Miscellaneous conditions of the equine head.

Nutritional secondary hyperparathyroidism is associated with horses that are fed diets with an imbalance of calcium and phosphorus or diets containing oxalates. Clinical signs include a shifting lameness, with tenderness of the joints, reluctance to move, or a stiff, stilted gait. Some horses may have broadening of the nasal bones, enlargement of the maxilla and/or the mandible, or a ridge over the nasal bones. Diagnosis may include physical examination findings; analysis of feed; and clinical pathologic data, which may include normocalcemia, normal to increased serum phosphorus, and increased fractional excretion of phosphorus (normal FxP < 0.5%). The primary objective of therapy is to correct the nutritional calcium to phosphorus imbalance. Sialoliths are calcific concretions that develop in the salivary gland or duct. Therapy generally involves surgical removal, and associated complications are uncommon. Obstruction of the nasolacrimal duct occurs most commonly secondary to intraluminal foreign material, although congenital atresia may occur. Clinical signs include epiphora, conjunctivitis, and mucopurulent discharge. Foreign material is often removed by retrograde saline flush and atresia is resolved by surgery.