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Diseases of the Guttural Pouch University of Pennsylvania ScholarlyCommons Departmental Papers (Vet) School of Veterinary Medicine 7-1976 Diseases of the Guttural Pouch Charles W. Raker Follow this and additional works at: https://repository.upenn.edu/vet_papers Part of the Large or Food Animal and Equine Medicine Commons Recommended Citation Raker, C. W. (1976). Diseases of the Guttural Pouch. Modern Veterinary Practice, 57 (7), 549-552. Retrieved from https://repository.upenn.edu/vet_papers/65 This paper is posted at ScholarlyCommons. https://repository.upenn.edu/vet_papers/65 For more information, please contact [email protected]. Diseases of the Guttural Pouch Disciplines Large or Food Animal and Equine Medicine | Medicine and Health Sciences | Veterinary Medicine This journal article is available at ScholarlyCommons: https://repository.upenn.edu/vet_papers/65 The Equine Practitioner DISEASE S OF THE GUTTURAL POUCH c. W. Raker, VMD Si gns of upper airway obstr uction Yal") University of Pennsylvania New Bolton Center in intensity with the degree of distention of Kennett Square, Pennsylvania 19348 the GP. The anomaly is said to be unilat­ eral ,2 but I have see ll 2 cases wi th bilateral TlIe pai red g uttural pouches (G P) in tbe involvement. The nature of the defect i· lj()r~ e rep r e ~ e lll ventral dive nicula of the not known, but it appear, to ill volve rh ellsla t.hiall tubes, although theif true func­ pharyngea l orifice of the eustachi an tube, liull is unknown. T hey Dlay fUIlctio n as a allowing ail to el1l er the GP, where it is teJi d valve mechani, m ~i n c e Lhey fill with trapped. :t\ur,ing fo als are susceptible to lit Juring expira tion and empty during in­ aspira tion (milk) pneumonia- a serious CCl m­ ' pir:llion. <It which time the contained ;lir plica tion; regurgitatt:d mi lk may be ob­ mi gllt assiSl in warming inspired air. T heir served at the extern<:J 1 narc!,. ca pacity is approximatel y 300 ml, and each Several surgical methods to repair the WlJneClS wi th the pharynx through a slit­ defect are avai lable. and in the absence of lik e openiJl g. pneumonia the prugnosis is favorable_ He­ h e~c opellings can bc scen with an en­ fo re surgery, deculOpression should be per­ do1copc. bUI they are normally collapsed formed to determine whethel the c1e[cn i~ (exce!)t during furceful eXl-'i ratioll and sw al­ unilatr::i1 or bila teraL U n ila teral tympan­ lowing) and the inside of the pouch is not ites may ca use distelltion on both sides 01 \J ~ i ble unless the endosc0pe i ~ introduced the neck, but the signs should disappear 0 11 di recll y into the GP. T he medial ~ i d e of the unilateral decompressiun. If bilateraL signs opening consists of a fold o[ fibrocartilag would still be evident following unilateral (O \'cred with mucous membrane. decompression. The GP may be involved in i1 11 infec tions The foal is placed under general clll es­ the respiratory tract. but the incidence of or thesia in la teral recumbency wi th the af­ primary GP disea, e is low. fected GP up. The skin O V(I- Viborg's tri ­ Tymplmiles angle is prepared fo r surgery. and a 3-4" T ympani tcs (emphysema) of the GP is ski n incision is made in the triangle. T it seen occa sionally in suc kl i ng~ and wean­ wall of the distended GP lie, directly under Ji ugs. Some reports sugges t th at this i, a the skin and is ex p o ~e d by careful b lum co ugenital defect which may not be In :1 ni ­ dissection. It is ca refull y incised, causing it les tcd until the horse is 1 year of age] The to collapse. If the defect is unila teral. a peninel1l clinical signs are dislention of one l -c m ~ or larger window is made through tit OJ both GP in the region of Viborg's tr i­ med ian walls of the left and ri ght GP. T lli, allgl e. Percussion reveals an air-fill