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 were identified of which 13 showed evidence of carriage in the guttural pouch. Treatment was initiated to eliminate S. equi colonisation since these animals posed an infectious risk to susceptible horses. Two further horses were referred to us with severe guttural pouch pathology and from which S. equi 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 combination of irrigation of the pouch with moderate to large amounts of saline, suction of fluid material and endoscopic manipulation of chondroids. Subsequently, antibiotic treatment was used to eliminate S. equi infection. All animals received systemic antibiotics, in some cases combined with topical antimicrobial treatment. Treatment was generally regarded as successful when the guttural pouches appeared normal and S. equi was not detected in nasopharangeal swabs and pouch lavages on 3 consecutive occasions. Successful treatment of one carrier required surgical intervention due to occlusion of both guttural pouch pharyngeal openings. Fourteen of 15 carriers were successfully treated by endoscopic removal of inflammatory material and antibiotic treatment, without surgical intervention. Five carriers originally given potentiated sulphonamide (33%) required further therapy with penicillin or ceftiofur, administered both systemically and topically, before S. equi infection and associated inflammation of the guttural pouches were eliminated.