Page 640 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Respir atory system: 3.2 Surgical conditions of the respir atory tr act 615

VetBooks.ir 3.39 3.40

Fig. 3.39 The depression fracture in Fig. 3.38
repaired with a small 2.7 mm bone plate.

Fig. 3.40 A horse that presented with intermittent
bilateral epistaxis and which on examination had firm,
ulcerated, multiloculated masses in both nostrils.
Biopsy confirmed amyloidosis. There were also masses
involving both palpebral conjunctivae.

polymer or carbon fibre to restore the facial contour. loss may occur if there is a primary disease process.
Small bone plates and screws can be used for peri- Treatment of the primary disease problem is essen-
orbital fractures to restore the orbit but are seldom tial along with removal of the localised deposits.
necessary on the flat bones of the sinus compart-
ments (Fig. 3.39). Aetiology/pathophysiology
The amyloid is formed secondary to a chronic
Prognosis immunological stimulation, which in some cases is
The prognosis is good. Almost all facial wounds and not identified. The URT is one of the more common
fractures will heal, usually without any functional sites of deposition and can occur with or without
problems. The cosmetic result varies with the origi- skin deposits.
nal injury and whether it is treated conservatively or
surgically. Most cases have a firm swelling left after Clinical presentation
healing has finished, although remodelling of the Amyloid deposits have been recorded in the nostrils,
bone contours continues for several months after the alar folds, nasal septum, nasal conchae and, more
fracture has healed. rarely, in the nasopharynx and guttural pouches
(Fig. 3.40). Presenting clinical signs may include
NASAL AMYLOIDOSIS nasal discharge often containing small amounts of
blood, nasal obstruction and subsequent respiratory
Definition/overview noise, and exercise intolerance. If a primary dis-
This is a rare disease in the horse, where deposits of ease process is present, then a variety of other signs
amyloid occur in various sites of the URT. There including weight loss may be present.
are a variety of clinical signs specifically associated
with the deposits in the respiratory tract. Nasal Differential diagnosis
amyloidosis is rarely associated with other primary Other causes of nasal discharge, epistaxis and soft-
systemic diseases, but other signs such as weight tissue formation in the URT.