title: A novel treatment for dynamic laryngeal collapse associated with poll flexion: the modified checkrein.
abstract: BACKGROUND
  Dynamic laryngeal collapse (DLC) associated with poll flexion is a performance limiting dynamic upper airway disorder commonly diagnosed in Coldblooded trotters. An inspiratory obstruction occurs when affected horses are driven with tension on the reins, inducing poll flexion. To date, surgical treatment and conservative management have failed to improve racing performance in affected horses.
  
  
  OBJECTIVE
  To test the efficacy of an external device, the modified checkrein, in limiting poll flexion, diminishing laryngeal collapse and improving airway mechanics when horses are driven on a treadmill with tension on the reins and test the hypothesis that the modified checkrein will limit poll flexion thereby improving endoscopic appearance of the larynx and reduce airway obstruction in harness racehorses affected with DLC.
  
  
  METHODS
  Fourteen Norwegian Coldblooded trotter (NCT) racehorses previously diagnosed with DLC associated with poll flexion exercised on a high-speed treadmill at speeds that resulted in heart rate >200 beats/min. Upper airway videoendoscopy recordings, tracheal pressures and video recordings of the head and neck position were collected while horses exercised with the conventional checkrein on Day 1 and the modified checkrein on Day 2.
  
  
  RESULTS
  The modified checkrein successfully limited poll flexion as measured by no change in head position parameters between phases of no rein tension and phases of rein tension. Endoscopic scores were significantly improved (arytenoids cartilage collapse P<0.0001; vocal fold collapse P<0.0001) and tracheal peak inspiratory pressures were significantly less negative (P = 0.0162) when horses were fitted with the modified checkrein compared to the conventional checkrein.
  
  
  CONCLUSIONS
  The modified checkrein successfully limited poll flexion and also prevented upper airway obstruction in NCT horses affected with DLC associated with poll flexion. The modified checkrein seems promising in offering a method of conservative management in harness racehorses affected with this disorder.
authors.affiliation: Department of Companion Animal Clinical Sciences, Equine Teaching Hospital, Norwegian School of Veterinary Science, Oslo, Norway. cathrine.fjordbakk@nvh.no
authors.forename: C T
authors.initials: CT
authors.lastname: Fjordbakk
authors.forename: S
authors.initials: S
authors.lastname: Holcombe
authors.forename: C
authors.initials: C
authors.lastname: Fintl
authors.forename: H
authors.initials: H
authors.lastname: Chalmers
authors.forename: E
authors.initials: E
authors.lastname: Strand
mesh_terms: D000818:Animals; D005080:Exercise Test; D005260:Female; D006734:Horse Diseases / Q000517:prevention & control*; D006736:Horses; D007818:Laryngeal Diseases / Q000517:prevention & control / Q000662:veterinary*; D007830:Larynx / Q000473:pathology; D008297:Male; D010805:Physical Conditioning, Animal