Veterinary Clinical Medicine-I (General and Systemic)

GUTTERAL POUCH DISORDERS

• Gutteral Pouch Empyema - Pus in the guttural pouch. Inspisated pus = chondroids. Usually culture S. zooepidemicus. Develops 2° to upper respiratory infection in horses, can also develop 2° to congenital tympany. Affects horses of any age. See chondroids on rads. Endoscopy. Nonsx if no chondroids, place indwelling cath, flush, lavage. Surg via viborg’s triangle, get chondroids out, leave drainage.

• Gutteral Pouch Mycosis - Caused by a fungal infection of the gutteral pouch, usually Aspergillus. Unilateral epistaxis due to fungal erosion of the internal or external carotid. Hemorrhage may be fatal. Treat as an emergency, is life threatening. Clinical signs 2° to damage to cranial nerves and arteries within gutteral pouch mucosa. Dysphagia, Horner's syndrome, laryngeal hemiplegia, dorsal displacement of the soft palate. Endoscopy, check both pouches. Treatment is surgical, hyovertebrotomy. Occlude blood blow on both sides of lesion so no retrograde flow using balloon-tipped catheter. Ddx – ethmoid hematoma.

• Gutteral Pouch Tympany - Distention of the guttural pouch with air in young horses (days to 1 y.o). Nonpainful swelling, may cause dyspnea, dysphagia, aspiration. Rads or needle decompression to dx. Sx – viborg’s triangle, excise medial lamina of eustachian tube, fenestrate median septum between pouches. Good px if no aspiration.