Racing Performance in 72 Racehorses Treated with Prosthetic Laryngoplasty for Laryngeal Hemiplegia

The purpose of this study was to compare racing performance before and after prosthetic laryngoplasty for treatment of laryngeal hemiplegia in inexperienced (horses without at least one start before surgery) and experienced (horses with at least one start before surgery) Thoroughbred and Quarter Horse racehorses. Medical records of 54 Thoroughbred and 18 Quarter Horse racehorses or horses intended for racing treated with prosthetic laryngoplasty and unilateral ventriculectomy for laryngeal hemiplegia were reviewed. Signalment, age at the time of surgery, resting endoscopic grade of laryngeal function, surgical procedure, and type of suture were recorded. Median performance index (PI), earnings, distance, and Beyer speed figure (BSF) per start for three races before and after surgery were compared, and factors associated with improved postsurgical performance were evaluated. Seventy-three percent of horses that had not raced before surgery and 84% of horses that competed in at least one race before surgery were able to return to racing after surgery. Fifty-nine percent and 27% of Thoroughbreds and Quarter Horses, respectively, were able to improve their PI after surgery. Sixty-two percent and 20% of Thoroughbreds and Quarter Horses, respectively, significantly increased their distance after surgery. Additionally, 61% and 66% of racehorses were able to increase their earnings and BSF after surgery, respectively. Horses treated with laryngoplasty and unilateral ventriculectomy have a good prognosis for return to racing. Inexperienced racehorses have a better prognosis for improvement after surgery than do experienced racehorses. Thoroughbred racehorses have a better success rate than Quarter Horse racehorses.     

Career racing performance in Thoroughbreds treated with prosthetic laryngoplasty for laryngeal neuropathy: 52 cases (1981-1989)

OBJECTIVE: To compare racing performance before and after prosthetic laryngoplasty for treatment of laryngeal neuropathy in inexperienced and experienced Thoroughbred racehorses. DESIGN: Retrospective study. ANIMALS: 52 Thoroughbred racehorses treated with prosthetic laryngoplasty for laryngeal neuropathy. PROCEDURE: Lifetime race records were analyzed by use of a verified regression model. Individual race records and hospital records were also reviewed. RESULTS: Experienced horses had a decline in performance, as measured by performance index, earnings percentage, and mean prediction error, during the 6-month period before prosthetic laryngoplasty. Performance improved after surgery, relative to performance in 1 to 4 races immediately before surgery, but did not attain previous baseline values for performance index and earnings percentage, although racing speed was restored to baseline values. Factors associated with failure to attain baseline levels of performance included other racing-related injuries and disorders, major complications of surgery, and age. Individually, however, many horses had long and successful careers after surgery. Performance of inexperienced horses after surgery was at least equal to that of experienced horses. CONCLUSIONS AND CLINICAL RELEVANCE: In addition to warning clients of the complications associated with prosthetic laryngoplasty, it may be prudent to provide a guarded prognosis for full restoration of racing performance in older horses, unless they are especially talented and are free of other racing-related problems.     

The effect of recurrent laryngeal neurectomy in conjunction with laryngoplasty and unilateral ventriculocordectomy in thoroughbred racehorses

OBJECTIVE: To investigate the effects of recurrent laryngeal neurectomy (RLN) in combination with laryngoplasty and ventriculocordectomy on the postoperative performance of Thoroughbred racehorses treated for grade III left laryngeal hemiparesis (LLH). STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Fifty-five Thoroughbred racehorses. METHODS: Medical records for Thoroughbred racehorses treated surgically by laryngoplasty and laser ventriculocordectomy with or without RLN between June 1993 and December 1996 were reviewed. Outcome was evaluated subjectively by assessment of performance obtained from telephone interviews with owners and trainers, and objectively by assessment of racing performance for 3 races before and after surgery using a performance index (PI). RESULTS: Fifty-five Thoroughbred racehorses with resting endoscopic grade III LLH were treated by laryngoplasty and ventriculocordectomy either with (39 horses) or without (16 horses) RLN. For RLN horses, respondents for 38 horses believed performance was improved in 19 horses, unchanged in 16 horses, and decreased in 3 horses. For horses without RLN, respondents for 9 horses reported that performance was improved in 5 horses, unchanged in 2 horses, and decreased in 2 horses. PI scores were improved in 18 RLN horses and in 6 horses without RLN; there was no statistical difference in outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Use of RLN in combination with laryngoplasty and ventriculocordectomy for treatment of grade III LLH may not improve postoperative racing performance.     

