Two years later, Magnificent, a miniature horse, continues to do well with his intratracheal stent–the first ever implanted in a horse.


Magnificent suffered from tracheal collapse, an uncommon–and probably underreported–condition in which the
tracheal rings cannot maintain their shape, leading to a narrowed or collapsed tracheal airway. Tracheal collapse can be congenital or caused by a tumor, abscess, respiratory infection, or trauma. In mild cases, the airway obstruction can present as exercise intolerance–the horse tires quickly, breathes heavily, or coughs. In more severe cases, the horse has difficulty breathing even at rest, often emitting an abnormal respiratory sound. Diagnosis is based on a complete clinical examination, endoscopy, and radiography.


If left untreated, severe cases can become life-threatening. With treatment, prognosis ranges from excellent to poor, depending upon severity and underlying cause. The traditional means of correction is, after addressing any underlying problems, either removing up to five affected tracheal rings and replacing them with a small tube (after which the horse will have to wear a martingale to prevent over-extension of the neck and breakdown of the sutured trachea) or installing a prosthesis around the trachea to support the airway. However, both are involved procedures and are limited to the neck region of the trachea; surgical access deeper in the chest isn’t possible.


After examining Magnificent, Laurent Couetil, DVM, Dipl. ACVIM, associate professor of large animal medicine and equine sports medicine director at Purdue University, determined that traditional surgical means weren’t possible due to difficulty in the approach and risk of complications. After consulting a local pulmonologist, Couetil decided to use an endoscope to insert a tiny stent (a tube inserted into a passage to keep it open and prevent closure) to open and expand the trachea. In addition to allowing access into the collapsed area, the procedure was also far less invasive. “We placed the device with an endoscope, going in through the normal airways, from the nose down,” Couetil says. “We didn’t have to cut anything, there is no surgery, and the effect is immediate

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