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View Full Version : What has been your experience with Larynhgeal Hemiplegia (or paralzyed flap)?



brightskyfarm
Jun. 13, 2011, 02:49 PM
I have a retired tb mare who has a paralyzed flap. Im considering surgery since its her 2nd episode of compromised breathing in a year.

Chicken Legs
Jun. 20, 2011, 10:09 PM
If the flap is completely paralyzed surgery is probably the only thing to
help the horse. We have had good luck with Dr. Palmer's clinic in NJ with
wind surgeries.

The horse will need some special treatment afterwards like having all the hay
and water on the ground.

evntr5218
Jun. 21, 2011, 10:18 AM
i had an ottb gelding and he had prosthetic laryngoplasty (tie back), by dr. woody from rood and riddle here in lexington. he has been able to event up to prelim without any breathing problems. he couldnt be taken swimming in the pool (since his flap wont close) for conditioning but other than that the surgery had helped tremendously.
i know racing is different than eventing but i had really good results.

sonomacounty
Jun. 21, 2011, 01:21 PM
Sending well wishes from NY.

Sonoma

Calamber
Jun. 22, 2011, 06:30 PM
Speaking as someone who has seen this surgergy performed far more times than I like to think about, and having seen some horrendous after effects which disfigures the horse for life (water running out of the nose while drinking from a bucket at chest level), I would try another option first. It is irreversible, sometimes it helps and sometimes it does not. There is a lifetime of special care for those who it adversely affects, and like others have said, the horse will not be able to swim, new owners will also need to always have the knowledge that this procedure has been done in order to keep the horse safe from mishandling due to ignorance.

Perhaps you can try this first.

http://www.pulsepowernow.com/equine.html

brightskyfarm
Jun. 23, 2011, 12:10 AM
I will certainly run that (Pulse) by my vet tomorrow.

Im exploring the costs of surgery. medication cannot resolve her inability to breath.
The mare is a retrain, retired a year ago --- showing career with no indicatons, just arose after a trail ride 2 weeks ago --- strange, but it is what it is. Sad.

thanks sonoma :)

Calamber
Jun. 26, 2011, 07:05 PM
Hey Bright, here is another very interesting alternative to surgery.

http://www.bloodhorse.com/horse-racing/articles/54234/roaring-improved-after-electroacupuncture

brightskyfarm
Jun. 26, 2011, 10:59 PM
Thanks Calamber,
Great article. This is all new territory to me so I am amazed at all the alternatives.

The article cites many additional studies and treatments offering numbers lower than I expected in the success rates of surgeries.. Only 61% for the older tbs, 66% for those 2 and under. :(

Calamber
Jun. 27, 2011, 09:32 AM
It has helped some and it has been dramatic, but I was not able to follow their life and the changes I mentioned before. Because it is permanent I would certainly try managing her environment like you were discussing in the pm. Also, since the dex is helping (but like you said, not a longterm solution), she may be having a severe allergic response to the bedding, barn, forage). Just a question of figuring it out if she did not have the problem before and now after some time at your place she does. Like the Australian research papers was suggesting in the tying up syndrome they were researching, there could be a nutritional component, some type of plant they suggested which they had in their target groups' environment which they ingested. That also was their interest when investigating stringhalt.

I had been pondering the reason for the epidemic of paralyzed flaps with the US thoroughbreds and thought that there might be a nutritional deficiency component since they talk about the paralysis of the nerve so much being the culprit.

In any case, have you ever tried Tri-Hist granules? Maybe because of the bizarre weather, extra moisture etc., there might be a bloom going on that she never had to deal with before. It is distressing to see your horse struggle with breathing. I hope you get it sorted out and she recovers.

brightskyfarm
Jul. 7, 2011, 03:16 PM
June 27th I moved the mare to another farm, bright airy stall, dust/mold free barn and turn out. Within the week+, her condition has resolved itself.

Last week, I was seeking a 2nd opinion. That vet suggested moving her, arranging for grass and turnout -- see what improvements she makes. He recommended Clem @ 3cc p/d (but I only did that for only 2 days, her response was so immediately great!)
So, within an hour she had a new home. Nearly overnight, the distraut breathing stopped.
4 nights ago started dark & cool of night time out in the paddock -- first night she ran pretty hard but didnt distress, 2nd night only trotted around, again no distress. 3rd night I took a blanket and sat outside the fence in the grass. She did a lot of walking but finally settled to graze -- last night I turned out and left as she immeidately started grazing quietly.
She has an appt with my 2nd vet next week to assess again.

