Unilateral and bilateral compression of the epiglottis during poll
flexion in harness racehorses
Abstract
Background: Horses exercised “onto the bit” with periods of induced
poll flexion can demonstrate a unique array of upper respiratory tract
(URT) disorders. Objectives: To describe a previously unreported
exercise-induced disorder of the epiglottis associated with poll flexion
in harness racehorses. Study design: Retrospective observational study.
Methods: Medical records of all harness racehorses that presented for
exercising URT endoscopy between 2005 and 2022 were reviewed. These
horses were exercised on a high-speed treadmill using a previously
standardised protocol with alternating one-minute phases of free head
carriage (no rein tension on the bit) and poll flexion (driven onto the
bit with long reins) until they could no longer maintain the trotting
gait. Results: Seven Standardbreds and 11 Norwegian-Swedish Coldblooded
trotters were diagnosed with unilateral or bilateral compression of the
epiglottis during exercise in poll flexion. These horses demonstrated
progression of this disorder during the phases of induced poll flexion
and showed no signs of epiglottic compression during phases exercised
with free head carriage. Main limitations: Retrospective nature of study
and limited sample size due to low prevalence. Conclusions:
Exercise-induced compression of the base of the epiglottis is an URT
disorder only evident videoendoscopically when horses are driven onto
the bit leading to poll flexion. It is most often seen in association
with dynamic laryngeal collapse but can also be witnessed as a solitary
disorder. Videoendoscopically, it appears that the compression is
initiated by the rostral advancement of the larynx and hyoid apparatus
within a progressively narrowing intermandibular space during poll
flexion. Visually this leads to local inward compression of the lateral
nasopharyngeal walls and base of the epiglottis. Further studies are
ongoing to confirm this hypothesis and to objectively quantify the
degree of URT obstruction caused by this conformational narrowing of the
epiglottis during poll flexion.