Successful combination treatment of bilateral guttural pouch mycosis with salpingopharyngeal fistulation and potassium iodide

A 9-month-old Thoroughbred colt was presented to the University College Dublin Veterinary Hospital for investigation of suspected neck pain. Clinical signs included severe dullness, bilateral mucopurulent nasal discharge, ptosis of the right eyelid, reduced range of motion of the neck and ataxia. Endoscopy of the medial compartment of both guttural pouches showed fungal-like plaques, from which Aspergillus was cultured. Laser salpingopharyngeal fistulation was performed under standing sedation and the colt received treatment with oral potassium iodide. The colt developed bacteraemia post-operatively which resolved after antimicrobial treatment. Serial endoscopic evaluation of the guttural pouches showed complete resolution of fungal plaques 4 months post-operatively. Minimal neurologic deficits remained 6 months post-operatively. This report highlights the importance of considering guttural pouch mycosis in young horses and those presenting with reduced range of neck motion and neck pain. It offers support for the use of salpingopharyngostomy as an effective treatment method for guttural pouch mycosis and documents its use in the case of bilateral disease confirmed by fungal culture. It also documents the recovery of a horse from GPM with associated severe neurological signs.