Laryngeal dysfunction in horses refers to a range of conditions affecting the larynx, which is a critical structure involved in breathing and vocalization. These conditions can impact the horse's performance and respiratory efficiency. Common types of laryngeal dysfunction include recurrent laryngeal neuropathy (RLN), arytenoid chondritis, and laryngeal hemiplegia. These disorders may result in abnormal respiratory noises and exercise intolerance. Diagnosis typically involves endoscopic examination to assess the structure and function of the larynx. This page compiles peer-reviewed research studies and scholarly articles that explore the etiology, diagnosis, and management of laryngeal dysfunction in horses.
Burns JJ, MacMillan KM, John E.Respiratory disease is common in the horse population and is often associated with poor performance in equine athletes. Despite their outstanding strength and aerobic capacity, little regard is given to draft horses and the respiratory disorders they may encounter when performing athletic activity. For this reason, the objectives of this study were: (1) to determine the prevalence of exercise-induced pulmonary hemorrhage (EIPH), tracheal mucus (TM) and recurrent laryngeal hemiplegia (RLH) in a population of competitive draft pulling horses, and (2) to determine if there was an association betw...
Lean NE, Franklin SH, Steel C, Woolford L, White J, Ahern BJ.Little is known about potential differences in the left recurrent laryngeal nerve (Lrln) and left cricoarytenoideus dorsalis (LCAD) muscle between domestic and feral horse populations. If a difference exists, feral horses may provide a useful control population for research related to recurrent laryngeal neuropathy (RLN) and increase our understanding of potential population pressures influencing the incidence RLN. The objective of this study was to compare the Lrln and LCAD of domestic and feral horses using histological and immunohistochemical techniques (IHC). Sixteen horses, domestic (n = ...
Roe HA, Biedrzycki AH, Davenport PW, Freeman DE, Porter EG, McCarrel TM.To develop 3D models of larynges to compare arytenoid abduction measurements between specimens and models, and to investigate the anatomic feasibility of placing an implant across the cricoarytenoid joint (CAJ) with or without arthrotomy. Methods: Cadaveric equine larynges (n = 9). Methods: Equine larynges underwent sequential CT scans in a neutral position and with 2 arytenoid treatments: bilateral arytenoid abduction (ABD) and bilateral arytenoid abduction after left cricoarytenoid joint arthrotomy (ARTH). Soft tissue, cartilage, and luminal volume 3-dimensional models were generated. Rima g...
Tucker ML, Wilson DG, Bergstrom DJ, Carmalt JL.Computational fluid dynamics (CFD) has proven useful in the planning of upper airway surgery in humans, where it is used to anticipate the influence of the surgical procedures on post-operative airflow. This technology has only been reported twice in an equine model, with a limited scope of airflow mechanics situations examined. The reported study sought to widen this application to the variety of procedures used to treat equine recurrent laryngeal neuropathy (RLN). The first objective of this study was to generate a CFD model of an box model of ten different equine larynges replicating RLN a...
Wilson DG, Roquet I, Tucker ML, Carmalt JL.Evaluation of the strength of the novel suture technique by comparison with a 2-interrupted suture technique. Methods: 40 equine larynges. Methods: 40 larynges were used; 16 laryngoplasties were performed using the currently accepted 2-suture technique and 16 using the novel suture technique. These specimens were subjected to a single cycle to failure. Eight specimens were used to compare the rima glottidis area achieved with 2 different techniques. Results: The mean force to failure, as well as the rima glottidis area of both constructs, were not significantly different. The cricoid width did...
Lean NE, Sole-Guitart A, Ahern BJ.To investigate the feasibility and describe the clinical experience of performing laryngeal tie-forward (LTF) in standing horses unaffected (experimental) and affected (clinical) by intermittent dorsal displacement of the soft palate (iDDSP). Methods: Experimental study and case series. Methods: Five normal experimental controls and five client owned horses affected by iDDSP. Methods: Standing LTF was performed and evaluated in five experimental horses and five clinical cases diagnosed with iDDSP. Standing LTF was performed under endoscopic guidance with horses sedated and the surgical site de...
Barton AK, Troppenz A, Klaus D, Lindenberg I, Merle R, Gehlen H.There is contradictory evidence on the potential benefits of tongue ties on upper airway function and their efficacy in inhibiting intermittent dorsal displacement of the soft palate (DDSP) in racehorses. Objective: To test the hypothesis that tongue ties increase the pharyngeal diameter and decrease the occurrence of dynamic airway obstruction in racehorses. Methods: Prospective, crossover blinded clinical study. Methods: Data of 22 Thoroughbred and 8 Standardbred racehorses examined using overground endoscopy under full-intensity exercise on training racetracks with and without fixation of t...