Race Performance After Laryngoplasty and Ventriculocordectomy in National Hunt Racehorses

Objective— To evaluate the effect of laryngoplasty (LP) on race performance in longer distance (National Hunt) Thoroughbred racehorses. Study Design— Case‐control study. Animals— National Hunt Thoroughbred racehorses (n=71) and race‐matched controls (n=126). Methods— Race records for National Hunt racehorses that had LP and ventriculocordectomy were analyzed and racing performance was compared with race‐matched controls. Results— Sixty‐three of 71 cases were matched with controls. Postoperatively, 78% of cases raced, 47% improved their individual performance and cases were as likely to start in 1 or 3 races as controls. In the 5 preoperative races, case horses earned less prize money than race‐matched controls but there was no difference in prize money earned in 5 postoperative races between groups. Cases started in significantly fewer total (lifetime) races both before and after the date of surgery compared with controls. Conclusions— LP seemingly restored short‐term postoperative racing performance of National Hunt horses to a level comparable with that of a matched control population; however, the career “longevity” of case horses appears to be shorter than that of control horses. Clinical Relevance— LP appears to be a suitable treatment for recurrent laryngeal neuropathy in National Hunt racehorses.     

Laryngeal Hemiplegia in Draft Horses A Review of 27 Cases

Case records of 27 draft horses with laryngeal hemiplegia were reviewed. Twenty-one horses were treated by ventriculectomy with or without prosthetic laryngoplasty, and 17 owners were contacted to determine the results. Fifteen horses improved after surgery and were able to perform to the owners' expectations. Performance improved significantly and hospitalization was shorter after ventriculectomy alone. Results of this study indicate that the clinical signs of exercise intolerance and excessive inspiratory noise associated with left laryngeal hemiplegia in draft horses can be treated successfully by ventriculectomy without prosthetic laryngoplasty.     

Performance after partial arytenoidectomy without mucosal closure in 27 Thoroughbred racehorses

OBJECTIVE: To examine the effect of partial arytenoidectomy without mucosal closure on postoperative racing performance and long-term complications in Thoroughbred racehorses treated for laryngeal hemiplegia, arytenoid chondropathy, or failed laryngoplasty. STUDY DESIGN: Retrospective study. ANIMALS: Twenty-seven Thoroughbred racehorses. METHODS: Medical records of Thoroughbred racehorses that had partial arytenoidectomy without mucosal closure between 1992 and 2002 were reviewed. Horses were divided into groups: horses that had not raced (Group 1) and those that had raced (Group 2) before surgery. Lifetime race records were compared between groups. A standard starts index (SSI) and performance index (PI) were used for Groups 1 and 2, respectively, to objectively evaluate each horse's postoperative performance. Telephone interviews of owners and trainers were used for subjective performance evaluation and to determine prevalence of long-term complications. RESULTS: Eleven (61%) Group 1 and 7 (78%) Group 2 horses raced and earned money after surgery. All Group 1 horses that raced performed at a level lower than the national average. Only 1 Group 2 horse had an improved PI score postoperatively. CONCLUSIONS: Thoroughbred racehorses have a fair prognosis for racing successfully after partial arytenoidectomy without mucosal closure. CLINICAL RELEVANCE: This technique may be a practical alternative to primary mucosal closure, would decrease surgical time, and avoid some problems reported with primary mucosal closure.     

