Diagnosis on the run

Athletes of all kinds use exercise machines to evaluate and improve performance, but it’s a rare machine that can handle the world’s largest and fastest athletes. Horse trainers and referring veterinarians can bring race horses to Cornell’s Equine Performance Testing Clinic, where a horse-sized treadmill, an array of examination equipment, and a team of seasoned technicians and surgeons work together to evaluate the performance of equine athletes. The Clinic’s treadmill can bring horses to racing speeds of up to 40mph while allowing veterinarians to examine patients under the same strain they experience on a race track, revealing problems that may otherwise be difficult to diagnose. Since its inception in 1989, the Clinic has run over one thousand horses in a safe, weatherproof indoor environment, using the treadmill as a diagnostic tool to find causes of poor performance and determine better ways of treating them.

The Clinic is equipped to examine a wide variety of problems, including upper and lower respiratory disease, neurological issues, high-speed lameness and orthopedic problems using flexion tests and gait analysis, and cardiac abnormalities such as arrhythmia using EKG, blood gas analysis, and exercising ultrasound. Upper respiratory problems comprise the bulk of cases, including issues such as pharyngeal collapse, palate displacement, laryngeal paralysis, and epiglottal entrapment. Video endoscopy can examine the upper respiratory tract while a horse is running. Sound spectrograms can reveal acoustic abnormalities during inspiration and expiration, and airway pressure determination and airflow analysis may indicate airway obstructions during exercise.

An internist, a cardiologist, and several technicians and equine surgeons comprise the Clinic’s team, which has found that the majority of upper airway problems can be managed with surgery if diagnosed early. Headed by Dr. Norm Ducharme and Dr. Jon Cheetham, the group investigates ways to diagnose diseases more accurately while expanding the toolbox of techniques for their treatment. Several projects have had immediate clinical impact, while others may have future applications in human medicine.

Research Highlights:

–Laryngeal tie-forward treatment: a widely-used surgical procedure developed at the Clinic in 2001 to treat palate displacement with an effectiveness of 80-85%.

Cornell Collar: an external device developed at the Clinic and patented by Cornell, providing a non-surgical alternative treatment for soft palate displacement.

Laryngeal Pace-Maker: an electrical implant placed into the muscle or around the nerve to stimulate the muscle to open the laryngeal cartilage (aretynoid) during exercise.

In addition to major innovations, the Clinic’s research has made improvements in several existing equine surgical procedures including laryngeal tie-back, suture replacement, bone cement, and post-surgery stabilization methods. The recently developed laryngeal pacemaker device is currently being tested on race-horses in Europe for regulatory approval, and investigations are underway for possible applications to humans with laryngeal paralysis or transplants.

The Equine Performance Clinic works in partnership with local veterinarians to understand problems with horses and how their clients want to address them. Horses have come from as near as New York’s Equine Alley and as far as Ohio for performance evaluation and diagnosis. If you would like to schedule an evaluation, contact the Clinic or visit the website for more information.

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