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33 Cards in this Set
- Front
- Back
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When does intermittent dorsal displacement of soft palate (DDSP) usually occur?
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only at very fast exercise (dynamic)
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Tx of DDSP if caused by dysfunction of palate muscles
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Fibrose palatal tissue (laser or thermal cautery)
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Tx of DDSP if caused by dysfunction of thyro-hyoid mm
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Tie forward ( pulls larynx dorsal and rostral)
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Tx of DDSP if caused by excessive caudal retraction of larynx
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a) myectomy of strap muscles
b) Sternothyroid tenectomy at insertion in thyroid cartalige c) Tongue tie- pull tongue rostral may pull larynx rostral |
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Tx of DDSP if caused by damage to vagus nerve
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Rest
tx inflammation/URT infection Topical/systemic corticosteroids |
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Dx of DDSP
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History- gurgling and PP
High speed treadmill endoscopy Ulceration of caudal border of soft palate |
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When do you often get permanent DDSP?
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secondary to other dz:
- Epiglottic entrapment - sub-epiglotic fibrosis/ulcers - sub-epiglottic cyst - Palatal cyst - Epiglottitis - N/M dysfunction |
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What is epiglottic entrapment (EE)?
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Rostral aspect of epiglottis becomes trapped in a pouch of mucosa that develops from mobile sub-epiglottic mucosa
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What 3 stages can EE exist in?
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Permanent
Intermittent Exercise |
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Tx of EE
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Section entrapping membranes using hooked bistoury (per nose or os)
or transendoscopic laser |
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a) What does subepiglottic cysts do?
b) Dx |
a) Deviate epiglottis dorsally --> airflow OBS +/- dysphagia
b) Endoscopy |
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Whats common to happen secondary to subepiglottic cysts?
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EE and DDSP
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Tx of subepiglottic cysts
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Surgical excision
- per os (adults) - Intermandibular approach (foals) |
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When is epiglottic retroflexion seen?
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Dynamic disorder (therefore seen during high speed tredmill endoscopy --> epiglottis is inhaled into the rima glottis)
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a) Cx signs of epiglottic retroflexion
b) Tx |
a) Abnorm resp noise
+/- PP b) No treatment |
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What is the most important URT airway obstuction dz of the larger breed horses (rare in ponies)?
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Recurrent laryngeal neuropathy (RLN)
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What muscle of the larynx opens it during exercise?
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cricoarytenoideus (aductor)
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Other than neuropathy of left recurrent laryngeal nerve, what else can cause unilateral paralysis?
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Guttural pouch mycosis
Irritates/damages the RL nerve: -Perivascular inj irritating the RL nerve -Intrathoracic tumor -Post sx of oesphagus/throid |
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Cx signs of RLN
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- Abnormal inspiratory noise at exercise
+/- PP - Laryngeal mm atrophy |
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Dx of RLN
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- Endoscopy at rest:
Look for asymmetry and asynchrony (at swallowing) - Listen to sounds at fast exercise |
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What are the grades for RLN
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1-5 Grading
1+ 2 = unlikely to be associated with collapse at exercise 3 = Equivocal 4 = total hemiparesis during exercise 5 = always collapsed (must tx) |
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Tx for RLN:
a) Mild cases b) Sever cases |
a) Ventriculectomy (hobdays) or ventriculocordectomy
b) Laryngoplasty (tie back) |
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Complications associated with tie back?
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Loss of sx abduction (implant fails)
Aspiration tracheitis Post op wound odema |
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What does a tie-back do?
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Its a prosthesis (suture) that acts like CAD muscle --> permanent abduction of left arytenoid
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Causes for bilateral laryngeal paralysis?
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HE
Organophosphate posioning Lead posioning After GA 4-BAD |
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What is 4th branchial arch defect (4-BAD)?
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congenital abnormal/missing cricopharyngeus (upper oesphageal sphincter) and cartilage
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Cx of 4-BAD
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Abnormal resp noises
PP belching/colic --> aerophagia |
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Dx of 4-BAD
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Laryngeal palpation (gap between cricoid and thyroid)
Endoscope (collapse of palato-pharyngeal arch, decreased movement of arytenoid) X-ray (air in proximal oesphagus) |
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In what does tracheal collapse usually occur?
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Small pony breeds
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What is tracheal collapse caused by?
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Cartilage deformity or degeneration of dorsal trachealis ligament
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Does it matter where the collapse/obs occurs on type of noise?
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Yes-
Intracervical = inspiratory Intrathoracic = expiratory |
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Tx for tracheal collapse?
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Sx = tracheal stenting (very complicated) only if cervical
Try and improve environment as LRT dz makes it worse |
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What would your dx work up be to abnormal resp noise in performance horse?
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History- any other clinical signs
Palpate larynx (CAD wasting, previous sx, 4-BAD) Listen to horse during exercise (I of E) Resting endoscopy Tredmill endoscopy |
