Effect of topical anesthesia of the laryngeal mucosa on upper airway mechanics in exercising horses.

OBJECTIVE: To determine the effect of desensitization of the laryngeal mucosal mechanoreceptors on upper airway mechanics in exercising horses. ANIMALS: 6 Standardbreds. PROCEDURE: In study 1, videoendoscopic examinations were performed while horses ran on a treadmill with and without topical anesthesia of the laryngeal mucosa. In study 2, peak tracheal and nasopharyngeal pressures and airflows were obtained from horses during incremental treadmill exercise tests, with and without topical anesthesia of the laryngeal mucosa. A nasal occlusion test was performed on each horse while standing during an endoscopic examination for both trials. RESULTS: In study 1, horses had nasopharyngeal collapse while running on the treadmill when the laryngeal mucosa was anesthetized. In study 2, inspiratory upper airway and nasopharyngeal impedance were significantly higher, and peak tracheal inspiratory pressure, respiratory frequency, and minute ventilation were significantly lower in horses when the laryngeal mucosa was anesthetized, compared with values obtained when horses exercised without topical anesthesia. Peak inspiratory and expiratory airflows were lower in horses when the laryngeal mucosa was anesthetized, although differences did not quite reach significance (P = 0.06 and 0.09, respectively). During a nasal occlusion test, horses had episodes of nasopharyngeal collapse and dorsal displacement of the soft palate when the laryngeal mucosa was anesthetized. Upper airway function was normal in these horses without laryngeal mucosal anesthesia. CONCLUSIONS AND CLINICAL RELEVANCE: Receptors within the laryngeal mucosa may be important in maintaining upper airway patency in exercising horses.     

The displaced equine soft palate as a source of abnormal respiratory noise during expiration

REASONS FOR PERFORMING STUDY: To develop the technique of respiratory sound analysis for the diagnosis of dorsal displacement of the equine soft palate. OBJECTIVES: To show that 1) the displaced soft palate can spontaneously vibrate in the presence of expiratory airflow; 2) the observed frequency of vibration can be detected in respiratory sound recordings; and 3) the frequency of vibrations measured in cadaveric specimens are similar to those obtained from audio spectra in exercising horses with DDSP. METHODS: Palatal movements and respiratory sounds were recorded from artificially ventilated cadaveric heads. The fundamental mode of palate vibrations calculated from high-speed videoendoscopic recordings was compared with frequencies detected in the audio spectra and with data collected from exercising horses with DDSP. RESULTS: Palate vibrations occurred when air was blown through the trachea. The fundamental mode of vibrations was present in the audio spectra and was not significantly different from those recorded in vivo. CONCLUSIONS: Vibrations of the soft palate are the probable source of expiratory sounds recorded in horses with DDSP. POTENTIAL RELEVANCE: This study strengthens the case for the application of respiratory sound analysis in the diagnosis of DDSP in exercising horses.     

Spectral analysis of respiratory noise in horses with upper airway disorders

REASONS FOR PERFORMING STUDY: It has long been recognised that the production of abnormal respiratory sounds by horses during exercise is frequently associated with upper airway obstructions. Respiratory acoustic measurements have shown promise in investigation of upper airway disorders in man and, more recently, in horses with experimentally-induced obstructions. OBJECTIVES: To evaluate sounds from exercising horses with naturally occurring dynamic obstructions of the upper respiratory tract and to compare these with those from normal horses in order to determine whether different obstructions produce characteristic spectral patterns. METHODS: The audio signal, airflow and videoendoscopic images were recorded simultaneously during an incremental exercise test on a high-speed treadmill. RESULTS: Spectral analysis of the audio signal showed marked differences between control and clinically afflicted horses. Dorsal displacement of the soft palate was characterised by a narrow low frequency (20-80 Hz) peak during expiration. Horses with dynamic laryngeal collapse produced inspiratory sounds characterised by a broad band high frequency spectral component in the range 1.1-2.7 kHz. CONCLUSIONS AND POTENTIAL RELEVANCE: Spectral analysis of respiratory sounds in horses has potential as a diagnostic technique for field use especially when facilities for high-speed treadmill assessment are not practicable.     