Postoperative Race Performance is Not Correlated with Degree of Surgical Abduction After Laryngoplasty in National Hunt Thoroughbred Racehorses

Objectives— To (1) assess the degree of arytenoid cartilage abduction lost after laryngoplasty (LP) in Thoroughbred National Hunt racehorses and (2) to correlate postoperative racing performance with degree of arytenoid abduction after LP. Study Design— Case series. Animals— National Hunt Thoroughbred racehorses (n=68). Methods— Grade of postoperative arytenoid abduction for National Hunt racehorses that had LP with ventriculocordectomy was assessed at 1 day, 6 days, and 6 weeks after LP. Race records were analyzed to ascertain if there was correlation between the degree of arytenoid cartilage abduction and various measures of race performance (return to racing postoperatively, total earnings in 5 races immediately postoperatively, and lifetime number of starts postoperatively). Results— Median postoperative arytenoid abduction was grade 2 on day 1 but had decreased to grade 3 by 6 weeks. Horses with grades 1, 2, and 3 abduction 1 day after surgery had median losses of 1, 1, and 0.5 abduction grades, respectively, at 6 weeks. Horses with grade 1 abduction on day 1 were significantly more likely to lose abduction by day 6 after surgery than horses with grade 3 abduction on day 1. There was no statistically significant correlation between the postoperative grade of arytenoid abduction at any time point and earnings in 5 races after surgery, likelihood of racing postoperatively, or total number of lifetime race starts postoperatively. Conclusions— Horses with maximal (grade 1) surgical arytenoid abduction are significantly more likely to suffer postoperative loss of abduction than those with grade 3 abduction. Postoperative grade of abduction does not appear significantly correlated with markers of racing performance in National Hunt racehorses; however, very few horses with poor (grade 4 or 5) abduction were included and thus conclusions regarding racing performance in such horses cannot be drawn from this study. Clinical Relevance— Seemingly, most horses with grade 3 laryngeal abduction can race successfully and perhaps surgeons should not be disillusioned by the appearance of only moderate (grade 3) abduction in the long term after LP in racehorses.     

Long-term study of partial arytenoidectomy with primary mucosal closure in 76 Thoroughbred racehorses (1992-2006)

REASON FOR PERFORMING STUDY: The effectiveness and best method to perform a partial arytenoidectomy in racehorses is unclear. This study was performed to evaluate the success of and complications that can occur after a unilateral partial arytenoidectomy with primary mucosal closure in Thoroughbred racehorses. HYPOTHESIS: Partial arytenoidectomy is an effective surgical procedure to return Thoroughbred racehorses, afflicted by arytenoid chondropathy or a failed laryngoplasty, to preoperative levels of performance. METHODS: Seventy-six Thoroughbred racehorses admitted to the New Bolton Centre between 1992 and 2006 were assessed. Information was obtained from the medical records about the horse, laryngeal abnormalities, surgery and other findings during hospitalisation. Racing information was evaluated relative to those independent variables by an analysis of variance with a level of significance of P<0.05. RESULTS: Arytenoid chondropathy was the presenting complaint in 54 horses and failed laryngoplasty in 22 horses. Thirteen horses (17%) underwent a second surgery for laser excision of intralaryngeal granulation tissue at the arytenoidectomy site. Seventy-three horses were discharged from the hospital and racing outcome was evaluated. Sixty horses (82%) raced after surgery and 46 horses (63%) raced 5 or more times after surgery. The median time from surgery to the first start was 6 months. The average earnings/start was not significantly different before and after surgery. There was no association between earnings after surgery and age, gender, location of lesion, type of lesion, duration of tracheal intubation or undergoing a second surgery. CONCLUSIONS AND POTENTIAL RELEVANCE: A Thoroughbred racehorse is likely to race after a unilateral partial arytenoidectomy with primary mucosal closure and return to a preoperative level of performance.     

Use of successive dynamic videoendoscopic evaluations to identify progression of recurrent laryngeal neuropathy in three horses

CASE DESCRIPTION: 3 racehorses were evaluated because of poor performance or abnormal noise originating from the upper portion of the respiratory tract. CLINICAL FINDINGS: During maximal exercise, initial dynamic videoendoscopy of the upper respiratory tract revealed complete arytenoid cartilage abduction in 2 horses and incomplete but adequate abduction of the left arytenoid cartilage in 1 horse. Subsequent exercising endoscopic evaluation revealed severe dynamic collapse of the left arytenoid cartilage and vocal fold in all 3 horses. TREATMENT AND OUTCOME: 2 horses were treated with prosthetic left laryngoplasty and raced successfully. One horse was retired from racing. CLINICAL RELEVANCE: Idiopathic laryngeal hemiplegia can be a progressive disease. Successive dynamic videoendoscopic upper airway evaluations were used to confirm progression of left laryngeal hemiplegia in these 3 horses. Videoendoscopy of the upper respiratory tract during exercise should be considered as part of the clinical evaluation of horses with signs of upper respiratory tract dysfunction.     

