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.
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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.
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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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