The owner of a horse who has recovered from guttural pouch mycosis (GPM) is sharing her story in hope of raising awareness of the rare and often fatal condition.
Sophie Barnes’ thoroughbred Gary has been confirmed clear of the fungal infection and his future looks bright. But Sophie told H&H that she has woken up every day for the past five months not knowing whether it would be Gary’s last.
“When the vet confirmed it, his reaction was ‘S**t, this is bad’,” she said. “But surprisingly, he pulled through. After five months of sleepless nights, wondering how on earth we were going to get through this, and whether he was going to survive. It was a very tough time.”
Sophie had been eventing Gary, who was then eight, having retrained him through some challenging behaviour. She gave all her horses a holiday owing to the hot weather, and when she brought Gary back into work, he had a runny nose.
Despite veterinary treatment, the discharge refused to clear; sometimes appearing less but then returning, and changing colour, Sophie said.
“They X-rayed him and the vet said he was fine but it wasn’t right as this was nearly a month on,” Sophie said. “My aunt Sue said ‘Could it be something in the guttural pouch?’ and the vet said it was unlikely but they’d check to cover all bases.
“The scoped him and followed the snot trail up to the throat, and saw it oozing out; the guttural pouch was swollen and inflamed. It was horrific, the whole thing was fungus.
“The vet had only seen it in one horse before, who didn’t survive; it bled out before it got to the operating table.”
In GPM, fungus forms in the pouches, which are extensions of an air-filled canal that connects the throat to the middle ear. Fungal plaques most commonly form on the walls of the major blood vessels, typically affecting the internal carotid artery.
As the fungus grows, it erodes the walls of the blood vessels, resulting in an aneurysm, or excessive swelling. This eventually leads to a hole in the vessel wall — and potentially a life-threatening haemorrhage.
“I asked if it would be better for his quality of life to put him down,” Sophie said. “I didn’t want him to go through bleeding out. He owes me nothing and I didn’t want him to go through that pain. But the vets said ‘Let’s give this a go’. They said they didn’t know if he had 10 minutes or 10 years but he needed treatment as soon as possible.”
The vets said Sophie had three options: surgery followed by medication, a laser incision in the pouch, after which he would be on a drip for months, or a catheter for medication to be administered at home.
“It would have been a four-hour or a two-hour trip for the first two, and I thought something could go wrong in that time, and he’d be somewhere he didn’t know,” Sophie said. “With the third option, if he went at least he was at home with people who loved him.
“I went to bed that night wondering if I’d wake up to find him dead in a pool of blood.”
Sophie’s “amazing” vets at Wessex Equine came every other day to give Gary Imaverol. This involved scoping and using a catheter – there was hope Sophie might be able to administer the drug herself but the longest Gary kept the catheter in was a day and a half.
“They didn’t want to touch the fungus but towards the end, they said they’d start giving it a poke,” Sophie said. “They went up there with a biopsy hook and grabbed it. We got that on video; all of a sudden it came loose – and I’ve kept that bit of fungus as a memento!
“It was absolutely disgusting; it looked like a little mushroom, and I said ‘Gary, you’re a fun guy!’He probably had no clue what was going on.”
Sophie was allowed to start bringing Gary back into work at Christmas as progress was being made, then this month had the news, from cultures taken, that he was clear.
“They called Sue and I heard her, from about 20 acres of field away, shouting ‘Yeah!’” Sophie said. “The vets had to get gold of a French drug, which is hard to get because of Brexit, but the whole vet practice researched and they’ve found it, which should wipe the fungus out of his body. It’s been so hard, but now a massive weight off my shoulders.”
Gary will be scoped again in the summer to check the fungus has not returned but now has the green light to get back out. Sophie is hoping to contest the Retraining of Racehorses championships at Barbury, but also to raise awareness of GPM.
“We had a professional rider on the yard who’s had hundreds of horses and he’d never heard of it,” she said. “A lot of experienced people have never seen it, and I feel there should be a bit more research.
“It’s sad because a lot of horses have lost their lives to this and I hope Gary will be a message, to say look out for anything like this. Snot is a very uncommon symptom but Gary had bacteria on the fungus, which caused it.”
Sophie added: “Gary, you have surprised everyone with surviving this disease. So this year will be spent having fun, lots of cuddles and thanking that I get to spend another day with you, raising awareness for GPM and proving people wrong with my little buddy at my side.”
Sophie praised the “amazing” Wessex Equine vet Sarah Mould, who told H&H the cause of the fungal growth is unknown, and that clinical signs are few until late-stage infection, when nosebleeds and difficulty swallowing can be seen.
“This disease is frequently fatal as once the artery is compromised by fungal growth the horse will unfortunately bleed out rapidly,” she said.
“In Gary’s case the guttural pouch was colonised by fungus and bacteria. Therefore, he had a nasal discharge that we began investigating before knowing what his condition was.”
“Treatment options included surgical referral to occlude the internal carotid artery and allow treatment to take place without fear of a bleed, or, medical treatment at the yard. The surgery is the gold-standard option but carries some risk of haemorrhage and his lovely owners decided to perform medical treatment as he had had no bleed as yet.
“Medication was placed through the scope three times a week to start then decreased to twice a week as the fungal plaque was shrinking. We placed a tube into his pouch that was sutured in to try to only have to instil medication and allow fewer visits, however, he unfortunately rubbed these out very quickly. He had in total 36 visits! Which unfortunately included an emergency colic visit, luckily easily resolved and unrelated to treatment.
“On our last visit we flushed his pouch which came back completely clear of infection. We will likely recheck him in a few months to make sure all is well but are very happy that he is currently fully recovered.”
You might also be interested in:
Horse & Hound magazine, out every Thursday, is packed with all the latest news and reports, as well as interviews, specials, nostalgia, vet and training advice. Find how you can enjoy the magazine delivered to your door every week, plus options to upgrade your subscription to access our online service that brings you breaking news and reports as well as other benefits.
