Whistling and roaring
The terms ‘whistler’ and ‘roarer’
are used to describe horses which make an abnormal respiratory noise during
exercise. The noise is heard during inspiration (i.e. breathing in) and
may be anything from a high-pitched soft whistle to a harsh ‘roar’.
What causes the noise?
With each breath, air is taken in through the nostrils and passes via
the nasal passages to the throat (pharynx), which is a dynamic and muscular
tube. From here it passes through a cartilaginous valve, the larynx
(voice box), before entering the windpipe (trachea) and lungs. During
exercise, the nostrils dilate and the horse extends its head and neck,
further opening the pharynx and larynx to take in more air. Anything
which interferes with the smooth passage of this increased air flow may
result in the horse making an audible noise.
Laryngeal hemiplegia (one-sided paralysis) is the most
common cause of horses making abnormal noises during inspiration at fast
exercise. The noise is caused by partial or total paralysis of one
(usually the left) side of the larynx (voice box). It occurs mainly
in larger horses, because it is thought that this conformation can predispose
to injury to the long nerve (recurrent laryngeal nerve) which motivates
the left side of their larynx. Nevertheless, it can be seen in smaller
horses and ponies.
In mild cases the noise may only be heard during strenuous exercise
but in severe cases the noise might be evident during trotting.
Exercise intolerance (i.e. getting tired quickly) can be a problem as
the horse has difficulty getting enough air through the incompetent larynx.
The disease is progressive and gets worse with time. In a severely
paralysed larynx, the airway actually gets smaller rather than bigger
during strenuous exercise as the paralysed side collapses inwards.
How can the diagnosis be confirmed?
Laryngeal hemiplegia is usually diagnosed firstly by listening to your
horse exercising to detect either normality or an abnormal inspiratory
noise. Next the horse should undergo an endoscopic examination,
i.e. a flexible periscope-type instrument is passed through the nose,
into the pharynx, to look at the larynx as the horse breaths. Both
sides of the larynx should open and close in synchrony, almost symmetrically
and completely. In the horse with laryngeal hemiplegia, usually
the left side of the larynx moves sluggishly and incompletely, ‘hanging’
into the larynx and obstructing airflow during inspiration. In some
difficult cases, it may be necessary to have an endoscopic examination
performed while the horse is exercising on a high-speed treadmill, in
order to make the diagnosis. The treadmill has now been superseded
by "overground endoscopy". This consists of a camera inserted
up the horses nose and secured to the bridle. A pack on the riders back
transmits a signal to a monitor allowing the larynx to be visualised while
the horse undergoes its normal excerise.
What treatment is available?
Horses used for hacking or less strenuous jobs can cope without treatment.
It is important to keep their respiratory tract healthy from infections
and allergies with good management (i.e. low dust, good ventilation, proper
vaccination regime etc.).
In moderately severe cases, it may help to do a ‘Hobday’ operation
in which a piece of laryngeal tissue (laryngeal saccule) is surgically
removed to encourage a scar to form to ‘tighten’ the larynx
in a more open position. In more severe cases a ‘tie-back’
operation is often recommended. This more elaborate operation places
sutures in the paralysed side to pull and hold it open. The ‘Hobday’
operation is often performed at the same time so that the resulting scar
also helps to hold the paralysed side open, even if the sutures fail to
retain their strength over time. In horses where a tie back has
failed or is not an option for other reasons, a brass or plastic tracheotomy
tube may be inserted into the windpipe to allow air to bypass the larynx
completely. The tracheotomy tube and wound must be carefully managed
to prevent infection and secondary complications and this method is very
invasive and many people understandably find it unacceptable for aesthetic
What other conditions cause whistling and roaring?
There are several other conditions which may cause a horse to make an
abnormal inspiratory noise.
- Lymphoid hyperplasia is a term used to describe a
condition where lymphoid (immune) tissue lining the pharynx becomes
inflamed and nodules form. It is a condition affecting young horses
and most cases improves with age.
- Cysts (fluid-filled sacs) may form beneath the epiglottis.
The epiglottis is a triangular cartilage at the base of the larynx.
Its job is to prevent food material from going down ‘the wrong
way’ i.e. down the windpipe. If a cyst forms under it, the
epiglottis is pushed up and it obstructs the opening of the larynx causing
a noise. Large cysts require surgical treatment to remove them.
- Infections, tumours etc. in the nostrils or nasal
passages may result in the horse making an abnormal noise.
- Epiglottic entrapment is a term used to describe
a condition where the epiglottis is trapped under an abnormal fold of
tissue and cannot move normally. Treatment consists of cutting the abnormal
tissue, for which a surgical procedure is required.
- Congenital problems are conditions of the pharynx
and larynx which are present from birth. In general terms, these
conditions cannot be treated.
The material contained in this website is presented for information purposes
only . The material is in no way intended to replace professional veterinary
care or attention from a professional veterinary surgeon.
The advice given in any of our web pages cannot be used as the basis
for a diagnosis or choice of treatment.
Clyde Vet Group advises that you should always consult a veterinary surgeon
about any queries with animals under your care.