Firing of soft palate?

C

chestnut cob

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Hello all, not been on here in many months (can't get on at work!).

I have a quick question, probably won't mean a lot to most people. I just wondered if anyone has had any experience of horses having their soft palate fired/burned to deal with a dynamic collapse into the airway?

Long story but basically my horse is going in to have this done to in January (provided insurance co agree!) as when he works in an outline his soft palate collapses upwards and totally fills his airway - cue suffocating horse when on the bit! The idea of the op is that the burning will create scar tissue, which will then tighten the soft palate and stop it collasping.

I'm told it has a 50/50 chance of improving his condition, that it can't make it any worse, and only 2 weeks off work. Any experiences would be interesting, but vet I saw last week said they only see 1 or 2 cases a year of it.

Thanks
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The literature states around a 60% chance of success, I hope that it works for Rhyn. Not had it done to any of my horses but have seen horses that have had it done. Fingers crossed.
 
Wish I had seen this before now (it's gone midnight!) our vet called in for tea after hunting tonight and I could have asked him, sorry!
Hope it goes well for Rhyn, poor boy; fingers crossed for the insurance!
 
Vet said it has a 50/50 chance of working. Am quite prepared for the fact it may not work but have to give it a go. He said in the past they used to remove part of the soft palate and stitch the remaining two sides together but apparently this has a high chance of infection and horses won't eat afterwards. Although this sounds brutal it has a better chance of working.

He said it works nearly 100% in racehorses but less chance in "dressage" horses.

Vicijp - does that say "tye forward"? Can you elaborate?
 
Thanks Lucy.

What experiences have you had with the horses you've seen have it done? Vet says it sounds brutal but that it's relatively painless because it's third degree burns, which will deaden the nerves anyway. He also said it's very difficult to treat because it's so rare - trust mine to get it!
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CC, that makes sense.

Hannah was scalded quite badly as a toddler in an accident at a restaurant. The areas where the burns were really bad, third degree, she never complained about but when they were treating the minor burns she was absolutely besides herself with the pain. Awful to witness.

Transferring that logic to Rhyn, perhaps it won't be as painful as you might imagine when someone says "burn the roof of your mouth".

I have everything crossed for you that it works. Poor lad loves his work so he really does need it.

Good luck x
 
Clare, that's exactly what the vet said! He said the options were rest, which only has a chance of working in very young horses, hard work (which won't help in this case), or this op. If it doesn't work then it doesn't work, but at least I will have tried. Vet said he will have plenty of pain killers anyway but that it's much less painful than the old method.

If any one has any other suggestions I would be interested to hear them.
 
When you initially told me about it, I'll be honest, I just thought "phew...that doesn't sound too bad". Far rather think of him having that done than actual "open" surgery as the infection risk is bound to be higher and recovery longer with a more invasive procedure.

I'd not be phased at having it done if it was my horse. It can only serve to improve his life and ability to exercise. Go for it!

I've been trying to search Tie Forward surgery. It's recommended for Dorsal Displacement of the Soft Palate but I'm not sure exactly was is involved in it.
 
Insurance won't pay at all, or won't pay second time around?

Vet didn't say it would/might need doing again, just that it didn't have a great success rate. Also said without it (or with it if it doesn't work) he will hack and hunt for the rest of his life without probs, just won't be able to school/dressage.
 
You have a 12 months window to get the insurance company to pay from the start of treatment..initial consult. After 12 months it's excluded.

I'm assuming this is what Vicijp is referring to. If the firing works but only for 12 months or so, you'll be left to either foot the bill for the second procedure later after insurance co have slapped an exclusion on your policy, or of course if funds are limited, you may not have it done.

I was wondering, if he may go on to need a tie forward....how will the scar tissue affect the operation for stitching etc?

I'm presuming what Vicijp is saying that if he was her horse she'd opt for the route that has a higher success rate whilst you have the insurance company footing the bill?

Of course, I might have read between the lines wrong there. If so, I'm sorry.
 
Have tie forwards been performed in horses other than race horses? I can't find much about them.

Vet said the firing is v successful in race horses but less so in horses used for other things.

TBH I'm aware that it may not work at all anyway and if I'm left with a horse I can only hack and hunt then so be it. It's not ideal but not much I can do about it.

What happens when the firing doesn't work - horse just goes back to how it was before the op?

I'm worried now
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I've never heard of it until today and I'm like you, I can't find much about the procedure at all. Only slight info I can gleam is in relation to racehorses, same as you.

The vet knows that he's covered by insurance and that therefore the surgery would be paid for. I'm assuming if they felt it was the right option for Rhyn, they'd have recommended it to you.

It's easy to say it, but try not to worry. The vets have Rhyn's best interests at heart.
 
I just wonder if it's a case of statistics as well.... if the tie forward has been performed on 100 horses and worked on say 80, it has an 80% chance of success. If the firing has been performed on more horses, eventually the statistics will change as there are more incidences of it not working. As I said, my vet said initially the firing had a near 100% chance of success but as time has passed this has decreased.

I do agree that the vets have his best interests at heart. The second opinion vet was fairly optimistic but my usual vet was more pessimistic. Just said go into it not expecting it to work at all, then if it does it's a bonus. Also said it was the worst news I could have expected to get, as the op has a fairly low success rate but unfortunately this would be the only option for him.
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Alot of vets don't like to give any promises for fear of you blaming them when it all goes wrong. All of our local vets are quite pessimistic but couldn't be happier for you when all turns out well.

I wasn't given very good odds on Patches surgery being successful. Post surgery I was given even less odds on her becoming sound and off bute.

