Thank you Dr. O and Laurie;
The breathing problem with the yearling was noticed a little after he turned 1 year old. It could have been there before but it was not noticed as he was in pasture with other foals. I will ask for more info from the owner (this is a yearling I was considering buying...) There was no nasal discharge or smell when I saw him, just some noise during breathing and lots of yawning. I was told he never gave any sign of infection whatsoever either. He should be seen by local vet soon, I will report back with more information.
Member:
clauee

Posted on Thursday, Jan 17, 2019 - 8:12 am:

Hello, I spoke with the current owner and apparently there are no more symptoms after using some natural products (I was told it was buckwheat... 🤔?). After that he got seen by a vet for castration and got a general check including auscultation, the vet apparently didn't hear anything abnormal. I am very confused - any suggestions of questions I should ask? Are there some conditions that can "come and go"? How can buckwheat possibly cure weeks of mild respiratory issues? I am going tomorrow to see him again, is there anything I should pay attention to in particular?
Member:
clauee

Posted on Saturday, Jan 19, 2019 - 8:05 am:

Update from yesterday's visit. I got a chance to really observe the yearling, and the difficulty in his breathing is at inspiration. We hear the noise most on the left side but also the right, and he clearly has to do an effort to take air in. I've spoke with owner and daily care giver, they observe the symptoms mostly when the horse is relaxing, for example when they groom or in the evening when it's very quiet at the barn - and it's almost impossible to notice when he is alert or doing exercise. I observed this also. He does not cough at all. There is a mild clear discharge (watery), very little but continuous. Their vet did an exam with breathing in an air bag and the lungs seem normal. Again no fever, depression or abnormal behavior, his overall health condition is normal. I spoke with my vet and might have him do a pre-purchase exam, but he said, according to this descrption, he might recommend to perform endoscopy for a proper diagnosis?
Member:
lsweeney

Posted on Saturday, Jan 19, 2019 - 11:52 am:

I suspect without further diagnostics or progression of additional symptoms we are still left guessing at what the source could be. Even with an endoscopy it may only eliminate causes? (But could perhaps eliminate the most catastrophic causes)
Googling I found that a clear discharge can be allergies, wind or dust irritation or viral infections. You would think with a viral infection it would either resolve or progress, not stay static.

It could be a mild allergy.

So interesting that exercise does not exacerbate the issue.

From internet:

Noisy breathing at rest:

Breathing noise at rest is usually associated with something causing an upper respiratory tract respiratory airway obstruction. This could result from infection, guttural pouch problems, mechanical problems of the upper airway (displaced soft palate or laryngeal paralysis), or anything else affecting the upper airway. Recently sedated horses often make snoring sounds.

Breathing accompanied by audible sounds usually indicates some obstruction to air flow in the upper airway (versus the lungs). The exception to this is RAO or Heaves in which whistling sounds can sometimes be heard without a stethoscope. These upper respiratory sounds can be described as rattling, whistling, or wheezing.

A rattling sound suggests that there is something interfering with air flow in the upper airway, usually mucus. Snoring sounds usually indicate obstruction of the nasal passages versus the throat. Wheezing indicates air flow through an abnormally narrow passage.
Moderator:
DrO

Posted on Monday, Jan 21, 2019 - 9:34 am:

Hello clauee,
I think having your vet look and possible endoscopy is the best way to get to the bottom of this.
DrO
Member:
clauee

Posted on Thursday, Jan 31, 2019 - 9:39 am:

Update; my vet came for the pre-purchase exam. The yearling is in very good health despite the mild respiratory issue. Although he had castration surgery two weeks ago, and last week it needed to be re-opened to clear some fluids, so he is getting antibiotics at this time.

My vet had him breath in a bag and there is no red flag at auscultation or at exercise: the noise is only at rest. After exercise there was a very mild white discharge, so he suggested to continue the antibiotics for 2 weeks to clear any residual infection if there has been any.

The next step would be to do a standing endoscopy after treatment, but he doubts that this will give us a definite diagnosis. He thinks it can be a form of roaring, but to have a clear diagnosis/pronostic we need to go at hospital for endoscopy in movement, to know if this is really the cause and how it might evolve over time and if it will affect performance... What is weird is that symptoms are not worse at exercise.