Campos Schweitzer A, Mespoulhès-Rivière C, Möller D, Ducharme N, Genton M, Farfan M, Rossignol F.Selective laryngeal reinnervation using the first and second cervical nerve (C1C2) is a treatment option for recurrent laryngeal neuropathy that aims to restore the function of the cricoarytenoideus dorsalis (CAD) muscle. Despite the technique's satisfying success rate, it has several limitations. These triggered the search for another potential donor nerve that could reduce CAD muscle fatigue and shorten rehabilitation. The ventral branch of the spinal accessory nerve, providing motor innervation to the sternomandibularis (SM) muscle, was identified as a potentially well-adapted nerve. Object...
Lo Feudo CM, Stancari G, Collavo F, Stucchi L, Conturba B, Zucca E, Ferrucci F.Dynamic upper airway obstructions (DUAO) are common in racehorses, but their pathogenetic mechanisms have not been completely clarified yet. Multiple studies suggest that alterations of the pharyngo-laryngeal region visible at resting endoscopy may be predictive of the onset of DUAO, and the development of DUAO may be associated with pharyngeal lymphoid hyperplasia (PLH), lower airway inflammation (LAI) and exercise-induced pulmonary hemorrhage (EIPH). The present study aims to investigate the possible relationship between the findings of a complete resting evaluation of the upper and lower ai...
Lo Feudo CM, Stucchi L, Cavicchioli P, Stancari G, Conturba B, Zucca E, Ferrucci F.To evaluate the association between the severity of dynamic upper airway obstruction (DUAO) and selected fitness parameters in Standardbred racehorses measured by treadmill test. 191 Standardbred racehorses that underwent a standardized diagnostic protocol for poor performance evaluation between 2002 and 2021 at the Veterinary Teaching Hospital, University of Milan. Horses underwent a diagnostic protocol including clinical examination, lameness evaluation, laboratory analyses, ECG, resting upper airway endoscopy, metabolic incremental treadmill test, high-speed treadmill endoscopy, postexercis...
Almonte H, Schumacher J, Johnson CR, Berk JT, Bell RP.To the authors' knowledge, the effect of a combination of butorphanol tartrate and detomidine hydrochloride on the laryngeal function and symmetry of the arytenoid cartilages in young Thoroughbred horses has not been examined. Therefore, this study aimed to examine the effects of administration of butorphanol and detomidine on left-to-right rima glottidis ratio (L:R RGR), cross-sectional area of the rima glottidis (CSARG) and grade of laryngeal function of Thoroughbred yearlings examined endoscopically at rest. Forty-six Thoroughbred yearlings underwent laryngeal video endoscopy, at rest, befo...
Tucker ML, Wilson DG, Reinink SK, Carmalt JL.To characterize the 3-D geometry of the equine larynx replicating laryngeal hemiplegia and 4 surgical interventions by use of CT under steady-state airflow conditions. Secondly, to use fluid mechanic principles of flow through a constriction to establish the relationship between measured airflow geometries with impedance for each surgical procedure. Methods: 10 cadaveric horse larynges. Methods: While CT scans were performed, inhalation during exercise conditions was replicated for each of the following 5 conditions: laryngeal hemiplegia, left laryngoplasty with ventriculocordectomy, left lary...
Broyles AH, Embertson RM, Brett Woodie J, Machado V.There is persistent concern among some trainers, owners and veterinarians regarding the effect of preoperative laryngeal function grade on the outcome of laryngoplasty and ventriculocordectomy (LPVC). Objective: To determine the effect of laryngeal function grade prior to LPVC on postoperative performance. Methods: Retrospective case-series. Methods: Medical and race records of Thoroughbred racehorses diagnosed with recurrent laryngeal neuropathy (RLN) and treated with LPVC between 1998 and 2013 were reviewed. Horses were placed into three groups based on preoperative laryngeal function grade ...
Fitzharris LE, Franklin SH, McConnell AK, Hezzell MJ, Allen KJ.Exercise-induced upper airway collapse (UAC) probably occurs when the stabilising muscles of the upper airway are unable to withstand the dramatic changes in airflow and pressure that occurs during exercise. In racehorses, the mainstay of treatment is surgical intervention. In human athletes, exercise-induced laryngeal obstruction has been treated successfully with inspiratory muscle training (IMT). The aims of this study were: (1) to assess the feasibility of IMT in racehorses; and (2) describe the exercising endoscopy findings pre- and post-IMT in racehorses diagnosed with dynamic UAC. Horse...
