displacement of the soft palate (iDDSP) in horses in a recent study
iDDSP is a dynamic upper respiratory tract disorder that occurs during exercise, particularly in racehorses and performance horses. It involves the soft palate displacing dorsally above the epiglottis, which can lead to partial obstruction of the airway. This displacement often results in a characteristic gurgling noise, exercise intolerance, and poor performance.
The condition is intermittent and may only occur during intense work, which complicates diagnosis. The best way to confirm the diagnosis is using overground endoscopy (OGE), observing the horse’s upper airway during exercise under natural conditions
Another condition frequently observed in association with iDDSP is Palatal instability (PI). It is characterised by abnormal movement or fluttering of the soft palate during exercise, which may precede or predispose to full dorsal displacement. The presence of PI is often considered a potential risk factor for the development of iDDSP.
A retrospective case series conducted by Tim Barnett and colleagues investigated the efficacy of LTF surgery by analysing OGE findings and subsequent racing performance in horses diagnosed with iDDSP. The study focused on horses that had been definitively diagnosed with iDDSP, had undergone LTF surgery, and had at least one postoperative OGE evaluation. A full report of the work is published in the journal Veterinary Surgery.
Analysis of the records showed that seventy five percent of horses that had undergone LTF had no evidence of iDDSP on postoperative OGE. There was also a 23% reduction in the presence of palatal instability on OGE after LTF.
In 16 horses, soft palate thermocautery (SPTC) was performed at the same time as LTF. However, this additional intervention did not reduce the incidence of iDDSP beyond what was achieved with LTF alone, indicating no added benefit.
There was a 22% increase in the number of horses that raced and an 18% increase in those achieving placings following LTF surgery, indicating a positive impact on athletic performance.
The authors also found that horses that continued to have suspected upper airway impairment after the tie forward operation were likely to have continued iDDSP.
They conclude that laryngeal tie-forward surgery is a reliable and effective treatment for iDDSP in horses. While soft palate thermocautery is often employed with the aim of enhancing soft palate stability, this study suggests it does not improve outcomes when used in conjunction with LTF. Furthermore, ongoing respiratory noise or performance issues post-surgery should prompt repeat OGE, as they may indicate persistent or recurrent iDDSP.
For more details, see:
Barnett, Timothy P., Colgate, Victoria A., Robinson, Natalie, Smith, Lewis C. R., Palmer, Lorraine, Barakzai, Safia Z.
Overground endoscopic examination following laryngeal tie-forward in horses with dorsal displacement of the soft palate
Veterinary Surgery (2025)
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