Management of arytenoid chondropathy and failed laryngoplasty in horses: 75 cases (1979-1985)

By use of endoscopy, 75 horses with respiratory noise and/or exercise intolerance were determined to have structural arytenoid cartilage abnormalities (60 primary, 11 after previous laryngeal surgery), or failed left laryngoplasty (4 horses) for laryngeal hemiplegia in which the arytenoid cartilage still appeared normal. Eighty-eight percent of the horses were either Thoroughbred (54 horses; 72%) or Standardbred (12 horses; 16%) racehorses; only 9 horses (12%) had occupations not related to racing. Seventy-six percent of the racehorses were 2 to 4 years old; all non-racehorses were greater than 4 years old. The male:female ratio was approximately 2:1. Of the horses with cartilage abnormalities, 28 had left-sided involvement, 22 had right-sided involvement, and 21 had bilateral involvement. Sixty-two arytenoidectomies were performed, 58 for cartilage abnormalities (22 left, 19 right, 17 bilateral), and 4 for failed left laryngoplasties. Overall, 45% of the Thoroughbred racehorses that returned to racing after arytenoidectomy raced successfully (50% left, 75% right, 22% bilateral); only 20% of the Standardbreds were able to race. Seventy-five percent of non-racehorses were able to return to their previous use. Many horses were retired intentionally after surgery.     

Treatment of laryngeal hemiplegia in horses by prosthetic laryngoplasty, ventriculectomy and vocal cordectomy

The medical records of 80 horses treated for left laryngeal hemiplegia by prosthetic laryngoplasty, ventriculectomy and vocal cordectomy were examined, first to compare the subjective and objective success rates for groups of horses of different ages and used for different purposes, and secondly, to compare the efficacy of including vocal cordectomy in the surgical protocol with published success rates for laryngoplasty and ventriculectomy alone. Subjectively, 70 per cent of the horses were said to have had a successful surgical outcome. The success rate for thoroughbred racehorses (66 per cent) was lower than for other breeds (90 per cent) on the basis of a subjective assessment by owners and trainers. Thoroughbreds two years old or younger had a success rate of 69 per cent, but older thoroughbreds had a success rate of 61 per cent. Of the 17 horses for which an objective performance index could be calculated, 10 (59 per cent) had an improved performance postoperatively. There was a nearly significant association between the objective and subjective assessments (P=0.078). Six of 69 horses (8.7 per cent) continued to make a respiratory noise after surgery. The subjective assessment of success did not appear to correlate with the objective measure of success used in this study and age had no apparent association with a successful surgical outcome. Inclusion of a vocal cordectomy in the surgical protocol may be more important in the eradication of postoperative respiratory noise than in improving clinical success rates.     

Ventriculocordectomy as the sole treatment for recurrent laryngeal neuropathy: long-term results from ninety-two horses

