Have you heard of EOTRH SYNDROME? Resorption lesions of the incisors… very painful.

Sunday, August 2nd, 2020 | Filed under Medical

I belong to a riders’ group and this email was in my box.  I found it very interesting… I have plenty of older horses around here and I need to check for this.  However, it can happen in younger horses, too.

The article:


This attached brochure is from GCTC members, Karrie and Vern Dunham. It was given to them by their dental specialist vet from Oregon who came down to consult with their local vet on a horse with suspected Equine Odontoclastic Tooth Resorbtion and Hyperementosis, or EOTRH.

EOTRH is becoming more common, and you can keep an eye on your own horses.

EOTRH Syndrome
Equine Odontoclastic Tooth Resorption and Hypercementosis, also known as EOTRH, is a syndrome in horses that results in resorptive lesions of the incisors and sometimes canine teeth. It is usually gradual in onset, though often isn’t diagnosed until quite extensive lesions are present. Most commonly it is a condition of older horses (15+), though we have seen it in horses as young as 13.

More in-depth information.
This is a fairly recently recognized disease that can cause severe changes to the tooth roots and surrounding gingiva (gums) in older horses, most often in the incisors and canines, although some very new research indicates it can affect their premolars and molars, as well. In moderate and severe cases it results in chronic infection of the tissues and is very painful to the horse; it can also cause loss of affected teeth or enough pain that they must be extracted to allow the horse to eat comfortably.

The cause of EOTRH is not known for certain, though it appears to be correlated with equine pituitary pars intermedia dysfunction (PPID, or equine Cushing’s disease), a history of overly aggressive dental procedures by improperly trained individuals, horses that are not allowed to graze (i.e., kept on a drylot), and the presence of certain types of bacteria or other microorganisms in the mouth. Geldings seem to be predisposed. It’s theorized that saliva constantly bathing the teeth, as occurs in the head-down grazing position when horses are at pasture for many hours per day, may be protective, so incorporating this into your horse’s management program might be helpful.

The earliest externally visible signs of EOTRH are gingivitis (inflammation of the gums around the teeth) or small draining tracts from the roots of the tooth that look like pimples in the gingiva–these appear as tiny red dots initially. These might occur years before the more obvious loosening of teeth or tooth root enlargements, and your veterinarian should take note of this during routine dental examinations. Dental radiographs taken at that time might show the start of small resorptive (bone breakdown) lesions in the tooth root or the laying down of cementum around the roots, which is the body’s attempt to stabilize the teeth.

Early identification allows more proactive care and can prevent your horse from experiencing chronic pain and complications such as chronic infections. When the affected teeth become painful or loose, veterinarians recommend extraction. Often, if all or most of the incisors are affected, the veterinarian removes them completely. While it seems like a drastic measure, owners find that their horses recover quickly, are much more comfortable afterward (with previous hard keepers often gaining weight more easily), and can still graze grass effectively!”

Radiographs from UC Davis

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