Exam 2 - Equine Poor Performance

Question 1

You are called out to see a 16yo QH gelding who is “breathing hard” *

On arrival, the horse has his head outstretched standing in front of the barn

• Respiratory rate and effort are severely increased
• T: 102.8F; P: 76bpm; R: 32rpm
• Inspiratory time severely prolonged
• Inspiratory noise
• Thoracic auscultation just referred UA sounds

1. is this problem upper airway or lower? why?
2. primary rule out?
3. While discussing this with the owner, the horse stumbles but catches itself. What do you want to do?

Answer 1

1. upper - noisy
2. DDSP or cicatrix
3. temporary tracheostomy

Question 2

A 5 y/o gelding purchased 1 year ago by the current owners as a high level show jumping prospect. He has a 3 month history of his performance deteriorating towards the end of each round either not making time/knocking down fences. No significant work, just hacking with a less experienced rider in the off season. Horse has shown a cough recently & has feed material in its nostrils after being fed the last few days.

Physical exam is WNL.
- slap test subjectively asymmetrical with decreased response on the left
- auscultation WNL
- resting ECG WNL
- feeding resulted in 1-2 coughs.

Exercising exam - no lameness noted in a straight line or lunge.
- initially no respiratory noise noted
- after 5 minutes of work, begin hearing a respiratory noise.

respiratory noise appears to be on exhale
- low, almost grunting/roaring sound
- cheeks flutter when the noise is heard

1. what are your 2 main differentials?
2. what is your next diagnostic step?

Answer 2

1. DDSP & epiglottic entrapment
2. static endoscopic exam

Question 3

on the endoscopic exam of the 5 y/o gelding, dysphagia, DDSP, & previous left-sided prosthetic laryngoplasty is seen - what does this explain?

what other diagnostic may you do?

Answer 3

dysphagia - feed material in upper airway, explains coughing

DDSP - respiratory noise & horse choking down during exercise

previous left-sided prosthetic laryngoplasty - slap test & maybe dysphagia

dynamic exam - evaluate under exercise

Question 4

what treatment options are available for the 5 y/o gelding with dysphagia, DDSP, & previous left-sided prosthetic laryngoplasty?

Answer 4

anti-inflammatories

strict rest

laryngeal tie forward

undo tie back - only an option after 6 weeks post op or so