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Topic:Guttural Pouch
The guttural pouch is a unique anatomical structure in horses, consisting of a pair of air-filled sacs located within the head. These sacs are extensions of the Eustachian tubes and are situated between the base of the skull and the atlas vertebra. The guttural pouch is involved in various physiological functions, including temperature regulation of blood traveling to the brain and possibly influencing auditory processes. Due to its location, the guttural pouch is susceptible to infections and diseases such as guttural pouch mycosis and empyema, which can have significant health implications for horses. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, function, and clinical aspects of the guttural pouch in equine health.
Experimental induction of mycotic plaques in the guttural pouches of horses. Guttural pouch mycosis (GPM) is a rare but potentially life-threatening condition in horses. GPM is caused by a fungal invasion into the mucosal lining of the guttural pouches and, frequently, the associated neurovascular structures. Although several species of fungi have been associated with this disease, Aspergillus spp. appear to be the most common isolated from the guttural pouches. However, it remains unclear which are the predisposing factors leading to the development of the infection. The objectives of the present study were to experimentally reproduce an infection by Aspergillus fumig...
Preliminary study of tissue concentrations of penicillin after local administration into the guttural pouches in four healthy horses. Treatment of subclinical carriers of Streptococcus equi subsp. equi with a gelatine-penicillin formulation deposited in the guttural pouch has been empirically proposed, but data on local tissue penicillin concentrations after treatment are lacking. Methods: We analysed tissue levels of penicillin after administration into the guttural pouches of four healthy horses. Two horses received local treatment with gelatine-penicillin and two horses received local treatment with an intramammary formulation of penicillin. Tissues were harvested for analysis either 12 or 24 h later. Conclusions: Resul...
Cytological and bacteriological evaluation of transendoscopic guttural pouch lavages in clinically healthy horses. Thirty-eight guttural pouch lavages from 19 clinically healthy horses were collected transendoscopically. Cytological examination and bacteriological culture of the samples were carried out. All 38 lavages assessed for cytology contained less than five per cent neutrophils and could be termed as cytologically 'normal'. In none of the lavages did the neutrophil count vary between five and 25 per cent or exceed 25 per cent, which are the borderlines for being termed 'reactive' or 'pathological', respectively. Epithelial cells were the most commonly represented cell type in all lavages. Bacteriol...
COMPUTED TOMOGRAPHIC APPEARANCE OF MELANOMAS IN THE EQUINE HEAD: 13 CASES. Melanomas are one of the most common neoplasms in the horse and are frequently found in the head region. There is a genetic predisposition in horses with a gray hair coat. Computed tomography (CT) is frequently used in referral practice to evaluate the equine head but there are few reports describing the CT appearance of melanomas in this location. The aim of this retrospective, case series study was to describe characteristics in a group of horses with confirmed disease. Case records from two referral hospitals were reviewed, and 13 horses were identified that had undergone CT of the head, wi...
Streptococcus equi Detection Polymerase Chain Reaction Assay for Equine Nasopharyngeal and Guttural Pouch Wash Samples. Bacterial culture and polymerase chain reaction (PCR) assays for the detection of Streptococcus equi in nasopharyngeal washes (NPW) and guttural pouch lavage (GPL) samples have low sensitivity. In human diagnostics, processing of samples with flocked swabs has improved recovery rates of bacterial agents because of improved surface area and elution factors. Objective: For S. equi subsp. equi (S. equi) detection in NPW and GPL samples we hypothesized that: direct-PCR would be more reliable than flocked swab culture (FS culture); flocked swab PCR (FS-PCR) would be equivalent to direct-PCR; and FS...
Ligation of the ipsilateral common carotid artery and topical treatment for the prevention of epistaxis from guttural pouch mycosis in horses. The objective of the study was to evaluate the effect of ligation of the ipsilateral common carotid artery (CCA) combined with various antimycotic treatments for the prevention of epistaxis in horses with guttural pouch mycosis. For each case, ipsilateral ligation of the CCA was performed, followed by application of various topical medications under endoscopic guidance. Frequency and number of treatments, outcome and recurrence of haemorrhage were retrospectively recorded. Twenty-four horses were included. Topical medication was administered by detachment of the diphtheric membrane and sprayin...
