Elimination of guttural pouch infection and inflammation in asymptomatic carriers of Streptococcus equi

Three protracted outbreaks of strangles were investigated using endoscopic examination and a total of 14 asymptomatic carriers of Streptococcus equi w ere identified of which 13 showed evidence of carriage in the guttural pouc h. Treatment was initiated to eliminate S. equi colonisation since these an imals posed an infectious risk to susceptible horses. Two further horses we re referred to us with severe guttural pouch pathology and from which S. eq ui was cultured, and treatment of these cases is also described. Treatment in the first instance was directed towards removal of gross guttural pouch pathology as seen on endoscopic examination. This was done with a combinati on of irrigation of the pouch with moderate to large amounts of saline, suc tion of fluid material and endoscopic manipulation of chondroids. Subsequen tly, antibiotic treatment was used to eliminate S. equi infection. All anim als received systemic antibiotics, in some cases combined with topical anti microbial treatment. Treatment was generally regarded as successful when th e guttural pouches appeared normal and S. equi was not detected in nasophar angeal swabs and pouch lavages on 3 consecutive occasions. Successful treat ment of one carrier required surgical intervention due to occlusion of both guttural pouch pharyngeal openings. Fourteen of 15 carriers were successfu lly treated by endoscopic removal of inflammatory material and antibiotic t reatment, without surgical intervention. Five carriers originally given pot entiated sulphonamide (33%) required further therapy with penicillin or cef tiofur, administered both systemically and topically, before S. equi infect ion and associated inflammation of the guttural pouches mere eliminated.