The guttural pouch is a unique anatomical structure in horses, consisting of a pair of air-filled sacs located within the head. These sacs are extensions of the Eustachian tubes and are situated between the base of the skull and the atlas vertebra. The guttural pouch is involved in various physiological functions, including temperature regulation of blood traveling to the brain and possibly influencing auditory processes. Due to its location, the guttural pouch is susceptible to infections and diseases such as guttural pouch mycosis and empyema, which can have significant health implications for horses. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, function, and clinical aspects of the guttural pouch in equine health.
McLinden LA, Kemp-Symonds JG, Daly JM, Blanchard AM, Waller AS, Freeman SL.Infection with Streptococcus equi subspecies equi (S. equi) is characterised by acute disease, with about 10% of infected animals remaining persistently infected. Clinically, infection with S. equi cannot readily be distinguished from infection caused by other respiratory pathogens, including Streptococcus equi subspecies zooepidemicus (S. zooepidemicus), equine influenza virus, and equine herpes virus. Screening protocols, with appropriate quarantining facilities, are important to detect horses infected with S. equi and avoid strangles outbreaks. Virulent strains of S. zooepidemicus can also ...
Forni G, Ellero N, Mannini A, Scacco L, Freccero F.A 3-year-old Quarter Horse stallion was referred for headshaking (HS) syndrome of one month duration. The horse underwent complete HS workup. Physical examination revealed up-and-down head movements associated with nose snorting during lunging and riding, in the absence of other abnormalities at rest or in motion. Lameness, neurologic and behavioural evaluations were unremarkable. Endoscopic examination of the upper respiratory tract showed bilateral guttural pouches (GPs) inflammation. The mucosal surface was altered by the presence of areas of microbullous appearance coalescing into some bul...
Himmele M, Engl JPM, Schwarz BC.The present report describes an 8-week-old warmblood foal presented following two episodes of epistaxis. The foal had a history of an umbilical infection, which had been treated with antibiotics when it was 8 days old. Four days before admission the filly showed severe, self-limiting epistaxis. The second hemorrhage occurred on the day of admission. The foal was lethargic and the remainder of the clinical examination unremarkable. A latero-lateral radiograph of the head revealed a fluid line within the guttural pouch. Endoscopy showed large amounts of blood within the pharynx and the upper thi...
Nourinezhad J, Abdi A, Moarabi A, Hanafi MG, Fatahian Dehkordi RA, Tomańska A.Visualizing the major salivary glands (MSGs) in domestic mammals using plain radiology and identifying damaged their structures is impossible. To accurately display MSGs, the knowledge of normal sectional imaging anatomy is essential for veterinarians, aiding them significantly in identifying the exact relations and position of MSGs; however, no reports on the MSGs sectional imaging anatomy in this species have been made. Objective: This study aimed to evaluate computed tomography (CT), magnetic resonance imaging (MRI) and gross sections of MSGs. Methods: Seven healthy adult donkeys were used ...
Lopes MAF, Hollenbach E, Schliewert EC, Murphy MA, Corrêa F.A mare was admitted for progressive swelling of the neck, lethargy and anorexia. Radiography revealed perilaryngeal, peritracheal, and periesophageal emphysema. Endoscopy revealed pharyngeal and tracheal roof collapse, and a small laceration on the trachea. Treatment with antimicrobials, fluids, and flunixin was initiated. To prevent exacerbation of the emphysema, temporary tracheostomy was performed. Clipping for the tracheostomy revealed a hoofprint mark on the ventral neck. Subsequent endoscopies revealed laceration of the esophagus and guttural pouch septum communicating with the visceral ...
Cardona GC, Dahlgren LA, Byron CR, McKenzie HC, Werre SR, Bogers SH.The aim of the present study was to determine if a three-dimensional (3D)-printed instrument technique would improve lavage removal of plastic beads (guttural pouch [GP] chondroid mimics) through a dorsal pharyngeal recess (DPR) fenestration. We hypothesized that using a 3D-printed instrument placed through the DPR fenestration would remove more beads, reduce lavage time and incur less soft tissue damage than using a lavage tube control or instrument placement through the salpingopharyngeal ostium (SPO). Methods: Experimental cadaveric study. Methods: A total of 30 cadaveric equine heads. Meth...
