Diseases of the guttural pouches veterinary clinics. Although the swelling is most prominent on the affected side, it can extend across the neck and give the impression of bilateral involvement. Yag laser fenestration of the mesial septum is an approach for access to guttural pouch chondroids. Standing surgical removal of inspissated guttural pouch. Guttural pouch empyema may compress the dorsal pharynx and produce upper airway obstruction. With guttural pouch diseases, the vagus and glossopharyngeal nerves running through the medial compartment that is, the larger of the two segments of the guttural pouch can become inflamed or even paralyzed, resulting in. Fistulation of the auditory tube diverticulum guttural pouch. The infection usually develops subsequent to a bacterial primarily streptococcus spp infection of the upper respiratory tract. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and wellbeing around the world. Transarterial coil embolization for prevention of hemorrhage. Thus guttural pouch disease can result in pharyngeal dysfunction, dysphagia, and occasionally other neurologic signs such as laryngeal paralysis, horners syndrome, and facial paralysis.
Urt infections, especially pathogenic streptococcus equi equi the horse can be an asymptomatic carrier. Guttural pouch mycosis is a fungal infection of one or both guttural pouches. Fogle c a et al 2007 spontaneous rupture of the guttural pouch as a complication of treatment for guttural pouch empyema. It is covered laterally by the pterygoid muscles, parotid and mandibular glands. Guttural pouch empyema the vet will do an endoscopic examination to confirm that it is guttural pouch empyema. Clinical signs include intermittent purulent nasal discharge, painful swelling in the parotid area, and in severe cases, stiff head carriage and stertorous breathing. Guttural pouch empyema is defined as the accumulation of purulent, septic exudate in the guttural pouch. How to flush guttural pouches in the field without the use of. The horse was diagnosed with a right guttural pouch empyema with many large chondroids. Guttural pouch empyema affects all ages bloodhorse. Oct 01, 2006 objective to report use of a modified whitehouse approach in standing horses for management of inspissated guttural pouch empyema.
Trostle ss1, rantanen nw, nilsson sl, oman dd, cranney gc. Equine veterinary guttural pouch disease horse first aid. It also can develop as a complication of guttural pouch diseases, local. Pasteurella multocida isolation in a horse with retropharyngeal. Guttural pouch mycosis is an emergency disease of the upper respiratory tract in equine species. The guttural pouches are auditorytube diverticula that contain about 300500 ml of air. Edinburgh research explorer university of edinburgh. These structures are large air filled sacs, positioned on either side of the neck, below the ear of the horse. A 20yearold pony mare was presented to the equine hospital with a tenday history of dysphagia, regurgitation and coughing. Abnormal guttural pouch anatomy in a 3yearold quarter. Histology revealed fungal hyphae within thrombi in the lumen of the maxillary artery in the affected guttural pouch. The filly suffered recurrent bacterial infections despite multiple courses of systemic antimicrobial therapy and ultimately underwent transendoscopic laser salphingopharyngostomy to establish effective guttural pouch drainage. A diagnosis of guttural pouch mycosis of the maxillary artery was confirmed by postmortem examination. Empyema of the guttural pouch auditory tube diverticulum in.
A function for guttural pouches in the horse nature. Guttural pouches are unique to few species of animals, including the horse. Guttural pouch empyema secondary to a periocular foreign. Mar 23, 2017 an abnormal guttural pouch was defined when one or more of the following characteristics were found in either the left or the right guttural pouch. Guttural pouch lavage for detection of carriers of strep equi duration. In a distended state the pale wall of the guttural pouch would become visible immediately. If guttural pouch empyema is not treated, chondroid material may form in the guttural pouch and serve as a source of chronic infectious exudate. Guttural pouch empyema secondary to a periocular foreign body m.
Urt infections, especially pathogenic streptococcus equi equi the horse can be an asymptomatic carrier retropharyngeal abscess. As equine distemper is a common precursor to this condition the same diagnostic examinations may be performed to confirm the presence of s. Clinically apparent symptoms include painful swelling of the parotid area and recurrent infected nasal discharge, and in severe circumstances, difficulty. Empyema of the guttural pouch auditory tube diverticulum. Equine guttural pouch empyema, why does it become chronic. The goal of this study is to document the occurrence of guttural pouch disorders among foals admitted to the veterinary teaching hospital at king faisal university, alahssa, saudi arabia.
