Epiglottitis in horses: 20 cases (1988-1993)

Epiglottitis was diagnosed and treated in 20 horses (13 Thoroughbreds and 7 Standardbreds) over a 5-year period. Eighteen horses were used for racing, and 2 Standardbreds were broodmares. Primary clinical signs were exercise intolerance, respiratory noise, and coughing. The most common endoscopic diagnosis made by referring veterinarians was epiglottic entrapment (11 horses). In 19 horses, endoscopic evaluation at admission revealed mucosal ulceration and thickening of the lingual surface of the epiglottis. Other endoscopic findings included dorsal displacement of the soft palate (14 horses), and dorsal deviation of the epiglottic axis (11 horses). Only 1 horse had epiglottic entrapment. Treatment consisting of stall confinement for 7 to 14 days, topical administration of a solution of furacin, dimethyl sulfoxide, glycerin, and prednisolone, and systemic administration of nonsteroidal anti-inflammatory drugs and corticosteroids was effective in controlling epiglottic edema and inflammation. Antimicrobials were administered to 6 horses. Racing performance of the 18 racehorses was evaluated by examination of racing records. One horse was still convalescing at the time of the study, and 1 horse had been euthanatized 1 week after treatment for epiglottitis because of colic. The remaining 16 horses all started at least 1 race (mean time between initial examination and start of first race, 74 days; range, 8 to 265 days). Thirteen horses started at least 4 races following treatment for epiglottitis; racing performance after treatment was the same in 8 and decreased in 5. Long-term sequelae of epiglottitis included epiglottic deformity (5 horses), intermittent or persistent dorsal displacement of the soft palate (4 horses), and epiglottic entrapment (1 horse).