de Preux M, Precht C, Guevar J, Graubner C, Thenhaus-Schnabel S, Buser L, Lukes A, Koch C.A 16-year-old warmblood mare was referred with a progressive history of behavioral changes and left-sided blindness. Following neuroanatomical localization to the forebrain, magnetic resonance imaging of the head revealed a well-delineated, 4.5 cm in diameter, round pituitary mass causing marked compression of the midbrain and optic chiasm. Euthanasia was recommended but declined by the owners. Veterinary specialists and a human neurosurgeon collaboratively prepared for surgical case management. A novel navigated transmandibular lateral transsphenoidal approach was developed to access the re...
van der Vossen N, Cavalcante P, Glynn S, Achappa D, Mehmood W, Oikawa M, Vinardell T, Jamieson C.Upper respiratory disease was reported over many seasons in Arabian foals on a single stud farm in the Middle East. Affected foals were noted to have mucopurulent nasal discharge, cough, fever and tachypnea. All affected foals had been empirically treated with a macrolide and rifampicin, by the referring veterinarian without improvement. On endoscopic examination, all affected foals had significant guttural pouch empyema (GPE). (1) To document a previously unreported presentation of guttural pouch empyema (GPE) in a family of juvenile Arabian foals; (2) To document the cytological and microbia...
Bond S, McMullen C, Timsit E, Léguillette R.The lower respiratory tract microbiota of the horse is different in states of health and disease, but the bacterial and fungal composition of the healthy respiratory tract of the horse has not been studied in detail. Objective: The respiratory tract environment contains distinct niche microbiotas, which decrease in species richness at more distal sampling locations. Objective: Characterize the bacterial and fungal microbiotas along the upper and lower respiratory tract of the horse. Methods: Healthy Argentinian Thoroughbred horses (n = 11) from the same client-owned herd. Methods: Prospectiv...
Vitoria A, Laborda A, Serrano-Casorrán C, Fuente S, Romero A, Vázquez FJ. There are different indications for endovascular surgery in horses, mainly the treatment of guttural pouch mycosis. Traditionally, these procedures are carried out by open arteriotomy of the common carotid artery (CCA), although less invasive percutaneous ultrasound-guided carotid access (PUGCA) has been described in experimental horses. In human medicine, commercial closure systems are used to seal these arterial puncture sites and reduce complications. The aims of this study are to retrospectively describe our experience with PUGCA in clinical cases and to report, for the first time, the us...
Koch DW, Ericksen KA, Easley JT, Hackett ES.To report the clinical outcomes of horses with chronic guttural pouch infection characterized by accumulation of mucopurulent material following transpharyngeal diode laser fenestration. 13 client-owned horses. Horses undergoing diode laser fenestration for chronic guttural pouch infection were identified by medical record search. Signalment, disease history, presence of mucopurulent empyema or chondroids, and pre- and postoperative therapy were recorded. Owners were contacted for follow-up information at a minimum of 6 months following surgery. 13 horses underwent laser fenestration for chron...
Jaramillo-Morales C, Gomez DE, Renaud D, Arroyo LG.The objectives of this study were to determine the prevalence of S. equi in a horse population in Colombia, to determine the risk factors associated with its detection in the guttural pouches and to report the antimicrobial susceptibility of the isolates. Fifteen farms and 137 horses >6 months of age were enrolled. Sampling was randomly, stratified and proportional to the population size of each farm. The guttural pouch (GP) was swabbed via endoscopic guidance and culture was performed. DNA extraction and conventional PCR were performed in colonies compatibles with S. equi, the PCR products we...
Pringle J, Aspán A, Riihimäki M.The value of repeated nasopharyngeal lavage (NPL) to detect silent carriers of Streptococcus equi has not been investigated. Objective: Determine if results of serial testing for S. equi by NPL predicts subsequent true carrier status as determined by both NPL and guttural pouch lavage. Methods: An outbreak of strangles with 100% morbidity in 41 mature Icelandic horses was followed prospectively to investigate development of silent carriers. All were initially positive to S. equi on NPL. The farm was closed to horse movement during the entire study. Methods: Prospective observational study. Tes...
