Disease of Equine head + neck 4 Flashcards
What splits the guttural pouches into medial + lateral compartments?
*Stylohyoid - medial larger than lateral
What does the guttural pouch connect to?
*Nasopharynx via auditory tube
What is the circle of willis?
*Vessel Area around guttural pouch where internal carotid arteries combine from 2 to 1
Why are diseases of the guttural pouch important?
*Common + can be life threatening
What are clinical signs of diseases of the guttural pouch?
*Epistaxis
*Dysphagia
*Dyspnoea
*External swelling
*Neurological signs
How would you assess the guttural pouch?
*History + clinical exam
*Endoscopy
*CT / radiography
What is guttural pouch mycosis?
*Fungal plague forms over artery (usually internal carotid)
-Aspergillus
=epistaxis - can be fatal
What are history + clinical signs of guttural pouch mycosis?
*History = may have had several mild episodes of epistaxis, dysphagia
*CS = Nasal discharge, epistaxis + nerve dysfunction (dysphagia)
What are Ddx for epistaxis?
Guttural pouch
*Guttural pouch mycosis
*Head trauma - rupture of longis capitus / rectus capitus
Paranasal sinuses
*Progressive ethmoid haematoma
*Sinus trauma, neoplasia
Nasal passages
*Trauma
How is guttural pouch mycosis diagnosed with endoscopy?
*Blood seen draining from guttural pouch - usually unilateral
-if so refer
*Fungal plaque over internal carotid
What is emergency management of GPM? (guttural pouch mycosis)
*Triage - HR, Peripheral Pulse, MM colour, mentation
*keep horse calm
*Minimise risk of dislodging haemorrhage
Surgery essential
How is a GPM surgery done?
*Occlude affected artery incase it explodes/bleeds out
*needs to be occluded on cardiac side + cerebral side as circle of willis will connect other internal carotid + will bleed out
*Treat hypovolaemia - blood transfusion
What is medical management of GPM?
*Topical / systemic antifungals - Enilconazole - following surgery / or very mild cases
What can history of head trauma indicate?
*Damage to longus capitis + rctus capitis ventralis = muscles haemorrhage into GP - seen as epistaxis
*Rest horse
What are differentials of dysphagia?
*Oesophageal obstruction
*Retropharyngeal abscess - strangles
*Masses
*Foreign bodies
*Guttural pouch mycosis, empyaema, Grass sickness, botulism, polyneuritis equi, tetanus, rabies
What is guttural pouch empyaema?
*Purulent material in guttural pouch - liquid / chondroids
*CS = purulent nasal discharge + lymph node enlargement
*Dx = endoscopy - always rule in / out strangles
What is chondroids?
*mineralised pus
*Chronic infection
*large size = challenging removal
What is Treatment of empyaema + chondroids?
*Empyaema = endoscopic lavage
*Chondroids = Endoscopic assisted removal
-laser assisted techniques
-surgical approach
What is guttural pouch tympany? What is it seen in?
*Seen in foals - up to 1 year
*Air trapped in GP
What are clinical signs + diagnosis of guttural pouch tympany?
*CS = retropharyngeal swelling, dysphagia + respiratory stridor
*Dx = Radiography + Endoscopy
How is guttural pouch tympany treated?
*If unilateral = allow air to escape via unaffected side - break septum
*If bilateral = allow escape from both sides - catheters / surgery
What is temporohyoid osteoarthropathy? (THO)
*Progressive disease of middle ear / temporohyoid joint - hyoid fuses to temporal bone
What are clinical signs of THO? temporohyoid osteopathy
*Early = head shaking + beahviour changes
*Chronic = CN VII +VIII signs, ptosis, muzzle deviation, head tilt + ataxia, nystagmus
How is THO diagnosed+ managed? temporohyoid osteopathy
*Dx = CS, endocospy of GP, radiography, CT
*Management = systemic antimicrobials, systemic NSAIDs
*Surgery - keratohyoidectomy
What is otitis media?
*Ear Infection = headshaking, vestibular signs
*Tx = long course of antimicrobials
What is the most common neoplasm of the guttural pouch?
*Melanoma
