The impact of grade of laryngeal function immediately prior to laryngoplasty and ipsilateral ventriculocordectomy on postoperative performance: 623 Thoroughbred racehorses (1998-2013)

Background: There is persistent concern among some trainers, owners and veterinarians regarding the effect of preoperative laryngeal function grade on the outcome of laryngoplasty and ventriculocordectomy (LPVC). Objectives: To determine the effect of laryngeal function grade prior to LPVC on postoperative performance. Study design: Retrospective case-series. Methods: Medical and race records of Thoroughbred racehorses diagnosed with recurrent laryngeal neuropathy (RLN) and treated with LPVC between 1998 and 2013 were reviewed. Horses were placed into three groups based on preoperative laryngeal function grade (grade III.1, grades III.2/III.3, and grade IV). The effect of preoperative laryngeal function grade on postoperative performance was determined by multivariable logistic regression, Cox proportional hazard model and multivariable linear regression analysis. Results: In a multivariable logistic regression, grade III.2/III.3 horses had 1.88 times higher odds (95% CI = 1.03-3.43) of racing after LPVC than grade IV (P =.04). A multivariable Cox's proportional hazard analysis controlling for race prior to surgery (P <.01) showed that likelihood of racing postoperatively was not different between grade III.1 and grade IV (P =.6), and although not statistically significant, there was a tendency for grades III.2/III.3 to be more likely to race postoperatively than horses with grade IV (P =.07). Kaplan–Meier survival analysis showed that grade IV horses took a longer time to race compared with grade III.1 and grade III.2/III.3. Laryngeal function grade did not influence the mean earnings per start. Main limitations: The small number of horses in the grade III.1 group compared with the III.2/III.3 and IV groups influenced the effect of grade III.1 on outcome. Conclusions: Laryngeal function grade may affect likelihood of racing after LPVC, but not earnings per start. Grade III. 2/III.3 horses were more likely to race postoperatively than grade IV horses, and grade IV horses took a longer time to first race after LPVC.