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Learn about the veterinary topic of Guttural Pouch Disease in Horses. Find specific details on this topic Guttural Pouch Mycosis. Guttural pouch mycosis, horse. Guttural pouch empyema. Trostle SS(1), Rantanen NW, Nilsson SL, Oman DD, Cranney GC. Author information: (1)San Luis Rey Equine Hospital, Holly Ln . J Am Vet Med Assoc. Dec 1;(11) Empyema of the guttural pouch (auditory tube diverticulum) in horses: 91 cases (). Judy CE(1).

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Guttural pouch empyema is characterized by the unilateral or bilateral accumulation of mucopurulent exudate in the guttural pouches. Concerning the sudden death, it is known that bacterial pneumonia in foals may lead to the development of sepsis WILSON, ; ROY, and severe sepsis is accompanied by multiple organ dysfunction syndrome due to factors including increased circulating levels of inflammatory mediators, hypotension and poor vascular perfusion BONE et al.

Guttural pouch empyema can be diagnosed by endoscopy and culture of the exudate.

Empyema of the guttural pouch (auditory tube diverticulum) in horses: 91 cases ().

Before surgery for guttural pouch mycosis, carotid angiography has been recommended to help visualize the anatomy of gutturl vasculature associated with the head 7,9 FIGURE 4. The fibrocartilage flap covering the pharyngeal orifice of the guttural pouch must be adducted or elevated to advance the endoscope. Once in the guttural pouch, the tubing is advanced, and up to 50 ml of sterile saline can guthural instilled into the guttural pouch and subsequently aspirated using the endoscope to visualize the fluid.

Alternatively, indwelling Foley catheters can be placed easily with the help of a Chamber’s catheter or stylet and visualized with the endoscope in the opposite nasal passage.

As the purulent material accumulates, the GP distends – forming a palpable, fluctuating visible swelling behind the jaw. Diagnosis of Guttural Pouch Empyema in Horses. The goals of culturing the affected guttural pouch are to confirm the presence smpyema S. Services on Demand Journal. More invasive nonsurgical treatments for chondroids include using acetyl cysteine i.

Retrieved from ” https: This article reviews the anatomy and diagnostic imaging of the equine guttural pouch and discusses the clinical signs as well as diagnostics, treatments, and techniques used in adult horses with guttural pouch empyema.


The owners reported a normal foaling and normal colostrum ingestion. Extended neck carriage can also be observed A,B. In horses who require surgery it is expected that only a short period of hospitalisation is needed. We advise against blind placement of the Chamber’s catheter and recommend that placement be confirmed by endoscopic visualization.

Distention of the balloon within the funnel of the pharyngeal opening could cause pressure necrosis. To maintain sterility, an injection cap can be placed on the end of the needle until the syringe is used. Because the biopsy channel is eccentrically located in the endoscope, the biopsy instrument actually rotates the flap away from the wall of the pharynx to facilitate passage of the scope into the guttural pouch.

The pathogenic equine streptococci. The epithelium is pseudostratified and ciliated and contains goblet cells; mucous glands and lymph nodules are also present.

What is your diagnosis? Guttural pouch empyema.

This entire procedure may take 30 to 60 minutes. In addition, the problems with retention catheters must be weighed against the trauma to the pharynx induced by passage of a firm metal Chamber’s catheter on a daily basis.

The most common treatment is daily lavage for days, this may require hospitalisation or daily visits from your veterinarian to perform treatment. More aggressive surgical treatment strategies may be needed for cases that are refractory to medical management. Mucous membranes were congested and of a red color, capillary refill time was prolonged 3 secondsfacial artery pulse was weak and the extremities were cold.

In these cases, abscesses may pouvh, however, your veterinarian may be able to lance these to encourage draining and flush the pouch to remove as much exudate as possible. One-fifth of horses with guttural pouch empyema develop chondroids that may require more aggressive therapy.

Guttural Pouch Empyema in Horses

Radiography is slightly less sensitive than endoscopy in detecting chondroids. Also, a horse may require irrigation of the guttural pouches for an extended period of time beyond what was initially estimated. Streptococcus equi was isolated from the guttural pouch in 14 of 44 horses; for Streptococcus spp, in vitro resistance to sulfadimethoxine and trimethoprim-sulfamethoxazole was detected. The use of fluoroscopy and angiography provides a road map of the vasculature when using arterial coil embolization for treating guttural pouch mycosis.

The foal presented with severe right and left retropharyngeal swellings Figure 1A-B empyeka were painful on palpation and with a copious bilateral nasal mucopurulent discharge Figure 1C.


Medical records of horses with guttural pouch empyema were reviewed. The ventral aspect of the lateral compartment contains the external carotid artery which becomes the maxillary arterymaxillary vein, chorda tympani nerve, and facial nerve i. Their presence can be confirmed endoscopically or radiographically. Many important structures are anatomically related to the guttural pouch and must be considered when treating guttural pouch disease either medically empuema surgically.

The prognosis for horses suffering from this disease is good if treatment is commenced early.

Guttural Pouch Empyema – WikiVet English

Empyem guttural pouch disorders and managing guttural pouch empyema in adult horses. Guttural pouch empyema, when diagnosed early and treated appropriately, generally resolves uneventfully. Probably the stress caused by physical restraint for catheter implantation and fluid administration, increased the tissues oxygen consumption, and the foal developed myocardial ischemia due gutturap poor perfusion, followed by a cardiac arrest.

Clinical signs of guttural pouch disorders are associated with other structures in the area. This can be costly to a client because lavaging the guttural pouches requires hospitalization mean hospitalization time for horses was 8 days in one study, although the range was 1 to days 11 or repeated visits to the farm.

Therefore, gkttural uncommon at the age of 2 months, the foal was infected and developed a primary GP empyema, without lymph nodes abscesses. Equine guttural pouches auditory tube diverticula are unique because of their size—Equine guttural pouches are the largest of several species examined in one study. A guttural pouch wash can be obtained by using sterile technique and advancing a sterile polyethylene tube through the biopsy channel of a previously sterilized endoscope into the guttural pouch.

Alternatively, a Chamber’s catheter can gkttural placed nasally, advanced into the nasopharynx, and viewed by the endoscope, which is passed into the opposite nostril. The owners reported that during the last 7 days the foal showed progressive enlargements caudally in the head, followed by nasal discharge. Ruptured retropharyngeal abscess in a mare with strangles D.

Causes of Guttural Pouch Empyema in Horses. Auscultation revealed tracheal mucus accumulation and abnormal lung sounds.


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