Up your nose with a rubber hose.
It’s been a while since I’ve written, because until late last week, there wasn’t much to say. Derby was finally re-scoped on Thursday, and we now have a better understanding of what is going on in his larynx. Dr. Chris Downs from Merritt Equine, the surgeon with whom my vet Dr. Nicky Wessel has been consulting, concluded that it’s likely that Derby has a partially entrapped epiglottis, and that the situation may be alleviated with a relatively minor surgery to free the entrapment.
Once again, while the scope was in, Derby displaced his soft palate. Below you can see what his airway looks like, before he displaced. Even a layperson can see the asymmetry of the structure of the larynx, which contributes to the problem. In addition, one of his flaps (arytenoid cartilages) is paralyzed, and the tie-back surgery he had as a two-year old has failed.
Derby's airway, before displacement. Click on the image for a larger view.
Here’s a picture of the airway after he displaced.
Derby's airway, when he displaced his soft palate. Click on the image for a larger view.
When a horse displaces its soft palate, the airway is significantly constricted, which you can see in the photos above. The epiglottis disappears under the soft palate, which is the strangest thing. The entire confirmation of the airway appears to change (and, in effect, does change) in a split second.
The drugs Derby has been on (SMZ, dex, Previcoxx) have had a significant effect in reducing the inflammation of the airway structures since the first scoping. However, Derby has developed a fairly large ulcer on the edge of his epiglottis (clearly visible in the second photo, above) so we’re continuing with the SMZ and other meds. Dr. Downs did his surgical internship at Hagyard-Davidson-McGee in Kentucky – one of the top clinics in the world and one that does a lot of work on Thoroughbreds. He’s going to send Derby’s pictures to some colleages there for a consult, but right now, it looks like a surgery to help free the epiglottis will be the next step.
Separately, I mentioned in an earlier post that I was wondering if Derby’s meds were having an effect on his rideability recently. However, after talking to my vet and some others, it looks like the cause of the hot and spooky behavior was weather-related. We’ve had really strange weather lately – including a nose dive into real frigid temperatures, followed by more abnormal warmth. My vet tells me that they’ve been inundated with calls complaining of horses acting crazy, and others at my barn are being uncharacteristically loony.
During this time, I stood down. If you recall, I’ve come off Derby twice in the last couple months. Neither fall was a bad one and I was able to get back on. However, when on the heels of those falls Derby started acting crazy, my confidence was rattled. After a couple rides in which I rode numerous stupid spooks, I decided to take a little time off, since those falls were pretty close to the surface. Simply put, I couldn’t push through it. I can ride spooks, and Derby’s aren’t bad. However, the change in overall behavior (big blow up spooks on the ground, and under saddle) combined with still-fresh bruising from my last trip into the dirt were just too intimidating for this ammy.
While I doubt that we’re out of the woods with weather induced behavior, I did ride on Friday, and Derbs didn’t put a foot wrong. Unfortunately, I’m now laid up with a bout of the flu, and won’t be riding until I feel better. But I’m happy that the problem isn’t the meds – if Derby needs to stay on some of those meds for a longer term, once the weather warms up, I should have my old sweat pea back. 🙂
Collecting Thoroughbreds 