Blazyczek i et al 2004 inheritance of guttural pouch tympany in the arabian horse. The right guttural pouch was not accessible to endoscopic examination initially, but after anti. Guttural pouch empyema is defined as the presence of purulent exudate or chondroids within one or both pouches freeman and hardy 2012. Two horses displayed signs consistent with cranial nerve damage in the guttural pouch. In both, humans and horses this tube comes from the inner ear and opens into the pharynx.
It most commonly occurs secondary to one of the following. In early cases, manual compression of the pouches can relieve the distention, confirming the presence of air. However, most of the pouch is ventral to his slit, and therefore drainage may be rather ineffective. The article by deloache et al 2016 in the current issue of equine veterinary education guttural pouch empyema caused by corynebacterium pseudotuberculosis in a pregnant mare highlights the need to broaden our. This involves passing an endoscope, which is a small flexible camera, up the nose and into the guttural pouches. Infection can become established in the guttural pouches as an extension from upper airway bacterial infection, and tends to persist because of the anatomy of the pouch. Guttural pouch mycosis in six horses in new zealand. How to flush guttural pouches in the field without the use. If blocked, secretions accumulate and the pouch distends producing a palpable swelling.
Guttural pouch empyema is a disease of any age mostly associated with bacterial infection while guttural pouch tympany is a condition of young foals. A small flap covers the opening of the auditive tube. Guttural pouch empyema is a the infection and accumulation of purulent material within the guttural pouch gp. Methods inspissated exudate in 1 or both guttural pouches was removed surgically through a modified whitehouse approach, with the horses standing and sedated. The affected guttural pouch is distended with air to form a nonpainful, elastic swelling in the parotid region. This is caused by a bacterial infection, usually secondary to strangles.
Emphysema of the guttural pouch iowa state university. Guttural pouch empyema pus collection, mycosis fungal disease, and tympany swelling from air accumulation. Hawkins, dvm, dacvs nicholas frank, dvm, dacvim janice e. Naturally occurring persistent and asymptomatic infection. It may influence internal carotid artery blood pressure. Laser fenestration of the mesial septum for treatment of. Animals adult horses n10 with guttural pouch empyema. Blazyczek i et al 2004 retrospective analysis of 50 cases of guttural pouch tympany in foals. The guttural pouch is a blind pouch or diverticulum of the auditive tube. An empyema is a collection of pus in a natural body cavity, in this case the guttural pouch.
Guttural pouch empyema is the infection of these structures caused by bacterial invasion. Several large vessels and nerves run over its surface and are vulnerable to pathology of the pouch. Freeman d e 2006 guttural pouch tympany a rare and difficult disease. Normally it is under cover of the digastricus, stylomaxillaris and occipito hyoideus muscles. Fourth branchial arch defect in horses respiratory. Blood can often be seen coming from one or both guttural pouch openings if the horse is examined shortly after an episode of a nose bleed. The floor lies mainly on the pharynx and beginning of the oesophagus. The most common disease of the guttural pouches is called guttural pouch empyema. Gilger, in equine ophthalmology second edition, 2011. Find specific details on this topic and related topics from the merck vet manual.
Guttural pouch tympany develops in foals shortly after birth and up to 1 year of age. Fistulation of the auditory tube diverticulum guttural pouch with a neodymium. Guttural pouch empyema produces pus discharge from one nostril or both. Guttural pouch article about guttural pouch by the free. This study demonstrates that guttural pouch lavage specimens should be used to detect s. In some cases an incision will be made at the side of the pouch to allow the pouch to be drained of puss and then to allow the pouch to be aggressively flushed out. At six months after surgery, there was no recurrence of nasal discharge or guttural pouch empyema.
Guttural pouch diseases large animal hospital college. Balloontipped catheter arterial occlusion for prevention of hemorrhage caused by guttural pouch mycosis. It is unclear if empyema of the guttural pouches by other. The bacteria is primarily streptococcus equi, the infectious agent of strangles. Diseases of the guttural pouch scholarlycommons university of. Aug 15, 2016 guttural pouch empyema in horse sara hassouna. Guttural pouch mycosis is a fungal infection in the guttural pouch caused by a common fungi that most all horses carry. Guttural pouch definition of guttural pouch by medical. Learn about the veterinary topic of guttural pouch disease in horses.
