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SUMMARY

Upper airway flow mechanics and arterial blood gas measurements were used to assess the efficacy of subtotal arytenoidectomy for treatment of induced left laryngeal hemiplegia in horses. Measurements were collected with the horses at rest, and trotting or pacing on a treadmill (6.38° incline) at speeds of 4.2 and 7.0 m/s. Experimental protocols were performed after right common carotid artery exteriorization (baseline), after left recurrent laryngeal neurectomy (lrln), and after left subtotal arytenoidectomy.

At baseline, increasing treadmill speed progressively increased peak inspiratory and expiratory flow (Vi max and Ve max respectively), peak inspiratory and expiratory transupper airway pressure (PuI and PuE, respectively), respiratory frequency (f), tidal volume (VT), minute volume (VE), and heart rate. Inspiratory and expiratory times (TI and TE, respectively) and arterial oxygen tension (Pao2) decreased with increased treadmill speed; inspiratory and expiratory impedance (ZI and ZE, respectively) did not change.

After lrln, Vi max, f, and Pao 2 significantly (P < 0.05) decreased at exercise, whereas PuI, TI, and ZI significantly increased. Minute volume decreased at exercise after lrln, but the changes were not significant; lrln had no effect on Ve max PuE, ZE, heart rate, arterial carbon dioxide tension (Paco 2), or VT.

Subtotal arytenoidectomy did not improve upper airway flow mechanics or blood gas measurements impaired by laryngeal hemiplegia.

Free access
in American Journal of Veterinary Research

Abstract

Objective—To record respiratory sounds in exercising horses and determine whether spectrum analysis could be use to identify sounds specific for laryngeal hemiplegia (LH) and dorsal displacement of the soft palate (DDSP).

Animals—5 Standardbred horses.

Procedure—Respiratory sounds were recorded and pharyngeal pressure and stride frequency were measured while horses exercised at speeds corresponding to maximum heart rate, before and after induction of LH and DDSP.

Results—When airway function was normal, expiratory sounds predominated and lasted throughout exhalation. After induction of LH, expiratory sounds were unaffected; however, all horses produced inspiratory sounds characterized by 3 frequency bands centered at approximately 0.3, 1.6, and 3.8 kHz. After induction of DDSP, inspiratory sounds were unaffected, but a broad-frequency expiratory sound, characterized by rapid periodicity (rattling) was heard throughout expiration. This sound was not consistently detected in all horses.

Conclusions and Clinical Relevance—The technique used to record respiratory sounds was well tolerated by the horses, easy, and inexpensive. Spectrum analysis of respiratory sounds from exercising horses after experimental induction of LH or DDSP revealed unique sound patterns. If other conditions causing airway obstruction are also associated with unique sound patterns, spectrum analysis of respiratory sounds may prove to be useful in the diagnosis of airway abnormalities in horses. (Am J Vet Res 2001;62:659–664)

Full access
in American Journal of Veterinary Research

Summary

The efficacy of a nerve muscle pedicle (nmp) graft in restoring upper airway function was evaluated in exercising horses with induced left laryngeal hemiplegia. The nmp graft was created from the first cervical nerve and the omohyoideus muscle and transplanted into the left cricoarytenoideus dorsalis muscle. Seven adult Standardbreds were trained to exercise on a treadmill inclined at 6.38°. With the horses at rest and exercising at 4.2 and 7.0 m/s, the following variables were recorded: peak inspiratory and expiratory transupper airway pressures (defined as the pressure difference between a lateral tracheal catheter and a mask catheter), peak inspiratory and expiratory air flow, inspiratory and expiratory impedance, tidal volume, minute ventilation, heart rate, and respiratory frequency. Measurements were made before left recurrent laryngeal neurectomy (lrln), 28 days after lrln, and 12, 24, and 52 weeks after the nmp graft (n = 5) or sham operation (n = 2). Before lrln, exercise increased inspiratory and expiratory air flow and transupper airway pressure, whereas the impedance was unchanged. After lrln, transupper airway inspiratory pressure and impedance were significantly greater and inspiratory air flow was significantly less than baseline values at 7.0 m/s. The sham operation did not improve airway function. Twelve weeks after insertion of the nmp graft, inspiratory impedance and inspiratory air flow were significantly different (improved) from lrln values. Twenty-four weeks after insertion of the nmp graft, inspiratory impedance was not significantly different from lrln values. Fifty-two weeks after insertion of the nmp graft, inspiratory impedance was not significantly different from the baseline value and was significantly less than the value after lrln. We conclude that the nerve muscle pedicle graft can restore upper airway function within 52 weeks in horses with induced left laryngeal hemiplegia.

Free access
in American Journal of Veterinary Research

Abstract

Objective—To evaluate the safety and efficacy of thoracoscopically guided pulmonary wedge resection in horses.

Animals—10 horses (5 control horses and 5 horses affected with recurrent airway obstruction [ie, heaves]).

