title: Ligation of the ipsilateral common carotid artery and topical treatment for the prevention of epistaxis from guttural pouch mycosis in horses.
abstract: The objective of the study was to evaluate the effect of ligation of the ipsilateral common carotid artery (CCA) combined with various antimycotic treatments for the prevention of epistaxis in horses with guttural pouch mycosis. For each case, ipsilateral ligation of the CCA was performed, followed by application of various topical medications under endoscopic guidance. Frequency and number of treatments, outcome and recurrence of haemorrhage were retrospectively recorded. Twenty-four horses were included. Topical medication was administered by detachment of the diphtheric membrane and spraying (n=16) or by intralesional injection directly in the plaques using a transendoscopic needle (n=8). Epistaxis recurred in five horses (20.8 per cent), causing death of four horses (16.6 per cent). The mean number of treatments was 6.3±4.0 (range 2-14) for all topical treatments. Ligation of the ipsilateral CCA and topical medication carries a fair prognosis for avoidance of recurrent episodes of epistaxis, but fatal haemorrhage can occur. Removal of the fungal plaque and topical treatment of the underlying lesion appeared to speed up resolution of the mycotic mucosal lesions. The described technique is a salvage procedure when financial or technical constraints prevent the use of transarterial catheter occlusion techniques.
authors.affiliation: Clinique Equine de Livet, St Michel de Livet, France.
authors.forename: M
authors.initials: M
authors.lastname: Cousty
authors.affiliation: Clinique Equine de Livet, St Michel de Livet, France.
authors.forename: C
authors.initials: C
authors.lastname: Tricaud
authors.affiliation: Clinique Equine de Meslay, Meslay du Maine, France.
authors.forename: T
authors.initials: T
authors.lastname: De Beauregard
authors.affiliation: Clinique Equine de Livet, St Michel de Livet, France.
authors.forename: V
authors.initials: V
authors.lastname: Picandet
authors.affiliation: CISCO, Equine Medicine, ONIRIS, Nantes, France.
authors.forename: C
authors.initials: C
authors.lastname: Bizon-Mercier
authors.affiliation: Department of Equine Surgery, ONIRIS, Nantes, France.
authors.forename: C
authors.initials: C
authors.lastname: Tessier
mesh_terms: D000287:Administration, Topical; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017536:Carotid Artery, Common / Q000601:surgery*; D004844:Epistaxis / Q000517:prevention & control / Q000662:veterinary*; D005260:Female; D006734:Horse Diseases / Q000517:prevention & control*; D006736:Horses; D008026:Ligation / Q000662:veterinary; D008297:Male; D009181:Mycoses / Q000188:drug therapy / Q000662:veterinary*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: common carotid artery; epistaxis; guttural pouch; horse; ligation; mycosis