Potential for iatrogenic coil embolization of the caudal cerebellar artery during treatment of internal carotid artery bifurcation in two horses with guttural pouch mycosis. 2 horses were examined for chronic nasal discharge secondary to unilateral guttural pouch mycosis. Results: Initial endoscopic examination of both horses confirmed the presence of a fungal plaque on the dorsomedial aspect of the medial compartment of the guttural pouch (auditory tube diverticulum) involving the internal carotid artery (ICA). No signs of hemorrhage or neurologic deficits were present at admission. Results: Transarterial stainless steel coil embolization of the affected ICA was performed under general anesthesia, with fluoroscopic guidance. During treatment, an aberrant branch o...
Predictor variables for and complications associated with Streptococcus equi subsp equi infection in horses. To evaluate predictor variables for and complications associated with Streptococcus equi subsp equi infection (strangles) in horses. Methods: Retrospective case-control study. Methods: 108 horses with strangles (cases) and 215 horses without strangles (controls). Methods: Medical records from January 2005 through July 2012 were reviewed. Cases were defined as horses with clinical signs of strangles (pyrexia, retropharyngeal lymphadenopathy, and mucopurulent nasal discharge) that were associated with a confirmed strangles outbreak or had positive results for S equi on PCR assay or bacteriologic...
Angiographic Variation of the Internal Carotid Artery and its Branches in Horses. To record the angiographic anatomy of the equine internal carotid artery (ICA) using angiography techniques. Methods: In vitro descriptive study. Methods: Equine cadaver specimens (n = 50). Methods: Head and neck specimens from horses of mixed breed, age, sex, and use without a history of guttural pouch disease had carotid and cerebral angiography using conventional (n = 7) and rotational angiography (43). Angiographic findings were verified by arterial latex casts. Results: Variation in ICA anatomy was categorized into 4 groups: (1) the internal carotid and occipital arteries arising ...
Laryngeal advancement surgery improves swallowing function in a reversible equine dysphagia model. Pharyngeal dysphagia is a debilitating, sometimes fatal condition in horses, with multiple aetiologies. The pathophysiology is complex and not fully understood. Treatment is largely supportive. Laryngeal advancement surgery may diminish symptoms of dysphagia and improve swallowing in affected horses. Objective: 1) to induce reversible moderate and marked pharyngeal dysphagia by regional anaesthesia of branches of the glossopharyngeal (IX), vagus (X) and hypoglossal (XII) nerves; 2) to characterise the dysphagia produced by each model; and 3) to determine whether laryngeal advancement surgery i...
Update on disorders and treatment of the guttural pouch. The most common disorders of the equine guttural pouches are empyema, tympany, mycosis, and temporohyoid osteoarthropathy. Diagnosis of these conditions is made primarily by imaging with endoscopy, radiographs, computed tomography, and/or MRI. Medical treatment with anti-inflammatories, antimicrobials, and/or antifungals may be successful in some cases, but many of these disorders necessitate surgical intervention. Direct surgical approaches to the guttural pouch are difficult because of their complex anatomy and relationship with important structures, thus precipitating a move toward minimall...
Localised mitogenic activity in horses following infection with Streptococcus equi. Streptococcus equi subspecies equi (S. equi) is the causative agent of strangles, a highly contagious upper respiratory disease of equids. Streptococcus equi produces superantigens (sAgs), which are thought to contribute to strangles pathogenicity through non-specific T-cell activation and pro-inflammatory response. Streptococcus equi infection induces abscesses in the lymph nodes of the head and neck. In some individuals, some abscess material remains into the guttural pouch and inspissates over time to form chondroids which can harbour live S. equi. The aim of this study was to determine...
Ultrasound guided transarterial coil placement in the internal and external carotid artery in horses. To assess ultrasound guided transarterial coil placement (UGTACP) for occlusion of the internal carotid artery (ICA) and external carotid artery (ECA) in horses. Methods: Cadaveric and in vivo study. Methods: Cadaveric horses (n = 10), healthy horses (3), and 1 clinical case. Methods: Cadaveric and in vivo (healthy horses): UGTACP was performed in the caudal part of the ICA and ECA. Coil placement in the rostral part of the ICA was performed blindly and controlled by conventional radiography. No coils were placed in the rostral part of the ECA. Methods: UGTACP of the ICA was in a horse with gu...
