Dynamic tracheal collapse as a cause of exercise intolerance in a thoroughbred

A 2-year-old Thoroughbred filly was admitted to the hospital for evaluation of exercise intolerance. Resting videoendoscopic evaluation (i.e., while the horse was standing) of the nasopharynx and trachea revealed right arytenoid paresis and a tracheal defect that was 100 cm distal to the external nares. Surgery, consisting of a right prosthetic laryngoplasty, was performed. However, postoperative videoendoscopic evaluation revealed minimal abduction of the affected arytenoid cartilage. Dynamic videoendoscopic evaluation (i.e., while the horse was exercising) revealed the right arytenoid to be fixed in a submaximal position with no evidence of collapse into the airway. When the endoscope was positioned in the midcervical tracheal region, marked tracheal collapse was identified during exercise. Tracheal collapse can critically limit athletic function. Treatment of tracheal collapse depends on causative factors, the length of the trachea involved, and accessibility of the affected tracheal segment. The use of dynamic tracheal videoendoscopy should be considered in athletic horses with exercise intolerance in which the cause cannot be determined from resting or dynamic videoendoscopic evaluations of the nasopharynx.