I called and cancelled her appt with the* dead horse guy*& vet scheduled for 1pm tomorrow to be euthanized.

Moral> always get a 2nd opinion!
What was it? A heave reaction to her environment just like a human having an asthma attack.

evntr5218
Jul. 7, 2011, 04:06 PM
thats great news :D

sonomacounty
Jul. 7, 2011, 05:18 PM
Super ! So very glad.

sonoma

brightskyfarm
Jul. 8, 2011, 01:39 PM
thanks guys. Calamber had some really great ideas, even for horses without respiratory trouble, just general care for those under stress, or in those unusually dusty /moldy environments.

This came on suddenly, something Im not familar with ... and surprised how many remedies there are to keep a horse *level*/maintainence.

She still has some recovery time yet, but each day is a huge improvement. Shes (noisy) so possibly theres some windpipe obstruction --- when the vet scopes next week -- more answers.
But, for today, shes still with me ..and thriving.

Calamber
Jul. 11, 2011, 07:57 PM
thanks guys. Calamber had some really great ideas, even for horses without respiratory trouble, just general care for those under stress, or in those unusually dusty /moldy environments.

This came on suddenly, something Im not familar with ... and surprised how many remedies there are to keep a horse *level*/maintainence.

She still has some recovery time yet, but each day is a huge improvement. Shes (noisy) so possibly theres some windpipe obstruction --- when the vet scopes next week -- more answers.
But, for today, shes still with me ..and thriving.

Annie, I think Money and I were having some kind of kinetic cross purpose in our life. I had the same thing happen pretty much at the same time. I too resolved with "managing" my environment, carpet cleaning with non toxics, air filters, putting away the dust collectors, washing all that could be washed. Here in the PNW, mold is a given but I was assaulted by black dust mites from the ducts (I have video proof while they were vaccuuming the ducts), and heavy pollen from 100 ft Doug firs that are producing late because of the cool spring. Plus, and more to the point, stress, I was beyond stressed trying to buy a home and failing because of stonewalling & prevaricating from the real estate agent. Moral, never, ever, ever use a sole agent. It is illegal in some states. I too had to use prednisone for 4 days, anti-histamines, hot shower after hot shower to open up airways, inhalor and Ibuprofen. It was no fun. Bainbridge has stagnant air from all these damn trees that they worship so much, not much ocean current through here anyway, but the trees block out the sun and the oxygen. Greenies.......Finally we have relief, cool air driven by the ocean came in over the weekend and now a little bit of rain.....ahhhhhhh.

Calamber
Jul. 26, 2011, 08:38 AM
Annie, how is the mare doing now? And you? I had to use Advair very sparingly, what helped the most was coming to the east coast, going to the gym everyday and then going to the ocean. Thank God. I have a slight sinus infection but I am getting off the meds for the most part! Maybe take Money and go on vacation to the ocean, go swimming, or galloping on the beach. Unfortunately it is very limited where you can go here. You can always come to Washington when I get back!
Well it's a thought anyway. Maybe you can find beaches somewhere in NJ or Delaware, or Ocean City or Chincoteague or Assateague where you can go. I think I have seen pics of people trail riding on Assateague? Does anyone know?

Calamber
Jul. 26, 2011, 08:39 AM
Annie, how is the mare doing now? And you? I had to use Advair very sparingly, what helped the most was coming to the east coast, going to the gym everyday and then going to the ocean. Thank God. I have a slight sinus infection but I am getting off the meds for the most part! Maybe take Money and go on vacation to the ocean, go swimming, or galloping on the beach. Unfortunately it is very limited where you can go here. You can always come to Washington when I get back!
Well it's a thought anyway. Maybe you can find beaches somewhere in NJ or Delaware, or Ocean City or Chincoteague or Assateague where you can go. I think I have seen pics of people trail riding on Assateague? Does anyone know?

MintHillFarm
Jul. 26, 2011, 09:14 AM
June 27th I moved the mare to another farm, bright airy stall, dust/mold free barn and turn out. Within the week+, her condition has resolved itself.

