Guttural Pouch Disease: What You Need to Know

Infection of the guttural pouch can be serious — even life-threatening. Fortunately, this type of equine infection is rare, but all horse owners should know the symptoms.

What is the Guttural Pouch?

One of the main functions of the guttural pouch is temperature regulation. Its main purpose is to cool the brain through air circulation. It houses blood vessels, nerves and arteries.

Nerves in the guttural pouch control swallowing, breathing and chewing. Although there has been much research done this part of the equine anatomy, there’s still a lot to learn.

Where is the Guttural Pouch?

The guttural pouch spans from the inside surface of the eardrum down to the pharynx (the opening behind the mouth where the oral cavity and nasal passages meet; see illustration). 

What Causes Guttural Pouch Infection?

The most common causes of infection come from bacteria and fungi present within the pouch. Remember that the pouch aids in swallowing, chewing and breathing; horses naturally swallow and inhale environmental bacteria and fungi. In most cases a horse’s immune system fights off these microorganisms, but in some cases they become trapped in the guttural pouch, leading to infection. 

Common Symptoms of Guttural Pouch Infection

Keep an eye out for some of the most common symptoms of guttural pouch:

• Swelling in the pouch area
• Creamy nasal discharge from one nostril
• Drooping eyelid, lip, or ear
• Any facial abnormality from nerve damage
• Inability to eat or swallow
• Weight loss
• Bleeding from one or both nostrils

How is it Diagnosed?

There are several things a vet may do to diagnose guttural pouch infection, including taking X-rays or doing endoscopy. Computed tomography (CT) and magnetic resonance imaging (MRI) are not usually used to diagnose guttural pouch infections because they take more time, often require anesthesia and many equine hospitals don’t have these machines on-site.

Types of Guttural Pouch Disease

There are several types of guttural pouch disease: 

1. Guttural Pouch Empyema

• Most common type
• Caused by bacterial infection
• Symptoms: inflammation, pus, lethargy, fever
• Treatment: antibiotics, pain medication, flushing, possible surgery

2. Guttural Pouch Mycosis

• Rare
• Very Serious
• Caused by a fungus
• Can cause severe damage to arteries/nerves
• Hemorrhage can occur (can be fatal)
• Possible cranial nerve damage can occur
• Symptoms: facial paralysis, trouble swallowing, neck swelling, hemorrhaging/bleeding from nostrils.
• Treatment varies according to the extent of nerve damage

3. Guttural Pouch Tympany

• Congenital
• Often seen in foals
• Cheeks have swollen appearance
• Can cause swallowing difficulties
• Symptoms: swollen cheeks, like a chipmunk
• Treatment: surgery

4. Temporohyoid Osteoarthropathy

• Rare
• Caused by infection
• Affects middle ear
• Causes thickening of the temporohyoid joint
• Can cause the stylohyoid bone to fracture
• Affects nerves that run through guttural pouch
• Symptoms: facial drooping, head tilting, incoordination
• Treatment: antibiotics (mild cases); surgery (severe cases)

Prevention

The best way to prevent guttural pouch disease is to keep your horse’s environment clean. Thankfully, infection rare, and serious cases are rarer still. But if you notice any of the symptoms listed above, contact your vet immediately as early diagnosis often results in better outcomes.