Zetterström SM, Matz BM, Neto RLALT, Lindley SES, Cole RC, Wilhite R, Boone LH.To describe the surgical findings, histopathological features, and long-term outcome for a horse with parotid salivary carcinoma. Methods: Case report ANIMALS: Twelve year old American Quarter Horse gelding. Methods: The gelding was presented for a 10 × 10 cm swelling below the base of the right ear. Ultrasonographic examination revealed a mass involving the right parotid salivary gland. Incisional biopsy was consistent with parotid carcinoma. The tumor was marginally excised. The lateral wall of the guttural pouch was excised with the mass and was reconstructed with a porcine small int...
Lepage OM, Di Francesco P, Moulin N, Gangl M, Texier G, Marchi J, Cadoré JL.Background: The management of bleeding originating from the guttural pouch (GP) has a high success rate, but the resolution of the macroscopic inflammatory lesions in the case of mycosis (GPM) is highly variable; the resolution of neurological disorders is inconstant and challenging. Objectives: Our aim was to test the feasibility and safety of topical oxygen therapy (TOT) in horses after induction of GPM and in cases with naturally occurring disease. Study design: This study was an in vivo experimental and retrospective two-phase study. Methods: During phase 1, the pilot study, both GPs were ...
Bryant B, Meehan LJ, Roberts V.Standing computed tomographic (CT) examination of the equine guttural pouch frequently reveals deviation of the midline septum. The significance of deviation is currently unknown. The aims of this retrospective, single-centre study were to determine the prevalence of deviation of the midline septum of the guttural pouch and determine whether there was an association between the presence and degree of deviation of the septum, and guttural pouch disease. Case records were reviewed, identifying 95 horses that had undergone a standing, sedated, head CT and guttural pouch endoscopy. The presence, l...
Boyle AG, Rankin SC, O'Shea K, Stefanovski D, Peng J, Song J, Bau HH.Rapid point-of-care (POC) detection of Streptococcus equi subsp. equi (S. equi) would theoretically reduce the spread of strangles by identifying index and carrier horses. Objective: That the eqbE isothermal amplification (LAMP) assay, and the same eqbE LAMP assay tested in a microfluidic device format, are comparable to a triplex real-time quantitative polymerase chain reaction (qPCR) assay that is commonly used in diagnostic labs. Methods: Sixty-eight guttural pouch lavage (GPL) specimens from horses recovering from strangles. Methods: Guttural pouch lavage specimens were tested for S. equi ...
Genton M, Farfan M, Tesson C, Laclaire AL, Rossignol F, Mespoulhes-Rivière C.To assess the feasibility of balloon catheter occlusion of the internal carotid artery (ICA), external carotid artery (ECA), and maxillary artery (MA) in standing horses. Methods: Experimental and clinical cases series. Methods: Eight healthy horses (phase 1) and 11 clinical cases (phase 2). Methods: Occlusions were performed on standing horses under sedation and local anesthesia. In phase 1, four horses underwent bilateral ICA balloon catheter occlusion, and four horses underwent balloon catheter occlusion of the ECA and MA. In phase 2, horses were treated by occlusion of ICA (n = 7), ECA (n ...
Pringle J, Venner M, Tscheschlok L, Waller AS, Riihimäki M.Difficulty in detection of silent carriers of Streptococcus equi is a key reason for its continued spread to immunologically naïve groups of horses. Objective: To determine whether clinical examination, markers of inflammation, or serology differentiate silent carriers of S. equi in recovered comingled horses. Methods: Ninety-eight warmblood yearlings and 72 unaffected mares on a large breeding farm (outbreak A), 38 mature Icelandic horses at a riding stable (outbreak B), and 27 mixed breed horses at a boarding stable (outbreak C). Methods: Prospective observational study 6 months to 2 year...
Durham AE, Kemp-Symonds J.Serology is commonly used as a means of identifying horses that might be chronic and silent carriers of S. equi but its sensitivity is rarely examined. Objective: The study was designed to investigate the sensitivity of serological testing for antibodies against S. equi antigens A and C to detect guttural pouch carriers of S. equi. Methods: Retrospective clinical study. Methods: As part of routine surveillance and quarantine procedures horses arriving at a welfare charity quarantine unit were subject to both microbiological sampling of guttural pouches and also serological testing for antibo...