OBJECTIVE: To evaluate the effect ventriculocordectomy (VC) for treatment of recurrent laryngeal neuropathy (RLN) on exercise performance and owner satisfaction in a mixed-breed population of horses. STUDY DESIGN: Retrospective study. ANIMALS: Adult horses (n=92) with a history of abnormal respiratory noise and RLN. METHODS: Retrospective analysis of horse that had unilateral VC (and contralateral ventriculectomy in 63 horses) for treatment of idiopathic RLN. Owners/trainers completed a questionnaire about complications and outcome at least 1 year after surgery. Performance index was determined using race records for previously raced Thoroughbreds to evaluate outcome. RESULTS: Clinical signs included abnormal exercise-induced respiratory noises (noises; 52%), poor performance (11%), and noises and poor performance (37%). The median preoperative resting endoscopic grade of laryngeal function was Havemeyer grade III.1 (mild asymmetry). No discharge from the laryngotomy 1 week postoperatively occurred in 62% horses, 22% coughed after surgery, 66% made no noises, 9% continued to make noises at the canter, 21% made noise at the gallop, and 4% of owners were unsure whether noises were present. Ninety-three percent of horses returned to full work after surgery. Overall, 86% of owners considered the surgery worthwhile, 3% did not consider it worthwhile, and 11% were unsure. Surgery had a significantly beneficial effect on the racing performance index in Thoroughbreds (P=.004). CONCLUSIONS: VC is a useful alternative to laryngoplasty for selected cases of RLN and is associated with a positive effect on exercise performance, a low postoperative complication rate, and a high rate of owner satisfaction. CLINICAL RELEVANCE: Unilateral VC should be considered as a sole treatment in horses with low grades of RLN.     

Racing performance after combined prosthetic laryngoplasty and ipsilateral ventriculocordectomy or partial arytenoidectomy: 135 Thoroughbred racehorses competing at less than 2400 m (1997–2007)

Reasons for performing study: The success of combined prosthetic laryngoplasty with ipsilateral ventriculocordectomy (LPVC) has not been compared to that of partial arytenoidectomy (PA) in a clinical population. Hypotheses: In Thoroughbred (TB) racehorses: 1) earnings after LPVC are unaffected by the severity of recurrent laryngeal neuropathy (RLN) (laryngeal grade III vs. grade IV); 2) LPVC and PA yield similar results in the treatment of grade III RLN; 3) performance outcome following PA is independent of diagnosis (RLN vs. unilateral arytenoid chondritis [UAC]); and 4) neither LPVC nor PA returns horses to the level of performance of controls. Methods: Medical and racing records of 135 TB racehorses undergoing LPVC or PA for the treatment of grade III or IV RLN or UAC were reviewed. Racing records of age and sex matched controls were also reviewed. Results: After LPVC, horses with grade III RLN performed better compared to those with grade IV RLN. Furthermore, horses treated for grade III RLN by LPVC showed post operative earnings comparable to controls. Rate of return to racing were similar for PA and LPVC, although LPVC resulted in higher post operative earnings. Performance after PA was similar regardless of diagnosis (UAC or RLN). Finally, neither LPVC when performed for grade IV RLN, nor PA performed for either diagnosis restored post operative earnings to control levels. Conclusions: Thoroughbred racehorses treated by LPVC for grade III RLN show significantly better post operative earnings compared to horses treated for grade IV disease. In grade III RLN, LPVC returns earning potential to control levels. PA and LPVC lead to similar success in terms of rate of return to racing, but PA leads to inferior earnings after surgery. Potential relevance: Laryngoplasty should be recommended for all TB racehorses with grade III RLN to maximise return to racing at a high level. This contradicts the common approach of waiting for complete paralysis.     

Sternothyroideus Tenectomy Combination Surgery: Treatment Outcome in 95 Thoroughbred Racehorses (1996–2006)

This retrospective case series reports on the clinical experiences of a group of Thoroughbred racehorses in training that were treated surgically for intermittent dorsal displacement of the soft palate (DDSP) using sternothyroideus tenectomy in combination with soft palate surgery. The 95 horses included in the study were Thoroughbred racehorses in training referred for surgical treatment of intermittent DDSP over a 10-year period. Return to racing was 94% (89/95). Total earnings increased for up to three starts before and after surgery in 65% of horses (62/95, P= .0006). Of the 58 horses that raced in three or more races before and after surgery, 71% (41/58) improved their total earnings. Mean days to first start were 106 days. Performance index improved in 64% of these horses (37/58). Sixty of the 95 horses (63%) raced in six or more races after surgery. Sternothyroideus tenectomy combination surgery had a good prognosis for improving earnings and performance index after surgery in this group of horses that were treated for a working diagnosis of intermittent DDSP.     