Procedure—Each horse underwent a thoracoscopically guided pulmonary wedge resection. Before, during, and after surgery, heart rate, respiratory rate, arterial blood gases, and systemic and pulmonary arterial pressures were measured. Physical examination, CBC, and thoracic radiography and ultrasonography were performed 24 hours before and 2 and 48 hours after surgery. Pulmonary specimens were assessed by histologic examination. A second thoracoscopic procedure 14 days later was used to evaluate the resection site.

Results—The technique provided excellent specimens for histologic evaluation of the lung. Heart and respiratory rates decreased significantly after horses were administered sedatives. A significant transient decrease in PaO2 was detected immediately after pulmonary wedge resection, but we did not detect significant effects on arterial pH, Paco2, or mean arterial and pulmonary arterial pressures. All horses except 1 were clinically normal after thoracoscopic surgery; that horse developed hemothorax attributable to iatrogenic injury to the diaphragm. The second thoracoscopy revealed minimal inflammation, and there were no adhesions.

Conclusion and Clinical Relevance—Thoracoscopically guided pulmonary wedge resection provides a minimally invasive method for use in obtaining specimens of lung tissues from healthy horses and those with lung disease. This technique may be useful for the diagnosis of diseases of the lungs and thoracic cavity. (Am J Vet Res 2002;63:1232–1240)

Full access
in American Journal of Veterinary Research

Abstract

Objective—To determine clinical features of horses with a slab fracture of the central or third tarsal bone and to report outcome of horses in which treatment did not include surgery.

Design—Retrospective study.

Animals—25 horses (14 Standardbreds, 6 Thoroughbreds, 5 Quarter Horses).

Procedure—Medical records of horses with a slab fracture of the central (n = 9) or third (16) tarsal bone were reviewed. Only horses for which treatment consisted of confinement to a stall were included in this study. Clinical features and radiographic findings were recorded and summarized. Outcome was determined for racing breeds by obtaining official lifetime race results. Outcome for Quarter Horses was determined by phone survey of the owners.

Results—16 (64%) horses had a successful outcome. Ten of 14 (71%) Standardbreds and 2 of 6 Thoroughbreds returned to racing and started at least 5 races after injury. Four of 5 Quarter Horses for which follow-up information was available successfully returned to their previous activity. Sex, age, limb affected, or gait was not associated with final outcome. Percentage of racehorses with central tarsal bone fractures that had a successful outcome (2/7) was significantly less than percentage with third tarsal bone fractures that did (10/13).

Conclusions and Clinical Relevance—Results suggest that enforced rest without surgical fixation can be an effective therapeutic option for horses with a slab fracture of the central or third tarsal bone, even if athletic function is expected. (J Am Vet Med Assoc 2000;216:1949–1954)

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To compare endoscopic findings of the upper portion of the respiratory tract in Thoroughbred yearlings with their subsequent race records to determine whether subjective assessment of airway function may be used as a predictor of future racing performance.

Design—Retrospective study.

Animals—427 Thoroughbred yearlings.

Procedures—Endoscopic examination findings were obtained from the medical records and the videoendoscopic repository of the Keeneland 1996 September yearling sales. Racing records were requested for the yearlings through the end of their 4-year-old racing season (1997–2000). Twenty-nine measures of racing performance were correlated with endoscopic findings. Subjective arytenoid cartilage movement grades were determined, using a 4-point grading scale (grade 1 = symmetrical synchronous abduction of the arytenoid cartilages; grade 4 = no substantial movement of the left arytenoid cartilage).

Results—Of the 427 Thoroughbred yearlings included in this study, 364 established race records, and 63 did not. Opinions regarding suitability for purchase, meeting conditions of the sale, and the presence of epiglottic abnormalities had no significant association with racing performance. Arytenoid cartilage movement grades were significantly associated with many of the dependent variables. However, palatine abnormalities were not predictive of inferior racing performance.

Conclusions and Clinical Relevance—Thoroughbred yearlings with grade-1 and -2 arytenoid cartilage movements had significantly better racing performance as adults, compared with yearlings with grade- 3 arytenoid cartilage movements. In contrast, epiglottic and palatine abnormalities were not predictive of inferior racing performance. Therefore, evaluation of laryngeal function, but not epiglottic or palatine abnormalities, using the 4-point grading system, should be the major factor in developing recommendations for prospective buyers. (J Am Vet Med Assoc 2001;219: xxx–xxx)

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective

To evaluate the efficacy of prosthetic laryngoplasty with and without bilateral ventriculocordectomy for treatment of experimentally induced left laryngeal hemiplegia (LLH).

Animals

15 adult Standardbreds.

