Abnormal Respiratory Noise in Horses

Abnormal respiratory noise in horses can be an early indicator of upper airway disease. The most well known example is the so called roaring or whistling sound, a metallic inspiratory noise that typically occurs during exercise. In most cases, this sound is caused by laryngeal paralysis.

However, abnormal respiratory noises can also result from a wide range of other conditions, including anatomical abnormalities, inflammatory processes or soft tissue changes. Thorough diagnostic evaluation is therefore essential to determine the underlying cause and select the most appropriate treatment.

Table of Contents:

Causes

Abnormal respiratory noise can have many different causes. The most common is unilateral laryngeal paralysis resulting from degeneration of the recurrent laryngeal nerve. Additional causes include:

  • Degeneration of the recurrent laryngeal nerve, most commonly on the left side
  • Laryngeal paralysis, unilateral or bilateral
  • Laryngeal dysplasia, such as grade 4 arytenoid collapse
  • Chondritis of laryngeal cartilage
  • Pharyngeal collapse, dorsal, lateral or combined
  • Mucosal vibrations, for example aryepiglottic folds
  • Epiglottic retroversion
  • Subepiglottic cysts or epiglottic entrapment
  • Changes following previous surgical procedures
  • Other rare congenital or acquired abnormalities

Clinical presentation and optimal treatment vary significantly depending on the underlying cause.

Symptoms

Typical signs indicating disease of the upper airway include:

  • Metallic or whistling noise during exercise
  • Abnormal sounds during inspiration or expiration
  • Reduced performance under workload
  • Increased nostril flaring
  • Dyspnea in advanced cases
  • In some horses, visible muscle atrophy in the laryngeal region

Not every respiratory noise is diagnostic on its own. Comprehensive evaluation is therefore essential.

Course of Disease

Abnormal respiratory noise often develops gradually. In early stages, symptoms may only occur during exercise. If laryngeal paralysis remains untreated, progression can lead to significant restriction of airflow.

Other upper airway abnormalities may also worsen over time, resulting in reduced athletic performance and compromised welfare. Early diagnostic clarification is a key factor in achieving optimal outcomes.

Diagnosis

At Hanseklinik für Pferde, diagnosis follows a structured and comprehensive approach:

  • Dynamic endoscopy during exercise to evaluate laryngeal function under load
  • Resting endoscopy to assess the larynx, pharynx, soft palate and guttural pouches
  • Ultrasound examination of the larynx to assess muscle structure
  • Computed tomography in complex cases to visualize bony and soft tissue anatomy in detail


Possible Differential Diagnoses

  • Vocal fold vibration without paralysis
  • Guttural pouch infection or mycosis
  • Cysts or tumors affecting the upper airway
  • Combination of multiple anatomical abnormalities

Treatment

Not every abnormal respiratory noise automatically requires surgical intervention. At Hanseklinik für Pferde, treatment decisions are always based on individual diagnostic findings.

Possible treatment options include:

  • Laryngeal paralysis: laryngoplasty to stabilize the arytenoid cartilage, often combined with laser procedures
  • Other causes: individually tailored surgical corrections, such as cyst removal, guttural pouch surgery or soft palate procedures
  • Conservative management in mild cases
  • Always combined with controlled exercise, structured aftercare and medication when indicated

Prognosis

Prognosis depends strongly on the underlying cause and severity of the condition. With early diagnosis and expert surgical management, outcomes are often good to very good. Many performance horses are able to return to full athletic function.

If left untreated, however, symptoms may progress and lead to chronic respiratory distress.

Frequently Asked Questions (FAQ)

My horse makes a whistling noise during exercise. What could this be?

A whistling or metallic noise during inspiration is often associated with unilateral laryngeal paralysis. Dynamic endoscopy during exercise is required to confirm the diagnosis.

Does every abnormal respiratory noise require surgery?

No. Surgical intervention depends on diagnostic findings, severity and clinical impact. Not all abnormalities require treatment, but all should be evaluated.

How dangerous is untreated laryngeal paralysis?

If left untreated, laryngeal paralysis can lead to significant breathing difficulties and marked loss of performance. In severe cases, it may become life threatening, particularly during exertion.

Abnormal respiratory noise in horses can be an early indicator of upper airway disease. The most well known example is the so called roaring or whistling sound, a metallic inspiratory noise that typically occurs during exercise. In most cases, this sound is caused by laryngeal paralysis.

However, abnormal respiratory noises can also result from a wide range of other conditions, including anatomical abnormalities, inflammatory processes or soft tissue changes. Thorough diagnostic evaluation is therefore essential to determine the underlying cause and select the most appropriate treatment.

Häufig gestellte Fragen

My horse makes a whistling noise during exercise. What could this be?

A whistling or metallic noise during inspiration is often associated with unilateral laryngeal paralysis. Dynamic endoscopy during exercise is required to confirm the diagnosis.

Does every abnormal respiratory noise require surgery?

No. Surgical intervention depends on diagnostic findings, severity and clinical impact. Not all abnormalities require treatment, but all should be evaluated.

How dangerous is untreated laryngeal paralysis?

If left untreated, laryngeal paralysis can lead to significant breathing difficulties and marked loss of performance. In severe cases, it may become life threatening, particularly during exertion.

Make an Appointment

We kindly ask you to schedule appointments by phone. This way, we can plan the best treatment for your horse individually and directly.

+49 4282 - 5946340
Opening Hours

Please note our separate visiting hours.

Monday – Friday
8:00 – 18:00
Saturday
9:00 – 12:00
Sunday & Public Holidays
Closed
Besuchszeiten

Bitte vereinbaren Sie einen Besuchstermin im Voraus. Planen Sie etwa 1 Stunde ein und berühre bitte nur dein eigenes Pferd.

Monday – Friday
10:00 – 18:00
Saturday
9:00 – 12:00
Sunday & Public Holidays
Closed
Emergency Service – Open 24/7

Our clinic is available around the clock for emergencies.In case of an emergency, please call us immediately.

Call us:
+49 4282 - 5946 340
Appointment Image

Make an Appointment

We kindly ask you to schedule appointments by phone. This way, we can plan the best treatment for your horse individually and directly.

+49 4282 - 5946 340
Opening Hours

Please note our separate visiting hours.

Monday – Friday
8:00 – 18:00
Saturday
9:00 – 12:00
Sunday & Public Holidays
Closed
Besuchszeiten

Please schedule your visit in advance. Allow approximately 1 hour, and kindly only touch your own horse.

Monday – Friday
8:00 – 18:00
Saturday
9:00 – 12:00
Sunday & Public Holidays
Closed
Emergency Service
Open 24/7

Our clinic is available around the clock for emergencies.In case of an emergency, please call us immediately.

Call Us
+49 4282 - 5946 340
Appointment Image

Make an Appointment

We kindly ask you to schedule appointments by phone. This way, we can plan the best treatment for your horse individually and directly.

+49 4282 - 5946 340
Opening Hours

Please note our separate visiting hours.

Monday – Friday
8:00 – 18:00
Saturday
9:00 – 12:00
Sunday & Public Holidays
Closed
Besuchszeiten

Bitte vereinbare einen Besuchstermin im Voraus. Plane  etwa 1 Stunde ein und berühre bitte nur dein eigenes Pferd.

Monday – Friday
10:00 – 18:00
Saturday
9:00 – 12:00
Sunday & Public Holidays
Closed
Emergency Service – Open 24/7

Our clinic is available around the clock for emergencies.In case of an emergency, please call us immediately.

Call us:
+49 4282 - 5946 340
Appointment Image