Jukic CC, Cowling NR, Perkins NR, van Eps AW, Ahern BJ.Laser salpingopharyngostomy has been used as an adjunct to primary medical therapy allowing for topical debridement, topical treatment or to potentially alter the guttural pouch environment in horses with guttural pouch disease. Objective: To evaluate the effect of a laser salpingopharyngostomy on the guttural pouch environment in healthy horses. Methods: Experimental study. Methods: In six adult Standardbred female horses, under standing sedation a stab incision was made ventral to the sternocephalicus tendon and a customised trocar inserted into the medial guttural pouch compartment. Baselin...
Hibi H, Hatama S, Obata A, Shibahara T, Kadota K.A case of laryngeal squamous cell carcinoma (SCC) and squamous papilloma in a 19-year-old Thoroughbred stallion is described. The animal exhibited severe wheezing caused by laryngopharyngeal stenosis. Histological examination identified laryngeal, laryngotracheal, and guttural pouch tumor masses consisting of areas of SCC. In the epiglottic lesion, the overlying epithelium was replaced by papilloma cells, and superficial cells frequently had nuclear inclusion bodies that expressed oncoprotein E6, which is characteristic of high risk human papillomaviruses. The papillomatous epithelium was cont...
Koch DW, Easley JT, Nelson BB, Delcambre JJ, McCready EG, Hackett ES.Auditory tube diverticula, also known as guttural pouches, are naturally occurring dilations of the auditory tube in horses that communicate with the nasopharynx through a small ostium. Infection and select other conditions can result in inflammation and narrowing of the nasopharyngeal ostium, which prevents drainage of fluid or egress of air and can lead to persistent infection or guttural pouch tympany. Auditory tube diverticulotomy allows continuous egress from the auditory tube diverticula and is a feature of disease treatment in horses, in which medical treatment alone is not successful. ...
Watkins AR, Parente EJ.Guttural pouch mycosis (GPM) is a cause of nasal discharge, dysphagia and fatal haemorrhage in the horse. Objective: To report the complications and success of salpingopharyngeal fistulation in horses with GPM. We hypothesised that creating a direct static opening into the guttural pouch from the pharynx would cause a regression of fungal plaques due to a change in the guttural pouch environment and that this treatment would result in resolution of infection prior to secondary complications. Methods: Retrospective case series. Methods: The medical records of all horses diagnosed with GPM that ...
Mirra A, Klopfenstein Bregger MD, Levionnois OL.A 15-year-old Selle Francais gelding was presented to the equine referral hospital for treatment of a left guttural pouch mycosis previously diagnosed. After induction, the horse was shortly hoisted by all four feet, moved on a padded surgical table, and positioned in right lateral recumbency. In order to reduce the risk of bleeding during surgical manipulation of the carotid and maxillary arteries, a mean arterial pressure between 60 and 70 mmHg was targeted. After surgery, the horse was moved in a padded recovery box keeping the same lateral recumbency. Four unsuccessful attempts were perf...
Whitehead AE, Whitty J, Scott M, Léguillette R.A gelding was diagnosed with dysphagia and left guttural pouch mycosis. Treatments included topical antifungal drugs, systemic voriconazole, and balloon occlusion of the internal carotid artery. Ongoing dysphagia of neurological origin necessitated extra-oral feeding through an esophagostomy tube. Complementary case management included acupuncture. Clinical remission occurred over 10 weeks. Dysphagie réversible secondaire à une mycose de la poche gutturale chez un hongre traité médicalement avec du voriconazole et chirurgicalement par l’occlusion de la carotide et l’œsophagostomie. Un...
Boyle AG, Rankin SC, D￮ LA, Morris D.Methicillin-resistant Staphylococcus aureus (MRSA) is recognized as a cause of nosocomial infections in both human and veterinary medicine. Studies that examine the nasopharynx and guttural pouches of the horse as carriage sites for MRSA have not been reported. Objective: MRSA colonizes the nasopharynx and guttural pouch of horses. To determine the prevalence of MRSA in equine nasopharyngeal wash (NPW) and guttural pouch lavage (GPL) samples in a field population of horses. Methods: One hundred seventy-eight samples (123 NPW and 55 GPL) from 108 horses. Methods: Prospective study. Samples were...
Khairuddin NH, Sullivan M, Pollock PJ.In horses, the extracranial and intracranial pathway of the internal carotid artery has been described. The extracranial pathway of the internal carotid artery begins at the carotid termination and runs on the dorsal surface of the medial compartment of the guttural pouch. Thereafter the internal carotid artery passes through the foramen lacerum to continue intracranially, forming part of the rostrolateral quadrants of the cerebral arterial circle (Circle of Willis). The objectives of this study were to define and record the anatomy of the carotid arterial tree and the internal carotid artery ...