Genetics of upper and lower airway diseases in the horse. Genetic predispositions for guttural pouch tympany, recurrent laryngeal neuropathy and recurrent airway obstruction (RAO) are well documented. There is also evidence that exercise-induced pulmonary haemorrhage and infectious diseases of the respiratory tract in horses have a genetic component. The clinical expression of equine respiratory diseases with a genetic basis results from complex interactions between the environment and the genetic make-up of each individual horse. The genetic effects are likely to be due to variations in several genes, i.e. they are polygenic. It is therefore unlikel...
Transendoscopic laser surgery to correct nasopharyngeal obstruction caused by head flexion in horses. To determine outcome after transendoscopic laser fenestration of the median septum and removal of the salpingopharyngeal fold of the guttural pouch on nasopharyngeal obstruction caused by poll flexion in Warmblood horses. Methods: Clinical study. Methods: Horses (n = 9). Methods: Nine horses with a history of performance insufficiency and respiratory noise during poll flexion were examined. On endoscopy, an often asymmetric dorsoventral obstruction of the nasopharynx occurred during poll flexion. Left lateral radiographs were taken in neutral, extended, and flexed head positions showed that me...
Dysphagia caused by focal guttural pouch mycosis: mononeuropathy of the pharyngeal ramus of the vagal nerve in a 20-year-old pony mare. A 20-year-old pony mare was presented to the equine hospital with a ten-day history of dysphagia, regurgitation and coughing. An obstruction of the oesophagus was excluded via endoscopy, but the proximal oesophagus appeared to be distended and circular contractions were missing. A guttural pouch endoscopy revealed a single, black-mottled plaque on the pharyngeal ramus of the vagus nerve in the left guttural pouch, causing a local swelling of this nerve. The pharyngeal ramus seemed to be atrophic distal to the lesion. A biopsy was taken from the lesion and histopathological findings proved the ...
Guttural pouch mycosis in horses: a retrospective study of 28 cases. The medical records of 28 horses with guttural pouch mycosis were reviewed. The most commonly observed clinical signs were nasal discharge, epistaxis, dysphagia and/or cough. All 28 horses had the disease unilaterally, however, in five of them, it had spread into the contralateral pouch via the mesial septum. Three horses were treated medically, 11 horses underwent surgery and seven horses were treated both medically and surgically. Fifty percent of horses (14/28) were euthanased or died, fifty percent of horses (14/28) survived. There was no significant correlation between treatment method (m...
Mycotic encephalitis, sinus osteomyelitis, and guttural pouch mycosis in a 3-year-old Arabian colt. Mycotic encephalitis caused severe ataxia and other neurologic deficits in a horse. The finding of a single, large focus of cerebral malacia, with histopathologic evidence of fungal elements, suggested infection was a result of direct transfer from the frontal sinuses, rather than hematogenous spread from the guttural pouch. Une encéphalite mycotique a causé une ataxie grave et d’autres déficits neurologiques chez un cheval. La découverte d’un grand foyer unique de malacie cérébrale avec une preuve histopathologique d’éléments fongiques a suggéré que l’infection était un tr...
Guttural pouch mycosis in six horses in New Zealand. Six horses from several geographical locations in New Zealand presented with signs of guttural pouch mycosis. All horses had experienced epistaxis within 14 days of presentation. Results: In five horses with epistaxis, a diagnosis of guttural pouch mycosis was made on endoscopic observation of fungal plaques in the affected guttural pouches. One of these cases died before surgery was attempted. The remaining four cases underwent ligation and balloon catheter occlusion of the internal carotid artery of the affected pouch. Three of these horses survived and were reported to be healthy 1 year aft...
Trans-arterial coil embolization of the internal carotid artery in standing horses. To develop transarterial coil embolization (TACE) for occlusion of the internal carotid artery (ICA), in normal standing horses, and to evaluate it use for prevention of hemorrhage in horses with guttural pouch mycosis (GPM). Methods: Prospective study. Methods: Normal horses (n = 8) and 5 with GPM. Methods: Horses had TACE of the ICA in standing position under fluoroscopic guidance. Four normal horses were euthanatized 2 weeks after TACE for morphologic assessment and 4 were followed for 6 months. The 5 clinically affected horses were evaluated for long-term (10-12 months) success rate and co...
