1
|
Toft K, Kjeldsen ST, Otten ND, van Galen G, Fjeldborg J, Sinding M, Hansen S. Evaluation of Dynamic Structural Disorders in the Upper Airways and Applied Rein Tension in Healthy Dressage Horses During Riding in Different Gaits and Head-Neck Positions. J Equine Vet Sci 2020; 87:102934. [PMID: 32172921 DOI: 10.1016/j.jevs.2020.102934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 01/13/2020] [Accepted: 01/13/2020] [Indexed: 11/16/2022]
Abstract
Flexion of the horse's head and neck during dressage riding reduces the pharyngeal lumen with the risk of increased upper airway resistance and upper airway obstructions. According to the Fédération Equestre Internationale, hyperflexion is achieved through force, whereas the position low-deep-round is nonforced. The objectives of this study were to evaluate (1) applied rein tension and (2) dynamic structural disorders in the upper airways in dressage horses in different gaits and different head-neck positions (HNPs). Overground endoscopy (OGE) and rein tension were evaluated in 13 clinically healthy and high-performance Warmblood dressage horses while being ridden in a standardized program comprised of four different gaits (halt, walk, trot, and canter) and in four HNPs (unrestrained, competition frame, hyperflexion, and low-deep-round). All included horses were able to achieve the desired HNPs. The HNP low-deep-round showed significantly lower rein tension than competition frame (P < .001) and hyperflexion (P < .001). An association was found between dynamic structural disorders in the upper airway tract evaluated by OGE and head-neck flexion, but this association was not linked to the degree of flexion. The HNP hyperflexion was neither associated with greater rein tension nor severe dynamic structural disorders than the HNP competition frame. This study confirms that low-deep-round is a nonforced position, in contrast to hyperflexion. Further studies are needed to evaluate whether dynamic structural disorders are a result of flexion or if the degree of flexion has an impact.
Collapse
Affiliation(s)
- Katrine Toft
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark
| | - Sofie T Kjeldsen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark
| | - Nina Dam Otten
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - Gaby van Galen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark
| | - Julie Fjeldborg
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark
| | | | - Sanni Hansen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark.
| |
Collapse
|
2
|
Fretheim-Kelly Z, Halvorsen T, Heimdal JH, Strand E, Vollsaeter M, Clemm H, Roksund O. Feasibility and tolerability of measuring translaryngeal pressure during exercise. Laryngoscope 2019; 129:2748-2753. [PMID: 30698834 PMCID: PMC6900056 DOI: 10.1002/lary.27846] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 01/07/2019] [Accepted: 01/10/2019] [Indexed: 02/06/2023]
Abstract
Objectives/Hypothesis To determine if simultaneous tracheal and supraglottic pressure measurement performed during a continuous laryngoscopy exercise (CLE) test is possible, tolerable, and feasible, and if so, whether measurements can be used to determined airflow resistance over the larynx, thus providing an objective outcome measure for the CLE test, the gold standard for diagnosing exercise‐induced laryngeal obstruction. Study Design Explorative descriptive clinical study. Methods A CLE test was performed with the addition of two pressure sensors (Mikro‐Cath 825‐0101; Millar, Houston, TX) placed at the epiglottic tip and at the fifth tracheal ring. To place sensors, laryngeal anesthesia and a channel scope were required. Tolerability and feasibility was determined by a Likert score and subjective indication from subjects and operators. Adjustments to the technique were made to increase tolerability. The pressure data were continuously collected and analyzed for artifacts, drifts, frequency response, and used with flow data to calculate translaryngeal resistance. Results All subjects (n = 7) completed all procedures. Two main areas of concern were identified regarding tolerability: application of topical anesthesia to the larynx and nasal discomfort due to the added diameter of the laryngoscope. Protocol adjustments improved both. Pressure data were obtained from all procedures in all subjects, were consistent, and followed physiological trends. Conclusions Continuous measurement of the translaryngeal pressure gradient during a CLE test is possible, feasible, and tolerable. A CLE test with direct measurement of the translaryngeal pressure gradient might become a valuable tool in the objective assessment of respiratory function, and normal values should be established in health and disease. Level of Evidence NA Laryngoscope, 129:2748–2753, 2019
Collapse
Affiliation(s)
- Zoe Fretheim-Kelly
- Faculty of Veterinary Science, Norwegian University of Life Sciences, Oslo, Norway.,Pediatric Department, Haukeland University Hospital, Bergen, Norway
| | - Thomas Halvorsen
- Pediatric Department, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Eric Strand
- Faculty of Veterinary Science, Norwegian University of Life Sciences, Oslo, Norway
| | - Maria Vollsaeter
- Pediatric Department, Haukeland University Hospital, Bergen, Norway
| | - Hege Clemm
- Pediatric Department, Haukeland University Hospital, Bergen, Norway
| | - Ola Roksund
- Pediatric Department, Haukeland University Hospital, Bergen, Norway
| |
Collapse
|
3
|
Manneveau G, Lecallard J, Thorin C, Pamela H, Tessier C. Comparison of morphological changes and tactile sensitivity of the pharynx and larynx between four standing sedative and analgesic protocols in eight adult healthy horses. Vet Anaesth Analg 2018; 45:477-486. [DOI: 10.1016/j.vaa.2018.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 02/13/2018] [Accepted: 02/15/2018] [Indexed: 10/17/2022]
