Video Endoscopy

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Video-endoscopic examination of the horse’s upper respiratory tract is a routine procedure that allows thorough examination of a horse’s nasal passages, pharynx, larynx, guttural pouches and trachea (windpipe). A video-endoscope developed its name as it allows the image on the eyepiece to be projected in real-time to a TV monitor, which allows observers to visualise what is being seen with the scope.  We have the latest portable digital video-endoscope, the porta-scope which displays the image on a small portable screen so the owner also views the examination procedure.  Images can also be captured or recorded as a video in a digital format.

There are a number of reasons that your horse may require endoscopic examination. Some of these reasons include-

  • Airway noise during rest or exercise
  • Unexplained nasal discharge
  • Bleeding from the nostrils
  • Chronic cough
  • Poor performance

 

Noise production indicates turbulence of airflow thorugh the horses nasal passages or larynx. Turbulence is usually the result of some type of obstructive lesion or the horse having a condition that causes obstruction of the larynx during exercise.

Nasal passage

The most common cause of bleeding from one nostril is the condiiton known as ethmoid haematoma (see fig 1) which is a locally invasive mass consisting of blood vessels that begins towards the back of the horse’s nasal passage. These can be treated with a fairly good prognosis given if they are diagnosed early.

Ethmoid haematoma in the right nasal passage of a Quarterhorse.

 

 

 

 

 

Pharynx and larynx

Typically, when a horse makes noise during exercise (or occasionally at rest), upper airway endoscopic examination can identify conditions that may be causing the noise or turbulence. Commonly identified conditions include-

  • Laryngeal hemiplegia (roaring)
  • Dorsal displacement of the soft palate (DDSP)
  • Epiglottic entrapment

 

Laryngeal hemiplegia

This commonly affects the left side of th ehorse’s larynx and is caused by failure of normal function of the nerve that supplies that side of the larynx. Surgery is required and the type of surgery performed depends upon the use of the horse. The most common surgical technique in racehorses is the ‘tie-back’ procedure, which is successful in around 60-70% of cases to return them to their full athletic potential.

Normal larynx                                       Horse with laryngeal hemiplegia

 

 

Dorsal Displacement of the Soft Palate (DDSP)

This is typically a dynamic obstruction which means that is usually occurs at high speed when the horse is galloping. For this reason, DDSP is commonly diagnosed once the other causes of obstruction have been ruled out. Newer endoscopic equipment has been developed that allows horses to be fitted with an endoscope that records a video of the horse’s throat during exercise. There are many surgical therapies available for DDSP of which the ‘tie-forward’ has been reported to be the most successful.

Displaced soft palate.  Note the ulceration on the caudal border of the soft palate.

 

Epiglottic entrapment

This is a condition in which the epiglottis (triangular cartilage at the front of the larynx) becomes entrapped with surrounding folds of soft tissue. In some cases this condition does not affect the horse although constant movement and irritation of the tissues can lead to ulceration and thickening of the entrapping membrane, which can result in airway obstruction. For this reason, surgery is often recommended to treat the condition before it becomes problematic.

 

Epiglottic entrapment