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Equine Guttoral Pouch Disease - Coggle Diagram
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
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
Guttural pouch empyema
accumulation of pus in guttural pouch
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
Guttural pouch mycosis
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