Vermedal H, O'Leary JM, Fjordbakk CT, McAloon CG, Løkslett H, Stadsnes B, Fretheim-Kelly ZL, Strand E.The laryngeal tie-forward (LTF) procedure is commonly used to treat intermittent dorsal displacement of the soft palate (iDDSP). There is a wide range in reported efficacy of treating horses with and without a definitive diagnosis of iDDSP. Objective: To evaluate the racing performance of harness racehorses in which iDDSP had been definitely diagnosed and treated solely with the LTF procedure. Methods: Retrospective case series. Methods: Ninety-five harness racehorses were treated with LTF for confirmed iDDSP. A definite diagnosis of iDDSP was made with high-speed treadmill or overground endos...
Caspers MK, Bell CD, Tatarniuk DM.Objective: The objective of this study is to evaluate the safety, efficacy, and owner satisfaction following electrosurgical ventriculocordectomy (EVC), in conjunction with prosthetic laryngoplasty, in equine clinical cases affected with left- or right-sided recurrent laryngeal neuropathy. Methods: Retrospective data analysis of clinical signalment, surgery, athletic outcome, intra- and postoperative complications, and postoperative examinations from clinical cases wherein EVC was performed in conjunction with traditional prosthetic laryngoplasty from one practice. Owners were contacted by pho...
Joó K, Duque Betancourt D, Vasquez Marin T, Parra Moyano LA.The dynamic upper airway functional (URT) problems of Colombian paso horses (CPH) have not been investigated in literature up to date. These horses perform special walking gaits with high poll flexion of the neck. Our goal is to evaluate the upper airway mechanics in CPH, showing abnormal respiratory sounds and poor performance during exercise. Resting and overground endoscopy was performed in 40 CPHs. Statistical analyses were performed using the sciPy package. One-tailed Fisher exact tests were used to check for positive contingency between each pair of upper respiratory tract disorder (P < ...
Steel CM, Walmsley EA, Anderson GA, Coles CA, Ahern B, White JD.As myosin heavy chain (MyHC) profile of muscle fibres is heavily influenced by neural input, changes in MyHC expression are expected in horses clinically affected with recurrent laryngeal neuropathy (RLN) yet, this has not been thoroughly investigated. Objective: To describe the changes in MyHC and fibre diameter in left cricoarytenoideus dorsalis (L-CAD) muscle of horses with clinical signs of RLN. Methods: Observational cohort study. Methods: Immunohistochemistry was used to assess the MyHC-based fibre-type proportion, size and grouping in the L-CAD of 10 Thoroughbred horses, five clinically...
Cercone M, Brown BN, Stahl EC, Mitchell LM, Fortier LA, Mohammed HO, Ducharme NG.Respiratory function in the horse can be severely compromised by arytenoid chondritis, or arytenoid chondropathy, a pathologic condition leading to deformity and dysfunction of the affected cartilage. Current treatment in cases unresponsive to medical management is removal of the cartilage, which can improve the airway obstruction, but predisposes the patient to other complications like tracheal penetration of oropharyngeal content and dynamic collapse of the now unsupported soft tissue lateral to the cartilage. A tissue engineering approach to reconstructing the arytenoid cartilage would repr...
Lynch NP, Jones SA, Bazley-White LG, Wilson ZF, Raffetto J, Pfau T, Cheetham J, Perkins JD.To identify the degree of left arytenoid cartilage (LAC) abduction that allows laryngeal airflow similar to that in galloping horses, assess 2-D and 3-D biomechanical effects of prosthetic laryngoplasty on LAC movement and airflow, and determine the influence of suture position through the muscular process of the arytenoid cartilage (MPA) on these variables. Methods: 7 equine cadaver larynges. Methods: With the right arytenoid cartilage maximally abducted and inspiratory airflow simulated by vacuum, laryngeal airflow and translaryngeal pressure and impedance were measured at 12 incremental LAC...
Fretheim-Kelly Z, Fjordbakk CT, Fintl C, Krontveit R, Strand E.Bits have often been incriminated as a cause of upper respiratory tract obstruction in horses; however, no scientific studies are available to confirm or refute these allegations. Clinical signs of dynamic laryngeal collapse associated with poll flexion (DLC) are induced when susceptible horses are ridden or driven into the bit. Objective: To determine whether use of Dr Cook's™ Bitless Bridle, instead of a conventional snaffle bit bridle, would reduce the severity of DLC in affected horses measured objectively using inspiratory tracheal pressures. Methods: Intervention study using each horse...