Effect of commercially available nasal strips on airway resistance in exercising horses

OBJECTIVE: To determine the effect of a commercially available nasal strip on airway mechanics in exercising horses. ANIMALS: 6 horses (5 Standardbreds and 1 Thoroughbred). PROCEDURE: Horses exercised on a treadmill at speeds corresponding to 100 and 120% of maximal heart rate with and without application of a commercially available nasal strip. Concurrently, tracheal pressures, airflow, and heart rate were measured. Peak inspiratory and expiratory tracheal pressures, airflow, respiratory frequency, and tidal volume were recorded. Inspiratory and expiratory airway resistances were calculated by dividing peak pressures by peak flows. Endoscopic examination of the narrowest point of the nasal cavity (ie, nasal valve) was performed in 1 resting horse before, during, and after application of a nasal strip. RESULTS: During exercise on a treadmill, peak tracheal inspiratory pressure and inspiratory airway resistance were significantly less when nasal strips were applied to horses exercising at speeds corresponding to 100 and 120% of maximal heart rate. Application of the nasal strip pulled the dorsal conchal fold laterally, expanding the dorsal meatus. CONCLUSIONS AND CLINICAL RELEVANCE: The commercially available nasal strip tented the skin over the nasal valve and dilated that section of the nasal passage, resulting in decreased airway resistance during inspiration. The nasal strip probably decreases the amount of work required for respiratory muscles in horses during intense exercise and may reduce the energy required for breathing in these horses.     

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.     

Activity of selected rostral and caudal hyoid muscles in clinically normal horses during strenuous exercise

OBJECTIVE: To determine the phase and quantitate the electromyographic (EMG) activity of the genioglossus, geniohyoideus, hyoepiglotticus, omohyoideus, sternohyoideus, sternothyroideus, and thyrohyoideus muscles of clinically normal horses during strenuous exercise. ANIMALS: 7 clinically normal adult horses (2 Thoroughbreds and 5 Standardbreds). PROCEDURES: Bipolar electrodes were surgically implanted in the aforementioned muscles, and horses were subjected to an incremental exercise test on a high-speed treadmill. The EMG, heart rate, respiratory rate, and static pharyngeal airway pressures were measured during exercise. The EMG was measured as mean electrical activity (MEA). The MEA values for maximal exercise intensity (13 or 14 m/s) were expressed as a percentage of the MEA measured at an exercise intensity of 6 m/s. RESULTS: MEA was detected during expiration in the genioglossus, geniohyoideus, sternohyoideus, and thyrohyoideus muscles and during inspiration in the hyoepiglotticus and sternothyroideus muscles. Intensity of the MEA increased significantly with exercise intensity in the genioglossus, geniohyoideus, and hyoepiglotticus muscles. Intensity of the MEA increased significantly in relation to expiratory pharyngeal pressure in the geniohyoideus and hyoepiglotticus muscles. CONCLUSIONS AND CLINICAL RELEVANCE: Once exercise intensity reached 6 m/s, no quantifiable additional increase in muscular activity was detected in the omohyoideus, sternohyoideus, sternothyroideus, and thyrohyoideus muscles. However, muscles that may affect the diameter of the oropharynx (genioglossus and geniohyoideus muscles) or rima glottis (hyoepiglotticus muscle) had activity correlated with the intensity of exercise or expiratory pharyngeal pressures. Activity of the muscles affecting the geometry of the oropharynx may be important in the pathophysiologic processes associated with nasopharyngeal patency.     

Effect of a tongue-tie on upper airway mechanics during exercise following sternothyrohyoid myectomy in clinically normal horses

OBJECTIVE: To determine the effect of a tongue-tie on upper airway mechanics in clinically normal horses exercising on a treadmill following sternothyrohyoid myectomy. ANIMALS: 6 Standardbreds. PROCEDURE: Upper airway mechanics were measured with horses exercising on a treadmill at 5, 8, and 10 m/s 4 weeks after a sternothyrohyoid myectomy was performed. Pharyngeal and tracheal inspiratory and expiratory pressures were measured by use of transnasal pharyngeal and tracheal catheters connected to differential pressure transducers. Horses were fitted with a facemask and airflow was measured by use of a pneumotachograph. Horses underwent a standardized exercise protocol on a treadmill at 5, 8, and 10 m/s with and without a tongue-tie in a randomized cross-over design. Inspiratory and expiratory airflow, tracheal pressure, and pharyngeal pressure were measured, and inspiratory and expiratory resistances were calculated. RESULTS: We were unable to detect an effect of a tongue-tie on any of the respiratory variables measured. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicate that a tongue-tie does not alter upper airway mechanics following sternothyrohyoid myectomy in clinically normal horses during exercise.     