Last week, I was seeking a 2nd opinion. That vet suggested moving her, arranging for grass and turnout -- see what improvements she makes. He recommended Clem @ 3cc p/d (but I only did that for only 2 days, her response was so immediately great!)
So, within an hour she had a new home. Nearly overnight, the distraut breathing stopped.
4 nights ago started dark & cool of night time out in the paddock -- first night she ran pretty hard but didnt distress, 2nd night only trotted around, again no distress. 3rd night I took a blanket and sat outside the fence in the grass. She did a lot of walking but finally settled to graze -- last night I turned out and left as she immeidately started grazing quietly.
She has an appt with my 2nd vet next week to assess again.

I called and cancelled her appt with the* dead horse guy*& vet scheduled for 1pm tomorrow to be euthanized.

Moral> always get a 2nd opinion!
What was it? A heave reaction to her environment just like a human having an asthma attack.


Maybe she has the beginnings of COPD? Your making an environment change was the best way to go. If she is allergic as well this will help her too...

I had one that was supposed to go into Cornell several years ago for a tie back surgery, but upon a 2nd scoping there, he was diagnosed with mild COPD so they elected to do a vocalcordectomy instead. It gave him 30% more air during work and eliminated the roaring.

Now I have one that needs a tie forward surgery...:sadsmile:

brightskyfarm
Jul. 26, 2011, 07:39 PM
One relapse, last Sat in this horrible HHH of Pa weather. The vets have seen increased breathing troubles in even healthy animals, common in those battling COPD's and other difficulties.
4cc of Dex and she was ok in a few hours. The mare has No coughing ...at all.
One vet is suspecting heaves more than COPD, but without a proper scoping, its really anyones guess.

Vet appt this week to determine this mares status. She is happy, healthy, in good appetite, and weight; one would never know shes battling difficulty breathing. She does roar yet at exercise, but subsides at rest. You can hear *noise* at inhale, not exhale.

Shes down to 80cc Prednisone 1x a day and on 1/2 day turnout (nights)....
Im just waiting for a proper diagnosis at this point.

Today at the track a mare worked 3/8th and came back coughing terribly --- scoped and it seems the surgery she had (tie-back) isnt working. The vet gave some interesting stats that only 70% qualify for surgery anyway --- 30% of those have exceptionally good results ! that leaves 40% ?

MintHillFarm
Jul. 26, 2011, 08:01 PM
Please let us know what the vets find.

I am still thinking it sounds so much like COPD (hoping not!)...

brightskyfarm
Jul. 26, 2011, 10:36 PM
Im hoping Thursday for an appt; its a dark night, as we went to 5 days racing for this week -- everyone's maxed, especially with this heat too.

Fingers crossed for the best.

Lord Helpus
Jul. 29, 2011, 10:23 AM
My jumper had tie back surgery at R&R about 5 years ago. It worked for a bit, then, 2 years ago the problem came back, not so much in sound, but in exercise intolerance; after a certain amount of work, he would hit a brick wall.

By then he was in Va and went to The Marion duPont Center where he was seen and scoped (while on a treadmill) by their throat specialist (forget his name). The vet said he could not even tell that a tie back surgery had been performed.

This vet did a laser procedure on the left side (which is the side that gets paralyzed, due to the way the nerve runs). He also recommends lazering the right side in severe cases to get 100% relief, but you have to wait until the left side heals, (about 6 weeks) or else the 2 sides could heal by growing together:eek:. Not cool at all. :lol:

With my guy, the left side has given him about 80% relief, so I have not gone back for the right side.

By lasering off the flap, the surgery cannot "fail" by having the tie-back slip or break. This man (who must be a biggie since I had to wait to see him because he was in Switzerland giving a paper to the International group of throat vets on this exact topic) said he has performed over 200 of these surgeries and has never had a single one fail or have problems.

The success of this surgery is very dependant on the specific expertise of the surgeon. Everyone told me (including my vet who steered me away from his practice and the local vet hospitals) to make sure the vet operating was a specialist who had done hundreds of throat surgeries. A vet who specializes in throats can make a huge difference in the outcome.

brightskyfarm
Jul. 31, 2011, 12:15 PM
My vet did an appt today !

Findings> * infection of the vocal chords.

* not a candidate for tie-back surgery

* anti-biotics and tri-hist this week should reduce the inflammation to allow further scoping down the trachea/which she feels unnecessary, but precautionary & giving a FULL exam.

Diagnosis> shes a roarer. There is damage to both vocal chords.

Once the infection is cleared, 50% of the airway blockage should be relieved this week..

She will be fine for *regular* riding use without medications.

No, she will not be an upper level horse, or maybe even a foxhunter... but a trail, dressage/or-and light/hunter pace, show horse.......... fine.