Ronaldson HL, Monticelli P, Smith R, Adami C.A 13-year-old Shire horse was anesthetized for an elective orthopedic procedure. During recovery from anesthesia, the occurrence of severe acute dyspnea required a second anesthetic to allow endoscopy-guided nasotracheal intubation. Endoscopic findings were decreased mobility and swelling of the arytenoids with narrowing of the laryngeal aditus. Owing to a dislodgement of the nasotracheal tube during recovery, a third anesthetic was carried out to perform emergency tracheostomy. Recovery from the third anesthetic was long and the horse developed a post-anesthetic myopathy. The clinical conditi...
Miller SM.Endoscopy of thoroughbred (TB) yearlings at public auctions is common in South Africa. Laryngeal function (LF) is a common concern of buyers of young TBs. Cancellation of sale because of LF abnormalities is a concern for both the vendor and the buyer, with recurrent laryngeal neuropathy (RLN) being a common cause of sale cancellation. The aim of this descriptive study was to determine the prevalence of RLN at South African premier TB yearling sales. This study was designed as a retrospective descriptive analysis of upper respiratory tract (URT) endoscopic examinations to determine RLN grade, p...
Grzeskowiak RM, Schumacher J, Mulon PY, Steiner RC, Cassone L, Anderson DE.Rostral laryngeal advancement, also known as laryngeal tie-forward, is used to treat horses for intermittent dorsal displacement of the soft palate and has a morbidity rate of about 6%. We hypothesized that a novel laryngeal clamp would prevent morbidity associated with the sutures tearing through the thyroid cartilage. Larynges (n = 35 horses) were used for ex vivo testing. For uniaxial testing, 15 equine larynges were tested in one of three laryngeal tie-forward constructs [standard laryngeal tie-forward; modified laryngeal tie-forward using a suture-button; and modified laryngeal tie-forwar...
Satoh M, Higuchi T, Inoue S, Miyakoshi D, Kajihara A, Gotoh T, Shimizu Y.Recent studies have assessed the cricoarytenoideus dorsalis muscle (CAD) using transoesophageal ultrasonography in equine recurrent laryngeal neuropathy (RLN). We assessed the CAD using the external transcutaneous ultrasound technique, which may constitute an easier method in horses. Objective: To evaluate ultrasonographic imaging of the left cricoarytenoideus dorsalis muscle (LCAD) and right cricoarytenoideus dorsalis muscle (RCAD) as a diagnostic tool for RLN using the transcutaneous ultrasound technique. Methods: Cross-sectional study. Methods: The axial plane thickness, cross-sectional are...
Toft K, Kjeldsen ST, Otten ND, van Galen G, Fjeldborg J, Sinding M, Hansen S.Flexion of the horse's head and neck during dressage riding reduces the pharyngeal lumen with the risk of increased upper airway resistance and upper airway obstructions. According to the Fédération Equestre Internationale, hyperflexion is achieved through force, whereas the position low-deep-round is nonforced. The objectives of this study were to evaluate (1) applied rein tension and (2) dynamic structural disorders in the upper airways in dressage horses in different gaits and different head-neck positions (HNPs). Overground endoscopy (OGE) and rein tension were evaluated in 13 clinically...
Tucker ML, Sumner D, Reinink SK, Wilson DG, Carmalt JL.To compare laryngeal impedance, in terms of air flow and pressure, following arytenoid corniculectomy (COR) versus 3 other airway interventions (left-sided laryngoplasty with ipsilateral ventriculocordectomy [LLP], LLP combined with COR [LLPCOR], and partial arytenoidectomy [PA]) performed on cadaveric equine larynges with simulated left recurrent laryngeal neuropathy (RLN) and to determine whether relative laryngeal collapse correlated with the interventions performed. Methods: 28 cadaveric equine larynges. Methods: Each larynx in states of simulated left RLN alone and with airway interventio...
Vermedal H, Strand E.To report dynamic laryngeal collapse (DLC) associated with poll flexion as a potential complication of the laryngeal tie-forward procedure (LTFP) in harness racehorses. Methods: Short case series. Methods: Three harness racehorses. Methods: Preoperative and postoperative medical records of all harness racehorses that underwent the LTFP were reviewed, as were high-speed treadmill videoendoscopy recordings of 35 horses that returned for upper airway evaluation postoperatively. Results: One standardbred and two Norwegian coldblooded trotters in which dorsal displacement of the soft palate had bee...
Fretheim-Kelly ZL, Halvorsen T, Clemm H, Roksund O, Heimdal JH, Vollsæter M, Fintl C, Strand E.Dynamic obstructions of the larynx are a set of disorders that occur during exercise in equines and humans. There are a number of similarities in presentation, diagnosis, pathophysiology and treatment. Both equines and humans present with exercise intolerance secondary to dyspnea. During laryngoscopy at rest, the larynx appears to function normally. Abnormalities are only revealed during laryngoscopy at exercise, seemingly triggered by increased ventilatory demands, and quickly resolve after cessation of exercise. Lower airway disease (asthma being the most prevalent condition), cardiac diseas...
