Humid Climate
New User
My 10 year old TB gelding has had 3 nosebleeds recently and yesterday was diagnosed with Gutteral Pouch Mycosis. Without the quick thinking of our yard owner and our vet my darling horse would probably be dead now.
He was operated on last night and we are keeping our fingers crossed he makes a full recovery ......
Guttural Pouch Mycosis
Guttural pouch mycosis, a fungal infection of the wall of the pouch, is by far the most serious of the diseases affecting the guttural pouches. As with empyema, generally only one pouch is affected. Fungi are common in the horse's environment and frequently enter the guttural pouch. However, in most cases they don't invade the wall of the pouch. If the fungi do establish themselves, they usually do so directly over one of the major arteries that traverse the wall of the pouch. Some authorities believe that an abnormality in an artery is essential to the development of guttural pouch mycosis. This belief is supported by the fact that surgically obstructing the flow of blood through an involved artery frequently cures the condition without any other treatment.
At any rate, once the fungi become established, they invade the artery and cause repeated episodes of bleeding. At first the bleeding generally amounts to little more than a trickle, and the blood passes out the nostril on the affected side. However, if the condition is not treated, the flow of blood becomes so extensive that blood flows from both nostrils, even though it is coming from just one of the guttural pouches.
A high percentage of horses with guttural pouch mycosis will eventually bleed to death if they are not treated.
In addition to damaging the arteries, the fungi may attack some of the vital nerves that traverse the guttural pouches. Depending on the nerves that are damaged, the horse with guttural pouch mycosis may become a roarer, develop a dorsally displaced soft palate, have a paralyzed and drooping ear and/or lip on the affected side or, most importantly, have difficulty in swallowing. The last is an especially severe complication. Normal swallowing is unlikely to return once the nerves are disrupted, and the affected horse generally wastes away because he is unable to eat normally.
Signs: The cardinal sign of guttural pouch mycosis is repeated nosebleeds, occurring when the horse is resting in his stall or on pasture. Nosebleeds associated with exercise are generally due to conditions other than guttural pouch mycosis. Repeated nosebleeds are cause for genuine alarm and warrant an immediate examination by a veterinarian to determine their cause.
In some cases of guttural pouch mycosis, damage to the nerves in the guttural pouch precedes damage to the arteries. Sometimes horses with this disease, being unable to swallow because of nerve damage, die of starvation without ever having a nosebleed.
Diagnosis: The best (often the only) way to diagnose guttural pouch mycosis is by endoscopic examination of the guttural pouches. If the horse is bleeding heavily, the veterinarian may have to wait until the bleeding stops and stabilize the horse by giving intravenous fluids (or even a blood transfusion) before he can complete the examination.
The diagnosis is more challenging in horses who have difficulty in swallowing in the absence of bleeding, because guttural pouch disease may not be suspected. However, endoscopic examination of the guttural pouches of such horses will detect the fungal lesions.
Treatment: Various antifungal drugs have been used to treat guttural pouch mycosis, but drug treatment alone is seldom successful. The only treatment that has given consistent results is surgical ligation of the affected arteries. Such surgery is complicated because, due to the complex blood supply to the brain, blood can enter the affected arteries from two directions. Thus it is necessary to block the flow of blood to the affected artery from both sides of the fungal lesion. The surgery must not be delayed, once the diagnosis has been confirmed, because the horse may bleed to death at any time.
In most cases the fungal lesions will disappear with no treatment other than surgery, but antifungal drugs are sometimes placed in the guttural pouch following surgery.
The prognosis in guttural pouch mycosis is always guarded, even after surgical correction, because the blood flow to the arteries may be re-established and the horse may begin to bleed again several months to years after the surgery. A horse who has difficulty swallowing due to nerve damage associated with guttural pouch disease has a poor chance of recovering.
He was operated on last night and we are keeping our fingers crossed he makes a full recovery ......
Guttural Pouch Mycosis
Guttural pouch mycosis, a fungal infection of the wall of the pouch, is by far the most serious of the diseases affecting the guttural pouches. As with empyema, generally only one pouch is affected. Fungi are common in the horse's environment and frequently enter the guttural pouch. However, in most cases they don't invade the wall of the pouch. If the fungi do establish themselves, they usually do so directly over one of the major arteries that traverse the wall of the pouch. Some authorities believe that an abnormality in an artery is essential to the development of guttural pouch mycosis. This belief is supported by the fact that surgically obstructing the flow of blood through an involved artery frequently cures the condition without any other treatment.
At any rate, once the fungi become established, they invade the artery and cause repeated episodes of bleeding. At first the bleeding generally amounts to little more than a trickle, and the blood passes out the nostril on the affected side. However, if the condition is not treated, the flow of blood becomes so extensive that blood flows from both nostrils, even though it is coming from just one of the guttural pouches.
A high percentage of horses with guttural pouch mycosis will eventually bleed to death if they are not treated.
In addition to damaging the arteries, the fungi may attack some of the vital nerves that traverse the guttural pouches. Depending on the nerves that are damaged, the horse with guttural pouch mycosis may become a roarer, develop a dorsally displaced soft palate, have a paralyzed and drooping ear and/or lip on the affected side or, most importantly, have difficulty in swallowing. The last is an especially severe complication. Normal swallowing is unlikely to return once the nerves are disrupted, and the affected horse generally wastes away because he is unable to eat normally.
Signs: The cardinal sign of guttural pouch mycosis is repeated nosebleeds, occurring when the horse is resting in his stall or on pasture. Nosebleeds associated with exercise are generally due to conditions other than guttural pouch mycosis. Repeated nosebleeds are cause for genuine alarm and warrant an immediate examination by a veterinarian to determine their cause.
In some cases of guttural pouch mycosis, damage to the nerves in the guttural pouch precedes damage to the arteries. Sometimes horses with this disease, being unable to swallow because of nerve damage, die of starvation without ever having a nosebleed.
Diagnosis: The best (often the only) way to diagnose guttural pouch mycosis is by endoscopic examination of the guttural pouches. If the horse is bleeding heavily, the veterinarian may have to wait until the bleeding stops and stabilize the horse by giving intravenous fluids (or even a blood transfusion) before he can complete the examination.
The diagnosis is more challenging in horses who have difficulty in swallowing in the absence of bleeding, because guttural pouch disease may not be suspected. However, endoscopic examination of the guttural pouches of such horses will detect the fungal lesions.
Treatment: Various antifungal drugs have been used to treat guttural pouch mycosis, but drug treatment alone is seldom successful. The only treatment that has given consistent results is surgical ligation of the affected arteries. Such surgery is complicated because, due to the complex blood supply to the brain, blood can enter the affected arteries from two directions. Thus it is necessary to block the flow of blood to the affected artery from both sides of the fungal lesion. The surgery must not be delayed, once the diagnosis has been confirmed, because the horse may bleed to death at any time.
In most cases the fungal lesions will disappear with no treatment other than surgery, but antifungal drugs are sometimes placed in the guttural pouch following surgery.
The prognosis in guttural pouch mycosis is always guarded, even after surgical correction, because the blood flow to the arteries may be re-established and the horse may begin to bleed again several months to years after the surgery. A horse who has difficulty swallowing due to nerve damage associated with guttural pouch disease has a poor chance of recovering.
