Equine Guttoral Pouch Disease

Important structures in guttoral pouch

Neural structures = CNs 7, 9, 10, 11 and 12
& sympathetic trunk

Vascular structures = internal and external carotid and maxillary arteries

Guttural pouch tympany

  • seen in foals
  • non painful distension with air

Guttural pouch empyema

  • accumulation of pus in guttural pouch

Guttural pouch mycosis

Pathogenesis

  • unknown but could have to do with congenital abnormality with mucosal flap

Clinical signs

  • soft, non painful swelling in throat latch region
  • if swelling is large enough, can cause respiratory stertor, respiratory difficulty, occasional dysphagia and aspiration pneumonia

Diagnosis

  • clinical signs
  • signalment
  • x ray showing gas

Treatment

  • surgical correction

Prognosis

  • uncomplicated cases = good prognosis
  • horses with dysphagia or aspiration = bad prognosis

Pathogenesis

  • secondary to upper resp infection with strep equi or strep zooepi
  • rupture of retropharyngeal lymph node into the pouch

Clinical signs

  • nasal discharge
  • lymph node enlargement -> dysphagia
  • chondroid formation

Diagnosis

  • history of upper resp, physical exam and clinical signs
  • confirmation via endoscopy or radiography (fluid line in GP)

Treatment

  • medical treatment = lavage of the GP and administration of local and systemic antibiotics (may need to be repeated for several days until most of the exudate is removed)
  • if medical therapy fails, may need to do surgical lavage and drainage if chondroids are present

Prognosis

  • good to excellent

Pathogenesis

  • unknown but aspergillus is the common pathogen
  • causes plaques typically on the dorsal aspect of the guttural pouch
  • plaques can erode arteries and nerves

Clinical signs

  • depends on structures involved (hemorrhage if artery is affected)
  • dysphagia
  • Horner's syndrome or facial nerve paralysis

Diagnosis

  • based on clinical signs and endoscopy

Treatment

  • surgical occlusion of affected arteries
  • give antifungal meds (but not as effective as surgical intervention)

Prognosis

  • guarded to fair