The care that a horse receives during its lifetime will help to determine its health as it ages. Proper nutrition, parasite control, and hoof maintenance will help an older animal to preserve a healthy body condition. Additionally, without proper dental care, the aging process for many animals will be accelerated.

A Horse’s Physical Appearance Changes with Age

The physical appearance of older horses demonstrates subtle, but noticeable, changes as they approach their senior years. For example, their backs sag and their lower lip becomes droopy—indications that they are approaching the last phase of their life. Changes readily observable during examinations that indicate the approach of their geriatric years also include:

• Loss of body condition
• Loss of weight

When these losses occur in an older animal, they are often related to the animal’s inability to adequately grind and digest feed, a problem typically found to relate to the condition of their teeth. 

Equine Odontoclastic Tooth Resorption and Hyperplasia (EOTRH)

Equine Odontoclastic Tooth Resorption and Hyperplasia (EOTRH) is a disorder that affects the incisors and canine teeth of horses over 15 years of age. EOTRH causes changes to the normal breakdown and reattachment of a tooth, resulting in an odontoclastic resorption of the tooth, and characterized by symptoms of:

• Internal and external tooth resorption
• Cemental hyperplasia
• Excessive production of cementum found on a tooth’s exterior
• Disease progression indicated by inflammation and infection of the:
  • Pulp
  • Periodontal ligament
  • Alveolar bone
  • Loss of tooth structural support
  • Gingiva degradation
  • Fistula formation
  • Tooth fractures
  • Pain

Client Observations
Owners with horses diagnosed with EOTRH may communicate the following symptoms:

• Reduced ability to grasp offered treats, such as apples and carrots, which creates a diminished interest in treats.
• Pain and increased sensitivity, shown through:
  • Biting
  • Shaking head
  • Head shyness
  • Excessive salivation
  • Refusal to take the bit
  • Resistance to turning when being worked
  • Diminished grazing efforts
  • Reduced appetite
  • Weight loss

Caution
Completing an oral exam on a horse with EOTRH can be difficult, and care must be taken to limit the animal’s discomfort. Any increased pressure on the affected area, through lip manipulation or examination of the teeth, can be very painful.  Even when heavily sedated, an animal may react dangerously to the pain caused by the placement and opening of the oral speculum.

Examination
As reported by Rawlinson through the American College of Veterinary Surgeons, the findings of a thorough oral examination of an animal with EOTRH may uncover the following:

• Enlarged mandibular lymph nodes
• Decreased incisor angle not appropriate for age
• Prominent juga
• Loss of dental papillae
• Gingiva and mucogingival fistulas
• Severe regional inflammation
• Purulent drainage
• Calculus and feed accumulation
• Missing teeth
• Hyperplastic gingiva
• Gingival recession
• Bulbous enlargement of dental structures
• Tooth mobility
• Supragingival regions of dental resorption.

Radiographs
Evidence of EOTRH requires completion of oral radiographs, specifically of the incisors and canines, to uncover the extent of the disease and determine a treatment plan. Viewing the radiographs in cases with severe disease will typically show:

• Tooth fractures
• Supragingival lesions
• Osteomyelitis
• Alveolitis
• Extensive resorption of the root and reserve crown

Treatment
The type of treatment completed may depend on the stage of the disease. In early or mild cases where the horse remains comfortable, treatment may consist of completion of an annual oral exam and radiograph to monitor changes. In moderate or severe cases, recommended treatment may include staged extraction of tooth,complete debridement, or complete removal of affected tooth or affected teeth.

Ridding the animal of the pain of EOTRH is essential for the health of their geriatric years. While the treatment may cause changes in their feeding care needs, adaptations are not difficult, and the animal will be able to better maintain its ability to eat once the pain is removed. 

For further information on the care of the older horse, please contact your Covetrus representative at 855.724.3461.

Sources:

https://www.acvs.org/files/proceedings/2012/data/papers/156.pdf

http://equinedentalprinciples.com/article-1.html

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