Diagnosing Respiratory Tract Ulcers

“Indications to evaluate this area include respiratory noise and a persistent cough, often along with poor performance,” he said. “When the cough is observed while the horse is eating or when bitting up, this is pathognomonic (is indicative of a specific problem; in this case, subepiglottic ulceration).
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"Respiratory disease is the second-leading cause of lost training in the Thoroughbred racehorse, second only to musculoskeletal injuries," said Jeff Blea, DVM, of the Southern California Equine Foundation in Arcadia, Calif., during the 2003 American Association of Equine Practitioners convention. "Endoscopy of the upper respiratory tract plays a vital role as a first-line diagnostic tool and can provide a wealth of information at the initial exam."

Blea, who worked with California practitioner Rick Arthur, DVM, on this paper, discussed in depth a technique for inspecting the epiglottis and subepiglottic area (beneath the epiglottis) using endoscopy in the standing horse, and discussed his findings among California Thoroughbreds using this procedure. From Jan. 1, 2000 to March 31, 2003, he diagnosed 33 horses in active training with subepiglottic lesions.

The cause of the problem is unknown, but he described the following possible factors: Mucosal irritation from dorsal displacement of the soft palate (DDSP), upper respiratory tract infection, trauma from swallowing foreign bodies (i.e., dirt), or dynamic epiglottic entrapment while training.

"Indications to evaluate this area include respiratory noise and a persistent cough, often along with poor performance," he said. "When the cough is observed while the horse is eating or when bitting up, this is pathognomonic (is indicative of a specific problem; in this case, subepiglottic ulceration). Other pharyngeal abnormalities on endoscopic examination of a horse with this problem might include persistent dorsal displacement of the soft palate, epiglottic abnormality, and/or a mucoid discharge in the pharynx

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Christy West has a BS in Equine Science from the University of Kentucky, and an MS in Agricultural Journalism from the University of Wisconsin-Madison.

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