A 22-year-old female American Saddlebred horse was presented for evaluation of acute, mild epistaxis from the right nostril. The mare had a history of left epistaxis and guttural pouch mycosis in 2007 that was treated with left internal carotid artery ligation.Physical examination was normal apart from anxiety and sweating. A CBC revealed mild, normocytic, normochromic anemia (RBC 5.67 9 10 6 /lL; Reference interval [RI] 6.30-9.50 9 10 6 /lL). A chemistry profile revealed mild hyperglycemia (144 mg/dL; RI 81-110 mg/dL). Upper airway endoscopic examination of both guttural pouches revealed multiple plaques eroding through the septum between the pouches; plaques were not present on vessels, and no active bleeding was seen. The left internal carotid artery was not visible, confirming successful ligation in 2007. Samples of plaque (Figures 1 and 2) and guttural pouch fluid were submitted for cytologic evaluation. Figure 1. Smear of a plaque from a guttural pouch of a horse. Methanolic Wright's stain. 10009 magnification.Figure 2. Smear of a plaque from a guttural pouch of a horse. Methanolic Wright's stain. 5009 magnification. Inset is a close-up (10009 magnification) of an individual structure.
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