Surgical and nonsurgical management of sagittal slab fractures of the third carpal bone in racehorses: 32 cases (1991-2001)

OBJECTIVE: To compare results (ie, return to racing and earnings per race start) of surgical versus nonsurgical management of sagittal slab fractures of the third carpal bone in racehorses. DESIGN: Retrospective study. ANIMALS: 32 racehorses (19 Thoroughbreds, 11 Standardbreds, and 2 Arabians). PROCEDURE: Medical records and radiographs were reviewed to obtain information regarding signalment and treatment. Follow-up information was obtained from race records. Robust regression analysis was performed to evaluate earnings per start in horses that raced at least once before and after injury. RESULTS: 22 (69%) horses raced at least once after treatment of the fracture. All 7 horses treated by means of interfragmentary compression raced after treatment, and horses that underwent interfragmentary compression had significantly higher earnings per start after the injury than did horses treated without surgery. Eight of 9 horses treated by means of arthroscopic debridement of the damaged cartilage and bone raced after treatment, but only 7 of 16 horses treated without surgery (ie, stall rest) were able to return to racing after treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that racehorses with sagittal slab fractures of the third carpal bone have a favorable prognosis for return to racing after treatment. Horses treated surgically were more likely to race after treatment than were horses treated without surgery.     

Sternothyroideus myotomy, staphylectomy, and oral caudal soft palate photothermoplasty for treatment of dorsal displacement of the soft palate in 102 thoroughbred racehorses

Objective— To compare racing performance before and after sternothyroideus myotomy, staphylectomy, and oral caudal soft palate photothermoplasty in Thoroughbred racehorses with intermittent dorsal displacement of the soft palate (DDSP).
Study Design— Retrospective study.
Animals— Thoroughbred racehorses (n=102) with DDSP.
Methods— Retrieved data included signalment, primary complaint, and upper respiratory tract endoscopic finding. Lifetime race records were compared for earnings per start before and after surgery, days to 1st start, and races won postoperatively.
Results— Comparing mean earnings per start for 3 races before ($2792) and after ($3806) surgery, racing performance improved significantly after surgery in 63% (46/73) of horses that competed in at least 1 race before and after surgery ( P =.02). Mean and median days to 1st start after surgery were 109 and 69 days, respectively. Of horses that raced postoperatively 65% (60/92) won at least 1 race, and 77% (71/92) raced in >5 races after surgery.
Conclusions— Sternothyroideus myotomy, staphylectomy, and oral caudal soft palate photothermoplasty significantly improved racing performance in experienced Thoroughbred racehorses with performance limiting DDSP, and overall had a similar outcome to other reported surgical techniques for treatment of DDSP.
Clinical Relevance— Sternothyroideus myotomy, staphylectomy, and oral caudal soft palate photothermoplasty should be considered as a surgical approach to correction of DDSP in Thoroughbred racehorses; however, it is possible that staphylectomy may not be necessary to achieve a desirable outcome.     

Racing performance after arthroscopic removal of apical sesamoid fracture fragments in Thoroughbred horses age > or = 2 years: 84 cases (1989-2002)

REASONS FOR PERFORMING STUDY: Studies have shown that surgical removal of apical fracture fragments in Standardbred racehorses carries the best prognosis for return to racing performance, but there are no reports involving mature Thoroughbred (TB) racehorses. OBJECTIVES: To describe the incidence of apical proximal sesamoid fractures in TB racehorses and determine probability and quality of racing performance after arthroscopic removal of such fractures in TB racehorses age > or = 2 years. METHODS: Medical records and pre- and post operative race records of TB racehorses age > or = 2 years that underwent arthroscopic surgery for removal of apical proximal sesamoid fracture fragments were reviewed. RESULTS: Sixty-four percent of fractures occurred in the hindlimbs and 36% in the forelimbs. Horses with forelimb fractures had a reduced probability of return to racing (67%) compared to those with hindlimb fractures (83%), but the majority (77%) of treated horses recovered to return to race post operatively. Horses with medial forelimb fractures raced at only a 47% rate; those with suspensory desmitis at 63%. Unlike Standardbreds, there was no difference in probability of racing post operatively between horses that had, and had not, raced preoperatively. CONCLUSIONS: Data show that arthroscopic removal of apical proximal sesamoid fracture fragments is successful at restoring ability to race in skeletally mature TB horses without evidence of severe suspensory ligament damage. Prognosis for return to racing is excellent (83%) in horses with hindlimb fractures and good (67%) in those with forelimb fractures. Medial fractures of the forelimb have the worst prognosis. POTENTIAL RELEVANCE: The determination of prognosis for differing sites in TB racehorses should increase knowledge of apical proximal sesamoid bone fractures and improve communication from veterinarian to owner, and trainer, on the potential for arthroscopic restoration of the ability to race.     

