A 5-step treatment for extensive Guttural Pouch Mycosis in horses
De Beauregard T*, Sureda Matamalas S, Willems T, Hervieux M, De Lange L
Equine Clinic Meslay, Meslay du Maine, France.
Objectives:
Guttural pouch mycosis (GPM) has a guarded prognosis (50-76%). Slow resorption of the mycosis is observed with coil embolization or balloon catheter occlusion. However an aggressive mycosis can still cause damage.
The goal of this study is to evaluate an adjunctive treatment for GPM.
Methods:
Horses referred for GPM (2022-23) underwent a 5-step treatment :
1°) Emergency Common Carotid Artery ligature.
2°) Balloon catheter occlusion of the affected artery(ies) (GA or standing).
3°) Diode Laser Salpingopharyngostomy.
4°) Daily oxygenotherapy and antifongic nebulization (OAN) through the Salpingopharyngostomie.
5°) Transendoscopic detachment of the mycosis once dessicated.
Results:
Ten horses met the inclusion criteria. Median age was 4y [0.5-14], 60% TB+SB, 40% WB, with 2 pregnant mares (9 months and 2 weeks). Seven had epistaxis (E), 2 full dysphagia (D) (fed by nasogastric tube for 8 weeks) and 1 mucopurulent discharge (MD) for 1 month. Mycosis was localized on the ICA in 10/10 cases, plus on the ECA+ Maxillary A in 2 cases. Lesions were bilateral in 3 horses.
Horses received 10±5 days (mean±sd) of nebulization through the Salpingopharyngostomie. Total hospitalization time was 19±5 days.
Complete resolution of the mycosis was observed at 34±19 days.
Long term outcome (LTO) was 100% in the E+MD group. Both mares delivered alive foals. Both horses with dysphagia died due to complications (laminitis, abcesses) but the GPM was resolved 2 weeks before.
Conclusions:
In general, LTO was 80%. The non-survivors died of related reasons. Total resorption of the mycosis was 100% with the 5-steps GPM treatment.