However, she's done really well and the vets are thrilled for her. It's a self preservation thing I guess...don't get your hopes up too high and then you can't be as disappointed "if" things don't quite go as planned.

You are right though, statistics alter over time when more and more cases are performed of any given procedure.

You have to go with you gut instinct and the advice from your vet. There's no harm in mentioning a Tie Forward to your vet to gauge his reaction to one. If it's a new procedure he may not have performed many anyway.
 
I've found an article on the main HHO site about it actually. Have emailed my vet to see if it's something that would be worth looking into for mine, they can only say no.

Iv'e just been told it may or may not work, and that he must be kept super fit all year round. Now just have to find someone to exercise him for me during the week!
 
Goodness - never, ever heard of this. Though I have looked after a broodmare that had a problem with her soft palate, that was apparently caused by being tubed
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She's the dam of a few very good horses, so not hereditary - not that, that is an issue for Rhyn.

I'm so sorry to hear the smexy beastie is having problems! He's a such a superstar pony and you've come such a long way with him....... It really sucks!!!

Wish I had something constructive to say - sorry!! HUGGLES!!
 
I don't envy you the dilemma of having decide whether to, and which treatment to try for a displacing soft palate (DDSP). I can throw in some information but nothing of any great practical value unfortunately. The first thing is that all the surgical treatments for DDSP have the same poor success rate of about 60%. In surgery terms this isn't very good and indicates that the procedures are almost certainly not addressing the problem (not all, if any of the 60% will have improved because of the surgery). The statistics have been obtained from racehorses because they are by far the biggest proportion of horses operated on. There is no statistcial evidence that the procedures are less successful in non-racehorses although the cause of DDSP in these animals could easily be different so it would be unwise to assume the statistics apply to non-racing horses.

The best treatment would probably be to get your horse to learn the didjeridoo. This has been shown to help prevent snoring in humans (analogous condition) through strengthening the muscles that control the palate. This is not as daft as it sounds and scientists are looking at how to do it in horses!

There are so called 'conservative measures' that have been used for donkeys years to 'treat' DDSP. There is no evidence that they work but there again the studies haven't been done. One method is to put a spoonful of glycerine on the horses toungue before exercise. The idea is (at least I suppose this was the idea, its been lost in the mists of time) that the glycerine forms a seal between the toungue and the underside of the soft palate a bit like liquid between a glass and a beer mat. Just as the beer nat gets lifted with the glass, so the idea is the palate is prevented from displacement by the oropalatal seal. Another measure is the use of a 'tongue-tie'. Again, the idea presumably is that movement or withdrawl of the tounge causes displacement of the palate. In reality both these effects are reasonably unlikely to prevent the palate from displacing (I'll tell you why if you're interested) but they are easy to try out if you feel so inclined.

Another thing you could try is working your horse hard off the bit on a regular basis. It's generally accepted that the cause of DDSP has something to do with compromised muscle function in the palatal muscles. This could be neurological but it could be developmental in the muscles themselves, it's difficult to measure. by working the horse hard you would create the conditions under which these muscles would strengthen if they were able to. By 'working your horse hard' what I really mean is getting him out of breath. The objective is not to get him fit physiologically, it is to load the muscles associated with the upper airway and unless the horse is breathing hard this will not happen. Obviously the horse will get fit as a consequence and then it gets more difficult because you will have to work harder to get him out of breath. 7 or 8 weeks of regular execise in this way should be enough for you to notice a difference if there was going to be one.
 
I think our horse is having the same problem. Despite being scoped and showing nothing. Next stage is get him on the 'rolling road' and scope again then. But this is still being mulled over.
Have to say though, from the first scope, vet did say see what he's like when much fitter. And there has been an improvement but not perfect. The noise has lessened and recovery is much quicker and less distressing. He even managed to keep up with a mock hunt fun ride, much to our surprise (though got some looks due to the noise)!

So really in the same dilema as you Chesnut cob (rather our thoughts are at this stage) on having op, ins and vet fees rolled into one!
Good luck with your guy, be intrested to hear of any further news/ development with it all.
 
Endoscopy while standing isn't a reliable way of diagnosing dynamic collapse, a comparison with treadmill endoscopy was published earlier this year in Equine Veterinary journal. The problem is I guess, treadmill endoscopy is expensive and even then if it turns out to be DDSP there's no guaranteed cure. The type of noise your horse is making should give your vet a clue whether the palate or the larynx is involved.
 
Thanks Puddicat, that makes sense.

Presumably the last paragraph is why the vet has told me to keep him "hunting fit" all year round and to work him hard off the bit as often as possible, which is exactly what you've described.

TBH if it doesn't work then it doesn't, I end up with a horse I can't do dressage with. I don't see the problem when he's doing fast work off the bit, so XC, hunting, etc, which means if the surgery doesn't help we will just have to stick with those sorts of activities - most horses I know only hack, hunt and do XC anyway!

My vet said in racehorses the statistics are good because they are unlikely to be asked to work on the bit, and that in horses used for dressage the chances of success are much lower because working in an outline tends to exacerbate the problem.
 
Hi Fan_mail,

Interesting to hear you have a horse with a similar problem.

Mine was scoped at rest and it showed nothing, then scoped at another practise normally which also showed nothing. He was then essentially pulled down into an outline and scoped, which showed up the problem. I've never really noticed a problem with my horse when galloping, he's hunted lightly for the last 3 seasons inc this one and keeps up well when he's fit. He's fine XC and in straight lines too. I just find he cannot do dressage - trot work is okish but cantering on the bit just kills him. Also have a problem with SJing, dies half way around.
 
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