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Indications for and short- and long-term outcome of permanent tracheostomy performed in standing horses: 82 cases (1995–2005)

A. Berkley ChesenDepartment of Large Animal Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843-4475.

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Peter C. RakestrawDepartment of Large Animal Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843-4475.

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Abstract

Objective—To identify indications for and short- and long-term outcome of permanent tracheostomy performed in standing horses.

Design—Retrospective case series.

Animals—82 horses undergoing permanent tracheostomy.

Procedures—Data obtained from medical records included signalment, diagnosis, surgical technique, complications, use of the horse before and after surgery, and owner satisfaction. Follow-up information was obtained through a telephone questionnaire administered to owners.

Results—Indications for permanent tracheostomy included nasopharyngeal cicatrix (n = 59), arytenoid chondropathy (55), and laryngeal hemiplegia (20); 54 horses had multiple indications for tracheostomy. Complications identified prior to discharge included partial dehiscence (n = 8), transient fever (10), and excessive swelling (13). Complications identified after discharge included partial dehiscence (n = 3), inversion of skin (2), and stenosis of the tracheostomy requiring repair (1). Long-term follow-up information was available for 64 horses. Fifty-seven of the 64 (89%) horses returned to their previous use, and owners of 63 (98%) horses reported being very satisfied with the results. The owner of 1 (2%) horse was unsatisfied with the results. The 1-year survival rate was 97% (95% confidence interval, 95% to 100%). Mean estimated truncated survival time (ie, failure-free period) was 9.7 years (95% confidence interval, 9.3 to 10.1 years).

Conclusions and Clinical Relevance—Results suggested that permanent tracheostomy can be safely performed in standing horses and was a viable treatment for horses with obstructive disease of the upper respiratory tract that was unresponsive to medical treatment or other surgical treatments.

Abstract

Objective—To identify indications for and short- and long-term outcome of permanent tracheostomy performed in standing horses.

Design—Retrospective case series.

Animals—82 horses undergoing permanent tracheostomy.

Procedures—Data obtained from medical records included signalment, diagnosis, surgical technique, complications, use of the horse before and after surgery, and owner satisfaction. Follow-up information was obtained through a telephone questionnaire administered to owners.

Results—Indications for permanent tracheostomy included nasopharyngeal cicatrix (n = 59), arytenoid chondropathy (55), and laryngeal hemiplegia (20); 54 horses had multiple indications for tracheostomy. Complications identified prior to discharge included partial dehiscence (n = 8), transient fever (10), and excessive swelling (13). Complications identified after discharge included partial dehiscence (n = 3), inversion of skin (2), and stenosis of the tracheostomy requiring repair (1). Long-term follow-up information was available for 64 horses. Fifty-seven of the 64 (89%) horses returned to their previous use, and owners of 63 (98%) horses reported being very satisfied with the results. The owner of 1 (2%) horse was unsatisfied with the results. The 1-year survival rate was 97% (95% confidence interval, 95% to 100%). Mean estimated truncated survival time (ie, failure-free period) was 9.7 years (95% confidence interval, 9.3 to 10.1 years).

Conclusions and Clinical Relevance—Results suggested that permanent tracheostomy can be safely performed in standing horses and was a viable treatment for horses with obstructive disease of the upper respiratory tract that was unresponsive to medical treatment or other surgical treatments.

Contributor Notes

The authors thank Dr. Noah D. Cohen for assistance with statistical analyses.

Address correspondence to Dr. Chesen.