Treatment for bleeding guttural pouch mycosis

A useful emergency procedure to prevent death until more permanent treatment can be instituted. However, it requires specialized equipment and training.
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Balloon catheter occlusion of the maxillary, internal, and external carotid arteries in standing horses
Vet Surg. 2021 Feb 19. doi: 10.1111/vsu.13580. Online ahead of print.
Authors
Martin Genton 1 2 , Maëlle Farfan 1 2 , Camille Tesson 2 , Anne-Louise Laclaire 2 , Fabrice Rossignol 1 , Céline Mespoulhes-Rivière 2
Affiliations

1 Clinique vétérinaire de Grosbois, Boissy-St-Léger, France.
2 Ecole Nationale vétérinaire d’Alfort – Clinique Equine, Maisons-Alfort, France.

PMID: 33606309
DOI: 10.1111/vsu.13580

Abstract

Objective: 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.

Study design: Experimental and clinical cases series.

Animals: 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 = 2), or ECA and ICA (n = 2).

Results: Internal carotid artery occlusion was successful in seven of eight and seven of nine arteries in phases 1 and 2, respectively. The procedures lasted 53 and 50 minutes, respectively, and catheters were inserted over 13 ± 0.7 cm (mean ± SD). External carotid artery occlusion was successful in seven of seven and four of four arteries in phases 1 and 2, respectively, with mean durations of 31 and 26 minutes, respectively, and a mean distance of catheter insertion of 11.9 cm. Maxillary artery occlusion was successful in five of seven arteries (phase 1), with a mean surgical duration of 47 minutes and a mean distance of catheter insertion of 42.8 cm.

Conclusion: Balloon catheter occlusion of the ICA, ECA, and MA was achieved in most standing horses.

Clinical significance: Balloon catheter occlusion in standing horses provides an alternative to prevent or treat hemorrhage related to guttural pouch mycosis, particularly in horses in which general anesthesia might pose a risk.