Equine Guttural Pouch Mycosis: Symptoms, Risks, and Surgery

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1. What is Guttural Pouch Mycosis?

The Guttural Pouch is an anatomical extension of the eustachian tube, exclusive to the horse. In mycosis, there is a fungal infection, which usually belongs to the Aspergillus spp., resulting in the formation of diphtheritic membranes within the guttural pouch.

Anatomical location of the Equine Guttural Pouch showing fungal plaque development near the Internal Carotid Artery. | VetInsight PK


2. Why is it Dangerous? (Anatomical Significance)

The guttural pouch is very close to many important structures:

• Internal Carotid Artery: 

The fungus may break down the walls of the artery.

• Cranial Nerves: 

These include nerves involved in swallowing and facial movement.

3. Symptoms 

Epistaxis (Nosebleed):

 This is the most important sign. It is generally non-sporting, excessive, and spontaneous. Death is possible if there is arterial rupture.

Dysphagia: 

Due to damage to cranial nerves, difficulty swallowing.

Foul Smelling Nasal Discharge: 

Purulent discharge.

Horner’s Syndrome: 

Drooping eyelids or sympathetic dysfunction.



4.Diagnosis

Endoscopy: 

This is the method of choice where a flexible endoscope is used to examine the pouch.

Radiographs: 

May help identify masses and/or fluid lines in the region.

5. Treatment and Surgical Management


Approach Description
Medical Therapy Topical antifungal flushing (e.g., Enilconazole) directly into the pouch.
Surgical Occlusion Using coils or balloons to block the Internal Carotid Artery to prevent fatal hemorrhage.
Supportive Care If dysphagia is present, feeding through a nasogastric tube may be required.

Conclusion

 Guttural Pouch Mycosis is one of the most difficult and deadly diseases in the field of equine medicine. The close location of the guttural pouch to the internal carotid arteries and important cranial nerves means that a single occurrence of an "alarm" nose bleed must never be taken lightly. While medical therapy using antifungal drugs may suffice for milder cases, surgery to block off the involved blood vessels is usually necessary to avoid a catastrophic hemorrhage.

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