After an altercation in the field with a pasture mate, Clementine, a retired, 30-year-old quarter horse mare, was found the next morning with severe swelling in her throat latch area. Constricting her throat, the swelling was causing breathing issues, along with a loud respiratory stridor.

Clementine’s owners, Regina and Jim Galvin of Great Falls, Virginia, called Nancy Voytosh of Echo Equine Veterinary Services. Following a careful evaluation, Voytosh determined that Clementine needed immediate emergency treatment and referred her to the Equine Medical Center.

When Clementine arrived at the center, she was in severe respiratory distress, with a rapidly increasing heart rate, which resulted in a very slow walk into the hospital. Jennifer Barrett, Theodora Ayer Randolph Professor of Equine Surgery, and surgery resident Teresa Hopfgartner, immediately prepared the mare for an emergency tracheotomy and administered oxygen.

To add to the complexity of her symptoms, Clementine has suffered for many years with a chronic growth on the right side of her neck, which, presumed to be an enlarged thyroid gland, had not proved to be problematic in the past.

Under ultrasonographic guidance, the self-retaining, metal tracheostomy tube was manipulated and inserted into Clementine’s trachea. Although the procedure proved to be extremely challenging due to the severe swelling, everything went to plan, and Clementine was notably more comfortable after surgery. Once an airway had been established, the mare’s heart and respiratory rate gradually returned to normal levels.


Clementine was placed in a stall in the center’s Intensive Care Unit for close monitoring and aggressive medical treatment. Aminocaproic acid to aid in coagulation, intravenous fluid therapy, anti-inflammatories, and antimicrobials were started. In addition, oxygen supplementation was continued for the first 24 hours after surgery.

After a week of 24/7 treatment and care, Clementine’s tracheostomy tube was removed, and she was closely monitored throughout the day. Over the next 24 hours, the mare continued to have a normal respiratory rate and seemed very comfortable. She showed no evidence of elevated respiratory rate, coughing, stridor, or distress; Clementine was ready to go home!

“We are so grateful for the quality of care and genuine concern and support for both Clementine and her family,” said Regina Galvin. “Our region is so fortunate to have the caliber of equine care available that we do. God bless you all.”


Written by Sharon Peart for the Virginia-Maryland College of Veterinary Medicine.


Andrew Mann
Director of Communications and Marketing