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Techniques for Dealing with Dorsal Displacement of the Soft Palate
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Introduction
Dorsal displacement of the soft palate (DDSP) is most commonly diagnosed in Thoroughbred and Standardbred racehorses and less commonly in sport horses. During discussion of the results of treatment of DDSP, the uncertainty of the diagnosis must be recognised; there is not a good correlation between observation at rest and occurrence of DDSP at exercise. Indeed, Barakzai and Dixon (2011) reported a sensitivity and specificity of predicting DDSP based on resting endoscopy to be 25.5 and 95.1%, respectively. Although the physiological consequences of DDSP in horses are generally agreed upon, the methods clinicians use to manage DDSP vary greatly.
Management after initial diagnosis of intermittent DDSP
There is level 3 evidence-based data supporting that nonsurgical treatment of this condition is associated with a success rate comparable to surgery (Barakzai and Dixon 2005; Barakzai et al.2009). Horses with pharyngeal inflammation should be treated first with systemic, and perhaps topical, anti-inflammatory agents unless a prior EPM diagnosis has been made. Inflammation of the pharyngeal branch of the vagus nerve as it traverses the medial wall of the guttural pouch can result in DDSP. Two-year-old horses with DDSP may have an ‘immature nasopharynx’, so owners should consider waiting a year before pursuing any surgical treatment. An unfit horse’s fitness level should be raised before considering any surgical treatment. [...]
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