|
4
|
Franklin SH, Allen KJ. Assessment of dynamic upper respiratory tract function in the equine athlete. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12432] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S. H. Franklin
- School of Animal and Veterinary Sciences; University of Adelaide; Roseworthy Australia
| | - K. J. Allen
- Equine Sports Medicine Centre; University of Bristol; UK
| |
Collapse
|
5
|
Go LM, Barton AK, Ohnesorge B. Pharyngeal diameter in various head and neck positions during exercise in sport horses. BMC Vet Res 2014; 10:117. [PMID: 24886465 PMCID: PMC4057621 DOI: 10.1186/1746-6148-10-117] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 04/30/2014] [Indexed: 12/03/2022] Open
Abstract
Background In equine athletes, dynamic stenotic disorders of the upper airways are often the cause for abnormal respiratory noises and/or poor performance. There are hypotheses, that head and neck flexion may influence the morphology and function of the upper airway and thus could even induce or deteriorate disorders of the upper respiratory tract. Especially the pharynx, without osseous or cartilaginous support is prone to changes in pressure and airflow during exercise. The objective of this study was to develop a method for measuring the pharyngeal diameter in horses during exercise, in order to analyse whether a change of head-neck position may have an impact on the pharyngeal diameter. Results Under the assumption that the width of the epiglottis remains constant in healthy horses, the newly developed method for calculating the pharyngeal diameter in horses during exercise is unsusceptible against changes of the viewing-angle and distance between the endoscope and the structures, which are to be assessed. The quotient of the width of the epiglottis and the perpendicular from a fixed point on the dorsal pharynx to the epiglottis could be used to determine the pharyngeal diameter. The percentage change of this quotient (pharynx-epiglottis-ratio; PE-ratio) in the unrestrained head-neck position against the reference position was significantly larger than that of any other combination of the head-neck positions investigated. A relation between the percentage change in PE-ratio and the degree of head and neck flexion could not be confirmed. Conclusions It could be shown, that the pharyngeal diameter is reduced through the contact position implemented by the rider in comparison to the unrestrained head and neck position. An alteration of the pharyngeal diameter depending on the degree of head and neck flexion (represented by ground and withers angle) could not be confirmed.
Collapse
Affiliation(s)
- Li-mei Go
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, Hannover D-30559, Germany.
| | | | | |
Collapse
|
6
|
Barnett TP, O'Leary JM, Dixon PM, Barakzai SZ. Characterisation of palatal dysfunction after laryngoplasty. Equine Vet J 2013; 46:60-3. [DOI: 10.1111/evj.12081] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 02/22/2013] [Indexed: 11/27/2022]
Affiliation(s)
- T. P. Barnett
- Royal (Dick) School of Veterinary Studies; The University of Edinburgh; Roslin Midlothian UK
| | - J. M. O'Leary
- Royal (Dick) School of Veterinary Studies; The University of Edinburgh; Roslin Midlothian UK
| | - P. M. Dixon
- Royal (Dick) School of Veterinary Studies; The University of Edinburgh; Roslin Midlothian UK
| | - S. Z. Barakzai
- Royal (Dick) School of Veterinary Studies; The University of Edinburgh; Roslin Midlothian UK
| |
Collapse
|
7
|
Van Erck-Westergren E, Franklin SH, Bayly WM. Respiratory diseases and their effects on respiratory function and exercise capacity. Equine Vet J 2013; 45:376-87. [PMID: 23368813 DOI: 10.1111/evj.12028] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Accepted: 12/02/2012] [Indexed: 12/26/2022]
Abstract
Given that aerobic metabolism is the predominant energy pathway for most sports, the respiratory system can be a rate-limiting factor in the exercise capacity of fit and healthy horses. Consequently, respiratory diseases, even in mild forms, are potentially deleterious to any athletic performance. The functional impairment associated with a respiratory condition depends on the degree of severity of the disease and the equestrian discipline involved. Respiratory abnormalities generally result in an increase in respiratory impedance and work of breathing and a reduced level of ventilation that can be detected objectively by deterioration in breathing mechanics and arterial blood gas tensions and/or lactataemia. The overall prevalence of airway diseases is comparatively high in equine athletes and may affect the upper airways, lower airways or both. Diseases of the airways have been associated with a wide variety of anatomical and/or inflammatory conditions. In some instances, the diagnosis is challenging because conditions can be subclinical in horses at rest and become clinically relevant only during exercise. In such cases, an exercise test may be warranted in the evaluation of the patient. The design of the exercise test is critical to inducing the clinical signs of the problem and establishing an accurate diagnosis. Additional diagnostic techniques, such as airway sampling, can be valuable in the diagnosis of subclinical lower airway problems that have the capacity to impair performance. As all these techniques become more widely used in practice, they should inevitably enhance veterinarians' diagnostic capabilities and improve their assessment of treatment effectiveness and the long-term management of equine athletes.
