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