Upper airway abnormality diagnosed by treadmill endoscopy
The U-Vet Werribee Equine Centre has the expertise to investigate and manage poor performance, including various respiratory and cardiac issues.
Video: The team conducting an upper airway endoscopic examination with the horse galloping on the treadmill.
Tackling difficult diagnostic cases, a recent patient was referred to our specialist team due to poor performance and abnormal respiratory noise during exercise. The complex history of this horse included treatment for left laryngeal hemiplegia two years prior.
It was during this period that the horse underwent various surgeries including a tie-back of cartilage (to aid air flow), a left cordectomy and a left aryepiglottic fold resection. However, due to swallowing difficulties the prosthesis was removed in April and the exercise induced respiratory signs subsequently re-occurred.
Upon presentation at the U-Vet Equine Centre in August, the team conducted an upper airway endoscopic examination whilst the horse performed high speed work on the overground treadmill. This innovative test confirmed the presence of inspiratory upper respiratory noise and the presence of a Grade 4 left laryngeal hemiplegia (complete paralysis of cartilage and marked collapse of vocal fold).
This diagnosis was also coupled with an axial deviation of the right vocal cord and aryepiglottic fold, which resulted in severe narrowing of the rima glottides.
Image 1: Larynx at rest with Grade 4 left laryngeal hemiplegia
Image 2: Larynx during inspiration at high speed – Grade 4 left laryngeal hemiplegia, axial deviation of right aryepiglottic fold and right vocal cord
Based on previous complications, the decision was made to perform a standing left laryngoplasty (repair of the larynx), with right vocal cord and aryepiglottic fold resection. This was achieved using endoscopic guidance and laser techniques.
Image 3: Day 1 post surgery endoscopy
Post-surgical assessments including an endoscopic examination have confirmed that the horse has responded well to the procedure. After a short period of box rest and a following one-month yard restriction, this horse is predicted to return to training without respiratory issues in late October.
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