Boyle AG, Stefanovski D, Rankin SC.Streptococcus equi subsp equi (S. equi) is the cause of "equine strangles" which is a highly infectious upper respiratory disease. Detection of S. equi is influenced by site of specimen collection, method of sampling, and type of diagnostic test that is performed. We hypothesized i) that a loop-mediated isothermal amplification (LAMP) assay that targets the S. equi-specific eqbE gene would be more sensitive than a realtime PCR assay that targets the S. equi-specific seeI gene and ii) that LAMP of specimens obtained by guttural pouch lavage (GPL) would be more sensitive than LAMP of nasopharyng...
Newton JR, Wood JL, Dunn KA, DeBrauwere MN, Chanter N.During an outbreak of strangles on a farm with approximately 1500 horses, the spread of Streptococcus equi infection was monitored by repeated nasopharyngeal swabbing and culture. In order to control the infection and prevent new introductions of strangles on to the premises, a system of quarantine and swabbing of cases and all incoming animals was instituted. Long-term carriage of the organism was detected in four clinically healthy convalescent animals, and in two of 350 new ponies; it persisted for between seven and 39 months, but it was detected only intermittently by the culture of swabs ...
Newton JR, Verheyen K, Talbot NC, Timoney JF, Wood JL, Lakhani KH, Chanter N.Previous use of repeated nasopharyngeal swabbing and culture of Streptococcus equi showed that healthy carriers developed in more than 50% of 'strangles' outbreaks. The guttural pouches were the only detectable site of S. equi colonisation on endoscopic examination of horses during one of these outbreaks and S. equi was sometimes not detected by culture of nasopharyngeal swabs from carriers for up to 2 or 3 months before nasal shedding resumed sporadically. A more sensitive way of detecting S. equi on swabs from established guttural pouch carriers was therefore required. Conveniently selected ...
Gerber V, Tessier C, Marti E.Genetic predispositions for guttural pouch tympany, recurrent laryngeal neuropathy and recurrent airway obstruction (RAO) are well documented. There is also evidence that exercise-induced pulmonary haemorrhage and infectious diseases of the respiratory tract in horses have a genetic component. The clinical expression of equine respiratory diseases with a genetic basis results from complex interactions between the environment and the genetic make-up of each individual horse. The genetic effects are likely to be due to variations in several genes, i.e. they are polygenic. It is therefore unlikel...
Dobesova O, Schwarz B, Velde K, Jahn P, Zert Z, Bezdekova B.The medical records of 28 horses with guttural pouch mycosis were reviewed. The most commonly observed clinical signs were nasal discharge, epistaxis, dysphagia and/or cough. All 28 horses had the disease unilaterally, however, in five of them, it had spread into the contralateral pouch via the mesial septum. Three horses were treated medically, 11 horses underwent surgery and seven horses were treated both medically and surgically. Fifty percent of horses (14/28) were euthanased or died, fifty percent of horses (14/28) survived. There was no significant correlation between treatment method (m...
Sweeney CR, Whitlock RH, Meirs DA, Whitehead SC, Barningham SO.Complications associated with Streptococcus equi infection developed in 15 (20.3%) of 74 horses on one farm included death, guttural pouch empyema, purpura hemorrhagica, upper respiratory tract obstruction, pneumonia, pleuropneumonia, agalactia, mesenteric lymph node abscessation, and periorbital abscessation. Death was attributed to pneumonia in 3 horses and to upper respiratory tract obstruction in 2 horses. One horse was euthanatized because of severe purpura hemorrhagica.
Waller AS, Paillot R, Timoney JF.Strangles caused by the host adapted Lancefield group C Streptococcus equi subspecies equi (S. equi) is a frequently diagnosed infectious disease of horses worldwide. Critical to the global success of S. equi is its ability to establish persistent infections within the guttural pouches of recovered apparently healthy horses that can result in transmission to in-contact animals. Recent research has identified key events in the S. equi genome, which occurred during its evolution from an ancestral strain of S. equi subspecies zooepidemicus, that may enhance its ability to evade host innate immune...