Cercone M, Olsen E, Perkins JD, Cheetham J, Mitchell LM, Ducharme NG.Exercise induced intermittent dorsal displacement of the soft palate (DDSP) is a common cause of airway obstruction and poor performance in racehorses. The definite etiology is still unclear, but through an experimental model, a role in the development of this condition was identified in the dysfunction of the thyro-hyoid muscles. The present study aimed to elucidate the nature of this dysfunction by investigating the spontaneous response to exercise of the thyro-hyoid muscles in racehorses with naturally occurring DDSP. Intramuscular electrodes were implanted in the thyro-hyoid muscles of nin...
Dupuis MC, Zhang Z, Durkin K, Charlier C, Lekeux P, Georges M.We used the data from a recently performed genome-wide association study using the Illumina Equine SNP50 beadchip for the detection of copy number variants (CNVs) and examined their association with recurrent laryngeal neuropathy (RLN), an important equine upper airway disease compromising performance. A total of 2797 CNVs were detected for 477 horses, covering 229 kb and seven SNPs on average. Overlapping CNVs were merged to define 478 CNV regions (CNVRs). CNVRs, particularly deletions, were shown to be significantly depleted in genes. Fifty-two of the 67 common CNVRs (frequency ≥ 1%) we...
Duncan ID, Griffiths IR, Madrid RE.A study has been made of the pathological changes in the recurrent laryngeal nerves from horses with clinical and sub-clinical idiopathic laryngeal hemiplegia. Qualitative and quantitative studies showed in clinical cases there was a progressive distal loss of large myelinated fibres in the left recurrent nerve. Regenerating clusters and onion bulbs were frequently seen in affected nerves both at proximal and distal levels. Degenerating axons were characterized by collections of organelles, and denervated bands of Bungner were common. Similar but less severe changes were seen in the left recur...
Dupuis MC, Zhang Z, Druet T, Denoix JM, Charlier C, Lekeux P, Georges M.Recurrent laryngeal neuropathy (RLN) is a major upper-airway disease of horses that causes abnormal respiratory noise during exercise and can impair performance. Etiopathogenesis remains unclear but genetic factors have been suspected for many decades. The objective of this study was to identify risk loci associated with RLN. To that end we genotyped 234 cases (196 Warmbloods, 20 Trotters, 14 Thoroughbreds, and 4 Draft horses), 228 breed-matched controls, and 69 parents with the Illumina Equine SNP50 BeadChip. Using these data, we quantified population structure and performed single-marker and...
Tan RH, Dowling BA, Dart AJ.The purpose of the study was to describe the prevalence of upper airway abnormalities and establish if any significant associations existed between study variables and the two most frequently identified disorders; axial deviation of the aryepiglottic folds and dorsal displacement of the soft palate. The clinical records and video-recordings of all horses referred for upper respiratory tract evaluation during high-speed treadmill videoendoscopy between November 1997 and September 2003 were reviewed. Of 291 horses included in the study, 265 underwent resting endoscopy and 42% (112/265) had a rec...
Brakenhoff JE, Holcombe SJ, Hauptman JG, Smith HK, Nickels FA, Caron JP.(1) To determine the effect of age, height, weight, breed, sex, and specific use on the prevalence of idiopathic left laryngeal hemiplegia (ILH) in a population of draft performance horses; (2) to determine the association between tracheal mucus and laryngeal dysfunction, and the prevalence of exercise-induced pulmonary hemorrhage (EIPH) in a population of draft performance horses. Methods: Cross-sectional. Methods: Draft horses competing at the 2005 Michigan Great Lakes Draft Horse Show. Methods: Endoscopic examinations were performed on horses competing at the 2005 Michigan Great Lakes Draft...
Widmer A, Doherr MG, Tessier C, Koch C, Ramseyer A, Straub R, Gerber V.The objective of this study was to examine the association of pharyngeal lymphoid hyperplasia (PLH), recurrent laryngeal neuropathy (RLN), mucus accumulation (MA) score and tracheobronchial secretion neutrophil percentage (TBS-N) with rider-assessed performance in sport horses. Airway endoscopy scores, tracheobronchial secretion cytology, rider-assessed general impression and willingness to perform were investigated in 171 top-level sport horses. Increased MA appears to be associated with poor willingness to perform in sport horses. Older horses had decreased PLH scores and increased TBS-N. Mu...
