Equine epiglottitis: Diagnosis, treatment and outcome.

Background: Epiglottitis is an uncommon upper airway pathology manifested endoscopically by mucosal oedema, reddening and thickening of the epiglottic mucosa. Literature on epiglottitis in horses is sparse.

Objectives: To describe the diagnosis, treatment and outcome of Thoroughbred and Standardbred racehorses diagnosed with epiglottitis at a single centre. A secondary objective is to demonstrate the efficacy of inhaled and topical anti-inflammatories for this condition.

Study design: Retrospective case series.

Methods: Medical records (2009-2023) were reviewed for racehorses treated for epiglottitis. Data collected included signalment, history, endoscopic findings, treatment progression, hospitalisation duration and any reason for re-admission. Race records were obtained to determine days to first race, earnings and career length.

Results: Twenty-four horses were included in the study. Horses were referred for a variety of upper airway abnormalities including epiglottic entrapment, dysphagia and respiratory stridor. Of the horses admitted for epiglottic entrapment (18), a more accurate diagnosis of epiglottitis was made based on admission endoscopy. Horses were treated with systemic, topical and inhaled anti-inflammatories, as well as topical and inhaled antimicrobials. Twenty-two horses (91.6%) returned to racing after discharge. Eight horses (33.3%) were re-admitted, including six for recurrent epiglottitis and two for other airway pathologies.

Main limitations: The major limitations include those inherent to a retrospective report. The results would be stronger with higher case numbers. Additionally, we did not have sufficient case numbers to compare outcomes of horses treated with inhaled medications versus those that were not. Racehorses inevitably develop other racing-related problems which confound studies of this nature.

Conclusions: Epiglottitis is a rare upper airway condition that is challenging to diagnose. However, when accurately identified, it can be successfully treated, offering a good prognosis for a return to athletic function.