The guttural pouch volume in an average horse is 300500 ml each. Comparison of nasopharyngeal and guttural pouch specimens to. Gutturalpouch air temperature varied little with exercise 37. Guttural pouch empyema is defined as the presence of purulent exudate or chondroids within one or both pouches. Guttural pouch mycosis is a fungal infection that affects horses. In addition, the guttural pouch should be investigated in cases of head tilt. The affected guttural pouch is distended with air to. Pdf equine guttural pouch empyema, why does it become chronic. Guttural pouch empyema continues to be a challenging condition, and its therapy often involves mechanical as well as antimicrobial therapies. Tracheotomy may be necessary to provide a temporary alternative airway in these cases. Mar 31, 2016 complications include secondary cellulitis at external abscessation sites, guttural pouch empyema and its persistence into the carrier state, purpura haemorrhagica, metastatic abscessation, emergency tracheostomies and rarely secondary s.
A fold of the guttural pouch is held by tissue forceps and an opening is made into it. Guttural pouch disease in the horse may be remarkably difficult to contain and resolve. Endoscopic and bacteriological findings in a chronic. Pdf two equines were presented and treated for guttural pouch empyema tympany. Pdf equine guttural pouch empyema, why does it become. Guttural pouch empyema is characterized by the accretion of purulent, bacteria infested exudate in the pouch. They are lined with a thin membrane, which separates them from nerves and the jugular artery. Guttural pouch diseases causing neurologic dysfunction in the horse. Endoscopy of the guttural pouch is the goal standard to diagnose guttural pouch mycosis. The fibrocartilage flap emmpyema the pharyngeal orifice of the guttural pouch must be.
Diseases involving the guttural pouch include fungal empyema, streptococcus equi subspecies equi infection, chondroid formation, and bacterial empyema. A guttural pouch endoscopy revealed a single, blackmottled plaque on the pharyngeal ramus of the vagus nerve in the. Guttural pouch mycosis american college of veterinary. Contamination can occur from a penetrating exterior wound. Guttural pouch disease in horses merck veterinary manual.
Fungal plaques form within the guttural pouches, most commonly along the walls of the major blood vessels internal carotid, external carotid, and maxillary arteries figure 3. Find specific details on this topic guttural pouch mycosis. The flap opens during swallowing allowing the pressure to equalize on both sides of the eardrum. Comparison of nasopharyngeal and guttural pouch specimens. An obstruction of the oesophagus was excluded via endoscopy, but the proximal oesophagus appeared to be distended and circular contractions were missing. Guttural pouch empyema pdf learn about the veterinary topic of guttural pouch disease in horses. Guttural pouch definition of guttural pouch by the free. Sep 19, 2000 guttural pouch empyema involves pus in the guttural pouches, which usually results from upper respiratory tract infection. The guttural pouches are structures that are unique to few species of animals. Clinical relevance when guttural pouch empyema andor chondroids is associated with adhesion of the pharyngeal ostium, laser fenestration of the mesial septum from the opposite guttural pouch should be considered as an. Objective to report use of a modified whitehouse approach in standing horses for management of inspissated guttural pouch empyema. The horse did not improve and further clinical and radiographic evaluations detected a guttural pouch empyema.
In this disease, the thin lining of the guttural pouch becomes inflamed and the guttural pouch becomes filled with thick pus. Control of outbreaks requires strict isolation protocols and hygiene measures. Located dorsal to the pharynx the paired sacs cause swelling in the parotid region when distended. Two surgeries were required to completely remove all the chon. The guttural pouch is located below the cranial cavity, towards the caudal end of the skullwing of atlas. Diagnosis of guttural pouch empyema in horses your veterinarian will perform a full head to tail examination on your horse, and discuss their clinical history, symptoms and recent behavior with you.
1360 449 1301 810 1447 809 1159 970 559 1487 686 882 1437 1293 1245 378 1608 1590 1318 1066 1464 796 1398 1546 311 74 1237 1221 706 424 1339 514 1257 162 1371 838 1313 563 620 1054 1350 438 85 689