Dixon PM, McGorum BC, Railton DI, Hawe C, Tremaine WH, Pickles K, McCann J.Referred cases (n = 375) of laryngeal paralysis (1985-1998) from a mixed-breed equine population included 351 (94%) cases of recurrent laryngeal neuropathy (RLN) (idiopathic laryngeal hemiplegia) and 24 cases (6%) of laryngeal paralysis from causes other than RLN. Laryngeal movements were classified endoscopically into one of 6 grades, in contrast to the usual 4 grades. The RLN cases had a median grade 4 laryngeal paralysis, of which 96% were left-sided, 2% right-sided and 2% bilaterally affected. RLN cases included 204 (58%) Thoroughbred, 96 (27%) Thoroughbred-cross, 23 (7%) draught, 16 (5%) ...
Derksen FJ, Stick JA, Scott EA, Robinson NE, Slocombe RF.The effect of left laryngeal hemiplegia on airway flow mechanics in 5 exercising horses was examined, and the efficacy of surgical repair by prosthetic laryngoplasty was evaluated. Measurements of the upper airway flow mechanics were made with horses on a treadmill (incline 6.38 degrees) while standing (period A); walking at 1.3 m/s (period B); trotting at 2.6 m/s (period C); trotting at 4.3 m/s (period D); and standing after exercise (period E). Experiments were done on healthy horses before any surgical manipulation (control), at 10 days after left recurrent laryngeal neurectomy, and at leas...
Cahill JI, Goulden BE.This light microscopic investigation of 15 Thoroughbred horses provided substantial evidence for the classification of equine laryngeal hemiplegia as a distal axonopathy. Morphologic and morphometric examinations were performed on resin embedded recurrent laryngeal nerves from control, subclinical and clinical laryngeal hemiplegic animals. In the latter group of animals some distal hindlimb nerves were also examined. A distally graded loss of myelinated fibres selectively affecting those of large diameter was demonstrated in both left and right recurrent laryngeal nerves. Morphologic evidence ...
Draper ACE, Piercy RJ.Recurrent Laryngeal Neuropathy (RLN) is a highly prevalent and predominantly left-sided, degenerative disorder of the recurrent laryngeal nerves (RLn) of tall horses, that causes inspiratory stridor at exercise because of intrinsic laryngeal muscle paresis. The associated laryngeal dysfunction and exercise intolerance in athletic horses commonly leads to surgical intervention, retirement or euthanasia with associated financial and welfare implications. Despite speculation, there is a lack of consensus and conflicting evidence supporting the primary classification of RLN, as either a distal ("d...
Kannegieter NJ, Dore ML.Endoscopy of the upper respiratory tract was performed in 100 horses during high speed treadmill exercise. Reasons for endoscopy were a history of an abnormal noise during exercise in 75 horses, poor performance in 17 horses and to evaluate the results of upper respiratory tract surgery in 8 horses. Of the 75 horses with a history of an abnormal noise during exercise the cause was determined in 67 (89%). Endoscopic abnormalities were detected at rest in 40 of these 75 horses (53%). In these 40 horses, a similar diagnosis as to the cause of the abnormal noise was made at rest and during exercis...
Cahill JI, Goulden BE.This study confirmed that neurogenic muscle pathology exists in intrinsic laryngeal muscles supplied by the recurrent laryngeal nerves in horses subclinically and clinically affected with laryngeal hemiplegia. An important additional observation was the occurrence in three out of four laryngeal hemiplegic horses of neurogenic muscle changes in a hindlimb muscle, the extensor digitorum longus, a muscle supplied by another long peripheral nerve. This finding suggests that a polynenropathy exists in laryngeal hemiplegic horses, and supports the classification of this disease as a distal axonopath...
Stick JA, Peloso JG, Morehead JP, Lloyd J, Eberhart S, Padungtod P, Derksen FJ.To compare endoscopic findings of the upper portion of the respiratory tract in Thoroughbred yearlings with their subsequent race records to determine whether subjective assessment of airway function may be used as a predictor of future racing performance. Methods: Retrospective study. Methods: 427 Thoroughbred yearlings. Methods: Endoscopic examination findings were obtained from the medical records and the videoendoscopic repository of the Keeneland 1996 September yearling sales. Racing records were requested for the yearlings through the end of their 4-year-old racing season (1997-2000). Tw...
Franklin SH, Naylor JR, Lane JG.Videoendoscopy of the upper respiratory tract (URT) during high-speed treadmill exercise has proved to be invaluable in the assessment of URT dysfunction in racehorses. However, very little information exists regarding dynamic airway collapse in other sport horses used in nonracing equestrian disciplines. Objective: To evaluate the videoendoscopic findings at rest and during exercise in a mixed population of sport horses referred for investigation of poor athletic performance and/or abnormal respiratory noise. Methods: Videoendoscopy of the upper airway was performed at rest and during high-sp...
