The Effect of Topical Oxygen Therapy in Horses Affected with Mycosis of the Guttural Pouch: An Experimental Pilot Study and a Case Series.
Abstract: 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 inoculated with Aspergillus fumigatus. One GP was randomly assigned to receive one to four TOT 30 min sessions with 100% medical oxygen at 9 L/min. Follow-up endoscopic images were assessed for scoring macroscopic inflammatory lesions of the pharynx and both GPs. In phase 2, the clinical study, TOT was administered for 45 to 60 min at 15 L/min in six horses presenting with GPM. Results: In phase 1, TOT administration was easy to perform in the standing horse with no adverse effects. After more than two administrations, macroscopic inflammatory lesions decreased more quickly in size in the treated GP. In phase 2, horses were treated with TOT only (n = 1) or combined with a transarterial coil embolization (TACE) procedure (n = 5). After TOT and discharge from the hospital, nasal discharge resolved in three horses, and improvement was noted in the fourth one. Between days 2 and 10 after admission, upper respiratory tract endoscopy (URTE) indicated size reduction and alteration in the appearance of all the macroscopic inflammatory lesions. The partial or total recovery of neurological disorders (2/4 laryngeal hemiparesis, 3/5 dysphagia, 1/2 dorsal displacement of the soft palate (DDSP), and 1/1 Horner's syndrome) was recorded. Main limitations: In phase 1, the small number of horses did not allow for statistically significant conclusions; in phase 2, clinical signs at admission varied between horses, which made comparison difficult. Conclusions: In adult horses, TOT alone or in combination with TACE is feasible and safe with a propensity to reverse the course and the progression of inflammatory lesions without additional local or systemic treatment.
Publication Date: 2021-11-22 PubMed ID: 34828059PubMed Central: PMC8614901DOI: 10.3390/ani11113329Google Scholar: Lookup
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- Journal Article
Summary
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The research article discusses the application and effectiveness of topical oxygen therapy (TOT) in treating mycosis in the guttural pouch (GPM) of horses. The study also looks into the possibility of TOT in resolving neurological disorders associated with GPM.
Study Design
- The study is an in vivo experimental and retrospective two-phase study, comprising a pilot and a clinical phase.
- In the pilot phase, a GP of randomly selected horses was injected with Aspergillus spp. and treated with TOT for one to four 30-minute sessions, using 100% medical oxygen at 9 L/min.
- In the clinical phase, six horses with naturally occurring GPM were treated with TOT for 45–60 minutes at a 15 L/min dosage.
Findings and Observations
- The pilot phase showed easy application of TOT in standing horses with no adverse effects.
- Treatment demonstrated a reduction in the size of macroscopic inflammatory lesions after more than two applications.
- In the clinical phase, TOT was either applied alone or in combination with transarterial coil embolization (TACE).
- Post-TOT and discharge from the hospital, three horses displayed resolved nasal discharge, while the fourth one showed signs of improvement.
- Upper respiratory tract endoscopy (URTE) indicated a reduction in lesion size and alteration in appearance between days 2 and 10 after admission.
- Partial or total recovery from neurological disorders, including laryngeal hemiparesis, dysphagia, dorsal displacement of the soft palate, and Horner’s syndrome, was also recorded.
Limitations
- The pilot phase had a small sample size that did not allow for statistically significant conclusions.
- The clinical signs at admission varied between horses in the clinical phase, which posed difficulties in comparisons.
Conclusion
- TOT, used alone or in combination with TACE, proved to be feasible and safe for adult horses.
- The therapy showed promise in reversing the course and progression of inflammatory lesions without the need for additional local or systemic treatment.
Cite This Article
APA
Lepage OM, Di Francesco P, Moulin N, Gangl M, Texier G, Marchi J, Cadoré JL.
(2021).
The Effect of Topical Oxygen Therapy in Horses Affected with Mycosis of the Guttural Pouch: An Experimental Pilot Study and a Case Series.
Animals (Basel), 11(11).
https://doi.org/10.3390/ani11113329 Publication
Researcher Affiliations
- Centre for Equine Health, Ecole Nationale Vétérinaire de Lyon, VetAgro Sup, University of Lyon, F-69280 Marcy l'Etoile, France.
- Centre for Equine Health, Ecole Nationale Vétérinaire de Lyon, VetAgro Sup, University of Lyon, F-69280 Marcy l'Etoile, France.
- Centre for Equine Health, Ecole Nationale Vétérinaire de Lyon, VetAgro Sup, University of Lyon, F-69280 Marcy l'Etoile, France.
- Centre for Equine Health, Ecole Nationale Vétérinaire de Lyon, VetAgro Sup, University of Lyon, F-69280 Marcy l'Etoile, France.
- French Armed Forces Center for Epidemiology and Public Health, F-13568 Marseille, France.
- UMR 912/SESSTIM-INSERM/IRD, Faculty of Medicine, F-13385 Marseille, France.
- French Armed Forces Center for Epidemiology and Public Health, F-13568 Marseille, France.
