PATHOLOGY - Equine Guttural Pouch Disease Flashcards
(27 cards)
Describe the anatomy of the guttural pouches
The guttural pouches have medial and lateral regions seperated by the stylohyoid bone. The medial sections of the guttural pouches have CN IX, X, XI and XII running through them along with the internal carotid artery. The lateral sections of the guttural pouches have CN VII and the external carotid artery running through them
What are the main diseases associated with the guttural pouches in horses?
Guttural pouch empyema (Strangles)
Guttural pouch tympany
Guttural pouch mycosis
What is the main cause of guttural pouch empyema (Strangles)?
Stretococcus equi infection
What are the clinical signs of guttural pouch empyema (Strangles)?
Retropharyngeal swelling
Bilateral nasal discharge
Lymphadenopathy
± Abnormal respiratory noise
± Dysphagia
± Dyspnoea
How can guttural pouch empyema (Strangles) sometimes cause dyspnoea?
The guttural pouches can become so filled with pus and chondroids that the pouches will cause compression of the airway and dyspnoea
How can you diagnose guttural pouch empyema (Strangles)?
Clinical signs
Endoscopy
Radiography
Nasopharyngeal swab (and culture)
Lymph node abscess aspirate (and culture)
Guttural pouch lavage (and culture)
How can guttural pouch empyema (Strangles) appear on endoscopy?
Pus draining from the guttural pouch openings/ostia
How can guttural pouch empyema (Strangles) appear on radiography?
Fluid lines
How do you treat guttural pouch empyema (Strangles)?
Guttural pouches lavage (with saline or water)
Endoscopic or surgical removal of chondroids
Systemic penicillin (with glycerin)
± Emergency tracheostomy
Sometimes you have to remove the chondroids over several days
What are chondroids?
Chondroids are inspissated pus
What is the typical signalement for guttural pouch tympany?
Foals (filly foals most commonly)
(T/F) Guttural pouch tympany is usually bilateral
(T/F) Guttural pouch tympany is usually unilateral
What are the clinical signs of guttural pouch tympany?
Retropharyngeal swelling with resonance on percussion
Dysphagia
Stridor
± Dyspnoea
How do you treat guttural pouch tympany?
Transendoscopic laser surgery to create a fenestration between the abnormal and normal pouch to equalise the air pressure in unilateral cases, or create a fenestration between the pouches and pharynx in bilateral cases
What is the prognosis for guttural pouch tympany?
Good prognosis
What is guttural pouch mycosis?
Guttural pouch mycosis is the growth of diptheric fungal plaques within the guttural pouche(s) over the vessels and nerves
What is the most common species of fungus involved in guttural pouch mycosis?
Aspergillus
What are the clinical signs of guttural pouch mycosis?
Epistaxis
Neurological dysfunction
How does the epistaxis typically progress in guttural pouch mycosis?
Usually there are 1-3 episodes of epistaxis before the horse will have a fatal exsanguination, however, be aware these horses have can fatal exsanguination within minutes of the first episode of epistaxis
What are some key signs of guttural pouch mycosis on endoscopy?
If you see these you should refer immediately for surgery
Blood clot at the guttural pouch openings/ostia
Swollen guttural pouch as it is filled with blood (don’t put your scope in)
Fungal plaques within the guttural pouches
Which surgery is done to correct guttural pouch mycosis?
Intra-arterial coils inserted under angiographic contol
What causes rupture of the neck strap muscles?
Rupture of the neck strap muscles is usually caused by trauma, such as rearing and falling over backwards
What are the clinical signs of rupture of the neck strap muscles?
Profuse bilateral epistaxis
Ataxia
Head tilt
Upper airway obstruction (due to blood in the guttural pouches)
How do you diagnose upture of the neck strap muscles?
History
Clinical signs
Endoscopy
