title: Standing surgical removal of inspissated guttural pouch exudate (chondroids) in ten horses.
abstract: OBJECTIVE
  To report use of a modified Whitehouse approach in standing horses for management of inspissated guttural pouch empyema.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Adult horses (n=10) with guttural pouch empyema.
  
  
  METHODS
  Inspissated exudate in 1 or both guttural pouches was removed surgically through a modified Whitehouse approach, with the horses standing and sedated. Medical records of affected horses were reviewed to determine history; physical, endoscopic, and radiological examination findings; surgical technique; complications, and outcome.
  
  
  RESULTS
  All horses had purulent nasal discharge; 3 horses had dysphagia, 2 had recurrent laryngeal neuropathy on the side affected by guttural pouch empyema, and 1 had persistent soft palate displacement. Inspissated exudate was removed safely without causing apparent discomfort. Eight horses returned to their previous level of athletic activity after surgery; 1 horse dysphagic before surgery, was euthanatized because of persistent dysphagia after surgery, and 1 horse died 1 week after surgery for unknown reasons. Streptococcus equi subsp equi was isolated from the affected guttural pouch of 3 horses.
  
  
  CONCLUSIONS
  Inspissated exudate can be removed surgically from the guttural pouch in standing horses through a modified Whitehouse approach.
  
  
  CONCLUSIONS
  To eliminate risks associated with general anesthesia and avoid surgical suite contamination, removal of chondroids can be performed in standing sedated horses through a modified Whitehouse approach.
authors.affiliation: Department of Veterinary Clinical Sciences, Equine Referral Hospital, Royal Veterinary College, Hawkshead Lane, North Mymms, UK. JPerkins@rvc.ac.uk
authors.forename: Justin D
authors.initials: JD
authors.lastname: Perkins
authors.forename: Jim
authors.initials: J
authors.lastname: Schumacher
authors.forename: Ger
authors.initials: G
authors.lastname: Kelly
authors.forename: Jorge H
authors.initials: JH
authors.lastname: Gomez
authors.forename: John
authors.initials: J
authors.lastname: Schumacher
mesh_terms: D000818:Animals; D003680:Deglutition Disorders / Q000601:surgery / Q000662:veterinary; D004240:Diverticulum / Q000601:surgery / Q000662:veterinary*; D004653:Empyema / Q000601:surgery / Q000662:veterinary*; D005064:Eustachian Tube / Q000601:surgery*; D005122:Exudates and Transudates / Q000382:microbiology; D005260:Female; D006734:Horse Diseases / Q000601:surgery*; D006736:Horses; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000662:veterinary; D012189:Retrospective Studies; D018502:Streptococcus equi / Q000302:isolation & purification; D016896:Treatment Outcome