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. The guttural pouch is located below the cranial cavity, towards the caudal end of the skullwing of atlas. A fold of the guttural pouch is held by tissue forceps and an opening is made into it. Guttural pouch mycosis is a fungal infection that affects horses. Equine guttural pouch empyema, why does it become chronic. Blazyczek i et al 2004 inheritance of guttural pouch tympany in the arabian horse. Emphysema of the guttural pouch iowa state university. Fistulation of the auditory tube diverticulum guttural pouch with a neodymium. Guttural pouch tympany develops in foals shortly after birth and up to 1 year of age.
The bacteria is primarily streptococcus equi, the infectious agent of strangles. Guttural pouch disease in horses respiratory system. 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. Comparison of nasopharyngeal and guttural pouch specimens. Fourth branchial arch defect in horses respiratory. Trostle ss1, rantanen nw, nilsson sl, oman dd, cranney gc. Guttural pouch empyema is a disease of any age mostly associated with bacterial infection while guttural pouch tympany is a condition of young foals. Normally it is under cover of the digastricus, stylomaxillaris and occipito hyoideus muscles. Guttural pouch diseases large animal hospital college. It is unclear if empyema of the guttural pouches by other. The horse was diagnosed with a right guttural pouch empyema with many large chondroids. The floor lies mainly on the pharynx and beginning of the oesophagus. Contamination can occur from a penetrating exterior wound.
Several large vessels and nerves run over its surface and are vulnerable to pathology of the pouch. Diseases of the guttural pouch scholarlycommons university of. In this disease, the thin lining of the guttural pouch becomes inflamed and the guttural pouch becomes filled with thick pus. 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 in order to aid in the treatment. This study demonstrates that guttural pouch lavage specimens should be used to detect s. Urt infections, especially pathogenic streptococcus equi equi the horse can be an asymptomatic carrier. The guttural pouch volume in an average horse is 300500 ml each.
Guttural pouch empyema pus collection, mycosis fungal disease, and tympany swelling from air accumulation. It may influence internal carotid artery blood pressure. Pdf diagnosis and surgical management of guttural pouch. Tracheotomy may be necessary to provide a temporary alternative airway in these cases. Pdf two equines were presented and treated for guttural pouch empyema tympany. Diseases of the guttural pouches veterinary clinics. Guttural pouch disease in horses merck veterinary manual. Guttural pouch article about guttural pouch by the free. Find specific details on this topic guttural pouch mycosis. Guttural pouch diseases causing neurologic dysfunction in the horse. Balloontipped catheter arterial occlusion for prevention of hemorrhage caused by guttural pouch mycosis. Control of outbreaks requires strict isolation protocols and hygiene measures. 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.
In early cases, manual compression of the pouches can relieve the distention, confirming the presence of air. Guttural pouch mycosis is an emergency disease of the upper respiratory tract in equine species. Guttural pouch empyema secondary to a periocular foreign body. An empyema is a collection of pus in a natural body cavity, in this case the guttural pouch. Two surgeries were required to completely remove all the chon. A function for guttural pouches in the horse nature. It most commonly occurs secondary to one of the following. Methods inspissated exudate in 1 or both guttural pouches was removed surgically through a modified whitehouse approach, with the horses standing and sedated. Pdf equine guttural pouch empyema, why does it become. Guttural pouch empyema is a the infection and accumulation of purulent material within the guttural pouch gp. A 20yearold pony mare was presented to the equine hospital with a tenday history of dysphagia, regurgitation and coughing. The affected guttural pouch is distended with air to.
A small flap covers the opening of the auditive tube. Guttural pouch empyema may compress the dorsal pharynx and produce upper airway obstruction. The horse did not improve and further clinical and radiographic evaluations detected a guttural pouch empyema. 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. 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. Guttural pouch empyema is the infection of these structures caused by bacterial invasion. A guttural pouch endoscopy revealed a single, blackmottled plaque on the pharyngeal ramus of the vagus nerve in the. Two horses displayed signs consistent with cranial nerve damage in the guttural pouch. Guttural pouch disease in the horse may be remarkably difficult to contain and resolve. Guttural pouch empyema secondary to a periocular foreign. Guttural pouch empyema is defined as the presence of purulent exudate or chondroids within one or both pouches. An obstruction of the oesophagus was excluded via endoscopy, but the proximal oesophagus appeared to be distended and circular contractions were missing. Aug 15, 2016 guttural pouch empyema in horse sara hassouna. How to flush guttural pouches in the field without the use of.
The right guttural pouch was not accessible to endoscopic examination initially, but after anti. Guttural pouch lavage for detection of carriers of strep equi duration. 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. Laser fenestration of the mesial septum for treatment of. In addition, the guttural pouch should be investigated in cases of head tilt. Guttural pouch empyema is defined as the accumulation of purulent, septic exudate in the guttural pouch. Urt infections, especially pathogenic streptococcus equi equi the horse can be an asymptomatic carrier retropharyngeal abscess. Comparison of nasopharyngeal and guttural pouch specimens to. Guttural pouch definition of guttural pouch by the free. Yag laser fenestration of the mesial septum is an approach for access to guttural pouch chondroids.