- Centre for Equine Health, Ecole Nationale Vétérinaire de Lyon, VetAgro Sup, University of Lyon, F-69280 Marcy l'Etoile, France.
Conflict of Interest Statement
The authors declare no conflict of interest.
References
This article includes 40 references
- Cook W.R., Campbell R.S., Dawson C.. The pathology and aetiology of guttural pouch mycosis in the horse.. Vet. Rec. 1968;83:422–428.
- Cadoré J.-L., Tortereau A., Belluco S., Segard É., Leroux C.. Guttural pouch mycosis in horses: An intriguing and mysterious disease.. Equine Vet. Educ. 2017;31:75–79.
- Denning D.W., Ward P.N., Fenelon L.E., Benbow E.W.. Lack of vessel wall elastolysis in human invasive pulmonary aspergillosis.. Infect. Immun. 1992;60:153–156.
- Delling U., Killisch R., Gittel C., Schöniger S., Brehm W.. Persistence of fungal hyphae within nerves as possible cause for treatment failure in a horse with guttural pouch mycosis. Proceedings of the 25th Annual Scientific Meeting ECVS; Berlin, Germany. 2–5 July 2015; p. 124.
- Lepage O.M.. Challenges associated with the diagnosis and management of guttural pouch epistaxis in equids.. Equine Vet. Educ. 2015;28:372–378.
- Lepage O.M., Piccot-Crezollet C.. Transarterial coil embolization in 31 horses (1999–2002) with guttural pouch mycosis: A two years’ follow-up.. Equine Vet. J. 2005;37:430–434.
- Speirs V.C., Harrison I.W., Veenendaal J.C., Baumgartner T., Josseck H.H., Reutter H.. Is specific antifungal therapy necessary for the treatment of guttural pouch mycosis in horses?. Equine Vet. J. 1995;27:151–152.
- Watkins A.R., Parente E.J.. Salpingopharyngeal fistula as a treatment for guttural pouch mycosis in seven horses.. Equine Vet. J. 2018;50:781–786.
- Greppi M.C., Guillot J., Melloul E., Bourdoiseau G., Lepage O., Cadoré J.-L.. Experimental induction of mycotic plaques in the guttural pouches of horses.. Med. Mycol. 2016;55:308–313.
- Hall L.A., Denning D.W.. Oxygen requirements of Aspergillus species.. J. Med. Microbiol. 1994;41:311–315.
- Dhingra S., Buckey J.C., Cramer R.A.. Hyperbaric Oxygen Reduces Aspergillus fumigatus Proliferation in vitro and Influences In Vivo Disease Outcomes.. Antimicrob. Agents Chemother. 2018;62:e01953-17.
- Mader J.T., Brown G.L., Guckian J.C., Wells C.H., Reinarz J.A.. A Mechanism for the Amelioration by Hyperbaric Oxygen of Experimental Staphylococcal Osteomyelitis in Rabbits.. J. Infect. Dis. 1980;142:915–922.
- Kaufman H., Gurevich M., Tamir E., Keren E., Alexander L., Hayes P.. Topical oxygen therapy stimulates healing in difficult, chronic wounds: A tertiary centre experience.. J. Wound Care. 2018;27:426–433.
- Evans A.W., Gill R., Valiulis A.O., Lou W., Sosiak T.S.. Hyperbaric oxygen therapy and diabetic foot ulcers.. Can. Fam. Physician. 2010;56:444–452.
- Memar M.Y., Yekani M., Alizadeh N., Baghi H.B.. Hyperbaric oxygen therapy: Antimicrobial mechanisms and clinical application for infections.. Biomed. Pharmacother. 2019;109:440–447.
- García-Covarrubias L., Barratt D.M., Bartlett R., Metzinger S., Van Meter K.. Invasive aspergillosis treated with adjunctive hyperbaric oxygenation: A retrospective clinical series at a single institution.. South. Med. J. 2002;95:450–456.
- Segal E., Menhusen M.J., Shawn S.. Hyperbaric oxygen in the treatment of invasive fungal infections: A single-center experience.. Isr. Med. Assoc. J. 2007;9:355–357.
- Knighton D.R., Fiegel V.D., Halverson T., Schneider S., Brown T.W.. Oxygen as an antibiotic: The effect of inspired oxygen on bacterial clearance.. Arch. Surg. 1990;125:97–100.
- Stevens D.L., Tweten R.K., Awad M.M., Rood J., Bryant A.E.. Clostridial gas gangrene: Evidence that alpha and theta toxins differentially modulate the immune response and induce acute tissue necrosis.. J. Infect. Dis. 1997;176:189–195.
- Gordillo G.M., Sen C.K.. Evidence-Based Recommendations for the Use of Topical Oxygen Therapy in the Treatment of Lower Extremity Wounds.. Int. J. Low. Extrem. Wounds. 2009;8:105–111.
- Rao C., Xiao L., Liu H., Li S., Lu J., Li J., Gu S.. Effect of topical oxygen therapy on ischemic wound healing.. J. Phys. Ther. Sci. 2016;28:118–123.
