Peer-reviewed veterinary case report
Horse with nasal discharge due to fungal infection - treatment risks
By Bonilla, Alvaro G et al.·Published in Journal of the American Veterinary Medical Association·2015·View original on PubMed →
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Original publication title: Potential for iatrogenic coil embolization of the caudal cerebellar artery during treatment of internal carotid artery bifurcation in two horses with guttural pouch mycosis.
- Species:
- horse
Plain-English summary
Two horses were brought in with chronic nasal discharge caused by a fungal infection in their guttural pouches. During treatment, veterinarians discovered an unusual branching of the internal carotid artery, which they had to manage carefully to avoid complications. After using a special technique to block off the affected artery, both horses showed improvement in their fungal infection. However, one horse experienced temporary neurological signs after waking up from anesthesia, which resolved within two months.
People also search for: horse nasal discharge treatment · guttural pouch mycosis in horses · horse anesthesia complications
Abstract
CASE DESCRIPTION: 2 horses were examined for chronic nasal discharge secondary to unilateral guttural pouch mycosis. CLINICAL FINDINGS: Initial endoscopic examination of both horses confirmed the presence of a fungal plaque on the dorsomedial aspect of the medial compartment of the guttural pouch (auditory tube diverticulum) involving the internal carotid artery (ICA). No signs of hemorrhage or neurologic deficits were present at admission. TREATMENT AND OUTCOME: Transarterial stainless steel coil embolization of the affected ICA was performed under general anesthesia, with fluoroscopic guidance. During treatment, an aberrant branch of the ICA, or a proposed bifid ICA, that anastomosed with the caudal cerebellar artery was identified. Occlusion of the distal (noncardiac) side of the aberrant branch was performed in both horses because of potential mycotic involvement at that level. Following treatment, resolution of the mycotic infection was observed in both horses; however, 1 horse developed neurologic signs compatible with unilateral caudal cerebellar artery ischemia on recovery from anesthesia; these signs resolved over the following 2 months. CLINICAL RELEVANCE: Findings highlighted variability of the anatomy of the ICA in 2 horses that was identified during treatment for guttural pouch mycosis and identified caudal cerebellar artery infarction as a potential complication of treatment. Because of the size and pathway of both arterial branches, we suggest that the term bifurcation of the ICA is more appropriate than aberrant branching, as has been previously described in the literature. The information in this report may be of value to clinicians performing procedures involving the vasculature of the head and neck in horses.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/26642139/