Upper Respiratory tract horse what can go wrong?

Normal Cant see chest movements 8-16 breaths per minute

Severe emphysema/ Bronchiolitis (bilaretal lung disease) Nostrils flaring Thorax expansion and contraction Not much noise

Diaphragmatic hernia Flaring nostril Hypertrophy of the abdominal oblique muscle Thorax contraction and expansion

Heart failure (left side) with pulmonary oedema Big respiratory effort Some expiratory effort Large tracheal tug No noise Nostril flaring

Conclusion Horses with dyspnea caused by a LRT problem show marked abdominal effort, marked respiratory effort, pronounced expiratory effort. Still silent.

Necrotic fritzed lung (singular) Slight exaggeration of respiratory effort Slight nostril flare.

Conclusion the lung has a very large respiratory reserve.

Noise present on inspiration at rest No distress

No distress No nostril flaring No increase in respiratory rate Unilateral facial swelling over maxillary sinus area Fluid running down from the eye No nasal discharge No sneezing or coughing

Conclusion: hallmark of upper respiratory instruction is an inspiratory noise (stridor) and perhaps prolonged inspiration time. c.f. the silent, increased expiratory effort and prolonged expiration time seen in horses with severe pulmonary or other chest problems (as above).

Generally, the louder the noise the bigger the obstruction, but complete obstruction will be silent. The larynx is the narrowest part therefore airway obstruction here has the greatest impact as laminar airflow is realted to radius4. In addition, the obstruction also increases turbulence, which further increases resistance. If there is only a small obstruction it may not be noticed until exercise is performed. If there is respiratory noise at rest the obstruction is usually quite severe and often associated with distress. TEST to find an obstruction earlier make the horse exercise and lisen for a noise.

THE LARYNX Visualised using an endoscope. Things to look for: To see if one laryngeal saccule is more open than the other Does the pharyngeal roof remain raised Vasclar pattern on the epiglottis The movement of the vocal folds do they move/relax equally When swallowing the soft palate is raised, the epiglottis is raised (cant see larynx), the aretynoids close and then maximally open (abduction) (this opening is what can be seen). In the pharynx there are orifices to the guttural pouch. The guttural pouchs can be entered using a guide wire to see the internal carotid artery, glossopharyngeal & hypoglossal nerves, stylohyoid bone, lateral maxillary vein branches. Check for cleanliness. Rostrally to this is the ethymoidal turbinate area Cant easily enter paranasal sinuses (without drilling an external hole). Can enter ventral and middle meatuses (of nose passages) but not dorsal.

TEST to see maximal abduction of the aretynoids at rest make the horse swallow (irritate pharynx with water or endoscope) or obstruct the horses nostril so that they have to strain to breath.

TEST check blockage of nasal passage by feeling for air coming out of the nostrils and checking with endoscope.

TEST check paranasal sinus status via x-ray or through surgical introduction of an endoscope.

Arytenoid chondritis/ infection of arytenoid cartilage Progressive Causes distortion of the cartilage. Left only slight noise with maximal gallop post race. Middle Begun as a singular lesion that spread to other side with contact (ulceration kissing lesion). Still not noticed at rest. Duration of ~ 6 weeks. Right large inspiratory effort, large noise. Requires emergency tracheostomy. The same response is needed for complete obstruction of the nasal passages (as horses cant mouth breath, rabbits and rodents cant either).

Strenuous exercise Bigger inspiratory effort creates a bigger negative pressure gradient and bigger airflow (soft tissues have to resist this larger pressure gradient). Larynx maximally opens by abducting arytenoid cartilages Conditions seen/heard only during exercise (often functional and non-progressive): Weak or paralysed arytenoid = recurrent laryngeal neuropathy (laryngeal hemiplegia) Displacement of URT soft tissues (axial collapse of the ariepiglottic folds, collapse of the pharyngeal roof, dorsal displacement of the soft palate etc) obstructing airway in response to increased negative pressures

When the nasal passages are obstructed some species can mouth breath to compensate: Normal for dogs panting Cats, cattle, sheep only with dyspnea, commonly due to bilateral nasal blockage Horses, rabbits, rodents obligate nasal breathers due to position of soft palate below epiglottis forming an airtight seal around larynx.

Signs of a URT issue

Nasal discharge Discharge can come from anywhere in the URT but its source location may affect which nostril is affected. Discharge prior to the nasal passages may also be swallowed. Unilateral - most probably from an area after nasal septum i.e. Nasal passage Paranasal sinuses drain into either nasal passage Guttural pouches as they are placed laterally it is more likely to come out one side but if severe or associated with a cough could come out either side.

Bilateral Pharynx Guttural pouches Larynx Trachea Lungs

Sneezing Nasal passasge irritation

Coughing Trachea/bronchi irritation