Traumatic nasogastric intubation as a suspected cause of laryngeal obstruction in a horse recovering from emergency laparotomy

An 18‐year‐old mare, admitted for colic, underwent an exploratory laparotomy for right dorsal colon displacement. During recovery from anaesthesia, a severe acute onset laryngeal obstruction occurred at standing, requiring orotracheal re‐intubation, which relieved the obstruction. This was followed by secondary pulmonary oedema, treated with furosemide (2 mg/kg intravenously) and oxygen. At re‐extubation, attempted 30 minutes later, the horse re‐obstructed immediately and collapsed, prompting an emergency tracheostomy. Furosemide (2 mg/kg intravenously) and dexamethasone (0.1 mg/kg intravenously) were also administered. The horse stood up thereafter with a patent airway. In the history, to note, nasogastric intubation was particularly difficult at admission, and was identified as a potential cause of laryngeal trauma that may have precipitated laryngeal obstruction due to severe local inflammation. Dynamic laryngeal collapse probably also played a role due to high inspiratory negative pressure generated at the precise timing of standing, similar to exercise.