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The Management of Diseases Causing Equine Dynamic Upper Airway Obstruction
T. Greet
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Introduction
The development and introduction of flexible fibreoptic endoscopy into equine practice in the early 1970`s brought about a revolution in the diagnosis of equine upper airway diseases. However, it was not until the more widespread use of endoscopy during treadmill exercise in the 1980`s and 90`s that many of the conditions which solely manifest as a cause of airway obstruction at fast exercise were identified. This presentation will attempt to describe a variety of causes of dynamic obstruction and to detail their management. Obviously any condition which causes obstruction at rest can do so at exercise but such problems will not be covered here.
Assessment of the upper airway at exercise
A thorough clinical examination at rest and when the horse is cantering will allow the identification of inspiratory or expiratory noises and other features of such problems. This will include a detailed examination of the horse`s head and neck including careful palpation of the larynx both before and immediately after exercise.
Endoscopy should be carried out at rest and preferably in the unsedated horse to avoid any possible chemically induced artefacts of laryngeal motility, for example. Endoscopy after exercise can also be of value as can endoscopy after the administration of respiratory stimulants such as Lobelin.
In the absence of a diagnosis by this stage an endoscopic examination during treadmill exercise should be arranged. Indeed in many centres this is done as a matter of routine. However, it does add additional time and expense.
Diseases causing dynamic airway obstruction
Alar Fold vibration
The vibrant expiratory noise produced during faster paces can often be due to vibration of the alar fold and is generally called “high blowing” and considered of no significance. However, in its most extreme form it can produce a noise which causes owner`s concern and has been attributed as a cause of airway obstruction after a The diagnosis is confirmed by placement of mattress sutures to alter the noise. Resection of the alar folds can be carried out afterwards. However, there is considerable doubt about the clinical significance of the condition. [...]
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