What great news!
I am so hungry~!

MintHillFarm
Aug. 1, 2011, 03:21 PM
Good news! She will be much happier when inflammation goes away!

sonomacounty
Aug. 1, 2011, 06:26 PM
What great news!

WOW - Cool !
So happy for her & you !

brightskyfarm
Aug. 1, 2011, 09:08 PM
Thanks, Ive been eating a lot since the vets visit. :D

Its SMZ's, 25 of another pill, and tri-hist up her nose (this is 3x a day). Lip chain, rope twitch/clipped to her halter and .........well, shes just such a trooper.
I know, its for all that great feed she gets afterwards;)

Huge storms rolled through today, so, its in for the night but otherwise shes out 24/7 --- alone,......and very peaceful.

My vet is going to scope again this Sunday, just to check progress.
Yes, Im thrilled! Maybe soon we can get back to riding!

Heres her pedigree, what a sweet disposition! She couldnt run to save her life but then, maybe this *problem* has been brewing all along. Who knows.......today, shes ok.

http://www.equineline.com/Free-5X-Pedigree.cfm?page_state=ORDER_AND_CONFIRM&reference_number=7444313

brightskyfarm
Aug. 21, 2011, 06:26 PM
Today my mare got 4 new shoes! .:D
We would have ridden if the thunderstorms hasnt shut us out.:(
2 days ago her breathing returned to normal :eek:

I have a call in to my vet for another appt to scope to assess her current condition as she is still on throat spray & SMZ's -- and I feel there should be a intermediate level of medication to assure this throat infection is completely gone before taking her off all medication.

For the last month, shes been on meds, turned out (full time short of the *nasty* thunderstorms). Now this isnt quiet pasturing -- her pasture is between others that racing tb's are turned into, and many a 6 furlong race has been run!
Also, she and her pasture partner have been learning to manage their separation anxieties -- the training track is in view of her pasture so at first when we'd go out of sight, shes running the fence lines. Shes gotton used to him leaving so now she just keeps grazing.
No noise on inhale, no noise running!

Diagnosis: throat infection
Im still pinching myself shes alright:):):)

Calamber
Aug. 23, 2011, 08:35 AM
What wonderful news. I am better myself from visiting the "much warmer" shall we say, east coast, getting sun and swimming in the Atlantic. I think the stress of the extreme temperatures had put her over the top and she was brewing this for some time. Happy trails!

Calamber
Aug. 23, 2011, 08:42 AM
My jumper had tie back surgery at R&R about 5 years ago. It worked for a bit, then, 2 years ago the problem came back, not so much in sound, but in exercise intolerance; after a certain amount of work, he would hit a brick wall.

By then he was in Va and went to The Marion duPont Center where he was seen and scoped (while on a treadmill) by their throat specialist (forget his name). The vet said he could not even tell that a tie back surgery had been performed.

This vet did a laser procedure on the left side (which is the side that gets paralyzed, due to the way the nerve runs). He also recommends lazering the right side in severe cases to get 100% relief, but you have to wait until the left side heals, (about 6 weeks) or else the 2 sides could heal by growing together:eek:. Not cool at all. :lol:

With my guy, the left side has given him about 80% relief, so I have not gone back for the right side.

By lasering off the flap, the surgery cannot "fail" by having the tie-back slip or break. This man (who must be a biggie since I had to wait to see him because he was in Switzerland giving a paper to the International group of throat vets on this exact topic) said he has performed over 200 of these surgeries and has never had a single one fail or have problems.

The success of this surgery is very dependant on the specific expertise of the surgeon. Everyone told me (including my vet who steered me away from his practice and the local vet hospitals) to make sure the vet operating was a specialist who had done hundreds of throat surgeries. A vet who specializes in throats can make a huge difference in the outcome.

This is really good to know but limits those of us without access to those kind of specialist. Thanks for posting this, I did not know about this method. Do they have any stats for this surgery's success or is it too new?

Outyougo
Aug. 29, 2011, 12:19 PM
Check with both WSU (Pullman) and OSU (Corvallis) OSU had vet very experienced in Tie-back a does WSU

Calamber
Aug. 29, 2011, 11:03 PM
Check with both WSU (Pullman) and OSU (Corvallis) OSU had vet very experienced in Tie-back a does WSU

I did not mean tiebacks, this is a different procedure. Both OSU in Corvallis, OR and Pullman are a big hike from Seattle though.