Hibi H, Hatama S, Obata A, Shibahara T, Kadota K.A case of laryngeal squamous cell carcinoma (SCC) and squamous papilloma in a 19-year-old Thoroughbred stallion is described. The animal exhibited severe wheezing caused by laryngopharyngeal stenosis. Histological examination identified laryngeal, laryngotracheal, and guttural pouch tumor masses consisting of areas of SCC. In the epiglottic lesion, the overlying epithelium was replaced by papilloma cells, and superficial cells frequently had nuclear inclusion bodies that expressed oncoprotein E6, which is characteristic of high risk human papillomaviruses. The papillomatous epithelium was cont...
Anzai T, Timoney JF, Kuwamoto Y, Fujita Y, Wada R, Inoue T.The glossy non-encapsulated strain of Steptococcus equi, NCTC 9682, was compared with the matt strain Hidaka/95/2 which expresses a medium sized capsule and with the mucoid CF32 which expresses a large sized capsule in phagocytosis assays and for virulence in inoculated horses. The three strains, NCTC 9682, Hidaka /95/2 and CF32 produced 2.0, 3.1, and 5.3 mg/g wet cells respectively after 3 h incubation, but similar amounts of M-like proteins, cytotoxin and mitogen. NCTC 9682 showed no resistance to phagocytosis by equine neutrophils regardless of the presence of opsonin while strains Hidaka /...
Walker AM, Sellon DC, Cornelisse CJ, Hines MT, Ragle CA, Cohen N, Schott HC.A retrospective study of the medical records of 33 horses was performed to determine the clinical and diagnostic abnormalities associated with temporohyoid osteoarthropathy. Data collected from medical records included signalment, presenting complaints, history, physical examination findings, laboratory data, results of diagnostic imaging studies, and treatments. Follow-up information was obtained from a review of case records; by telephone conversation with the owner, veterinarian, or trainer; or by both methods. Of 33 horses with temporohyoid osteoarthropathy, 29 presented with facial nerve ...
Boyle AG, Rankin SC, D￮ L, Boston RC, Wheeler-Aceto H.Bacterial culture and polymerase chain reaction (PCR) assays for the detection of Streptococcus equi in nasopharyngeal washes (NPW) and guttural pouch lavage (GPL) samples have low sensitivity. In human diagnostics, processing of samples with flocked swabs has improved recovery rates of bacterial agents because of improved surface area and elution factors. Objective: For S. equi subsp. equi (S. equi) detection in NPW and GPL samples we hypothesized that: direct-PCR would be more reliable than flocked swab culture (FS culture); flocked swab PCR (FS-PCR) would be equivalent to direct-PCR; and FS...
Boyle AG, Stefanovski D, Rankin SC.Streptococcus equi subsp equi (S. equi) is the cause of "equine strangles" which is a highly infectious upper respiratory disease. Detection of S. equi is influenced by site of specimen collection, method of sampling, and type of diagnostic test that is performed. We hypothesized i) that a loop-mediated isothermal amplification (LAMP) assay that targets the S. equi-specific eqbE gene would be more sensitive than a realtime PCR assay that targets the S. equi-specific seeI gene and ii) that LAMP of specimens obtained by guttural pouch lavage (GPL) would be more sensitive than LAMP of nasopharyng...
Chanter N, Talbot NC, Newton JR, Hewson D, Verheyen K.The M-protein genes of Streptococcus equi isolated from 17 outwardly healthy horses after 4 strangles outbreaks had ended, including a quarantined animal, were compared with those of S. equi isolates from 167 active cases of strangles across 4 countries. The healthy horses included 16 persistent S. equi carriers, at least one from each of the four outbreaks. These carriers, despite being outwardly healthy, had empyema of the guttural pouch(es), an enlargement of the equine Eustachian tube. A persistent carrier from two of these outbreaks, the quarantined animal and a healthy animal with normal...
Verheyen K, Newton JR, Talbot NC, de Brauwere MN, Chanter N.Three protracted outbreaks of strangles were investigated using endoscopic examination and a total of 14 asymptomatic carriers of Streptococcus equi were identified of which 13 showed evidence of carriage in the guttural pouch. Treatment was initiated to eliminate S. equi colonisation since these animals posed an infectious risk to susceptible horses. Two further horses were referred to us with severe guttural pouch pathology and from which S. equi was cultured, and treatment of these cases is also described. Treatment in the first instance was directed towards removal of gross guttural pouch ...
