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Megaesophagus in Friesian Foals

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Megaesophagus in Friesian Foals THE FRIESIAN Megaesophagus in Friesian Foals We are so grateful for all we have learned while caring for Martin. 44 JULY/AUGUST 2021 By Angie dePuydt is the involuntary constriction and relaxation of the esophageal Education & Research Liaison, Fenway muscles, which create wave-like movements that push food in Foundation for Friesian Horses the esophagus towards the stomach. Many reported cases of acquired megaesophagus in Friesian horses involve mature or senior horses in their mid-teens that present with “choke” induced by an esophageal obstruction related to forage or feed. However, megaesophagus can be inherited or congenital (present at birth) and does occur in foals and very young horses. ix months ago, the members of the Fenway Foundation’s Board of Directors sat in the kitchen Dysphagia (difficulty swallowing) is sometimes observed in at Fenway Farms dumbfounded. We were on a call neonatal foals (less than one month old) and often resolves with Ids Helinga, Executive Director of the KFPS, spontaneously as the foal’s swallowing reflexes improve. discussing the structure and approach to a new However, nursing foals with megaesophagus may show early Sgenetic research project for megaesophagus in Friesian horses. signs of the disease with symptoms of esophageal dysphagia “What do you mean most of the samples you have are from with milk draining from one or both nostrils after nursing. foals?” was the comment one of us made. Upon hearing a large Difficulty swallowing may also be related to other conditions number of the DNA samples that had been collected from such as a cleft palate or neurological issues. If you suspect your Friesians with megaesophagus for previous research were from foal may be having difficulty swallowing milk while nursing, foals, we realized we had missed something. Megaesophagus especially if they are older than one month, consult with your was a disease we primarily associated with older horses. A Veterinarian to rule out megaesophagus. few days later we gathered again with Ids Helinga and the geneticists from the University of Kentucky’s Gluck Equine Young horses affected with megaesophagus often present with Research Center. The previous study conducted by the KFPS symptoms of choke after they are weaned and begin ingesting included samples from horses of all ages and was unfortunately solid food or after they begin creep feeding. These horses will unsuccessful. Ids recommended this time we approach this usually present with classic choke symptoms including but study with a very strict set of parameters for study candidates, not limited to discharge of saliva and feed material from the focusing on young foals who were most likely presenting with nostrils and/or mouth, depression and apparent difficulty in an inherited (congenital) form of the disease vs. one that is swallowing. In some cases, an obstruction in the esophagus acquired. Dr. Katheryn Graves, who heads up the genetics lab will be visible and can be felt at the base of the neck. Signs of at the University of Kentucky’s Gluck Equine Research Center, choke can be very subtle and unique to the individual horse agreed to this approach and felt this method would give her team with megaesophagus. Owners and caregivers should keep close the best chance to unlock the mystery of how megaesophagus watch on their horse to determine behaviors or patterns that is inherited and hopefully one day develop a test for the disease may signal the onset of a choke episode. in Friesian horses. Aspiration pneumonia is a very serious and common Later that same day a call came in from an owner with a complication that can occur in any horse with megaesophagus, weanling foal in North America that had just been diagnosed but foals and young horses are especially at risk for pneumonia with megaesophagus who was interested in surrendering the due to their immature immune systems. When choke occurs, horse to the Fenway Foundation due to its critical care needs. foreign objects such as bacteria and food particles may be It was not lost on us that perhaps this was divine intervention inhaled into the lungs. While the lungs are not sterile or free pointing us in the right direction with that phone call. And that from bacteria, they do have their own distinct microbiome, was really the start of our newest adventure and challenge at which is unique to the individual horse and can be very the Foundation– managing foals with megaesophagus. sensitive. When aspiration occurs, the sheer number of bacteria in the lungs may overwhelm the natural defense mechanisms of the lungs and in short order, the horse has pneumonia. About Megaesophagus Horses may show no obvious signs during the early stages of Megaesophagus is rare in horses but it appears to be more pneumonia but may rapidly develop more advanced symptoms common in Friesian horses compared to other breeds. Utrecht such as an increased respiratory rate, difficulty breathing, University Equine Hospital in the Netherlands reported Friesians lethargy or lack of interest in nursing/eating. Advanced cases present with megaesophagus at a rate of 2.2% in contrast to of pneumonia typically present with a fever, labored breathing 0.5% in other breeds. Megaesophagus typically manifests with and nasal discharge. Aspiration pneumonia requires treatment a chronic dilation in the lower part of the esophagus, esophageal with antibiotics and advanced cases may require hospitalization strictures (narrowing) and/or a decrease in peristalsis. Peristalsis and intensive round-the-clock care to resolve. 