Collapse
|
8
|
Allen K, Franklin S. The effect of palatal dysfunction on measures of ventilation and gas exchange in Thoroughbred racehorses during high intensity exercise. Equine Vet J 2012; 45:350-4. [DOI: 10.1111/j.2042-3306.2012.00627.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
9
|
Barakzai SZ, Cheetham J. Endoscopic examination of exercising horses: Effects on diagnosis and treatment of upper respiratory tract disorders. Equine Vet J 2012; 44:501-3. [DOI: 10.1111/j.2042-3306.2012.00625.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
10
|
Strand E, Skjerve E. Complex dynamic upper airway collapse: associations between abnormalities in 99 harness racehorses with one or more dynamic disorders. Equine Vet J 2011; 44:524-8. [PMID: 22168356 DOI: 10.1111/j.2042-3306.2011.00516.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
REASONS FOR PERFORMING STUDY Many horses demonstrate dynamic collapse of more than one upper respiratory tract (URT) structure during high-speed treadmill videoendoscopy (HSTV). OBJECTIVES To report the frequency of complex dynamic URT collapse in harness racehorses and determine if an association exists between occurrence of certain disorders. METHODS Retrospective study of 99 Standardbreds and Coldblooded trotters that had one or more dynamic URT disorders identified during HSTV between 1998 and 2006. The horses underwent HSTV using a protocol that included periods of free head carriage and poll flexion until fully fatigued. Dynamic abnormalities were classified as: dynamic laryngeal collapse (DLC) associated with poll flexion; axial deviation of the aryepiglottic folds (ADAF); dynamically flaccid epiglottis (FE); caudal palatal instability (PI); intermittent dorsal displacement of the soft palate (iDDSP); pharyngeal collapse (PC); alar fold collapse (AFC) and nasal flutter (NF). Cluster analysis and Fisher's exact test was performed between groups. Significance was set at P<0.05. RESULTS The overall incidence of complex dynamic URT collapse was 69.7%. Axial deviation of the aryepiglottic folds was significantly associated with PI (P<0.0001) and FE (P<0.0001); iDDSP was significantly associated with PI (P = 0.004) only. Dynamic laryngeal collapse associated with poll flexion was significantly associated with FE (P = 0.002). Cluster analysis confirmed strong associations between the above diagnosis groups and weaker associations between others. CONCLUSION Caudal PI seems to result in 2 diagnosis groupings: one that leads to ADAF and the other to iDDSP. Dynamic collapse of the margins of the epiglottis was a common finding in this study strongly associated with DLC, PI and ADAF. POTENTIAL CLINICAL RELEVANCE The associations between certain dynamic diagnoses identified in this study seems best explained as due to local anatomic and functional weaknesses that influence other structures through the Bernouilli principle, rather than being due to a generalised neurological disorder.
Collapse
Affiliation(s)
- E Strand
- Equine Section, Norwegian School of Veterinary Science, Oslo, Norway.
