Publikationsdatenbank

Beidseitiges Horner-Syndrom in Kombination mit beiseitigem Nüsternkollaps (2019)

Art

Zeitschriftenartikel / wissenschaftlicher Beitrag

Autoren

Barton, Ann Kristin (WE 17)

Loderstedt, Shenja (WE 20)

Lischer, C. J. (WE 17)

Gehlen, H. (WE 17)

Quelle

Pferdeheilkunde : offizielles Organ der DVG, Fachgruppe Pferdekrankheiten = Equine medicine

Bandzählung: 35

Heftzählung: 4

Seiten: 316 – 320

ISSN: 0177-7726

Verweise

URL (Volltext): http://www.pferdeheilkunde.de/10.21836/PEM20190402

DOI: 10.21836/PEM20190402

Kontakt

Pferdeklinik

Oertzenweg 19 b
14163 Berlin
+49 30 838 62299 / 62300
pferdeklinik@vetmed.fu-berlin.de

Abstract / Zusammenfassung

A 7-year-old German Warmblood gelding was presented 9 months after a respiratory infection, as it showed hanging upper eyelids, a respiratory noise and exercise intolerance. The clinical examination revealed excessive sweating on head and upper neck, ptosis and nostril collapse during exercise on both sides. Clinical pathology including arterial blood gas analysis and differential blood count were within reference limits. Upper airway endoscopy at rest including the guttural poaches and overground endoscopy during lunging exercise were unremarkable. Further diagnostic imaging including CT, MRI or thermography of the head was not performed. Microbiology of a lavage sample of both guttural poaches also yielded no pathological findings. The diagnosis was bilateral Horner’s syndrome and a bilateral distal facial nerve paralysis of an unknown pathogenesis. To us, this was most likely the consequence of a former infection or inflammation of the guttural poaches leading to nerval damage of the facial nerve, passing at the lateral wall of the lateral compartment, and the sympathetic ganglion cervicale craniale, which is located dorsocaudal in the medial compartment. Although no curative therapy for Horner’s syndrome is available, a therapeutic approach to the bilateral nostril collapse was planned. Several options have been described in the literature including resection of the alar folds and implantation of cartilaginous material from the ear or a metal cage. In this case, surgical therapy included moon shaped skin removal and imbrication of subcutaneous tissue on the dorsal aspect of both nostrils and resection of the alar folds using a Ligasure TM device to decrease the bleeding during alar fold resection. The gelding was treated with an NSAID (flunixin-meglumine 0,5 kg/BW p.o.) post surgery and was discharged from the clinic. Eight months later, an owner interview revealed that the horse was able to perform as a show jumper again, although the clinical signs of Horner’s syndrome had not improved.