- Dobesova O., Schwarz B., Velde K., Jahn P., Zert Z., Bezdekova B.. Guttural pouch mycosis in horses: A retrospective study of 28 cases.. Vet. Rec. 2012;171:561.
- Di Francesco P., Lepage O.M., Moulin N., Cadoré J.-L.. Gli effetti e l’utilizzo dell’ossigeno iperbarico nell’Aspergillosi delle tasche gutturali del cavallo: Studio preliminare. Proceedings of the 22nd SIVE International Congress; Milano, Italy. 14–15 October 2016; pp. 308–309.
- Lepage O., Perron M.-F., Cadoré J.-L.. The mystery of fungal infection in the guttural pouches.. Vet. J. 2004;168:60–64.
- Léveillé R., Hardy J., Robertson J.T., Willis M.A., Beard W.L., Weisbrode S.E., Lepage O.M.. Transarterial occlusion of the internal and external carotid and maxillary arteries for prevention of hemorrhage from guttural pouch mycosis in horses.. Vet. Surg. 2000;29:389–397.
- Dixon P.M., Robinson N.E., Wade J.. Proceedings of a Workshop on Equine Recurrent Laryngeal Neuropathy.. In: Dixon P.M., Robinson N.E., Wad J.F., editors. Havemeyer Foundation Monograph. R&W Publications; Newmarket, ON, Canada: 2003. pp. 93–97. (Series No. 11).
- Deluzurieux M., Desjardins I., Nolf M., Guidi E., Depecker M., Cadoré J.-L.. Endoscopic analysis of guttural pouch opening in horses.. J. Exp. Appl. Anim. Sci. 2013;1:10.
- Dissemond J., Kröger K., Storck M., Risse A., Engels P.. Topical oxygen wound therapies for chronic wounds: A review.. J. Wound Care. 2015;24:53–63.
- Sonoda A., Maekawa A.T., Kuwahara H.. Spontaneous gangrene of the scrotum and penis (Fournier’s gangrene). J. Dermatol. 1980;7:371–375.
- Brosnahan M.M., Holbrook T.C., Breshears M., Moll H.D.. Suitability of chlorhexidine gluconate for equine guttural pouches lavage. Proceedings of the 53rd Annual Convention American Association of Equine Practitioners; Orlando, FL, USA. 1–5 December 2007; p. 81.
- Lepage O.M.. Guttural Pouch Disease.. In: Orsini J.A., Grenager N.S., de Lahunta A., editors. Comparative Veterinary Anatomy: A Clinical Approach. 1st ed. Academic Press; Cambridge, MA, USA: Elsevier; Amsterdam, The Netherlands: 2021. Chapter 10.5.
- Siddiqui A., Connors D., Gruskin E., Wu L., Galiano R.D., Mustoe T.A.. Differential effects of oxygen on human dermal fibroblasts: Acute versus chronic hypoxia.. Wound Repair Regen. 1996;4:211–218.
- Mutluoglu M., Cakkalkurt A., Uzun G., Aktas S.. Topical Oxygen for Chronic Wounds: A PRO/CON Debate.. J. Am. Coll. Clin. Wound Spéc. 2013;5:61–65.
- Clark J.M., Pakman L.M.. Inhibition of Pseudomonas aeruginosa by hyperbaric oxygen. II. Ultrastructural changes.. Infect. Immun. 1971;4:488–491.
- Sheffield P.J., Smith A.P.. Physiological and pharmacological basis of hyperbaric oxygen therapy.. In: Bakker D.J., editor. Hyperbaric Surgery: Perioperative Care. Best Publishing; Flagstaff, AZ, USA: 2002. pp. 63–110.
- John B.V., Chamilos G., Kontoyiannis D.P.. Hyperbaric oxygen as an adjunctive treatment for zygomicosis.. Clin. Microbiol. Infect. 2005;11:515–517.
- Tragiannidis A., Groll A.H.. Hyperbaric oxygen therapy and other adjunctive treatments for zygomycosis.. Clin. Microbiol. Infect. 2009;15:82–86.
- Geiser D.R.. Hyperbaric Oxygen Therapy in Equine Rehabilitation.. Vet. Clin. Equine Pract. 2016;32:149–157.
- Parente E.J.. Deciphering and treating dysphagia in young horses.. Equine Vet. Educ. 2018;32:30–32.
- Tracey A.K., Alcott C.J., Schleining J., Safayi S., Zaback P., Hostetter J., Reinertson E.L.. The effects of topical oxygen therapy on equine distal limb dermal wound healing.. Can. Vet. J. 2014;55:1146–1152.
Citations
This article has been cited 2 times.- Lepage OM. Guttural Pouch Mycosis: A Three-Step Therapeutic Approach. Vet Sci 2024 Jan 19;11(1).
- Dobiáš R, Jahn P, Tóthová K, Dobešová O, Višňovská D, Patil R, Škríba A, Jaworská P, Škorič M, Podojil L, Kantorová M, Mrázek J, Krejčí E, Stevens DA, Havlíček V. Diagnosis of Aspergillosis in Horses. J Fungi (Basel) 2023 Jan 25;9(2).
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