45 THE FRIESIAN Horse Esophagus: A horse’s esophagus is 4 – 5 feet long and carries food to the stomach. Most horses with megaesophagus have an area of dilation at the lower end of the esophagus near the thoracic inlet (parallel to the first rib bone) where there is no motility followed by a small length of normal esophagus just prior to the stomach opening. Breeders and owners should be aware megaesophagus can Additionally, if your foal or young horse is diagnosed with occur in foals and young horses. It is important to closely pneumonia related to aspiration, further investigation may be observe any foal that appears to have difficulty swallowing prudent to rule out megaesophagus. and consult with your veterinarian to rule out any other issues that may cause dysphagia. Chronic choke in young horses Unfortunately, there is no medical treatment or procedure for may be a key indicator of megaesophagus and require further megaesophagus that restores functionality of the esophagus. examination. An Esophageal Barium Study (Barium Swallow This is a disease that will not get better with time and Test) is a key diagnostic tool for evaluating megaesophagus. unfortunately symptoms may worsen over time. The typical The study involves administering a chalky, white substance prognosis for horses with megaesophagus from a veterinary called barium to the horse. The barium coats the surface of the standpoint is often poor and euthanasia is often recommended esophagus and appears white on radiographs. The procedure for foals and young horses. However, it is critical this article produces detailed images of the linings of the esophagus and conveys to readers this disease CAN be managed, even in foals. can provide insight on the motility of the esophagus and location of dilated portions of the esophagus or strictures (narrowing). 46 JULY/AUGUST 2021 Martin & Andy: Their size difference is comical, and will only grow, but it’s the key to why their relationship is so successful. knew the odds didn’t seem to be great, we decided we had to Our Experience try and find a way to help this foal and we were willing to do whatever was in Martin’s best interest. After getting that phone call about a megaesophagus foal the owner wanted to surrender we knew the horse was going to be We arranged to meet Martin’s owners halfway for his surrender. a challenge from a management perspective. Martin’s owners We expected to see a sickly-looking foal. On the contrary, were first time Friesian owners who just wanted him to receive Martin looked very healthy and was bright with a very calm the best care. All of our knowledge and previous experience in disposition– a testament to his care thus far. We brought along caring for megaesophagus horses was with older horses who a miniature pony named Andy to pick up Martin as we planned did not seem to be as advanced in the disease as Martin. Martin to make the pony his pasture mate. We knew from our research had several severe choke episodes and aspiration pneumonia that social interaction, as normal as it could be and as much in a short period of time, so we were concerned about his as we could offer him, was going to be a critical component prognosis. After conducting some research into foals with of a normal, happy life for Martin. However, his need to be megaesophagus and consulting with veterinarians, the potential able to access a liquid diet 24/7 made it almost impossible to for Martin to have a good quality of life seemed guarded at pasture him with another full-sized horse, who would be sure best. In fact, most veterinarians recommended euthanasia for to help himself to Martin’s food. Because Andy is only 38” foals with megaesophagus. Naturally, we wondered if it was tall, he would be unable to reach Martin’s food if we arranged possible to offer this foal a normal life or if we would only be it properly and he had already previously proven himself to be prolonging the inevitable. After talking with the owners further, a great companion for foals on the farm. we understood the foal could not handle long stem forage (hay) and was on a liquid diet consisting of soaked feed and Once we arrived home it was very evident that Martin was very soaked hay pellets.
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