Guttural Pouch Infections in Horses by a Vet – 2025 Diagnosis & Care Guide 🐴👃
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Guttural Pouch Infections in Horses by a Vet – 2025 Diagnosis & Care Guide 🐴👃
By Dr Duncan Houston, BVSc
Introduction
The guttural pouch is a unique anatomical structure found in horses—and in just a few other species. This air-filled sac is part of the upper respiratory tract and plays an important, though not fully understood, role in equine health. Because it houses several critical arteries and cranial nerves, any infection of the guttural pouch can quickly become serious—even life-threatening. In this 2025 vet guide, we’ll explore bacterial and fungal infections of the guttural pouch, how to detect them, and how your vet can treat them effectively.
What Are Guttural Pouches? 🤔
- Located in the throatlatch area, one on each side of the head
- Extend from the Eustachian tubes between the ear and the pharynx
- Believed to help cool blood in the internal carotid artery during exercise
- Closely associated with vital structures: internal carotid artery and cranial nerves
Why Guttural Pouch Infections Matter ⚠️
Infections of the guttural pouch can lead to:
- Chronic nasal discharge (often pus or blood)
- Nerve damage causing difficulty swallowing or facial paralysis
- Severe or fatal arterial bleeding if fungal infection erodes major blood vessels
- Persistent disease spread—especially after strangles
Common Guttural Pouch Diseases 🦠
1. Bacterial Infection (Empyema)
- Usually secondary to strangles (Streptococcus equi)
- Pouch fills with pus and thick mucus
- Horse may appear recovered but continue to shed the bacteria
- Signs: Thick nasal discharge (often unilateral), swollen lymph nodes, mild fever
Treatment
- Endoscopic examination to confirm diagnosis
- Repeated flushing of the guttural pouch with sterile solution
- Topical antibiotics may be applied into the pouch
- Isolation: Critical to prevent spread of strangles
2. Fungal Infection (Guttural Pouch Mycosis)
This is more dangerous than bacterial infection and can lead to sudden death if not diagnosed early.
- Caused by Aspergillus or similar fungi
- Fungus adheres to the internal carotid artery wall or nearby cranial nerves
- Can cause erosion of the artery wall, leading to life-threatening bleeding
- Also damages cranial nerves, causing laryngeal dysfunction and dysphagia (difficulty swallowing)
Signs of Mycosis
- Persistent or bloody nasal discharge
- Choke or feed material draining from nostrils
- Head tilt or facial nerve paralysis
- In rare cases, sudden death from arterial rupture
Treatment
- Endoscopy to visualize fungal plaque
- Surgery: The most effective option is arterial embolization
- Veterinary surgeons insert a balloon catheter to block blood flow to the fungus—starving it of nutrients
- Medical antifungals are usually ineffective unless combined with surgical intervention
Diagnostic Tools 🧪
- Endoscopy: Direct visualization of pouches
- Culture & cytology: To identify bacteria or fungi
- Imaging: Radiographs or CT may aid in complex or chronic cases
When to Call the Vet 📞
- Unilateral or bloody nasal discharge
- Swelling at the throatlatch area
- Signs of strangles or history of recent outbreak
- Swallowing difficulty, choking, or weight loss
- Sudden behavioral changes with bleeding or drainage
Preventive Measures 🛡️
- Ensure timely and complete vaccination for strangles (per vet guidance)
- Isolate horses with respiratory symptoms or known strangles exposure
- Use individual water buckets and disinfect shared spaces
- Monitor closely after any upper respiratory infection—especially if nasal discharge persists
Case Example: Fungal Emergency
- A 10-year-old gelding develops a single-sided bloody nasal discharge and mild difficulty swallowing.
- Endoscopy reveals fungal plaque on internal carotid artery in left guttural pouch.
- Surgical embolization is performed to block blood flow to the fungus.
- Horse recovers fully with no further bleeding, but mild nerve dysfunction requires 2 months of rehab.
FAQs About Guttural Pouch Disease
Q: Can guttural pouch infections be prevented?
A: Not always—but early treatment of strangles and biosecurity can reduce risk. Fungal infections can occur spontaneously.
Q: Is my horse contagious with a guttural pouch infection?
A: If strangles is involved, yes. Horses may shed bacteria long after symptoms resolve. Isolation and endoscopy are essential.
Q: Can a horse recover fully?
A: Yes—with early intervention. But fungal infections can be fatal if the artery ruptures before treatment.
Conclusion
The horse’s guttural pouch is a small structure with big implications for health. Infections—especially fungal—can cause life-threatening hemorrhage or long-term nerve damage if left untreated. Early recognition of unusual nasal discharge or swallowing problems can be lifesaving. Partner with your vet for early diagnosis and management to protect your horse in 2025 and beyond.
Concerned about nasal discharge or strangles recovery? Reach out to Ask A Vet at AskAVet.com or our app 📱 to consult with Dr Duncan Houston and our veterinary team. 🩺🐴
