Diagnosis and treatment of dynamic collapse of the cricotracheal ligament in thoroughbred racehorses.
Authors: Kelly Padraig G, Pollock Patrick J
Journal: Veterinary surgery : VS
Summary
Cricotracheal ligament collapse (CTLC) represents an uncommon cause of dynamic upper airway obstruction in Thoroughbreds, though its true prevalence remains unclear given it was identified in only 8 of 600 dynamic endoscopic examinations in this retrospective case series. The condition manifested differently depending on the horse's age and training status: in five 2-year-olds during early training, CTLC resolved following treatment of concurrent upper airway inflammation (such as laryngitis or pharyngeal dysfunction), whereas in two mature horses in full work with no other respiratory abnormalities, conservative management failed and surgical intervention became necessary. The surgical approach—reduction of the cricotracheal space combined with imbrication (folding and suturing) of the ligament itself—successfully eliminated clinical signs in both cases, suggesting this technique addresses the mechanical instability driving the collapse. For practitioners encountering exercise-intolerant Thoroughbreds during dynamic endoscopy, recognising CTLC as a potential diagnosis is important; however, the authors recommend exhausting conservative management and treating any concurrent airway inflammation first, reserving surgery for those horses with persistent obstruction that significantly impacts performance.
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Practical Takeaways
- •Younger horses with CTLC may improve with conservative management addressing underlying airway inflammation rather than requiring immediate surgery
- •Mature horses with persistent CTLC unresponsive to conservative treatment are candidates for surgical imbrication of the cricotracheal ligament
- •Dynamic endoscopy during exercise is required to diagnose CTLC, as static examination will miss this condition
Key Findings
- •Cricotracheal ligament collapse (CTLC) occurred in 8 of 600 horses undergoing dynamic endoscopy (1.3% prevalence), predominantly affecting 2-year-old Thoroughbreds in early training
- •In young horses, CTLC resolved after treatment of concurrent upper airway inflammation without specific surgical intervention
- •In 2 mature horses without concurrent airway disease, surgical reduction of cricotracheal space and ligament imbrication successfully resolved clinical signs