Acute Life-threatening Laryngeal Dysfunction in a Draft Horse Recovering from General Anesthesia: A Case Report.

The research presents a case study of a draft horse that experienced severe post-anesthetic breathing problems, which required multiple additional anesthesia treatments and interventions. It highlights the potential for traumatic laryngeal dysfunction in these animals during intubation and extubation, suggesting the need for extra care during these procedures.

Clinical Presentation

• The horse in the study underwent anesthesia for an elective orthopedic procedure. However, as the horse was recovering from the anesthesia, it started to show severe shortness of breath. This complication required the practitioners to administer a second anesthetic.

Intervention

• The second round of anesthesia permitted an endoscopy-guided introduction of a breathing tube through the horse’s nasal passage into the windpipe. This procedure, known as nasotracheal intubation, helped to circumvent the horse’s laryngeal obstruction and reestablish a breathing passage.
• The endoscopic examination revealed swelling and reduced movement of the arytenoid cartilages, which led to a narrowed entryway into the larynx, causing the dyspnea.
• Unfortunately, the breathing tube became dislodged while the horse was recovering, necessitating a third anesthetic and subsequent emergency tracheostomy—a surgical procedure to create an alternate airway through an incision in the horse’s trachea.

Recovery

• Recovery after the third anesthetic was prolonged and the horse developed post-anesthetic myopathy, a muscle disease often driven by prolonged immobilization under anesthesia.
• A marked improvement in the horse’s clinical condition was observed over the next 48 hours. Before the horse was discharged, another endoscopic evaluation showed normal laryngeal function.

Conclusion

• The report concluded that the initial trauma to the horse’s larynx was likely caused by the mechanical manipulation of the trachea during intubation and extubation.
• The article hypothesizes that draft horses may need additional attention and care during the critical perioperative period to prevent such complications.