Caudal esophageal achalasia in a Quarter Horse colt.

Achalasia should be considered in horses with failure to thrive, colic, and aspiration pneumonia.

This case report describes achalasia, a primary esophageal motility disorder, in a 4-month-old Quarter Horse colt—a condition rarely reported in equine medicine. The colt presented with failure to thrive, recurrent colic episodes, and aspiration pneumonia, clinical signs consistent with esophageal dysfunction. Fluoroscopic evaluation revealed a caudal esophageal motility disorder characteristic of achalasia, with subsequent necropsy confirmation. While achalasia is well-documented as the most common esophageal motility disorder in humans and has been diagnosed in small animals including cats and dogs, its occurrence in horses is exceptionally uncommon. The diagnosis was established through advanced imaging techniques and pathological confirmation, providing definitive evidence of the condition. This case expands the differential diagnoses for equine failure to thrive and recurrent colic, particularly when accompanied by aspiration pneumonia. The clinical presentation and diagnostic findings contribute valuable information to the veterinary literature regarding rare esophageal disorders in large animals.

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