Guttural pouch diseases causing neurologic dysfunction in the horse. The close relationship between guttural pouches, cranial nerves, and sympathetic structures make neurologic abnormalities due to diseases of the guttural pouches (especially mycosis) possible. Recognition of epistaxis or mucopurulent nasal discharge, together with signs of dysfunction of the cranial nerves in contact with the guttural pouches, are important key points in order to consider a comprehensive evaluation of these structures and further definitive diagnosis. Diseases of the guttural pouches can also cause signs such as dysphagia, abnormal soft palate positioning, laryngeal paralysis,...
Streptococcus equi: a pathogen restricted to one host. Strangles caused by the host adapted Lancefield group C Streptococcus equi subspecies equi (S. equi) is a frequently diagnosed infectious disease of horses worldwide. Critical to the global success of S. equi is its ability to establish persistent infections within the guttural pouches of recovered apparently healthy horses that can result in transmission to in-contact animals. Recent research has identified key events in the S. equi genome, which occurred during its evolution from an ancestral strain of S. equi subspecies zooepidemicus, that may enhance its ability to evade host innate immune...
Successful treatment of hyperkalaemic periodic paralysis in a horse during isoflurane anaesthesia. A 3-year-old, 400 kg, gelding Quarter Horse was presented for investigation of epistaxis. Methods: The horse was bright, alert and responsive with rectal temperature, heart rate and respiration rate within normal limits. Results: During a second general anaesthetic for surgical treatment of guttural pouch mycosis by balloon-tipped catheter occlusion of the right major palatine artery and ligation of the right external carotid artery, signs consistent with hyperkalaemic periodic paralysis (HYPP) were exhibited. These included concurrent hyperkalaemia, hypercapnoea, sinus tachycardia, and muscle...
[Select changes in the upper airways of the horse – an overview]. Horses are obligate nasal breathers and depend on patency of their nasal passages. Several dynamic obstructive diseases in the pharyngeal and laryngeal area can be differentiated by high speed treadmill endoscopy and may be responsible for impaired exercise tolerance in the equine athlete. The anatomical specialty of guttural pouches predisposes the horse to species-specific diseases.
Use of a novel serological test for exposure to Streptococcus equi subspecies equi in hospitalised horses. Thirty horses with no external signs of strangles were tested for exposure to Streptococcus equi subspecies equi (S equi) using a new, commercially available serological test. The horses were also tested for persistent carriage of S equi by endoscopy of the guttural pouches and PCR analysis of lavage samples. The owners were questioned about the recent medical history of the horses. Serology suggested that four horses had been recently exposed to S equi. None of the horses had a known history of strangles but three of the four seropositive horses had recently shown non-specific signs of respir...
Partial resection of the plica salpingopharyngeus for the treatment of three foals with bilateral tympany of the auditory tube diverticulum (guttural pouch). 3 foals were referred for treatment of tympany of the auditory tube diverticulum (guttural pouch). Results: Bilateral guttural pouch tympany was diagnosed in all 3 foals on the basis of clinical signs and results of radiographic and endoscopic evaluations and gutturocentesis. In each foal, previous medical or surgical interventions or both had failed to correct the problem. Results: Bilateral surgical resection of the plica salpingopharyngeus was performed. Follow-up telephone interviews with owners 8 months to 3 years after surgery revealed that long-term resolution of the tympany had been ac...
Whole-genome scan for guttural pouch tympany in Arabian and German warmblood horses. Equine guttural pouch tympany (GPT) is a hereditary disease in foals of several breeds, including thoroughbreds, Arabian, Quarter and warmblood horses. We performed a whole-genome scan for GPT in 143 horses from five Arabian and five German warmblood families and genotyped 257 microsatellites. Chromosome-wide significant linkage was detected on ECA2 and ECA15 using multipoint non-parametric linkage analyses. Analyses stratified by sex revealed chromosome-wide significant linkage on ECA2 for fillies and chromosome-wide significant linkage on ECA15 for colts. For Arabian colts, the quantitative ...