Ludwig A, Gatineau S, Reynaud MC, Cadoré JL, Bourdoiseau G.This aetiological study of guttural pouch mycosis (GPM) in the horse was based on the retrospective study of 21 horses brought into the National Veterinary School of Lyon (France) between 1998 and 2002. Biopsies were taken from the lesions caused by GPM during endoscopic examination. In 87% of the cases, direct examination gave positive results, whereas 43% of the cultures were found to be negative. The main fungi observed were Aspergillus fumigatus (in three cases), A. versicolor (in two cases, together with other fungi), and A. nidulans and A. niger (one case each). In six cases, the Aspergi...
Watkins AR, Parente EJ.Guttural pouch mycosis (GPM) is a cause of nasal discharge, dysphagia and fatal haemorrhage in the horse. Objective: To report the complications and success of salpingopharyngeal fistulation in horses with GPM. We hypothesised that creating a direct static opening into the guttural pouch from the pharynx would cause a regression of fungal plaques due to a change in the guttural pouch environment and that this treatment would result in resolution of infection prior to secondary complications. Methods: Retrospective case series. Methods: The medical records of all horses diagnosed with GPM that ...
D￮ LR, Stefanovski D, Boston RC, Boyle AG.To evaluate predictor variables for and complications associated with Streptococcus equi subsp equi infection (strangles) in horses. Methods: Retrospective case-control study. Methods: 108 horses with strangles (cases) and 215 horses without strangles (controls). Methods: Medical records from January 2005 through July 2012 were reviewed. Cases were defined as horses with clinical signs of strangles (pyrexia, retropharyngeal lymphadenopathy, and mucopurulent nasal discharge) that were associated with a confirmed strangles outbreak or had positive results for S equi on PCR assay or bacteriologic...
Mitchell G, Fuller A, Maloney SK, Rump N, Mitchell D.Selective brain cooling (SBC) is defined as the lowering of brain temperature below arterial blood temperature. Artiodactyls employ a carotid rete, an anatomical heat exchanger, to cool arterial blood shortly before it enters the brain. The survival advantage of this anatomy traditionally is believed to be a protection of brain tissue from heat injury, especially during exercise. Perissodactyls such as horses do not possess a carotid rete, and it has been proposed that their guttural pouches serve the heat-exchange function of the carotid rete by cooling the blood that traverses them, thus pro...
Lepage OM, Perron MF, Cadoré JL.Advances in the understanding of guttural pouch physiology and novel therapeutic approaches to mycotic infections in the horse are reviewed. It is suggested that the guttural pouches may contribute to the regulation of arterial blood temperature, cooling the circulation to the brain to below body temperature. Aspergillus spp. is the major organism found in a guttural pouch affected with mycosis but it is unclear why this agent becomes aggressive. Conventional therapy aims to prevent fatal haemorrhage and to treat any neurological lesions but it is desirable to try to prevent the disease. A tec...
Greet TR.This paper describes the outcome of treatment of 30 cases of guttural pouch mycosis by ligation of the internal carotid artery on the cardiac side of the lesion and lavage of the affected pouch with natamycin. Twenty-three horses recovered fully following this treatment while laryngeal hemiplegia persisted in one case and slight dysphagia caused by pharyngeal hemiplegia in another. The remaining five horses died or were destroyed. Five horses with guttural pouch mycosis, which had shown no epistaxis but had pharyngeal hemiplegia, were treated by topical natamycin alone. Only two of these survi...
Lepage OM, Piccot-Crézollet C.There have been no previously published large case series describing short- and long-term outcome of transarterial coil embolisation (TCE) in horses with guttural pouch mycosis (GPM). Objective: To describe the clinical and surgical features of horses with GPM presented at the Veterinary School of Lyon during a 28 month period; and to evaluate immediate to long-term results of TCE as a treatment. Methods: Medical records of all horses with GPM treated with TCE between February 1999 and July 2002 were analysed. To be included in the study, no other surgical or medical treatment for the mycosis ...
Freeman DE, Donawick WJ.An intravascular procedure was used to occlude the internal carotid artery of two horses with epistaxis caused by guttural pouch mycosis. In each horse, the affected internal carotid artery was ligated close to its origin. A balloon-tipped catheter was introduced into the artery distal to the ligature, and its tip was advanced beyond the site of infection. The balloon was then inflated so that the infected segment of artery was isolated from the cerebral vascular system. The catheters were removed at 14 and 51 days, and both horses were returned to training and racing. Neither horse had furthe...
