A.  They are two reasons to use a tongue-tie.  Most commonly the tongue-tie is used to prevent backwards movement of the tongue that can lead to displacement of the soft palate.  Some trainers also use a tongue-tie out of concern that a horse can get its tongue over the bit resulting in some loss of control.  The TSD is far more effective than a tongue-tie in preventing DDSP.  Furthermore, the TSD's tight Figure-8 nose band makes it very difficult for a horse to get its tongue over the bit.

Therefore, there is no real advantage to use the tongue-tie with the TSD.  There are no contraindications to using both but the tongue-tie is probably unnecessary in the great majority of horses.

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Q.  Has the TSD been approved for use in racehorses? 

A.  There are over one thousand TSD collars in use in the field at this time (July 2007).  They have been sold in dozens of countries, mostly US, Canada, Europe, Australia and New Zealand.  Regulations vary from track to track and it is the responsibility of the trainer to conform to regulations in effect at each track.  The following represents our understanding of current approvals but regulations change almost daily.  The United States Trotting Association has classified the TSD as an equipment item not subject to their regulation and it is in wide use in US and Canadian Standardbreds.  For Thoroughbred racing, the TSD has been formally approved for use in Arizona, Kentucky, Illinois, Michigan, Ohio, Oklahoma, Minnesota, at Calder Race Course (Florida), in Calgary (Canada), in Australia and in Hong Kong.  The TSD collar has been approved for use in Standardbreds in Pennsylvania but not for Thoroughbreds.  It is under consideration by several other regulatory bodies in the US. 

Some trainers use the TSD as a training aid even in states that have not yet approved its use for racing.   

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Q.  My horse has just been diagnosed with palate displacement.  How do I decide whether to send him for surgery or to try the collar?

A.  The following is a summary of the pros and cons of each option:
There are many surgeries for DDSP.  The lowest cost surgical option is a standing strap muscle resection (cutting 2 muscles on each side of the underside of the neck).  A more popular treatment in North America is the “Llewellyn procedure”, a procedure in the anesthetized horse in which one muscle on each side of the voice box is cut.   The standing strap muscles resection has been around since ~1975 and the Llewellyn procedure since around ~ 1987.  Thousand of horses have undergone these surgeries with very few complications except for the occasional incisional infection more common with strap muscle resection.  The success rate for both procedures is approximately 60%.   Horses can be jogging within a few days after surgery so both those surgeries have been good choices.

The most recent surgery is the "laryngeal tie-forward" developed at Cornell University.  This procedure has been in use since 2001 and has an effectiveness of 80-82%.  We feel that this is the best surgical option and it has improved many horses that have not responded to other surgical procedures. Horses needs 2 weeks of rest after this surgery.

The TSD (“Cornell Collar”) and the laryngeal tie-forward surgery exert similar effects on the throat.  In experimental studies, the TSD and the laryngeal tie-forward surgery have had similar success rates.  We believe (based on feedback from trainers) that the two treatments yield similar results at the racetrack as well.  In some horses, the use of the TSD and the tie-forward surgery are additive.

The advantages of the TSD over surgery:

• The TSD can be used as an aid in diagnosis of DDSP.  Most horses displace their palate only during high speed exercise, making it challenging to confirm a diagnosis of DDSP.  Affected horses are usually normal on resting endoscopy.  Also up to 20% of the displacers are silent (no noise).  If a horse’s performance is noticeably improved wearing the TSD, it is highly likely that this horse is a displacer. 

• We believe that the TSD is more effective than other surgery except for the tie-forward.

• The TSD is less expensive than most surgical options. 

• No time off is required. 

• The TSD is moveable from horse to horse.  Surgery, of course, is not.

• The TSD can be used on horses that do not respond to a surgical procedure.

• In very young horses, some trainers prefer the TSD over surgery, given that palate displacement may spontaneously resolve in some horses as they grow and mature. 

The advantage of surgery over the collar:

• Surgery can always be performed.  The TSD may not appropriately fit the occasional horse with unusual throat conformation or that has scarring in the area from previous surgery. 

Disadvantages of the TSD:

• The TSD must be placed and adjusted properly to be effective. 

• The very rare horse may be temperamentally disinclined to wear the TSD. 

Disadvantages of surgery:

• Cost

• Interruption of training during with recovery from surgery

• Surgical complications such as incisional infection, swallowing difficulties (after palate trimming), risk of general anesthesia

• Risk of recurrence of palate displacement weeks or months following surgery
   

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Q. My horse has a paralyzed flapper.  What is that and will the TSD help him?

A.  A paralyzed flapper, commonly called roaring, is a disorder in which half of the voice box (larynx) is partially or completely paralyzed.  The medical term for this condition is laryngeal hemiplegia or hemiparesis.  The paralysis and associated effects on the horse are consistent.  These horses will always make a noise at high exercise and will always finish a race poorly.  In other words, they do not have good race and bad races—they are always bad.  The noise is more of a soft whistle to a roar, most common when the horse inhales, that increases with exercise intensity.  Over time, horses that are partially paralyzed become fully paralyzed so their noise increases and their performance deteriorates.  Affected horses may also experience lung bleeding (EIPH.  

The TSD is not effective in horses with roaring unless they are also displacing their palate.  In this case though, the TSD will benefit only the palate displacement, not the roaring.

The TSD is effective for horses that displace or “flip” their soft palate.  The medical name for this problem is dorsal displacement of the soft palate (DDSP).  Palate displacement is very different than roaring. Palate displacement may be inconsistent insofar as horses may not flip their palate at every race.  Since the airway is normal when the palate is not displaced, they can have good races in between bad starts.  If they do displace their palate, there is a sudden obstruction of airflow and they slow down.  Severely affected horses will choke down (very loud noise and severe exercise limitation).  Displacement often happens when the driver/jockey increase their hold (rein or line tension) or the horse loses its concentration.  Horses that displace their palate make a fluttering or raspy noise from the back of the throat sort of like snoring. The noise is most prominent when the horse exhales.  Be aware that not all displacers make a noise (up to 20% may be silent displacers).

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