Question: Can you tell me more about wry nose? Our mare gave birth to a foal with a nose so crooked that she could not nurse. We fed her with a bottle, but she didn’t do well. She couldn’t swallow properly. As a result, our veterinarian said she’d always have trouble eating. Eventually, we chose to have her put down. I can’t help but wonder why this happened. This mare’s previous foals were normal. Is there anything we could have done to help her?
Answer: Wry nose (campylorrhinus lateralis) is a congenital deformity of the bones of the nose that causes a lateral deviation. This gives the head of the affected horse an unsightly appearance. The deformity nearly always occurs within the space between the cheek teeth and incisors (interdental space).
This condition can occur in a wide variety of horse breeds. It may result from fusion, in utero, of the pair of small cranial bones at the tip of the upper jaw (premaxilla) to the nasal bone on the concave side of the deformity, which prevents growth of the nose on that side. Neither a genetic origin nor a teratogenic cause (that is, an agent that brings about an abnormality) has been documented, perhaps because the incidence is so low.
How wry nose affects foals
Most foals with wry nose are capable of nursing, but severely affected youngsters may have difficulty suckling. The tongue often protrudes on the convex side of the deformity. An extremely deviated nasal septum may be accompanied by respiratory stridor (emitting high-pitched sounds with the intake of air) and difficult respiration. All or some of the upper incisors may have poor or no contact with the lower teeth, causing the horse to have difficulty prehending feed. The maxillary cheek teeth are usually in good occlusion. But the sideways movement of the mandible is usually limited, so the cheek teeth wear abnormally.
Longterm prognosis
Moderately or severely affected horses have lifelong difficulty with breathing and grazing. Their cheek teeth wear unevenly, leading to difficulty masticating feed. Most owners decide to euthanize affected foals soon after birth. However, mildly affected foals can be treated successfully by retarding growth of the convex side of the deformity with orthodontic wiring. Horses with moderate or severe deviation require radical surgical treatment to improve their respiratory capacity, prehension and mastication of feed, and cosmetic appearance.
The surgery option
In corrective procedure, the surgeon excises the nasal septum and transects the bones of the nose and stabilizes them in a more normal position. The size and age of the horse at the time of surgery does not seem to affect the cosmetic or functional outcome. However the nasal bones of horses younger than 6 months old are more difficult to stabilize after transection because they are soft, which reduces their ability to hold screws.
Surgery to correct wry nose is seldom performed because it is expensive, due to its length and difficulty. In addition, a second surgery to remove the appliances used to stabilize the nose bones is necessary, compounding the expense. Most owners report satisfaction with the postoperative appearance of the horse. Corrective surgery can ensure respiratory capacity sufficient for the horse to perform athletic endeavors—even racing. It also can improve masticatory function.
Jack Easley, DVM, MS, Emeritus
DABVP, DAVDC (Equine)
Shelbyville, Kentucky
James Schumacher, DVM, MS,
DACVS
Las Cruces, New Mexico
Our Experts
Jack Easley, DVM, MS, Emeritus DABVP, DAVDC (Equine), operates Equine Veterinary Practice LLC, in Shelbyville, Kentucky, an all-inclusive practice with an emphasis on dentistry. Easley received his veterinary degree from Tuskegee University. He is a founding diplomate of the American Veterinary Dental College’s Equine Specialty. Easley has lectured on equine dentistry around the world. In addition, he has written articles for professional and lay equine journals, textbooks and periodicals.
James Schumacher, DVM, MS, DACVS, is a board-certified veterinary surgeon.He received his veterinary degree from Kansas State University College of Veterinary Medicine and completed his residency training at Texas A&M University. He is a Diplomate of the American College of Veterinary Surgeons (ACVS). His areas of expertise include lameness, urogenital surgery and respiratory surgery.
