Iatrogenic aspiration pneumonia in six horses: A retrospective case series.
Authors: Vainio K M E, Määttänen M K, Mykkänen A K, Huupponen A K, Niinistö K E
Journal: Journal of equine veterinary science
Summary
# Editorial Summary: Iatrogenic Aspiration Pneumonia in Horses Although aspiration pneumonia from accidental ingestion is uncommon in equine practice, this Finnish retrospective case series of six horses treated between 2018 and 2023 provides valuable insight into how the type of material aspirated and timing of intervention significantly influence survival and recovery. The study examined clinical presentations, treatment protocols, and outcomes across cases involving water, mineral oil, and psyllium, with particular attention to how delays in hospital admission affected prognosis. Half the affected horses survived, and crucially, the three survivors had either aspirated water or electrolyte solutions and were presented within two hours of the incident, whereas the three non-survivors had aspirated mineral oil or psyllium and experienced admission delays ranging from one to sixteen days. Water aspiration, whilst causing substantial acute respiratory compromise, carried a relatively favourable prognosis when treated promptly with nasogastric feeding of water or balanced electrolyte solutions, whereas lipoid pneumonia from mineral oil and the inflammatory response triggered by psyllium aspiration resulted in poor outcomes regardless of subsequent management. For equine professionals, this case series underscores the critical importance of rapid veterinary assessment and aggressive early intervention following any suspected aspiration incident, as the substance involved and time to treatment appear to be the primary determinants of whether affected horses survive and return to athletic function.
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Practical Takeaways
- •Immediate recognition and rapid transport to hospital (within 2 hours) significantly improves survival in iatrogenic aspiration cases
- •Type of aspirated material matters: water aspiration has better prognosis than mineral oil or psyllium aspiration, which carry poor outcomes
- •Early aggressive treatment with nasogastric fluids (water or electrolyte solutions) should be initiated promptly; delayed treatment of 1+ days is associated with mortality
Key Findings
- •Of 6 horses with iatrogenic aspiration, 3 survived (2 regained full athletic function), with survivors presenting within 2 hours of incident
- •Water aspiration caused marked respiratory compromise but had fair prognosis, while mineral oil and psyllium aspiration had poor outcomes
- •Non-survivors had delayed hospital admission of 1-16 days and were treated with mineral oil, mineral oil with water, or psyllium
- •Aggressive early treatment with nasogastric administration of water or electrolyte solutions improved survival outcomes