Very Common
OTHER DIAGNOSES CONSIDERED
Other conditions or ailments that might also need to be ruled out by a vet.
Diagnosis
Conditions or ailments that are the cause of a problem that you see - your observation.
Your vet may diagnose
Wry Nose
Synonyms: Campylorrhinus Lateralis, Deviated Nose, Crooked Nose, Twisted Nose
Summary
Wry nose is a congenital deformity of the face in which the front of the skull, made up of the incisive bone (premaxilla), the nasal bones and often the upper jaw (maxilla), develops twisted to one side. The muzzle is visibly deviated to the left or right, and the foal is born with it.
The deviation ranges from mild to severe. In mild cases the muzzle is only slightly off-centre, and the foal nurses, breathes and grows normally. In severe cases the nose is bent sharply to one side, the incisors do not meet, and the nasal passage on the inside of the curve is narrowed. The nasal septum and the hard palate are often deviated as well, and some affected foals also have a cleft palate.
What matters most is function: whether the foal can nurse well enough to get colostrum and milk, whether it can breathe adequately through both nostrils, and whether its bite will allow it to graze and eat normally as it grows.
The cause is not known. It is thought to result from the position of the foal in the uterus during development. A hereditary component has not been proven, but it has not been ruled out either.
Your vet will examine the foal to judge the severity of the deviation and to look for other abnormalities, especially a cleft palate. Radiographs or a CT scan of the skull, and endoscopy of the nasal passages and palate, show which bones are involved and are needed to plan any surgery. Because a foal that has trouble nursing may not absorb enough antibodies from colostrum, your vet will likely also check its IgG level.
Mild cases may need no treatment. Moderate and severe cases can be corrected surgically at a referral hospital, usually within the first weeks to months of life, by cutting and repositioning the deviated bones (osteotomy), often with bone grafting and sometimes in more than one stage. A foal that cannot nurse needs supplemental feeding until the problem is resolved. In the most severe cases, euthanasia may be the kindest choice.
The deviation ranges from mild to severe. In mild cases the muzzle is only slightly off-centre, and the foal nurses, breathes and grows normally. In severe cases the nose is bent sharply to one side, the incisors do not meet, and the nasal passage on the inside of the curve is narrowed. The nasal septum and the hard palate are often deviated as well, and some affected foals also have a cleft palate.
What matters most is function: whether the foal can nurse well enough to get colostrum and milk, whether it can breathe adequately through both nostrils, and whether its bite will allow it to graze and eat normally as it grows.
The cause is not known. It is thought to result from the position of the foal in the uterus during development. A hereditary component has not been proven, but it has not been ruled out either.
Your vet will examine the foal to judge the severity of the deviation and to look for other abnormalities, especially a cleft palate. Radiographs or a CT scan of the skull, and endoscopy of the nasal passages and palate, show which bones are involved and are needed to plan any surgery. Because a foal that has trouble nursing may not absorb enough antibodies from colostrum, your vet will likely also check its IgG level.
Mild cases may need no treatment. Moderate and severe cases can be corrected surgically at a referral hospital, usually within the first weeks to months of life, by cutting and repositioning the deviated bones (osteotomy), often with bone grafting and sometimes in more than one stage. A foal that cannot nurse needs supplemental feeding until the problem is resolved. In the most severe cases, euthanasia may be the kindest choice.
my vet's role
Diagnostics Used
These are tests that might be helpful to make this diagnosis or further characterize the condition.
Treatments May Include
These treatments might be used to help resolve or improve this condition.
PROGNOSIS AND RELEVANT FACTORS
Prognosis depends on severity. Mild cases: good for life and for pasture or light use, often without surgery. Moderate to severe cases corrected surgically. the prognosis is fair; many corrected foals lead useful lives and some have gone on to athletic careers, although the face rarely looks completely normal. Severe deformity with airway obstruction, inability to nurse or a cleft palate: guarded to poor.The prognosis is worse when the foal cannot nurse and develops failure of passive transfer, when a cleft palate leads to milk coming from the nostrils and aspiration pneumonia, when the narrowed nasal passage obstructs breathing, and when surgery is followed by complications such as infection, failure of a bone graft or the need for further surgery. Referral surgery for this condition is specialized and expensive, and that is a real factor in the decision.
my role
I might observe
You might make these observations when a horse has this condition.
Skills I Might Need
I might need these skills if my horse has this diagnosis.
Questions To Ask Your Vet:
- How severe is my foal's deviation, and does it affect breathing, nursing or the bite?
Has my foal received enough colostrum?- Should we check its IgG level?
Does my foal have a cleft palate or any other abnormality?
What imaging do you recommend: radiographs, CT or endoscopy?
Is my foal a candidate for surgical correction?- When should it be done, where, and what will it cost?
What can I expect for my foal's long-term use and quality of life?
Should this mare or stallion be bred again?
Prevention
There is no known way to prevent wry nose. Because a hereditary contribution has not been excluded, affected horses should not be bred, and whether to repeat the same mare and stallion cross is worth discussing with your vet.