Dynamic respiratory endoscopy in 67 Thoroughbred racehorses training under normal ridden exercise conditions

Reasons for performing study: There are potential advantages to imaging the upper portion of the respiratory tract (URT) of horses during ridden exercise. With the advent of a wireless endoscope, this is now possible. However, there has been no detailed validation of the technique and findings have not been compared to ridden speed. Objectives: To assess the combined use of a Dynamic Respiratory Scope (DRS) and global positioning system (GPS) receiver for examining the URT of a group of Thoroughbred racehorses randomly selected from a single flat racehorse training establishment. Methods: Horses were selected randomly from a population of Thoroughbred horses in training at the same training yard. Endoscopic images of the URT were recorded during a ridden exercise test on an ‘all‐weather‐gallop’ and were reviewed post testing. Speed was measured using a wrist mounted GPS receiver. Results: A total of 67 (34%) of the 195 horses in training were examined. Endoscopic findings included: normal URT function (44 cases); dorsal displacement of the soft palate (DDSP) (13 cases); laryngeal asymmetry (4 cases); and axial deviation of the aryepiglottic folds (3 cases). Maximum speed obtained by individual horses ranged from 41.8–56.3 km/h. Ridden speed was variably affected by DDSP. Conclusions: The DRS provides a safe effective system for imaging the equine URT during ridden exercise at speed. The abnormalities of the URT identified were similar to those observed during treadmill endoscopy studies reported in the literature. The effect of URT abnormalities on ridden speed requires further investigation. Potential relevance: This technique can be used to diagnose common causes of URT associated with poor performance in horses during normal training. This has substantial implications for future clinical diagnosis and treatment of URT pathology.     

Assessment of dynamic upper respiratory tract function in the equine athlete

Dynamic upper respiratory tract (URT) obstructions occur commonly in the equine athlete. During the past 25 years, veterinary diagnostic capabilities have improved greatly with the ability to perform endoscopy during exercise and thus to visualise upper airway function during various types of exercise. After correctly reproducing and diagnosing an URT obstruction, the veterinary surgeon must consider the functional significance of the endoscopic findings for that individual athlete. This is the third paper in this series and focuses on the diagnosis of URT obstructions, their relationship to the exercise test and their functional significance.     

Clinical trials using a telemetric endoscope for use during over‐ground exercise: A preliminary study

Dynamic collapse of the upper respiratory tract (URT) is a common cause of poor performance in horses. These conditions occur predominantly during strenuous exercise when the URT is unable to maintain dilation in the face of high inspiratory pressures. In most cases, these disorders cannot be accurately diagnosed during a resting endoscopic examination. To date, a definitive diagnosis of dynamic URT obstructions has been possible only by performing an endoscopic examination during high‐speed treadmill exercise. However, recent technological advances now enable URT endoscopy to be performed while the horse is exercising in its normal environment.     

Equine laryngeal dysplasia

Equine 4th and 6th branchial arch defects are not uncommon in the equine population at large but can be challenging to diagnose and treat. An understanding of the anatomical structures that can be involved and how structural abnormalities may affect laryngeal function is important for clinicians faced with such cases. Diagnosis is often made using resting endoscopic examination alone but, in many cases, laryngeal ultrasound, radiography and 3‐dimensional (3D) imaging techniques can be useful in confirming a diagnosis and for detecting which structures are abnormal. Exercising endoscopy is an important tool when ascertaining whether treatment is an option, for guiding treatment choice and making a prognosis for athletic function.     

Exercising videoendoscopic evaluation of 7 horses with abnormal respiratory noise and poor performance following partial arytenoidectomy

Exercising upper airway endoscopic evaluation was performed in 7 horses with a history of poor performance after partial arytenoidectomy. Treadmill endoscopy revealed axial deviation of the ipsilateral aryepiglottic fold in all horses. Dynamic collapse of one or more additional upper airway structures was also observed. In 4 horses, laser resection of soft tissue structures that obstructed the upper airway was performed. After laser surgery, 3 horses raced and one performed adequately as a riding horse. Of the remaining 3 horses, 2 raced at a lower class and one performed adequately as a riding horse. In this population of horses, dynamic endoscopy of the upper airway was critical for case management. Based on our observations, horses post arytenoidectomy can have dynamic collapse of the ipsilateral aryepiglottic fold and laser resection of the fold may help resolve the performance problem.     

Exercising upper respiratory videoendoscopic evaluation of 100 nonracing performance horses with abnormal respiratory noise and/or poor performance

Reasons for performing study: Although well documented in racehorses, there is paucity in the literature regarding the prevalence of dynamic upper airway abnormalities in nonracing performance horses. Objective: To describe upper airway function of nonracing performance horses with abnormal respiratory noise and/or poor performance via exercising upper airway videoendoscopy. Methods: Medical records of nonracing performance horses admitted for exercising evaluation with a chief complaint of abnormal respiratory noise and/or poor performance were reviewed. All horses had video recordings of resting and exercising upper airway endoscopy. Relationships between horse demographics, resting endoscopic findings, treadmill intensity and implementation of head and neck flexion during exercise with exercising endoscopic findings were examined. Results: Dynamic upper airway obstructions were observed in 72% of examinations. Head and neck flexion was necessary to obtain a diagnosis in 21 horses. Pharyngeal wall collapse was the most prevalent upper airway abnormality, observed in 31% of the examinations. Complex abnormalities were noted in 27% of the examinations. Resting laryngeal dysfunction was significantly associated with dynamic arytenoid collapse and the odds of detecting intermittent dorsal displacement of the soft palate (DDSP) during exercise in horses with resting DDSP was only 7.7%. Exercising endoscopic observations were different from the resting observations in 54% of examinations. Conclusions: Dynamic upper airway obstructions were common in nonracing performance horses with respiratory noise and/or poor performance. Resting endoscopy was only helpful in determining exercising abnormalities with recurrent laryngeal neuropathy. Potential relevance: This study emphasises the importance of exercising endoscopic evaluation in nonracing performance horses with abnormal respiratory noise and/or poor performance for accurate assessment of dynamic upper airway function.     

Dynamic respiratory endoscopy of Standardbred racehorses during qualifying races

Reason for performing study: Examination of the equine upper airway during racing has not previously been documented. Objective: To describe the feasibility and appearance of the upper airways by overground respiratory endoscopic examination during racing conditions. Methods: Overground videoendoscopic examinations were performed on 46 Standardbred racehorses during qualifying races. Examined horses' speeds were recorded throughout the race with a portable GPS device. Results: The procedure did not interfere with performance as there were no significant differences in race times between races in which horses were examined with the endoscope in place and prior unexamined races. Airway obstructions during or after the race were documented in 21 horses. Most previously reported causes of upper airway obstruction were observed; surprisingly bilateral ventro‐medial arytenoid displacement (VMAD; n = 5) was seen during exercise as frequently as dorsal displacement of the soft palate (DDSP). Although DDSP (n = 10) was the most common diagnosis made, many displacements (n = 5) occurred after the race. Horses that demonstrated DDSP after the race had slower speeds than unaffected horses during the race. Conclusions: Racing endoscopy permits the diagnosis of upper airway obstructions without affecting performance. The occurrence of DDSP immediately after exercise may be clinically relevant. During racing VMAD may be an important anomaly. Potential relevance: Racing endoscopy could be used to correlate the sensitivity of diagnostic endoscopy during race‐training or treadmill examination. The pathogenesis and significance of VMAD deserves further investigation.