ed cavity, communica tion betwee n the 2 GPs all o w ~ Jnd fi rm digilal pressure may res ul t in ex­ trapped air lO e.,ca pe through the opposite pulsion of air wi th collapse of th e GP. normal pharyngeal orifi ce. %C)u ld this procedure fa il, decompress ion If th e defect is bililteJ-al, in addition to ran b<.: achieved by im ening a needle into establishing a communica ting window, a 9" tll e distended GP. ­ Allis t i ~s ue or sponge forceps is passecl cra l1i­ Ju ly, 1976 549 a lly thro ugh u:J e eu, t3 clii;1I1 t u he lo lhe (HOlne] 's syndrom e). l nvolvem en t o ( ve::. ­ If' vel or i t ~ p h <t r ynge:Il orifi ce. U si ng tbe in ­ Is in the Wil lI ,Ino inff' ( lio ll ot lh e GP dex finger a, a gui de. tl1 c free c :1 r tih g inolJ ~ leads to e p i sl~ x i s , airway obstructio n, inter­ 'n:1rgi n of rh e j>hal'\' l1 gea I o rifi ce is securely m i ttent nasal exudate. a nd pain . .~ra~pcd in th e forceps. A section or tissue is .EIl d o ~c o p y of the GP is so m ewhat dif­ CII l fro m the orifice with a p air of Ion?; fi c ult. Sp ecial an gled tips for standard Ale tzcnl;aum sc i ~~o r ~ . T hi s p lO ce dure pre­ Lril iglI t endoscop es nre available, and a long ve n ts tIl(! trap ping of a ir a nd cor rect '> the curved l a thetcl (Guen th el' or N eib on) Ol <L el d en . T h e 1a Lte l" p roced u re can be use d C hambers' u terine catllelc !" is sui table for a long w i th u n ila teral involvemen Ll introduction into the G P . If d ifficulty is In a l'ecen t ly descrihed led lllic ;) speci;dly encountered p assing a catheter, vi e wing the deve lo ped cleclroca u tel y is i n troduced into entrance to the G P through the e ndosrope lil e GP, and with endoscop ic visualiza tion m ay h elp. C ultu res o f the G P m ay he ob­ a l,1" i nd ow is cut hetwecn th e r igh t a nd left t;li nccl ill a similar manner, using ster ile Gr . T h e G P G ill also be ap proached by the n asop h ar yngeal swab s. Similarly, irriga tion m ore classica l ro ute i n tbe regio n uf th e a nd washil lg o [ the p ou ch . wi th collection wing' l ) L the a tla~. ~ u f the fluid [or cytology a nd culture, can be A f l' er m mpletion o f tli e corrective sur­ perfor m ed. gery. l Ilt' wa ll of the G P a nd tl H! skin m ay If daily jrrjg~l tion and m ed icatio n of the Fig 1. The most charac l)c ~ Ill u re d , or I he wound m ::l) be left o p cn G P is d esira hle, a self-r ("' tain ing plastic in guttural pouch is the, the throat latch poster I f) ll eal hy gran ulat iun. Except Ior foreig n Ixa uterine cath eler is in ser ted . T he p ortion uod y p nclI mon ia, complications 'I re r3 1' (, of the tub e p ro tr uding from the ex ternal problem, calling a Il d prug-n osis is J;. \ ora b Je_ Proph yl;u I ic tel­ n arc's j ~ securely sutured i nsirle the noslril and the possibilit 3 11 m anlit oxin a n d anLibio tics 1'01 5 days to p reve n t the horse from tearing it Ollt b} be reported to tht are givel1. rubbing. T his p roced u re obvia tes dai ly p as· treatment is avail Di,,/tlherifl (My('o.~i .~ ) sage uf tubes for irr iga lion a n d medication. disease is undergo Fatal t p j ~ t axis h a~ becn att ribll ted to a Surgic;d cl rain aRe a n d loul m edica tion ,.viLl I E {(I 'Hliiio n termed d iph thel ia of the gll ttural vari o l!;; LII ugs has failed to a ller the my­ Empyema of th l pOUd l . A d iph th eritic J e~ i on was found j n­ cu Li( infe cti o n . ~ Surgical lemov::t l of Ihe secondary chroni "olving mO!o1 h eqllen il y tile d orsa l w ~tl l of m }l(o tic le~ j o ll m ay result in fa tal cxpislaxis. m o re generalized the m e rl ial comprll tlIl c n l of tlle GP III the IVfywsis/epistaxi 'i has b een dfectively lion. R adiographs reg-i on 01 t he petrom temp Ol al bo ne, th e L!'ca ted lJY insti ll a tio n of a 1:4 d iluliO!, of filled GP.
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