Yesterday the owner had a body worker at the barn, who had seen the same symptoms on another yearling in a different barn: apparently it ended up being caused by the growth of a tooth, which was adding pressure to nasal cavities, and that it resolved when the cap came off. Does that seem like a possible cause? Should we have a dentist see him?
Member:
lsweeney

Posted on Thursday, Jan 31, 2019 - 5:52 pm:

That makes a lot of sense. I don't know when teeth present themselves. I do know that I was disturbed by bumps on my filly. This was my filly at 2.5 years: https://www.horseadvice.com/horse/messages/4/146117.html
Member:
lsweeney

Posted on Thursday, Jan 31, 2019 - 5:54 pm:

Dr O's teeth article spells out when each set of teeth arrive. Interesting theory.
Moderator:
DrO

Posted on Monday, Feb 4, 2019 - 5:47 pm:

Hello Clauee,
No, an erupting tooth does not seem likely as a cause and hard to assess. The roots of the upper cheek teeth lie within the sinus cavities but not in the nasal passage. Perhaps with remarkable swelling this could be the case but I would expect noticeable swelling of the skull if such was a case. Also a obstruction of the nasal passages from a firm mass would worsen with exercise. Some functional causes can improve with exercise. I agree with your vets assessment.
DrO
Member:
clauee

Posted on Monday, Feb 4, 2019 - 8:22 pm:

Thank You Dr.O and Laurie
Can you give me examples of functional causes that can improve with exercise (maybe there are articles about this topic somewhere on this forum that I didn't see?)
I will give updates next week after completing antibiotic treatment. The owner reported it seems to help - in which case my vet thinks in can be a good idea to do a standing endoscopy next week, to see if there is any more infection or obvious condition that can be seen at rest. If not, then we will have to decide if we go to hospital for further diagnosis - I might just retract from the buying process at that point.
Member:
clauee

Posted on Tuesday, Feb 12, 2019 - 5:17 pm:

Update: today my vet came for the follow-up and standing endoscopy. There was no more white discharge, but lots more "watery" discharge. My vet thinks there has been a primary infection that needed to be resolved, and he says the watery discharge is normal at this stage after antibiotics. We gave some drugs to relax for the endoscopy, and this alone gave us some clues about the condition: the noise was a lot more present in complete relaxation. At endoscopy everything seems normal and healthy: epiglottis, sinus, etc. My vet thinks it's a form of roaring from the soft palate that we hear mostly at rest and in some particular positioning of the head/neck. It should not be a problem for the horse's future and riding. To "vulgarize" he told me it's like if his soft palate was "lazy". So here are my questions: is there a way to know if this can become worse or better with growth? Would you purchase this horse Dr.O? Does it increase the risk of recurrent infections?
Member:
clauee

Posted on Thursday, Feb 14, 2019 - 9:25 am:

One more question: at endoscopy the vet found some "normal " ulcerations. Apparently this is common for the age of the horse (20 months) and usually resolves itself? I have been doing research on internet and all the symptoms (possible previous infection, watery discharge, respiratory noise at rest, etc. ) point out to "pharyngeal lymphoid hyperplasia"?? Am I going crazy or this makes sense? Would this predispose the horse to more problems (allergies) or exercise intolerance? Because of the young age we had him exercise for only 5-6 minutes (canter + trot) during the diagnosis, which didn't show any increase of symptoms... But could that eventually be a problem for longer work periods?
Member:
lsweeney

Posted on Thursday, Feb 14, 2019 - 11:29 am:

In the end what would determine my decision in this purchase is what am I going to use this horse for? How much $ are involved and what are my resources if these issues are going to require medical treatment in the future. Is the horse a breeding prospect and are any of these potential issues congenital? Is there something unique about the animal that would make any risk associated with the purchase worth taking the risk? Can you afford the lost purchase price if the horse can't be used as you envision? Is the horse insurable?

If this is going to be a lightly used, trail prospect then I don't see any risk. If the horse is to be used as a stud or an eventing prospect, then I would weigh the cost/risk/benefit. Are there other horses of equal quality that don't have any health issues?
Member:
lsweeney

Posted on Thursday, Feb 14, 2019 - 11:34 am:

The only other thought is you can add a contingency to the purchase where you could return the horse or get a refund if the health issue becomes an issue within "x" years after purchase. This assumes that this seller will be around later and will comply.
Moderator:
DrO

Posted on Monday, Feb 18, 2019 - 8:12 am:

Hello clauee,
The questions you ask would be best answered by the vet who did the exam, he has a lot more definitive information. Concerning lymphoid hyperplasia this is a pathological description that could be caused by anything that irritates the pharynx, that cause would determine its prognosis.
DrO
Member:
clauee

Posted on Monday, Feb 18, 2019 - 10:25 am:

thank you Dr.O and Laurie,

I decided not to purchase the horse, and wait to see the evolution of its condition if he is not sold in the near future.
My vet thinks the prognosis is good, as he suspects primary infection to be the underlying cause, and environment not helping the resolution of symptoms (the horse is kept indoors, we have cold winters here so the doors and windows are closed and heat is on... so there are many "irritants" in the environment).
Dr.O, do you have articles or more information on lymphoid hyperplasia? I read that it usually resolves itself by the age of 4, but sometimes can predispose the horse to other conditions such as SPD?
Moderator:
DrO

Posted on Saturday, Feb 23, 2019 - 2:26 pm:

Clauee we have had a few discussions on this through the years, do a search on lymphoid hyperplasia above and you will be able to review them.
DrO
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