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Fungal granuloma in trachea

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  • Fungal granuloma in trachea

    Anyone dealt with this? 15 yr old tb mare, only symptom is recurrent bleeding from nose
    "You can't really debate with someone who has a prescient invisible friend"
    carolprudm

  • #2
    Not exactly the same - or even all that close, but I had granulomas in my lungs, fungal, turned out to be histoplasmosis:

    Histoplasmosis is an infection caused by breathing in spores of a fungus often found in bird and bat droppings. Histoplasmosis is most commonly transmitted when these spores become airborne, often during cleanup or demolition projects.

    Had to have surgery - drs and PET scan indicated potential for cancer, thankfully not that. Granulomas were removed along with a portion of my lung. Spent 6 weeks or so on an anti fungal med. I am fine.

    Histo appears to be rare in horses, but there are numerous other fungus types seen in horses. What is vet saying? I would think you would want to treat both the fungus and the granulomas; Google this situation in horses, there are options - both medical and surgical.

    My gut feeling is that this is not something to mess around with, though I am not a vet...

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    • #3
      I've see a horse with the fungal problem being in his guttural pouch. It eroded through and into his carotid artery. His bleeding spells were massive. At that time, there was nothing that could be done, and he was put down. Hopefully there are treatments for these fungal infections now.

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      • #4
        Was this diagnosed via endoscopy? How definitive is your diagnosis (any biopsy and culture)? These can be difficult to treat. Systemic antifungal therapy is expensive in horses. If the vet thinks it's possible, you may need to have the granuloma surgically removed or debulked with local antifungal treatment in addition to some systemic therapy. I would imagine the horse might need a temporary tracheotomy after, depending on location of lesion. Knowing which organism it actually is (via culture and histopathology) will allow the selection of the most appropriate drug. Where the horse has lived could also shed some light. If a SW horse, consider Coccidiodes. If midwestern, Histoplasma as the above poster mentioned could be considered. But there are other organisms to consider too. The only way to know is diagnostic testing.
        The size of the lesion, frequency of bleeding, and if there are any other fungal lesions in the horse may also inform the treatment plan. If there is blood coming out the nose from the trachea I might also be concerned that there is bleeding into the lungs as well. As always this is not medical advice and your vet should be able to help you work through what is going on to get a better handle on the risks of different ways to proceed. Just some ideas for discussion points with your vet.

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        • #5
          following..

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          • Original Poster

            #6
            Yes she was scoped. Diagnosis is tentative upon biopsy results. This horse is in Florida
            "You can't really debate with someone who has a prescient invisible friend"
            carolprudm

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            • #7
              That is a very good start. Your vet will know a lot more once the biopsy results are back. Sometimes the pathologist can identify a most probable organism from the biopsy, which can help guide antifungal drug choices. The good thing about being in FL is that many vets are very familiar with fungal issues. It would be interesting to share with the forum your experience with your horse going forward because it is not a super common diagnosis.
              Best wishes for a good outcome and good luck with your mare!

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              • Original Poster

                #8
                Thanks! I will update you as I find out things. She has been bleeding pretty heavily since the biopsy :-(
                Not my horse but one I train once in a while.
                "You can't really debate with someone who has a prescient invisible friend"
                carolprudm

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                • Original Poster

                  #9
                  Biopsy came back as pythium aka swamp cancer. Ugh
                  "You can't really debate with someone who has a prescient invisible friend"
                  carolprudm

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                  • #10
                    And what is the treatment for swamp cancer? I'd like to hear what your vet has Rx.'d

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                    • #11
                      Wow! Jingles for you and the horse. Just read this earlier today:
                      Seven ponies that roamed the Chincoteague National Wildlife Refuge have died of “swamp cancer.” And herd managers fear more could get sick.

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                      • #12
                        http://pavlab.com/pavlab/pythiosis-i...atory-disease/

                        Some type of immunotherapy. The bleeding is worrisome, IMO, and it seems the faster an ID made, the better the odds of successful treatment. Jingles to the horse and owner!

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                        • #13
                          Thanks for the update, OP. What an unusual location for a Pythium granuloma. Unfortunately, it is hard to treat no matter the site. Does the vet think that surgery is an option for this horse?

                          Getting rid of the granuloma via surgery, local treatment with iodine and/or antifungal drugs (even though Pythium isn't actually a true fungus and lacks some of the cell components that common antifungal drugs target), and immunotherapy are all options for Pythium. The immunotherapy doesn't help all horses; the goal is to switch the type of predominant immune response to get the horse's body to have a more appropriate response to the organism.

                          Again, being in FL the vet likely has suggestions about what has worked for him/her in the past.
                          Good luck to the horse and her owner. I hope the bleeding has resolved.

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                          • #14
                            Pythium is scary. It sounds like pythium is spreading throughout the Southeast. Where in Florida is the horse living? Has there been a lot of standing water in that area? Please keep us updated as you learn more about it. I hope the mare is doing better.

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                            • #15
                              I am not in Florida - I am in central Alabama. We have had a record year for rainfall and it is January and no cold weather to speak of. Plus we got 5-6 inches last week alone. I can see where this "water mold" would be thriving in the Southeast. I had a friend whose mare got pythium up her nose a few years back when we were having a lot of rain. Owner caught it early and the vet was able to treat it - not sure how. But they were able to heal the mare and I am not aware that it ever came back. From reading about it - Pythium is bad ju ju!!!!!

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                              • Original Poster

                                #16
                                She had some sort of procedure friday where they injected it. It is still bleeding and I have no idea how long that will last. She seems otherwise quite healthy. (I am farm sitting where she lives this week, her owner returns tomorrow)
                                "You can't really debate with someone who has a prescient invisible friend"
                                carolprudm

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