Question: My 8 year old aqha mare was just diagnosed with Cicatrix.  Treating with her 10 ml DMSO/antibiotic/glycerine throat spray bid and 2 gm bute qd for 30 days, then will have repeat nasalpharengeal scope.  What supplements, or additional tteatments, can you suggest to support my mare's health long term?  Thank you! Dr. Kellon: Nasopharyngeal Cicatrix Syndrome (NCS) is a recently described throat/upper airway problem characterized by swelling, pain and eventually scar formation in the pharynx (throat). It is currently unknown if this is an allergic type reaction, irritant exposure or infection but it has been linked to time at pasture. Risk also greatly increases with age. Treatments tried include all the measures you are using and, if necessary, surgery to relieve scarring. You could also try feeding soaked hay, wet bucket meals and adding psyllium, 2 oz, to feedings. Psyllium will coat the feed when it is made wet, making it less irritating to the tissues. Lung EQ will help if there is an allergic component. You could also consider keeping Resprun paste on hand if coughing is an issue.