Endoscopy of the upper respiratory tract during treadmill exercise: a clinical study of 100 horses

SUMMARY: 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 exercise on the treadmill in 19 cases, while in the remaining 21 the endoscopic findings during exercise varied from that seen at rest. This included 3 horses in which a diagnosis was made at rest but no abnormalities were detected during exercise. Some of the findings during treadmill endoscopy included laryngeal dysfunction, grades 3, 4 and 5 (22 cases), dorsal displacement of the soft palate (20), epiglottic entrapment (8), epiglottic flutter (4), aryepiglottic fold flutter (4), pharyngeal collapse (3), arytenoiditis (3), vocal cord flutter (3), false nostril noise (2), pharyngeal lymphoid hyperplasia (2), soft palate haemorrhage (1) and positional arytenoid collapse (1). More than one abnormality was observed during exercise in 7 horses. A complete and correct diagnosis based on the resting endoscopy findings alone was made in 19 (25%) of these 75 cases. In the 17 horses examined because of poor performance, no abnormalities were detected during treadmill endoscopy that were not evident at rest. None of these 17 horses presented with a history of an abnormal respiratory noise, although one, diagnosed as having grade 4 laryngeal function at rest and exercise, did make a characteristic inspiratory noise during treadmill exercise. Eight horses were evaluated after surgery for correction of laryngeal hemiplegia, as the post-operative performance or the amount of respiratory noise present was considered unsatisfactory. Of these, 3 were found to have a satisfactory airway during exercise and other reasons for poor performance were detected; 3 had insufficient abduction; and 2 had intermittent dorsal displacement of the soft palate. Endoscopy of the upper respiratory tract was found to be a useful technique for evaluating the cause of abnormal respiratory noise in most cases. We concluded that treadmill endoscopy in horses presented for poor performance, without a history of an abnormal respiratory noise, was of little value. The technique, in conjunction with arterial blood gas measurements, was useful in determining the efficacy of surgical treatment of laryngeal hemiplegia.     

Spectrum analysis of respiratory sounds in exercising horses with experimentally induced laryngeal hemiplegia or dorsal displacement of the soft palate

OBJECTIVE: To record respiratory sounds in exercising horses and determine whether spectrum analysis could be use to identify sounds specific for laryngeal hemiplegia (LH) and dorsal displacement of the soft palate (DDSP). ANIMALS: 5 Standardbred horses. PROCEDURE: Respiratory sounds were recorded and pharyngeal pressure and stride frequency were measured while horses exercised at speeds corresponding to maximum heart rate, before and after induction of LH and DDSP. RESULTS: When airway function was normal, expiratory sounds predominated and lasted throughout exhalation. After induction of LH, expiratory sounds were unaffected; however, all horses produced inspiratory sounds characterized by 3 frequency bands centered at approximately 0.3, 1.6, and 3.8 kHz. After induction of DDSP, inspiratory sounds were unaffected, but a broad-frequency expiratory sound, characterized by rapid periodicity (rattling) was heard throughout expiration. This sound was not consistently detected in all horses. CONCLUSIONS AND CLINICAL RELEVANCE: The technique used to record respiratory sounds was well tolerated by the horses, easy, and inexpensive. Spectrum analysis of respiratory sounds from exercising horses after experimental induction of LH or DDSP revealed unique sound patterns. If other conditions causing airway obstruction are also associated with unique sound patterns, spectrum analysis of respiratory sounds may prove to be useful in the diagnosis of airway abnormalities in horses.     