| | | |
Collapse
|
11
|
VAN ERCK E. Dynamic respiratory videoendoscopy in ridden sport horses: Effect of head flexion, riding and airway inflammation in 129 cases. Equine Vet J 2011:18-24. [DOI: 10.1111/j.2042-3306.2011.00492.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
12
|
|
13
|
Tessier C, Holcombe SJ, Stick JA, Derksen FJ, Boruta D. Electromyographic activity of the stylopharyngeus muscle in exercising horses. Equine Vet J 2010; 37:232-5. [PMID: 15892232 DOI: 10.2746/0425164054530759] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY There is a need to understand the process which leads to failure of recruitment of the stylopharyngeus muscle in clinical cases of nasopharygeal collapse. We therefore studied the timing and intensity of stylopharyngeus muscle activity during exercise in horses. OBJECTIVE To measure the electromyographic (EMG) activity of the stylopharyngeus muscle in exercising horses and correlate it with the breathing pattern. METHODS Five horses were equipped with a bipolar fine wire electrode placed on the stylopharyngeus muscle and a pharyngeal catheter. The horses exercised on a treadmill at speeds corresponding to 50 (HRmax50), 75 and 100% of maximum heart rate, and EMG activity of the stylopharyngeus muscle and upper airway pressures were recorded. The EMG activity of the stylopharyngeus muscle was then correlated to the breathing pattern and the activity quantified and reported as a percentage of the baseline activity measured at HRmax50. RESULTS There was ongoing activity of the stylopharyngeus muscle throughout the breathing cycle; however, activity increased towards the end of expiration and peaked early during inspiration. Tonic activity was present during expiration. Peak, mean electrical and tonic EMG activity increased significantly (P<0.05) with exercise intensity. CONCLUSION The stylopharyngeus muscle has inspiratory-related activity and tonic activity that increases with speed. POTENTIAL RELEVANCE The stylopharyngeus muscle is one of a group of upper airway muscles that function to support and maintain the patency of the nasopharynx during inspiration. Failure of recruitment of the stylopharyngeus muscle during exercise is a potential explanation for clinical cases of dorsal pharyngeal collapse, but further work investigating the activity of the stylopharyngeus muscle in horses affected by this disease is needed.
Collapse
Affiliation(s)
- C Tessier
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan 48824, USA
| | | | | | | | | |
Collapse
|
14
|
Radlinsky MG, Mason DE, Hodgson D. Transnasal laryngoscopy for the diagnosis of laryngeal paralysis in dogs. J Am Anim Hosp Assoc 2007; 40:211-5. [PMID: 15131101 DOI: 10.5326/0400211] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Four dogs with clinical signs of laryngeal paralysis and three normal dogs were evaluated with transnasal laryngoscopy. Six of these dogs subsequently underwent standard laryngoscopy. For transnasal laryngoscopy, a video endoscope was passed through the left nasal passage after intramuscular sedation and topical anesthesia. The laryngeal opening was observed during spontaneous ventilation. Laryngeal paralysis was diagnosed in four dogs and was confirmed with traditional laryngoscopy in three dogs. Normal motion of the arytenoid cartilages was present in the other three dogs; however, two required mechanical stimulation of the laryngeal mucosa for full evaluation. Transnasal laryngoscopy provided a means for diagnosing laryngeal paralysis in dogs without general anesthesia.
Collapse
Affiliation(s)
- MaryAnn G Radlinsky
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas 66506-5606, USA
| | | | | |
Collapse
|
15
|
|
16
|
Ducharme NG, Hackett RP, Woodie JB, Dykes N, Erb HN, Mitchell LM, Soderholm LV. Investigations into the role of the thyrohyoid muscles in the pathogenesis of dorsal displacement of the soft palate in horses. Equine Vet J 2003; 35:258-63. [PMID: 12755428 DOI: 10.2746/042516403776148200] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY Contributes to the understanding of the pathogenesis of dorsal displacement of the soft palate during exercise so that management of this condition could be enhanced. HYPOTHESIS That the thyrohyoid muscles play an important role in the stability of the laryngo-palatal relationship and that dysfunction of these muscles leads to dorsal displacement of the soft palate (DDSP) during exercise. METHODS Ten horses were exercised on a high-speed treadmill under 4 different treatment conditions: control conditions (n = 10), after resection of thyrohyoid muscles (TH, n = 10), after sham-treatment (n = 5), or after restoration of function of the thyrohyoid muscles with surgical sutures (prosthesis-treatment, n = 6). During trials, the following determinations were made: videoendoscopy of the upper airway, gait frequency and pharyngeal and tracheal static pressures. RESULTS None of the 10 horses developed DDSP during 2 separate treadmill-exercise trials under the control conditions. Seven of the 10 horses developed DDSP after resection of the TH muscles, 4 of 5 of these horses still experienced DDSP after sham-treatment, but 5 of 6 horses no longer experienced DDSP at exercise after the prosthesis-treatment. There were significant anomalies in airway pressures, respiratory frequency, and occurrence of DDSP in both the TH resection and sham-treatment conditions compared to control conditions. In contrast, no statistical differences were noted in any of the parameters measured between the prosthesis-treatment and control conditions. CONCLUSIONS That the function of the TH muscles is important to the stability of the laryngo-palatal relationship and plays a role in the pathophysiology of exercise-induced DDSP. POTENTIAL RELEVANCE Management of horses with DDSP could be enhanced by restoring the function of the TH muscles.
Collapse
Affiliation(s)
- N G Ducharme
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York 14853, USA
| | | | | | | | | | | | | |
Collapse
|