Procedure

Horses were allotted to 3 equal groups. Sham operation (group 1), prosthetic laryngoplasty (group 2), or prosthetic laryngoplasty with bilateral ventriculocordectomy (group 3) was performed after induction of LLH. Upper airway function testing was performed prior to left recurrent laryngeal neurectomy (LRLN), 14 days after LRLN, and 60 and 180 days after surgical treatment. Measurements were obtained at rest and at treadmill speeds corresponding to 75 and 100% of maximal heart rate. Videoendoscopy was performed at rest and during exercise in all horses prior to LRLN and 60 and 180 days after surgical treatment. Upper airway endoscopy was performed immediately after LRLN to document induction of grade-IV LLH. Also, horses in group 3 were endoscopically examined at 7, 14, 21, 28, and 120 days after surgical treatment to evaluate healing of the ventriculocordectomy sites.

Results

When horses were at rest, significant differences were not apparent between groups at any period or between periods for any measured variable. LRLN induced airway obstruction in all horses during exercise. In sham-operated horses, this obstruction was unaffected by time. In contrast, 60 and 180 days after surgical treatment, inspiratory flow limitations induced by LRLN were reversed in horses of groups 2 and 3. There were no significant differences between the 2 treatment groups. Endoscopy revealed the left arytenoid cartilage abducted beyond the intermediate position, but not touching the pharyngeal wall in all horses with a laryngeal prosthesis. After surgical treatment, 4 group-2 horses had filling of both ventricles with air during exercise. There was moderate to marked swelling of the ventriculocordectomy sites immediately after surgery, and this swelling resolved by 7 days after surgery. The ventriculocordectomy sites looked best at 14 and 180 days.

Conclusions

60 and 180 days after prosthetic laryngoplasty, upper airway function returned to pre-LRLN values in horses with experimentally induced LLH exercising at 100% of maximal heart rate. Combining ventriculocordectomy with prosthetic laryngoplasty does not further improve upper airway function in these horses. (Am J Vet Res 1996;57:1668–1673)

Free access
in American Journal of Veterinary Research

Summary

A nerve muscle pedicle (nmp) graft was placed in the cricoarytenoideus dorsalis (cad) muscle of 6 horses with induced left laryngeal hemiplegia. The nmp graft was created by use of the first cervical nerve and omohyoideus muscle. In 1 horse (control), the first cervical nerve was transected after placement of the nmp graft. One year after the surgical procedure, horses were examined endoscopically and then anesthetized. While the larynx was observed endoscopically, the first cervical nerve was stimulated. Horses were subsequently euthanatized, and the larynx was harvested.

Prior to anesthesia, the endoscopic appearance of the larynx of all horses was typical of laryngeal hemiplegia. During anesthesia, stimulation of the first cervical nerve produced vigorous abduction of the left aiytenoid in principal horses but not in the control horse. The right cricoarytenoideus lateralis and cad muscles were grossly and histologically normal. Also, the left cricoarytenoideus lateralis was atrophic in all horses as was the left cad muscle of the control horse. In contrast, the left cad muscle harvested from principal horses had evidence of reinnervation with type 1 or type 2 fiber grouping. One year after the nmp graft procedure, horses with left laryngeal hemiplegia had reinnervation of the left cad muscle. In another study, reinnervation was sufficient to allow normal laryngeal function during exercise. Combined, these data suggest that the nmp graft procedure is a viable technique for the treatment of left laryngeal hemiplegia in horses.

Free access
in American Journal of Veterinary Research

Abstract

Objective—To determine the effects of 2 weeks of intense exercise on expression of markers of pulmonary venous remodeling in the caudodorsal and cranioventral regions of the lungs of horses.

Animals—6 horses.

Procedures—Tissue samples of the caudodorsal and cranioventral regions of lungs were obtained before and after conditioning and 2 weeks of intense exercise. Pulmonary veins were isolated, and a quantitative real-time PCR assay was used to determine mRNA expression of matrix metalloproteinase-2 and −9, tissue inhibitor of metalloproteinase-1 and −2, collagen type I, tenascin-C, endothelin-1, platelet-derived growth factor, transforming growth factor (TGF)-β, and vascular endothelial growth factor (VEGF). Protein expression of collagen (via morphometric analysis) and tenascin-C, TGF-β, and VEGF (via immunohistochemistry) was determined.

Results—Exercise-induced pulmonary hemorrhage was detected in 2 horses after exercise. The mRNA expression of matrix metalloproteinase-2 and −9, tissue inhibitor of metalloproteinase-2, TGF-β, and VEGF was significantly lower in pulmonary veins obtained after exercise versus those obtained before exercise for both the caudodorsal and cranioventral regions of the lungs. Collagen content was significantly higher in tissue samples obtained from the caudodorsal regions of the lungs versus content in samples obtained from the cranioventral regions of the lungs both before and after exercise. Exercise did not alter protein expression of tenascin-C, TGF-β, or VEGF.

Conclusions and Clinical Relevance—Results of this study indicated 2 weeks of intense exercise did not alter expression of marker genes in a manner expected to favor venous remodeling. Pulmonary venous remodeling is complex, and > 2 weeks of intense exercise may be required to induce such remodeling.

Full access
in American Journal of Veterinary Research