Evaluation of upper respiratory tract function during strenuous exercise in racehorses

Forty-six racehorses with a history of poor performance underwent endoscopic evaluation of laryngeal and pharyngeal function while exercising on a high-speed treadmill. This evaluation allowed the definitive diagnosis of intermittent or continual upper respiratory tract obstruction as a cause of poor performance, as well as the documentation of the dynamic functional anatomy of the obstruction. Ten of the horses (22%) were determined to have a functional abnormality of the upper respiratory tract. These abnormalities included epiglottic entrapment (1 horse), persistent dorsal displacement of the soft palate during exercise (4 horses), and left laryngeal hemiplegia (5 horses). Thirty-two horses were observed to have signs of left laryngeal hemiparesis (asynchronous arytenoid movement) at rest that did not impair full laryngeal abduction during strenuous exercise.     

Investigations into the role of the thyrohyoid muscles in the pathogenesis of dorsal displacement of the soft palate in horses

REASONS FOR PERFORMING STUDY: Contributes to the understanding of the pathogenesis of dorsal displacement of the soft palate during exercise so that management of this condition could be enhanced. HYPOTHESIS: That the thyrohyoid muscles play an important role in the stability of the laryngo-palatal relationship and that dysfunction of these muscles leads to dorsal displacement of the soft palate (DDSP) during exercise. METHODS: Ten horses were exercised on a high-speed treadmill under 4 different treatment conditions: control conditions (n = 10), after resection of thyrohyoid muscles (TH, n = 10), after sham-treatment (n = 5), or after restoration of function of the thyrohyoid muscles with surgical sutures (prosthesis-treatment, n = 6). During trials, the following determinations were made: videoendoscopy of the upper airway, gait frequency and pharyngeal and tracheal static pressures. RESULTS: None of the 10 horses developed DDSP during 2 separate treadmill-exercise trials under the control conditions. Seven of the 10 horses developed DDSP after resection of the TH muscles, 4 of 5 of these horses still experienced DDSP after sham-treatment, but 5 of 6 horses no longer experienced DDSP at exercise after the prosthesis-treatment. There were significant anomalies in airway pressures, respiratory frequency, and occurrence of DDSP in both the TH resection and sham-treatment conditions compared to control conditions. In contrast, no statistical differences were noted in any of the parameters measured between the prosthesis-treatment and control conditions. CONCLUSIONS: That the function of the TH muscles is important to the stability of the laryngo-palatal relationship and plays a role in the pathophysiology of exercise-induced DDSP. POTENTIAL RELEVANCE: Management of horses with DDSP could be enhanced by restoring the function of the TH muscles.     

Effect of a respiratory gas collection mask on some measurements of cardiovascular and respiratory function in horses exercising on a treadmill

The effects of a respiratory gas collection mask on arterial blood gases, acid base values, oxygen content, respiratory frequency and heart rate, were investigated in standardbred horses during treadmill exercise at speeds up to 10 m sec-1 and a treadmill slope of 10 per cent. The mask had no significant effect on heart rates during exercise, but respiratory frequency was lower when the mask was used. The increase in respiratory frequency as treadmill velocity increased was also significantly slower with the mask operative. Arterial carbon dioxide tensions were significantly higher during exercise with the mask than without, and arterial oxygen tension was significantly lower at the highest exercise intensity. Arterial oxygen content was significantly lower at all work speeds when the mask was used. There were minimal effects of the mask on arterial acid base values. It was concluded that a respiratory gas collection mask caused alveolar hypoventilation in exercising horses, but did not markedly influence heart rate or arterial acid base values during exercise.     

