Guttural
Pouch Disease
As
per Merck Veterinary Manual
Guttural
pouch empyema is defined as the accumulation
of purulent, septic exudate in the guttural
pouch. The infection usually develops
subsequent to a bacterial (primarily Streptococcus
spp
) infection of the upper respiratory tract.
Clinical signs include intermittent purulent
nasal discharge, painful swelling in the
parotid area, and in severe cases, stiff head
carriage and stertorous breathing. Fever,
depression, and anorexia may or may not be
observed. Diagnosis is determined by
endoscopic examination of the guttural pouch.
Radiographs of the pharynx will demonstrate a
fluid line in the guttural pouch and may
allow the clinician to identify an associated
retropharyngeal mass.
*
* * * *
The guttural pouch is an air-filled area in the horse’s throat that has an unknown function. Simply put, it is a large open area that usually drains thru a slit in the bottom, when the donkey lowers his head to eat. While not common, occasionally because of infection causing excess secretions, or the small opening becoming clogged, the normal drainage will start to build up & become a problem.
Pus-filled pouches
Guttural pouch empyema, or the presence of
pus in the pouches caused by bacterial
growth, is the most common type of infection.
Empyema usually occurs following an infection
of the pharynx. Often significant infection
can be present before external swelling of
the pouch is noted.
The most common organism involved is
Streptococcus equi, which is a common cause
of strangles. Equines with strangles often
have abscesses in the pharynx that rupture
and drain, which allows Streptococcus
bacteria to gain entry into the guttural
pouch. This bacterial strain can live in the
guttural pouch for weeks to months causing a
large amount of mucus that contains white
blood cells from the immune system, bacteria,
and necrotic tissue from the guttural pouch.
A thick, pasty material develops that is not
easily drained away.
The top part of the pouch might contain more
fluid, but the bottom of the pouch holds a
thicker material of almost cottage-cheese
consistency with occasional solid masses of
debris called chondroids.
An affected equine will show a persistent,
creamy discharge, usually from one nostril.
When the head is lowered to graze, the
discharge usually increases as gravity allows
more pus to exit the pouch into the pharynx
and flow out the nasal passage.
*
* * *
Lucy
came to us with a “snotty” nose.
Over a period of months &
different types of treatment, she got worse
& started losing weight.
We took her to Dr. Taylor at the,
Arizona Equine Clinic, in Gilbert, AZ to be
endoscoped.
He couldn’t even get the scope into
her guttural pouch, so we knew she had a
problem.
We chose to treat her conservatively
with antibiotics, but after almost 2 months
with no change, opted for surgery.
Although I don’t think she ever had
strangles, they treated her at the clinic as
if she did have strangles, she was isolated
from all the others equines & was always
handled & treated last, in case she was
contagious.
We brought her home & continued to
treat her for almost 3 months with different
antibiotics before we considered her “cured”.
It’s been almost 5 years & she
still has more drainage than the other
donkeys.
But it drains on it’s own & she
doesn’t have to have any medications.
This
picture is 8.6 ounces of “stuff” they
removed from her left guttural pouch.
Although it looks like a chunk of
fatty hamburger, it’s actually infection
i.e. pus that couldn’t drain & dried
up. Once
that happens the resulting debris is called chondroids.
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