As summer temperatures rise, particularly in regions like Texas, equine veterinarians often see an uptick in respiratory cases. Among these, recurrent laryngeal neuropathy (RLN) remains a significant concern, especially in performance horses.
Pathophysiology and Clinical Signs
RLN is a degenerative condition that primarily affects the left recurrent laryngeal nerve. This nerve travels an unusually long course from the skull, around the aorta, and back up the neck to innervate laryngeal muscles. Degeneration leads to weakening of the laryngeal dilator muscle, reducing airway diameter and impairing airflow.
A hallmark clinical sign is the characteristic “roaring” sound during inspiration, caused by collapse and vibration of the arytenoid cartilage (“flapper”). As the disease progresses, horses often develop exercise intolerance and reduced athletic performance.
Risk Factors
While RLN is idiopathic, several risk factors are recognized:
- Large horse breeds: Thoroughbreds, warmbloods, draft horses, and larger Quarter Horses are predisposed due to longer nerve length.
- Heat stress: Elevated temperatures increase respiratory demand, exacerbating RLN symptoms.
- Trauma: Injury to the throat or complications from vascular injections can contribute to nerve damage.
Diagnostic Approaches
Diagnosis begins with a thorough history and physical examination. Upper airway endoscopy remains the gold standard for visualizing laryngeal function. For subtle cases, dynamic endoscopy performed during exercise provides valuable insights into airway collapse and secondary abnormalities.
Surgical Management
Definitive treatment typically involves a laryngeal tie-back procedure, which repositions the arytenoid cartilage to improve airflow. While this does not restore normal anatomy, it enables affected horses to return to performance levels by reducing airway obstruction.
Postoperative Care and Prognosis
Recovery requires structured rehabilitation:
- Six weeks of rest with at least one recheck.
- Ground feeding for two weeks to minimize aspiration risk.
- Gradual return to exercise once coughing subsides.
Long-term prognosis is favorable, with most horses regaining functional breathing and performance capacity.
For equine practitioners, early recognition of RLN and timely surgical intervention are key to preserving athletic potential in affected horses. With proper diagnosis, management, and postoperative care, horses can breathe — and perform — with renewed ease.
AUTHOR PROFILE
Innovative Veterinary Care Journal bridges the gap between the worlds of allopathic and integrative veterinary care. Thousands of veterinarians and vet technicians are interested in ways to enhance their practice and update their skills…and integrative health is considered to be highly innovative and requested by patients along with a vast number of other traditional and emerging techniques. IVC features articles by some of the top experts, focusing on market trends in health treatments, new product features, industry news, how to create a strong retail experience, leading integrative modalities, and nutrition education not typically taught in vet school.