Cardiac output determination by use of lithium dilution during exercise in horses

OBJECTIVE: To compare cardiac output (CO) obtained by the lithium dilution method (LiDCO) with CO calculated from the Fick principle (FickCO), in horses maximally exercising on a high-speed treadmill. ANIMALS: 13 Thoroughbreds. PROCEDURES: In part 1 of the study, 5 horses performed a warm-up (walk, trot, and canter) and exercise test (walk, trot, canter, and gallop [90% to 100% maximum oxygen consumption [{[Formula: see text]O(2)max}]) with measurements of LiDCO and FickCO obtained simultaneously after 60 seconds at each exercise level, for a total of 7 measurements. In part 2 of the study, 8 horses performed a warm-up (walk, trot, and canter) followed by an exercise test (walk and gallop [90% to 100% [Formula: see text]O(2)max], repeated twice). Measurements of LiDCO and FickCO were obtained 60 seconds into the first walk and each gallop of the exercise tests, for a total of 3 measurements. RESULTS: Cardiac output increased significantly with increasing speeds by use of both methods. In part 1, lithium dilution significantly overestimated CO, compared with the Fick principle, during the exercise test (as both injection number and exercise intensity increased). Mean +/- SD bias was 246 +/- 264 mL of blood/min/kg in part 1 and 67 +/- 100mL of blood/kg/min in part 2. Three injections of lithium (part 2) did not result in the same degree of overestimation of LiDCO that was observed with 7 injections (part 1). CONCLUSIONS AND CLINICAL RELEVANCE: Lithium dilution may be an acceptable substitute for the Fick principle as a means to measure CO in maximally exercising client-owned horses.     

Incidence of swallowing during exercise in horses with dorsal displacement of the soft palate

Reasons for performing study: The relationship between dorsal displacement of the soft palate (DDSP) and swallowing is unclear. Objective: To quantify the relationship between DDSP and swallowing in horses at exercise. Hypotheses: The frequency of swallowing increases immediately prior to DDSP in horses at exercise. Methods: Videoendoscopic and upper airway pressure data were collated from horses with a definitive diagnosis of DDSP at exercise. Horses with no upper airway abnormalities were matched by age, breed and sex and used as controls. Sixty‐nine horses were identified with a definitive diagnosis of DDSP during the study interval. Airway pressure data were available for 42 horses. Results: The majority of horses displaced at high exercising speeds while accelerating; a smaller number displaced during deceleration after peak speed had been reached. Horses swallowed significantly more frequently in the 1 min immediately preceding DDSP than in the control horses at equivalent speeds. DDSP at exercise results in a significant increase in tracheal expiratory pressure, a significant decrease in pharyngeal expiratory pressure and a significantly less negative pharyngeal inspiratory pressure compared to matched controls and compared to the pressures during the 1 min interval prior to DDSP. There was no significant difference between any measure of airway pressure before or after a swallow when examined at each time interval in the DDSP population. Conclusions: The frequency of swallowing decreases with increasing speed in normal horses. In contrast, the frequency of swallowing increases immediately prior to onset of DDSP. This is not a result of pharyngeal and tracheal pressure changes. Potential relevance: The increased frequency of swallowing observed prior to DDSP may be related to the aetiology of the disease.     

Effect of laryngeal hemiplegia and laryngoplasty on airway flow mechanics in exercising horses

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 least 14 days after prosthetic larynogoplasty. Increasing treadmill speed from period A to period D progressively increased heart rate, respiratory frequency, peak inspiratory flow, and peak expiratory flow, but inspiratory resistance and expiratory resistance remained unchanged. Neither left recurrent laryngeal neutrectomy nor prosthetic laryngoplasty affected heart rate, respiratory frequency, peak expiratory flow, or expiratory resistance when compared with those values at the control measurement periods. Left recurrent laryngeal neurectomy resulted in inspiratory flow limitation at peak inspiratory flow of approximately 25 L/s, and increased inspiratory resistance at periods D and E. Subsequent prosthetic laryngoplasty alleviated the flow limitation and reduced inspiratory resistance at measurement periods D and E.     