Strand E, Fjordbakk CT, Holcombe SJ, Risberg A, Chalmers HJ.Dynamic laryngeal collapse (DLC) associated with poll flexion is a newly diagnosed upper respiratory tract obstructive disorder that causes poor racing performance. Objective: To determine if Norwegian Coldblooded Trotters (NCTs) affected with DLC associated with poll flexion differ from normal, elite NCTs based on simple airway mechanics measurements. Methods: Five normal elite NCTs and 6 NCTs diagnosed previously with DLC underwent treadmill videoendoscopy while tracheal pressures were measured continuously. Alternating head positions were used such that horses were exercised with free head ...
Sweeney CR, Maxson AD, Soma LR.The frequency of upper respiratory tract abnormalities was determined in a selected population of racing Thoroughbreds. The prevalence of pharyngeal lymphoid hyperplasia was 34.2%; left laryngeal hemiplegia was 1.8%; and epiglottic entrapment was 0.74%. Excluding pharyngeal lymphoid hyperplasia and tracheal exudate, 3.7% of the population examined had upper respiratory tract abnormalities.
Brooks SA, Stick J, Braman A, Palermo K, Robinson NE, Ainsworth DM.Equine recurrent laryngeal neuropathy (RLN) is a bilateral mononeuropathy with an unknown etiology. In Thoroughbreds (TB), we previously demonstrated that the haplotype association for height (LCORL/NCAPG locus on ECA3, which affects body size) and RLN was coincident. In the present study, we performed a genome-wide association scan (GWAS) for RLN in 458 American Belgian Draft Horses, a breed fixed for the LCORL/NCAPG risk alelle. In this breed, RLN risk is associated with sexually dimorphic differences in height, and we identified a novel locus contributing to height in a sex-specific manner:...
Adreani CM, Li ZB, Lehar M, Southwood LL, Habecker PL, Flint PW, Parente EJ.The myosin heavy chain (MHC) composition of a given muscle determines the contractile properties and, therefore, the fiber type distribution of the muscle. MHC isoform expression in the laryngeal muscle is modulated by neural input and function, and it represents the cellular level changes that occur with denervation and reinnervation of skeletal muscle. The objective of this study was to evaluate the pattern of MHC isoform expression in laryngeal muscle harvested from normal cadavers and cadavers with naturally occurring left laryngeal hemiplegia secondary to recurrent laryngeal neuropathy. L...
Lane JG, Bladon B, Little DR, Naylor JR, Franklin SH.The reliability of diagnoses of obstructive conditions of the upper respiratory tract (URT) based on examinations performed at rest vs. at exercise is controversial. Objective: To compare diagnosis of URT by endoscopy at rest with that achieved during high-speed treadmill exercise (HSTE). Objective: Endoscopy of URT at rest, when performed in isolation from other simpler techniques is unreliable in the prediction of dynamic respiratory obstructions. Methods: Endoscopic findings of 600 Thoroughbred racehorses during quiet breathing were compared with findings during high-speed treadmill exercis...
Hahn CN, Matiasek K, Dixon PM, Molony V, Rodenacker K, Mayhew IG.Recurrent laryngeal neuropathy (RLN) is a common and debilitating peripheral nerve disease of horses, but it remains unclear if this disease is a mono- or polyneuropathy. An understanding of the distribution of the neuropathological lesions in RLN affected horses is fundamental to studying the aetiology of this very significant disease of tall horses. Objective: To determine whether RLN should be classified as a mono- or polyneuropathy. Methods: Multiple long peripheral nerves and their innervated muscles were examined systematically in 3 clinically affected RLN horses Results: Severe lesions ...
Dixon PM, McGorum BC, Railton DI, Hawe C, Tremaine WH, Pickles K, McCann J.Examination of the long-term histories and clinical findings was performed in 351 horses suffering from recurrent laryngeal neuropathy (RLN) to examine for possible evidence of progression of this disorder. Fifty-two out of 351 cases (15%) had evidence of progression of the degree of laryngeal dysfunction over a median period of 12 months (range 1.5-48 months) with the onset of progression occurring at median age 7 years. In 30 cases, there was both endoscopic (median deterioration of 3 endoscopic grades; range 1-5 grades) and clinical evidence, with 29 (97%) of these horses concurrently devel...
Parente EJ, Martin BB, Tulleners EP, Ross MW.To evaluate the occurrence of dorsal displacement of the soft palate (DDSP) during high-speed treadmill (HSTM) exercise in racehorses, and determine treatment efficacy relative to the endoscopic findings observed during resting and HSTM endoscopic examination. Methods: Retrospective study. Animals-Ninety-two racehorses (74 Thoroughbreds, 18 Standardbreds). Methods: The signalment, history (clinical and race), treatments, and video recordings made during resting and HSTM endoscopy were reviewed in 92 racehorses that developed DDSP during HSTM exercise. Only horses that completed 3 starts before...
