DDSP: Does Anything Work?

Once an accurate diagnosis of dorsal displacement of the soft palate (DDSP) has been made, the veterinary surgeon must advise an owner/trainer on the treatment options for that individual horse. Therefore it is important to understand the rationale and scientific evidence that led to the development of these procedures, as well as being aware of the results of clinical efficacy studies. Numerous treatment options have been described for DDSP, which usually sends a ‘warning’ that no one treatment is considered optimal. The number of treatments is a reflection of our relatively poor understanding of the aetiopathogenesis. Whenever possible, clinical decision making should be based upon the best available evidence. Recently a systematic review of the efficacy of interventions for DDSP was undertaken. The results of this systematic review revealed that, in evidence-based medicine terms, the quality of the literature was considered to be low. It is therefore difficult from the current evidence to draw firm conclusions regarding the true efficacy of these procedures or to determine which procedures might be the most successful and least harmful for treatment of DDSP. As systematic reviews only include efficacy studies in clinical cases, several well-conducted research studies performed in clinically normal horses that might provide further evidence to support or refute a treatment were not included. This talk will attempt to summarise the findings of the systematic review and highlight some of the findings from other research studies in an attempt to draw all the evidence together. During the talk a variety of interventions will be covered; however, it is beyond the scope of this abstract to describe all in detail, so a brief summary of the more commonly performed procedures in the UK is noted here. [...]