Langford Equine Sports Medicine Centre
At the Langford Equine Sports Medicine Centre we advise and treat a high number of competition and racehorses. Many owners and trainers prefer that information relating to their horses’ remain confidential and we consider it very important to protect that. As a result, most of our successes are not reported in the media. However, in the last few years we have been involved in the veterinary care of gold cup winners, grade 1 and group winners and 4 star eventers.
Our 2016 ‘mystery horse’ was already a successful young event horse, with several wins and places at novice & intermediate level eventing nationally and 1 star & 2 star level internationally. The rider had noticed that the horse made obstructive respiratory noises, particularly during the cross country phase. The noise had progressed during the 2015 season and was now quite loud. Endoscopy of the upper airways of this horse revealed that the left side of the larynx was paralysed. Paralysis of the larynx reduces the size of the airway that the horse can breathe through – this results in turbulence of the airflow which was the source of the noise and also can result in a reduction in performance as the horse finds it much harder to breathe through the narrowed airway. Although this particular horse was still able to cope at intermediate level with this condition, his owner and rider think he is talented enough to progress further up the levels. However at 3 and 4 star level, the demands of the cross country test increase and often horses find this level difficult if they have a paralysed larynx.
Endoscopy images taken at rest from a normal horse (left) and a horse with laryngeal paralysis (right). With laryngeal paralysis the left side of the larynx (right side of the image) cannot open up fully (arrow).
Endoscopy image taken during fast exercise. As the horse breathes harder during exercise the paralysed side of the larynx is drawn even further over leaving the horse to breathe through a narrow slit (arrow)
After discussion with the rider it was decided to go ahead with a tieback and Hobday procedure. During the tieback procedure a suture is placed which fixes the left side of the larynx in an open position. The Hobday procedure involves removal of the ventricles and vocal cords which contribute to the abnormal noise. The tieback procedure is a technically demanding surgery and is known to have a fairly high rate of complications in comparison to other airway surgeries. The surgery went ahead under general anaesthetic and seemingly went well, with the horse recovering well from the general anaesthesia. However a repeat endoscopy performed 24 hours later revealed that the left side of the larynx was still not open enough and required adjustment. After further discussions with the rider, it was decided to repeat the general anaesthetic and revise the tieback procedure. This time endoscopy revealed a much better position of the left side of the larynx.
Endoscopy image after a tieback and hobday. The left side of the larynx (right side of the picture – blue arrow) is now fixed in a more open position. The hobday surgery (red arrow) is starting to heal.
The horse was discharged from the hospital and had 5 weeks rest and walking before resuming his normal training programme. We are delighted to report that he has made an excellent start to the season, completing his first three 3 star competitions double clear and inside the time – a wonderful achievement for all involved. We are really excited to watch how the horse progresses and hope we will see him at a 4 star event such as Badminton next season.
Kate Allen and Geoffey Lane
