Treatment of DDSP

The treatment of dorsal displacement of the soft palate (DDSP) must be tailored to the cause. The intrinsic causes of DDSP included the neuromuscular causes of decrease tone in the palatinus and palatopharyngeus muscle (Holcombe et al., 1998) and structural abnormalities like sub-epiglottic and palatal masses/cysts and severe epiglottic deformation. Extrinsic causes are related to the respective position of the larynx, basihyoid and soft palate (Ducharme et al., 2003; Chalemrs et al., 2009). However when no structural anomaly of the larynx is found it is clearly more difficult to identify the cause of the DDSP.

Initial management:
Any horses or guttural pouch infection should be treated first. For example treatment of guttural pouch infection with physiological and sterile balanced electrolytes solution with non-irritant anti-microbial and systemic antibiotics must precede any surgical treatment for DDSP. Horses with nasopharyngeal inflammation are treated with systemic, and topical, anti-inflammatory agents. Two different anti-inflammatory protocols are used as treatment: 1) dexamethasone (30 mg PO or IV SID for 3 days, 20 mg PO or IV SID for 3 days, 10 mg PO or IV SID for 3 days, and 10 mg PO or IV EOD for 3 treatments) and 2) prednisolone (300 mg PO BID for 2 weeks, 300 mg PO SID for 2 weeks, and 300 mg PO EOD for 2 weeks). The dexamethasone protocol is more potent. […]