Dorsal Displacement of the Soft Palate

Dorsal Displacement of the Soft Palate



Basic Information image



Definition


Intermittent dorsal displacement of the soft palate (DDSP) is a purely dynamic upper airway obstruction occurring during exercise. In this clinical presentation, the caudal edge of the soft palate is located dorsal to the epiglottic cartilage, resulting in an obstruction during exhalation as air is being diverted through the oropharynx. Permanent dorsal displacement of the soft palate is seen at rest and may be accompanied by dysphagia. This clinical presentation thus leads to early interference with ventilation during exercise and may be accompanied by lower airway infection in its more severe form.



Synonym(s)


Palate displacement



Epidemiology



Species, Age, Sex


Higher prevalence in younger horses (ages 2 to 3 years)



Genetics and Breed Predisposition


It is unknown if there is a genetic predisposition to this disease, although racehorses (Standardbred and Thoroughbreds) are more commonly affected; it cannot be determined if the high prevalence in those breeds is really breed related or related to their being subjected to the most strenuous exercise conditions.



Risk Factors


Racing conditions and upper airway inflammation



Associated Conditions and Disorders


Aside from the aforementioned upper airway inflammation, associated conditions include various epiglottic abnormalities such as shortened or deformed epiglottic cartilage, appearance of epiglottic flaccidity, and subepiglottic masses (cysts or granulomas). Similarly, palatal abnormalities such as cysts or granulomas are occasionally seen with dorsal displacement of the soft palate.



Clinical Presentation



Disease Forms/Subtypes




• Intermittent displacement of the soft palate


• Permanent displacement of the soft palate



History, Chief Complaint




• Typically, racehorses with intermittent DDSP experience a sudden decrease in performance in the last half of the race. The trainer, driver, or jockey generally reports a “gurgling” sound during exercise or as the horse slows down. Sport horse riders report a respiratory noise more marked with collection, which may or may not be accompanied by a decrease in performance.


• Horses with permanent DDSP have the same abnormal upper respiratory noise starting with initiation of exercise. In addition, signs of dysphagia can be seen with this presentation.



Physical Exam Findings




• The most common sign of this condition is auditory (ie, hearing an abnormal fluttering noise). However, some horses with dorsal displacement of the soft palate do not make an abnormal upper respiratory sound; the percentage of “silent” displacers has been estimated to be as high as 38%.


• Few other signs of DDSP are seen on external physical examination except for evidence of upper airway inflammation (enlarged submandibular lymph node, bilateral nasal discharge) or billowing of the cheeks during exercise as airflow is diverted through the mouth.

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Jul 24, 2016 | Posted by in SMALL ANIMAL | Comments Off on Dorsal Displacement of the Soft Palate

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