Standing surgical removal of inspissated guttural pouch exudate (chondroids) in ten horses.
Authors: Perkins Justin D, Schumacher Jim, Kelly Ger, Gomez Jorge H, Schumacher John
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Standing Surgical Removal of Guttural Pouch Chondroids Inspissated guttural pouch exudate (chondroids) can cause significant clinical signs in horses, including purulent nasal discharge, dysphagia, and secondary neurological complications such as recurrent laryngeal neuropathy, yet treatment options that minimise anaesthetic risk remain limited. This retrospective review of ten adult horses examined the application of a modified Whitehouse surgical approach performed under standing sedation to remove accumulated inspissated material from one or both guttural pouches, with detailed documentation of clinical presentation, surgical outcomes, and complications. Eight of the ten horses (80%) successfully returned to their previous level of athletic activity following the procedure, whilst exudate removal was achieved without apparent discomfort to the standing animals; notably, one pre-operative dysphagic case remained persistently affected post-operatively and required euthanasia, and one horse died of unknown causes one week post-surgery. Culture of material from three horses identified *Streptococcus equi* subsp. *equi*, indicating strangles-associated infection as a potential underlying aetiology. The standing approach offers practical advantages for practitioners by eliminating general anaesthetic risks, avoiding operating theatre contamination, and providing a viable alternative for managing chronic guttural pouch empyema in cases where chondroid formation represents a mechanical obstruction; however, practitioners should counsel clients that whilst most horses achieve good athletic recovery, resolution of pre-existing secondary complications such as dysphagia cannot be guaranteed.
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Practical Takeaways
- •Guttural pouch chondroids can be safely removed in standing sedated horses using a modified Whitehouse approach, avoiding general anesthesia risks and costs
- •Most horses (80%) return to full athletic function post-operatively, making this a viable treatment option for cases refractory to medical management
- •Pre-operative evaluation should include endoscopy and radiography to confirm diagnosis and assess for concurrent conditions like dysphagia or laryngeal neuropathy that may affect prognosis
Key Findings
- •Inspissated exudate was successfully removed in 10 horses using a modified Whitehouse approach in standing, sedated animals without apparent discomfort
- •Eight of ten horses (80%) returned to their previous level of athletic activity after surgery
- •Streptococcus equi subsp equi was isolated from affected guttural pouches in 3 of 10 horses (30%)
- •Standing surgery avoided risks of general anesthesia and surgical suite contamination