Electromyographic activity of the stylopharyngeus muscle in exercising horses

REASONS FOR PERFORMING STUDY: There is a need to understand the process which leads to failure of recruitment of the stylopharyngeus muscle in clinical cases of nasopharygeal collapse. We therefore studied the timing and intensity of stylopharyngeus muscle activity during exercise in horses. OBJECTIVE: To measure the electromyographic (EMG) activity of the stylopharyngeus muscle in exercising horses and correlate it with the breathing pattern. METHODS: Five horses were equipped with a bipolar fine wire electrode placed on the stylopharyngeus muscle and a pharyngeal catheter. The horses exercised on a treadmill at speeds corresponding to 50 (HRmax50), 75 and 100% of maximum heart rate, and EMG activity of the stylopharyngeus muscle and upper airway pressures were recorded. The EMG activity of the stylopharyngeus muscle was then correlated to the breathing pattern and the activity quantified and reported as a percentage of the baseline activity measured at HRmax50. RESULTS: There was ongoing activity of the stylopharyngeus muscle throughout the breathing cycle; however, activity increased towards the end of expiration and peaked early during inspiration. Tonic activity was present during expiration. Peak, mean electrical and tonic EMG activity increased significantly (P<0.05) with exercise intensity. CONCLUSION: The stylopharyngeus muscle has inspiratory-related activity and tonic activity that increases with speed. POTENTIAL RELEVANCE: The stylopharyngeus muscle is one of a group of upper airway muscles that function to support and maintain the patency of the nasopharynx during inspiration. Failure of recruitment of the stylopharyngeus muscle during exercise is a potential explanation for clinical cases of dorsal pharyngeal collapse, but further work investigating the activity of the stylopharyngeus muscle in horses affected by this disease is needed.     

Effect of a tongue-tie on upper airway mechanics in horses during exercise

OBJECTIVE: To determine the effect of a tongue-tie on upper airway mechanics in exercising horses. ANIMALS: 5 Standardbreds. PROCEDURE: Peak inspiratory and expiratory tracheal and pharyngeal pressures and airflow were measured while horses exercised on a treadmill with and without a tongue-tie. Respiratory rate was also measured. Horses ran at speeds that corresponded to 50 (HR50), 75, 90 (HR90), and 100% of maximal heart rate. The tongue-tie was applied by pulling the tongue forward out of the mouth as far as possible and tying it at the level of the base of the frenulum to the mandible with an elastic gauze bandage. Peak inspiratory and expiratory tracheal, pharyngeal, and translaryngeal resistance, minute ventilation, and tidal volume were calculated. Data were analyzed by use of 2-way repeated-measures ANOVA. For post hoc comparison of significant data, the Student-Newman-Keuls test was used. RESULTS: We were unable to detect significant differences between groups for peak inspiratory or expiratory tracheal or pharyngeal resistance, peak pressure, peak expiratory flow, tidal volume, respiratory rate, or minute ventilation. Horses that ran with a tongue-tie had significantly higher peak inspiratory flows, compared with horses that ran without a tongue-tie. In the post hoc comparison, this effect was significant at 4 m/s, HR50, and HR90. CONCLUSION AND CLINICAL RELEVANCE: Application of a tongue-tie did not alter upper respiratory mechanics in exercising horses and may be beneficial in exercising horses with certain types of obstructive dysfunction of the upper airways. However, application of a tongue-tie does not improve upper airway mechanics in clinically normal horses.     

Can an external device prevent dorsal displacement of the soft palate during strenuous exercise?

REASONS FOR PERFORMING STUDY: Dorsal displacement of the soft palate (DDSP) is a common condition in racehorses for which various surgical treatments are often performed. In light of recent findings that suggested the position of the larynx may influence the occurrence of DDSP, we investigated whether a noninvasive mean of affecting the position of the larynx could be effective in the management of DDSP. HYPOTHESIS: An external device (laryngohyoid support; LHS) positioning the larynx in a more rostral and dorsal location and preventing caudal displacement of the basihyoid bone would be effective in preventing DDSP during strenuous exercise. METHODS: Ten horses were exercised on a high-speed treadmill under 4 different treatment conditions: control (n = 10); control with external device (n = 10); after bilateral resection of thyrohyoid (TH) muscles (n = 7); and after bilateral resection of TH muscles with external device (n = 7). Two trials were performed randomly for each of the 4 conditions. In Trial 1, videoendoscopic images of the upper airway, pharyngeal and tracheal static pressures, and arterial blood gases were collected. In Trial 2, airflow measurement combined with mask and tracheal static pressure was obtained, and upper airway impedance calculated. The trials allowed calculation of airway impedance and respiratory frequency, and assessment of ventilation using arterial PO2 and PCO2. RESULTS: Under control conditions, none of the 10 horses developed DDSP. There was no statistically significant effect from the LHS on airway impedance or respiratory frequency, nor on arterial PO2 and PCO2. Seven of the 10 horses developed DDSP during exercise after resection of the TH muscles. None of these 7 horses continued to experience DDSP during exercise with the external device. In the latter group and condition, the LHS significantly improved inspiratory and expiratory flow and impedance. CONCLUSIONS: The LHS helped prevent experimentally induced DDSP at exercise, probably by statically positioning the larynx in a more rostral and dorsal position. POTENTIAL RELEVANCE: Field studies are required to investigate whether the LHS can successfully prevent DDSP in horses with naturally occurring disease.     

