Dynamic epiglottic retroversion as a cause of abnormal inspiratory noise in six adult horses

This case report describes the endoscopic findings and outcome in 6 horses diagnosed with dynamic epiglottic retroversion (ER) during exercise. Horses included 2 showjumpers, one eventer, one pleasure riding horse and 2 Thoroughbred racehorses. All were adults (age range: 4–10 years). Dorsal angulation of the epiglottis was identified at rest in one horse. However, resting endoscopy was unremarkable in the remaining 5 horses. Exercising endoscopy was performed during high‐speed treadmill exercise in 3 horses and during ridden exercise in the other 3. Intermittent ER occurred during inspiration in all horses and the frequency increased with increasing speed. In 2 horses the epiglottis retroverted beyond the rima glottidis. All horses made an abnormal respiratory noise described as a ‘grunt’ when retroversion of the epiglottis occurred. Poll flexion was found to be an exacerbating factor in the nonracehorses. Two horses continued in work but abnormal inspiratory noise persisted. Surgical treatment, in the form of subepiglottic resection, was attempted in one horse. However, it never raced again after the procedure. Of the remaining horses, 2 were retired and the third was subjected to euthanasia.