Naturally occurring persistent and asymptomatic infection. In both, humans and horses this tube comes from the inner ear and opens into the pharynx. Sep 19, 2000 guttural pouch empyema involves pus in the guttural pouches, which usually results from upper respiratory tract infection. This is caused by a bacterial infection, usually secondary to strangles. Abnormal guttural pouch anatomy in a 3yearold quarter. Edinburgh research explorer university of edinburgh. Fistulation of the auditory tube diverticulum guttural pouch. 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. A diagnosis of guttural pouch mycosis of the maxillary artery was confirmed by postmortem examination. Fogle c a et al 2007 spontaneous rupture of the guttural pouch as a complication of treatment for guttural pouch empyema. Guttural pouch mycosis american college of veterinary.
As equine distemper is a common precursor to this condition the same diagnostic examinations may be performed to confirm the presence of s. The affected guttural pouch is distended with air to form a nonpainful, elastic swelling in the parotid region. Diseases involving the guttural pouch include fungal empyema, streptococcus equi subspecies equi infection, chondroid formation, and bacterial empyema. 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. Transarterial coil embolization for prevention of hemorrhage. If guttural pouch empyema is not treated, chondroid material may form in the guttural pouch and serve as a source of chronic infectious exudate. Pdf equine guttural pouch empyema, why does it become chronic.
Guttural pouches are unique to few species of animals, including the horse. Fistulation of the auditory tube diverticulum guttural. Guttural pouch empyema produces pus discharge from one nostril or both. Clinical signs include intermittent purulent nasal discharge, painful swelling in the parotid area, and in severe cases, stiff head carriage and stertorous breathing. 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. Guttural pouch definition of guttural pouch by medical.
Equine veterinary guttural pouch disease horse first aid. Our findings suggest that guttural pouch empyema and tympany must be considered in equines with signs of. Freeman d e 2006 guttural pouch tympany a rare and difficult disease. 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. 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. Guttural pouch mycosis is a fungal infection in the guttural pouch caused by a common fungi that most all horses carry. Blazyczek i et al 2004 retrospective analysis of 50 cases of guttural pouch tympany in foals. Endoscopic and bacteriological findings in a chronic. Animals adult horses n10 with guttural pouch empyema.
Guttural pouch mycosis is a fungal infection of one or both guttural pouches. Guttural pouch empyema affects all ages bloodhorse. Histology revealed fungal hyphae within thrombi in the lumen of the maxillary artery in the affected guttural pouch. Guttural pouch empyema pdf learn about the veterinary topic of guttural pouch disease in horses.
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. Guttural pouch empyema the vet will do an endoscopic examination to confirm that it is guttural pouch empyema. Oct 01, 2006 objective to report use of a modified whitehouse approach in standing horses for management of inspissated guttural pouch empyema. Guttural pouch empyema is characterized by the accretion of purulent, bacteria infested exudate in the pouch. In a distended state the pale wall of the guttural pouch would become visible immediately. How to flush guttural pouches in the field without the use. At six months after surgery, there was no recurrence of nasal discharge or guttural pouch empyema. Gutturalpouch air temperature varied little with exercise 37. These structures are large air filled sacs, positioned on either side of the neck, below the ear of the horse. It also can develop as a complication of guttural pouch diseases, local. The flap opens during swallowing allowing the pressure to equalize on both sides of the eardrum. This involves passing an endoscope, which is a small flexible camera, up the nose and into the guttural pouches. The fungus has an affinity for growing on the surface of the guttural pouch overlying the nerves and arteries.
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. Gilger, in equine ophthalmology second edition, 2011. Although the swelling is most prominent on the affected side, it can extend across the neck and give the impression of bilateral involvement. Clinically apparent symptoms include painful swelling of the parotid area and recurrent infected nasal discharge, and in severe circumstances, difficulty. The infection usually develops subsequent to a bacterial primarily streptococcus spp infection of the upper respiratory tract. If guttural pouch empyema does not fully drain for the. Guttural pouch empyema is defined as the presence of purulent exudate or chondroids within one or both pouches freeman and hardy 2012. It is covered laterally by the pterygoid muscles, parotid and mandibular glands.
The guttural pouches are auditorytube diverticula that contain about 300500 ml of air. Located dorsal to the pharynx the paired sacs cause swelling in the parotid region when distended. If blocked, secretions accumulate and the pouch distends producing a palpable swelling. However, most of the pouch is ventral to his slit, and therefore drainage may be rather ineffective. Guttural pouch empyema secondary to a periocular foreign body m. Empyema of the guttural pouch auditory tube diverticulum in. Hawkins, dvm, dacvs nicholas frank, dvm, dacvim janice e. Empyema of the guttural pouch auditory tube diverticulum.
The fibrocartilage flap emmpyema the pharyngeal orifice of the guttural pouch must be. Guttural pouch empyema continues to be a challenging condition, and its therapy often involves mechanical as well as antimicrobial therapies. Learn about the veterinary topic of guttural pouch disease in horses. Thus guttural pouch disease can result in pharyngeal dysfunction, dysphagia, and occasionally other neurologic signs such as laryngeal paralysis, horners syndrome, and facial paralysis. The most common disease of the guttural pouches is called guttural pouch empyema. Objective to report use of a modified whitehouse approach in standing horses for management of inspissated guttural pouch empyema. Pasteurella multocida isolation in a horse with retropharyngeal. The guttural pouch is a blind pouch or diverticulum of the auditive tube.
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