Qualitative and quantitative documentation of the racing performance of 461 Thoroughbred racehorses after arthroscopic removal of dorsoproximal first phalanx osteochondral fractures (1986-1995)

The purpose of this study was to examine the longevity of postoperative careers and quality of performance of 461 Thoroughbred racehorses after arthroscopic removal of dorsoproximal first phalanx (P1) osteochondral fractures. Six hundred and 59 dorsoproximal P1 chip fractures were removed arthroscopically from 574 joints in 461 horses presented for lameness or decreased performance attributed to the chip fractures. Radiological and arthroscopic examination revealed an average of 1.43 fragment sites/horse, 1.15 fragment sites/joint and 1.25 affected joints/horse. Eighty-nine percent of the horses (411/461) raced after surgery and 82% (377/461) did so at the same or higher class. Fifty horses did not race after surgery. Sixty-eight percent of the horses raced in a Stake or Allowance race postoperatively. Data, previously undocumented, establishes that the quantity and quality of performance is not diminished after arthroscopic treatment of dorsoproximal P1 fragmentation. Surgical removal of chip fractures is a means of preserving the economic value of an injured Thoroughbred, allowing a rapid and successful return to racing at the previous level of racing performance.     

Excision of Intralaryngeal Granulation Tissue in 25 Horses Using a Neodymium:YAG Laser (1986 to 1991)

Granulation tissue masses arising from the axial surface of the arytenoid cartilage in 25 horses were excised using a contact neodymium:yttrium aluminum garnet laser. A technique that eliminated the need for general anesthesia or laryngotomy was developed for transen-doscopic removal of the masses in standing horses. Nineteen racehorses made abnormal upper respiratory tract noises or their performance was decreased, whereas six horses not used for racing had a history of stertor (five horses) or epistaxis after nasogastric intubation (one horse). Thoroughbreds were significantly (p = .0126) overrepresented compared with the hospital population. The granulation tissue masses were successfully excised and the defect healed in all 25 horses, although a second excision of granulation tissue regrowth was necessary in four horses. In 21 horses, the underlying chondrosis did not progress appreciably. In four horses with preexisting moderate arytenoid cartilage thickening and concurrent laryn-geal abnormalities, the surgery site healed but the underlying chondrosis progressed substantially. Twelve of 19 (63%) racehorses returned to race at least three times after the surgery. Of the 19 racehorses, five had only slight arytenoid cartilage involvement whereas 14 had moderate cartilage thickening or concurrent laryngeal pathology. All five horses with slight apparent arytenoid cartilage involvement and no concurrent laryngeal pathology returned to racing. Seven of the 14 horses (50%) with moderate underlying cartilage thickening or concurrent laryngeal pathology returned to racing. The six horses not used for racing returned to their previous activity without further respiratory problems.     

Laryngeal fistula formation after laryngoplasty in two Warmblood mares

Recurrent laryngeal neuropathy usually results in left‐sided laryngeal hemiparesis or hemiplegia and is one of the most common problems of the upper respiratory tract in equids. There are multiple methods of management, and the laryngoplasty procedure is still the most common surgical treatment. Different nonabsorbable suture materials and techniques are used for laryngoplasty. Post surgical complications are not uncommon. Of these complications, coughing is the most common. The following case report describes diagnosis and treatment of 2 horses with chronic coughing after laryngoplasty due to infection at the surgical site and laryngeal fistula formation. In both horses an elastic material (probably Lycra) had been used as part of the prosthesis implant. This material had deteriorated into multiple small pieces making removal difficult, and therefore use of this material for a laryngoplasty procedure should be avoided.