ULTRASONOGRAPHIC ASSESSMENT OF LARYNGOHYOID POSITION AS A PREDICTOR OF DORSAL DISPLACEMENT OF THE SOFT PALATE IN HORSES

Dorsal displacement of the soft palate is an important cause of poor performance in racehorses, yet its etiology is not fully understood. Diagnosis requires treadmill videoendoscopy, which is not widely available. The relationship of the larynx, the hyoid apparatus, and the remainder of the skull may be important in predisposing horses to dorsal displacement of the soft palate. We hypothesized that this relationship could be accurately assessed in unsedated horses through ultrasonographic examination. Fifty-six racehorses presented for evaluation of poor performance were subjected to treadmill videoendoscopy and resting ultrasonography. Using ultrasound-assisted percutaneous measures of laryngo-hyoid position, the relationship between selected anatomic structures and the occurrence of dorsal displacement of the soft palate was evaluated. A significant relationship was found between the depth of the basihyoid bone at rest and the occurrence of dorsal displacement of the soft palate at exercise ( P =0.03). Other measures of laryngohyoid position were not found to be associated with dorsal displacement of the soft palate. Thus, there is an association between the occurrence of dorsal displacement of the soft palate at exercise and the resting position of the basihyoid bone, whereby on average a more ventral location of the basihyoid bone is present in horses with dorsal displacement of the soft palate. The pathophysiologic implications of this finding are not fully understood but, based on our findings, ultrasound examination is of value in assisting in the diagnosis of dorsal displacement of the soft palate.     

The relationship between respiratory exchange ratio, plasma lactate and muscle lactate concentrations in exercising horses using a valved gas collection system.

A valved gas collection system for horses was validated, then used to examine the relationship between the respiratory exchange ratio (RER), and plasma and muscle lactate in exercising horses. Four healthy Standardbred horses were trained to breathe through the apparatus while exercising on a treadmill. Comparisons of arterial blood gas tensions were made at 3 work levels for each horse, without (control), and with the gas collection system present. At the highest work level, the arterial oxygen tension (PaO2) was significantly lower (P < 0.05), and the arterial carbon dioxide tension (PaCO2) was significantly higher (P < 0.05), than control levels when the apparatus was present; however arterial oxygen content remained unchanged. The horses completed a standardized incremental treadmill test on 4 occasions to determine the repeatability of measurements of oxygen consumption (VO2), carbon dioxide production (VCO2), inspired minute ventilation (VI), respiratory exchange ratio (RER), ventilatory equivalent for oxygen (VI/VO2), tidal volume (VT), and ventilatory frequency (VF). All gas exchange and respiratory measurements showed good reproducibility with the mean coefficient of variation of the 4 horses ranging from 3.8 to 12%. We examined the relationship between 3 indices of energy metabolism in horses performing treadmill exercise: respiratory exchange ratio (RER), central venous plasma and muscle lactate concentrations. A relationship between RER and plasma lactate concentration was established. To compare muscle and plasma lactate concentrations, the horses completed a discontinuous exercise test without the gas collection apparatus present. Significant relationships (P < 0.05), between plasma lactate concentration and RER, and between plasma and muscle lactate concentration, were described for each horse. The valved gas collection system produced a measurable but tolerable degree of interference to respiration, and provided reproducible measurements of gas exchange and ventilatory measurements. It was concluded that measurements of both gas exchange and blood lactate may be used to indicate increased glycolytic activity within exercising skeletal muscle.