Foal with nosebleeds treated by blocking artery in guttural pouch

Abstract

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 third of the trachea. Following cessation of the hemorrhage, the left guttural pouch was identified as the origin of the bleeding. A black-gray, plaque-like deposit upon the internal carotid artery of the left guttural pouch was discerned endoscopically. This led to the diagnosis of unilateral guttural pouch mycosis. Consequently, the internal carotid artery was closed using a transendoscopic clip application proximal and distal to the mycotic granuloma. The foal was discharged from the hospital and a re-examination 17 days later showed a satisfactory healing process and no remaining mycotic growth within the guttural pouch. The foal was in good general health. There was no further bleeding at the age of 7 months following closure of the internal carotid artery. A treatment complication in this case was temporary dysphagia with respiratory signs and fever, successfully treated with antibiotics.