Iatrogenic aspiration pneumonia in six horses: A retrospective case series.

Overview

• This study reviews six cases of iatrogenic aspiration pneumonia in horses, focusing on clinical features, treatments, and outcomes.
• The research highlights differences in prognosis depending on the aspirated material and emphasizes the importance of early intervention.

Background

• Iatrogenic aspiration pneumonia occurs when substances accidentally enter the lungs during medical treatment.
• In horses, this condition is uncommon, with most reported cases linked to mineral oil aspiration causing lipoid pneumonia.
• The study aims to deepen understanding of various types of aspirated materials and their impact on prognosis.

Study Objectives

• To describe the clinical presentation, treatment approaches, and outcomes of horses that developed iatrogenic aspiration pneumonia.
• To identify differences in prognosis based on the materials aspirated, such as water, mineral oil, or psyllium.

Methods

• A retrospective review was conducted of six horses treated for iatrogenic aspiration pneumonia at the University of Helsinki Equine Hospital from 2018 to 2023.
• Clinical records were analyzed detailing the aspirated substance, time to hospital presentation, treatment methods, and outcomes.

Findings and Results

• Out of six cases, three horses survived, with two achieving full recovery including return to athletic function.
• The survivors had aspirated either water or water with electrolytes and were brought to the hospital within two hours post-aspiration.
• Non-survivors had aspirated mineral oil alone, mineral oil combined with water, or psyllium and exhibited delayed referral ranging from 1 to 16 days.
• Water aspiration resulted in acute, severe respiratory distress but generally a better prognosis.
• Aspiration of psyllium or mineral oil was associated with poorer outcomes and higher mortality.

Conclusions and Implications

• Early identification and aggressive treatment are critical to improving survival in horses with iatrogenic aspiration pneumonia.
• The type of aspirated material significantly affects prognosis; water aspiration, though causing serious respiratory compromise, has a relatively favorable prognosis if managed promptly.
• Materials such as mineral oil and psyllium pose higher risks and are linked to worse clinical outcomes.
• The study suggests that veterinary practitioners should prioritize rapid assessment and treatment in cases of suspected aspiration to enhance recovery chances.