Pringle J, Venner M, Tscheschlok L, Waller AS, Riihimäki M.Difficulty in detection of silent carriers of Streptococcus equi is a key reason for its continued spread to immunologically naïve groups of horses. Objective: To determine whether clinical examination, markers of inflammation, or serology differentiate silent carriers of S. equi in recovered comingled horses. Methods: Ninety-eight warmblood yearlings and 72 unaffected mares on a large breeding farm (outbreak A), 38 mature Icelandic horses at a riding stable (outbreak B), and 27 mixed breed horses at a boarding stable (outbreak C). Methods: Prospective observational study 6 months to 2 year...
Freeman DE.The most common disorders of the equine guttural pouches are empyema, tympany, mycosis, and temporohyoid osteoarthropathy. Diagnosis of these conditions is made primarily by imaging with endoscopy, radiographs, computed tomography, and/or MRI. Medical treatment with anti-inflammatories, antimicrobials, and/or antifungals may be successful in some cases, but many of these disorders necessitate surgical intervention. Direct surgical approaches to the guttural pouch are difficult because of their complex anatomy and relationship with important structures, thus precipitating a move toward minimall...
Bond S, McMullen C, Timsit E, Léguillette R.The lower respiratory tract microbiota of the horse is different in states of health and disease, but the bacterial and fungal composition of the healthy respiratory tract of the horse has not been studied in detail. Objective: The respiratory tract environment contains distinct niche microbiotas, which decrease in species richness at more distal sampling locations. Objective: Characterize the bacterial and fungal microbiotas along the upper and lower respiratory tract of the horse. Methods: Healthy Argentinian Thoroughbred horses (n = 11) from the same client-owned herd. Methods: Prospectiv...
Lévéille R, Hardy J, Robertson JT, Willis AM, Beard WL, Weisbrode SE, Lepage OM.To develop a transarterial coil embolization technique for occlusion of the internal carotid artery (ICA), external carotid artery (ECA), and maxillary arteries (MA) in normal horses and to evaluate this technique for prevention of hemorrhage in horses affected with guttural pouch mycosis. Methods: Ten adult, normal horses and 4 horses with guttural pouch mycosis. Methods: All horses had transarterial coil embolization of the rostral and caudal ICA, caudal MA, and rostral ECA. In 1 affected horse, an aberrant actively bleeding branch of the ECA was also occluded. Normal horses had a premortem ...
Durham AE, Kemp-Symonds J.Serology is commonly used as a means of identifying horses that might be chronic and silent carriers of S. equi but its sensitivity is rarely examined. Objective: The study was designed to investigate the sensitivity of serological testing for antibodies against S. equi antigens A and C to detect guttural pouch carriers of S. equi. Methods: Retrospective clinical study. Methods: As part of routine surveillance and quarantine procedures horses arriving at a welfare charity quarantine unit were subject to both microbiological sampling of guttural pouches and also serological testing for antibo...
Jaramillo-Morales C, Gomez DE, Renaud D, Arroyo LG.The objectives of this study were to determine the prevalence of S. equi in a horse population in Colombia, to determine the risk factors associated with its detection in the guttural pouches and to report the antimicrobial susceptibility of the isolates. Fifteen farms and 137 horses >6 months of age were enrolled. Sampling was randomly, stratified and proportional to the population size of each farm. The guttural pouch (GP) was swabbed via endoscopic guidance and culture was performed. DNA extraction and conventional PCR were performed in colonies compatibles with S. equi, the PCR products we...
Church S, Wyn-Jones G, Parks AH, Ritchie HE.Seventeen cases of guttural pouch mycosis (including two bilaterally affected cases) were diagnosed in a three year period. The presenting signs were, in order of frequency, epistaxis at rest, nasal catarrh, pharyngeal paralysis, ipsilateral laryngeal hemiplegia, swelling of the submandibular/parotid region, extension of the head and neck and dyspnoea. Ligation of the origin of the internal carotid and occipital arteries was attempted in 10 of the cases exhibiting epistaxis. Bilateral ligation was performed on one animal with an untoward sequelae. Where surgery was successfully completed furth...
