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Some horses make a fluttering noise with their nostrils as they breathe, often synchronizing each breath with a cantering stride. This pleasant sound doesn’t signal any problems with the horse’s airway. More alarming is a roaring noise as the horse breathes, particularly if it is accompanied by a decrease in performance. In many cases, this loud breathing is a sign of one or more physical obstructions at some point in the horse’s airway. Whether it’s constant or appears suddenly, such a sound is ominous because it may indicate a serious impact on the horse’s ability to race or perform other work.

One cause of noisy breathing is known as roaring (laryngeal paralysis). Horses have two arytenoid cartilages, one on either side of the larynx. If one or both of these structures becomes paralyzed, they can’t be pulled out of the way to widen the airway each time the horse breathes. Greater than 95% of the time, only the left side is affected. When this happens, air being drawn through the restricted spot causes a roaring or whistling sound. If the horse can’t get a good supply of air with each breath, it has to slow down because it lacks enough oxygen to support strenuous exercise.

Another airway obstruction may come on suddenly in the middle of an exercise period. Dorsal displacement of the soft palate, also known as a flipped palate, is a tissue misalignment in which the soft palate rides up over the epiglottis, interfering with exhalation and causing a choking or gurgling sound. This may occur while the horse is performing strenuous exercise, such as in a race.

A recently described airway obstruction problem is known as ventrorostral displacement of the dorsal laryngeal mucosa. In horses with this condition, tissues on top of the arytenoid cartilages increasingly obstruct the flow of air as exercise progresses. The condition may self-correct within two or three months, leading veterinarians to suspect it might be related to immaturity, training level, or other airway abnormalities in young Thoroughbreds in race training.

Unfortunately, it’s not uncommon for a horse with noisy breathing to have more than one airway problem. Owners or trainers may be disappointed that treatment of a diagnosed condition doesn’t return the horse to peak performance. In these cases, another abnormality could be present. Scoping the airway might not show every problem because some conditions are not obvious unless the horse is performing strenuous exercise. Horses can have endoscopic examination of the airway during exercise, a diagnostic procedure that may help to locate a treatable condition that won’t be observed in any other way.

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