Is specific antifungal therapy necessary for the treatment of guttural pouch mycosis in horses?

Speirs, V. C.; Harrison, Ian; Veenendaal, J. C.; Baumgärtner, Thomas; Josseck, H.; Reutter, Heiko

doi:10.1111/j.2042-3306.1995.tb03053.x

Cited by 36 publications

(22 citation statements)

References 9 publications

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“…There is some evidence that occlusion of the affected artery hastens resolution of the fungal lesion and thereby renders medical therapy unnecessary (Speirs and others 1995). However, this is controversial and must be balanced against evidence that the fungal plaques can undergo spontaneous regression (Cook and others 1968) within timeframes similar to those described in many horses that underwent arterial occlusion (Lepage and Piccot-Crezollet 2005).…”

Section: Discussionmentioning

confidence: 99%

Ligation of the ipsilateral common carotid artery and topical treatment for the prevention of epistaxis from guttural pouch mycosis in horses

Cousty

Tricaud

Beauregard³

et al. 2016

Veterinary Record

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The objective of the study was to evaluate the effect of ligation of the ipsilateral common carotid artery (CCA) combined with various antimycotic treatments for the prevention of epistaxis in horses with guttural pouch mycosis. For each case, ipsilateral ligation of the CCA was performed, followed by application of various topical medications under endoscopic guidance. Frequency and number of treatments, outcome and recurrence of haemorrhage were retrospectively recorded. Twenty-four horses were included. Topical medication was administered by detachment of the diphtheric membrane and spraying (n=16) or by intralesional injection directly in the plaques using a transendoscopic needle (n=8). Epistaxis recurred in five horses (20.8 per cent), causing death of four horses (16.6 per cent). The mean number of treatments was 6.3±4.0 (range 2-14) for all topical treatments. Ligation of the ipsilateral CCA and topical medication carries a fair prognosis for avoidance of recurrent episodes of epistaxis, but fatal haemorrhage can occur. Removal of the fungal plaque and topical treatment of the underlying lesion appeared to speed up resolution of the mycotic mucosal lesions. The described technique is a salvage procedure when financial or technical constraints prevent the use of transarterial catheter occlusion techniques.

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Section: Discussionmentioning

confidence: 99%

Ligation of the ipsilateral common carotid artery and topical treatment for the prevention of epistaxis from guttural pouch mycosis in horses

Cousty

Tricaud

Beauregard³

et al. 2016

Veterinary Record

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“…The typical location of mycotic plaques is distal to the sigmoid flexure of the ICA . The purpose of permanent surgical occlusion of the ICA in guttural pouch mycosis is to prevent fatal hemorrhage from erosion of the artery caused by invasion of the mycotic plaque across the wall of the medial compartment of the guttural pouch . Because the ICA is not an end artery, both normograde and retrograde blood flow must be prevented to prevent hemorrhage from the affected ICA.…”

Section: Discussionmentioning

confidence: 99%

Angiographic Variation of the Internal Carotid Artery and its Branches in Horses

2015

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“…It appears that the fungal plaque can spontaneously disappear over a variable time course (Freeman 1999), after the affected artery is properly occluded (Speirs et al, 1995) with, or without additional specific anti-fungal treatments. The premise being that this starves the fungal plaque resulting in its death (Lane 1989).…”

Section: Discussionmentioning

confidence: 99%

Atypical guttaral pouch mycosis in three horses

Carmalt¹,

Baptiste²

2004

PHK

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2 SummaryThree horses presented with clinical signs ranging from an intermittent cough, swollen neck and in one case suggestive of esophageal obstruction. A complete physical examination, upper airway endoscopy and microbiological examination revealed atypical guttural pouch mycosis in that no artery was associated with the fungal mass. Fungal organisms isolated from these cases were Rhizopus spp, Aspergillus nidulans, Penicillium spp, Mucor spp, Chrysosporium spp, and Alternaria spp. All cases were treated medically by local irrigation on a daily basis using a 0.9% or 1.7% enilconazole. Whilst the most successful treatment for guttural pouch mycosis is surgical occlusion of the artery associated with the fungal mass, the authors suggest that this represents a skewed population including only horses that present for epistaxis. These cases illustrate the importance of routine guttural pouch endoscopy as part of a complete upper airway examination in the horse. Medical management of early gutturomycosis is a tenable alternative to surgery with the caveat that the surgical option must be exercised in cases of epistaxis or fungal mass involving an artery.Keywords: Guttural pouch, mycosis, equine, medical therapy, atypical Atypische Luftsackmykose bei drei PferdenEs wurden drei Pferde mit den klinischen Symptomen intermittierender Husten, geschwollenem Nacken und in einem Fall Verdacht auf Schlundverstopfung untersucht. Die Allgemeinuntersuchung, Endoskopie der oberen Atemwege und mikrobiologische Untersuchung führ-ten zur Diagnose Luftsackmykose. Untypisch war, dass in keinem der Fälle eine Arterie in die mykotischen Plaques involviert war. Es wurden Rhizopus spp., Aspergillus nidulans, Penicillium spp., Mucor spp., Chryosporium spp. und Alternaria spp. isoliert. Alle Patienten wurden sofort mit sofort mit täglichen Luftsackspuelungen mit 0,95%iger bzw. 1,7%iger Enilconalzollösung behandelt. Die 1,7%ige Lösung ergab eine schnellere Heilung als die 0,9%ige, was zum Teil darauf zurückzuführen ist, das sie aufgrund ihrer hoeheren Viskositaet laenger im Luftsack verblieb. Bisher stellte der Verschluss der Arterie, die mit den mykotischen Plaques verbunden war die erfolgreichste Therapie dar. Die Autoren sind allerdings der Meinung, dass dies nur Pferde betrifft, die wegen Epistaxis vorgestellt werden und diese eine Randpopulation darstellen. Die vorliegenden Fälle machen deutlich, wie wichtig die routingemaeßige Luftsackendoskopie bei der Untersuchung der oberen Atemwege des Pferdes ist. Die medikamentöse Therapie von Luftsackmykosen in einem frühen Stadium ist ein durchaus tragbare Alternative zum chirurgischen Eingriffe unter Beachtung der Tatsache, dass eine Operation in Fällen von Epistaxis oder Pilzplaques verbunden mit einer Arterie unumgänglich ist.

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Is specific antifungal therapy necessary for the treatment of guttural pouch mycosis in horses?

Cited by 36 publications

References 9 publications

Ligation of the ipsilateral common carotid artery and topical treatment for the prevention of epistaxis from guttural pouch mycosis in horses

Ligation of the ipsilateral common carotid artery and topical treatment for the prevention of epistaxis from guttural pouch mycosis in horses

Angiographic Variation of the Internal Carotid Artery and its Branches in Horses

Atypical guttaral pouch mycosis in three horses

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