Rhee HS, Steel CM, Derksen FJ, Robinson NE, Hoh JF.We used immunohistochemistry to examine myosin heavy-chain (MyHC)-based fiber-type profiles of the right and left cricoarytenoideus dorsalis (CAD) and arytenoideus transversus (TrA) muscles of six horses without laryngoscopic evidence of recurrent laryngeal neuropathy (RLN). Results showed that CAD and TrA muscles have the same slow, 2a, and 2x fibers as equine limb muscles, but not the faster contracting fibers expressing extraocular and 2B MyHCs found in laryngeal muscles of small mammals. Muscles from three horses showed fiber-type grouping bilaterally in the TrA muscles, but only in the le...
Rakestraw PC, Hackett RP, Ducharme NG, Nielan GJ, Erb HN.Endoscopic examinations of the larynx were recorded on 49 horses at rest and while exercising on a 5% inclined high-speed treadmill for 8 minutes at a maximum speed of 8.5 m/sec. Subjective laryngeal function scores at rest and while exercising were based on the degree and synchrony of arytenoid abduction. Arytenoid abduction was expressed as a left:right ratio of rima glottidis measurements. Horses with arytenoid cartilage asynchrony at rest (grade 2) could not be distinguished from normal horses (grade 1) when exercising because full abduction was maintained throughout the exercise period. F...
Hackett RP, Ducharme NG, Fubini SL, Erb HN.Videorecordings of the laryngeal activity of 108 unsedated horses were obtained at rest by passing a flexible videoendoscope into the nasopharynx through the right ventral meatus. All videotaped images were reviewed once, and 72 were reviewed twice, by three veterinarians. Laryngeal cartilage movement was assessed subjectively with a five-tier grading system. The mean intraobserver agreement was 83.3% (range, 75.0%-90.2%) with a kappa statistic of .65 to .98. The mean interobserver agreement was 79.0% (range, 70.4%-80.6%) with a kappa statistic of .51 to .90. A computer program was developed t...
Greet TR.This paper describes the outcome of treatment of 30 cases of guttural pouch mycosis by ligation of the internal carotid artery on the cardiac side of the lesion and lavage of the affected pouch with natamycin. Twenty-three horses recovered fully following this treatment while laryngeal hemiplegia persisted in one case and slight dysphagia caused by pharyngeal hemiplegia in another. The remaining five horses died or were destroyed. Five horses with guttural pouch mycosis, which had shown no epistaxis but had pharyngeal hemiplegia, were treated by topical natamycin alone. Only two of these survi...
Cahill JI, Goulden BE.Individual nerve fibres were isolated from the recurrent laryngeal and some distal hindlimb nerves, in an investigation of equine laryngeal hemiplegia. One hundred teased fibres were obtained from each of three sampling sites on both left and right recurrent laryngeal nerves, from 15 Thoroughbred horses. These fibres were graded descriptively and internode lengths measured. A distal distribution of pathology was demonstrated in all groups studied, but was most severe in the clinical group of horses. The predominant change was one of short thinly myelinated internodes interspersed amongst norma...
Chalmers HJ, Cheetham J, Yeager AE, Ducharme NG.Nasopharyngeal and laryngeal evaluation is important when examining horses with upper airway signs for poor performance. Currently endoscopy is the most common method to evaluate the equine upper airway. Ultrasonography of the equine larynx has not previously been described. Using six cadaveric specimens and four standing horses, the ultrasonographic appearance of the equine larynx was established. A scanning technique, including useful acoustic windows and the normal ultrasonographic appearance at each site, is described. Ultrasound allowed visualization of portions of the hyoid apparatus, la...
Cheetham J, Perkins JD, Jarvis JC, Cercone M, Maw M, Hermanson JW, Mitchell LM, Piercy RJ, Ducharme NG.Bilateral vocal fold paralysis (BVCP) is a life-threatening condition that follows injury to the Recurrent Laryngeal nerve (RLn) and denervation of the intrinsic laryngeal musculature. Functional electrical stimulation (FES) enables restoration and control of a wide variety of motor functions impaired by lower motor neuron lesions. Here we evaluate the effects of FES on the sole arytenoid abductor, the posterior cricoarytenoid (PCA) muscle in a large animal model of RLn injury. Ten horses were instrumented with two quadripolar intramuscular electrodes in the left PCA muscle. Following a 12-wee...
