Respiratory Stridor Flashcards
T/F: stridor may/may not be associated with distress
True!
Stridor w/o distress shows no CS @ rest
Do dynamic airway obstructions cause distress?
No - they are temporary obstructions that usually only occur @ intense exercise
Which form do DDSP is most common: intermittent or persistent?
DDSP = dorsal displacement of soft palate
Intermittent is most common [often @ exercise]
Pathophysiology of intermittent DDSP:
- can be many factors that cause this!!
Inflammation, upper/lower resp dz, extensive head flexion, thyroid muscle dysfunction, etc…
Pathophysiology of persistent DDSP:
Neuro dz/issue
What are 3 major CS for DDSP:
- Exercise intolerance
- Noise
- Cheek puffing
Is the DDSP noise inspiratory/expiratory?
Can be both but MOSTLY EXPIRATORY
T/F: if you see cheek puffing in a horse, think DDSP right away
True!
What kinds of horses seem to be predisposed to DDSP?
Nervous/tense horses
T/F: DDSP horses show obv CS [like cheek puffing and expiratory noise] even at rest
False!
May not have any obvious CS, especially @ rest
How can we diagnose DDSP?
- Expiratory noise
2. Endoscopy - we can see the displacement
Differentiate DDSP vs EE endoscopy findings:
DDSP: wall flows straight down to floor
EE: wall stops and new structure begins
How must we perform the DDSP endoscopy? What must the horse be doing?
Needs to be running high speed on treadmill to see this!
”ventral placement of epiglottis relative to soft palate for greater than 8 seconds during high speed treadmill endoscopy”
There is conservative vs Sx tx for DDSP. Describe them:
she didn’t really talk about these in class
Conservative = TSD throat support device, loosen head carriage
Sx: laryngeal tie-forward, staphylectomy
Name 3 main CS of EE [epiglottic entrapment]
Exercise intolerance
Respiratory noise
Coughing
What kind of noise do we hear with EE?
Both inspiratory and expiratory
How do we diagnose EE?
Endoscopy @ rest usually
What does EE endoscopy show us?
Wall + new structure
How do we treat if we see significant epiglottic entrapment?
Surgery - transendoscopic laser correction
How do we treat is we see partial epiglottic entrapment?
Medical - local/topical anti-inflammatories
likely to recur though once training resumes
What is the most common side to see Laryngeal Hemiplasia [LH] on?
Is there another name for it?
Left!
Also called idiopathic LH
Why do ILHs occur?
Damage to the left recurrent laryngeal nerve
If we see a right LH, what do we look for?
Look for underlying neuro dysfunction
What is the signalment for LH?
Young Male Tall Working draft horses Some genetic component too
Name a few proposed etiologies to LH:
- mechanical stress
- ischemic nerve damage
- pressure damage
- toxins
- perivascular injections
T/F: we only see LH @ rest
False!
Only seen @ exercise!!
Exercise intolerance is a big CS
Name the noise LH makes: [ins vs ex]
“Roar”
Inspiratory noise!!
How do we diagnose LH?
- CS/history
- endoscopy
- US
- advanced imaging
With endoscopy, we can grade LH into 4 groups. Do we scope @ rest or while running?
We mostly see problem in grade 3 [“significant dysfunction @ exercise”]
We must scope while running!
What does LH treatment depend on?
All depends on level of exercise!
We treat differently if there is/is not impedance to exercise
How do we treat a horse who only has a noise issue?
Ventriculocordectomy
does not improve airway mechanics, only noise
How do you treat a horse with LH and exercise intolerance?
Do BOTH a laryngoplasty AND ventriculocordectomy
This will help open up the rima glottis and decrease noise
Is there ever an indication to just do the laryngoplasty without the ventriculocordectomy?
No, do both together.
How do we treat upper vs lower emergent respiratory distress?
Upper = tracheostomy
Lower = O2
T/F: upper airway obstruction = inspiratory distress
True
Name a few examples of UPPER airway obstructions
- Strangles
- lymphosarcoma
- HyPP
- Tracheal collapse
Name some LOWER airway obstruction examples:
ARDS
RAO
Acute Viral Pneumonia
Etc…
What age group gets infected with rhodococcus equi?
Young horses
