Winter 2011 TCEH Newsletter

We would like to wish all of our clients a Merry Christmas and a Happy New Year!

Staff News

Congratulations to Mark Georgetti for gaining his certificate in surgery (although it’s debatable whether he was more excited about New Zealand’s recent World Cup win at the rugby or passing his exams!). Well done also to Claire Williams who has recently passed her GP(Cert) examinations in Equine Practice.

Andrew Harrison (left) following Mark Georgetti (right)

We welcome Emma Poucher to our nursing team. Emma has worked for several years in a busy Equine Hospital and has not only brought a wealth of experience but also a lot of enthusiasm and fun. She is the nurse in charge of Scintigraphy and is most often seen lunging, rugging and bandaging horses prior to their bone scans!

Mark Georgetti and Andrew Harrison managed to find time to compete in ‘The Autumn Epic’, a 155k bicycle race around the Welsh Marches. Not quite the Tour de France but by all accounts the pain and cramps were comparable!

Dentistry

Oral and dental health can have a significant impact on a horse’s wellbeing, performance and lifespan. We recommend that your horse’s teeth are assessed and rasped routinely on a yearly basis. All our veterinarians have the skills and equipment required for routine procedures including wolf tooth removal and are happy to discuss any dental questions you may have. However, to carry out a complete and thorough examination of your horse’s teeth it is often necessary to give light sedation. For this reason we have a combined sedation and routine rasp teeth fee of £44.10 excluding VAT.

“He’s a bit Thick in the Wind”

This is a phrase that is used by trainers, riders and veterinarians but what does it really mean? In essence, it is used to describe a horse that makes a respiratory noise during exercise. The noise may be entirely normal or may indicate the presence of one of many respiratory problems.

The implications of these noises can be significant as it may indicate that the horse is unable to maintain an adequate, functional airway. When galloping, a horse will have 75 litres of air per second moving through the respiratory tract (compared with 4 litres of air per second in a resting horse). It is thus easy to understand how an impedance of these airways can severely affect a horse’s performance whilst racing or performing other high intensity activities such as eventing or top level dressage.

So what conditions can cause these noises?

There are numerous causes of respiratory noise in exercising horses but two more common causes are “Laryngeal Neuropathy” and “Dorsal Displacement of the Soft Plate” (DDSP).

Overground endoscopy

Laryngeal Neuropathy

This condition is characterised by paralysis of the larynx (the voice box) due to dysfunction of the nerve supplying the area.

The larynx acts as an air valve between the pharynx and the trachea (windpipe) of the horse. During exercise, it needs to open as wide as possible to allow air into the trachea and lungs but if it is paralysed then this will result in air turbulence (and a characteristic “roar” or “whistle” noise during inspiration). This can cause varying degrees of exercise intolerance.

This paralysis usually occurs only on the left side of the larynx and there is no known cause in the majority of cases. It is estimated to occur in up to 8% of adult horses and generally affects taller breeds such as thoroughbreds, warmbloods and draft breeds. The condition is permanent and in some cases can be progressive.

Laryngeal neuropathy can be suspected by listening to a horse and during clinical examination whilst palpating the larynx but a definitive diagnosis is made during endoscopy (a fibreoptic camera that is placed in the nasal passages in order to observe that larynx). The severity of the condition is graded on a four point scale and some horses may require endoscopy during high speed work (either on a treadmill or ‘over-the-ground’) to determine the exact severity.

Normal larynx	Larynx with laryngeal paralysis

Treatment options depend on the severity of the condition and also on the type of work the horse is performing. Many horses competing at only low levels will require no treatment at all as it will not affect their performance. However, if exercise intolerance is present then there are various surgical options recommended. The most common of these is a laryngoplasty (or “tie back”) procedure which involves suturing the paralysed cartilage out of the way so that it can’t interfere with airflow. Other options include a ventriculocordectomy (or “Hobday”) procedure or arytenoidectomy.

Dorsal Displacement of the Soft Palate (DDSP)

Photo of DDSP

DDSP is often referred to by trainers as “choking up”. It usually, but not exclusively, occurs in racehorses whilst galloping, a sudden “gurgling” or “snoring” noise is heard and the horse often stops within a few strides.

This condition is caused by a disruption between the normally air-tight seal of the soft palate and the larynx. The soft palate becomes displaced and the air then passes above and below it, causing it to flap (much like a sail in the wind). This produces considerable air turbulence and causes a distinctive noise on expiration. The air tight seal is rapidly regained when the horse swallows and thus the condition is usually only definitively diagnosed by endoscopy during high speed work.

Management of the disease includes the use of specific equipment (such as tongue ties, figure-eight nose bands), increasing fitness and decreasing local inflammation. However, if this fails then surgery is recommended. Many surgical treatments are available and include procedures to “stiffen” the soft palate, thermocautery or stabilize the larynx in a position that is optimal for preventing the displacement (a “tie-forward” procedure).

Christmas Opening Hours

The office will be closed from 25th-27th December inclusive and on 1st-2nd January inclusive, it will re-open as normal from 3rd January. However you can always reach our on call vets by telephoning the usual surgery number.