Q. There seems to be little information available on the Internet about guttural pouch tympany. I lost a filly to this, along with displaced soft palate. She looked very normal at birth, 41 inches (tall) and 125 pounds. But she had an egg-sized lump on the left side of her throat, which increased to the size of cantaloupes on both sides of her throat by Day 5.

Endoscopic evaluation and radiographs showed both sides were affected by the guttural pouch problem, and her swallowing reflex was decreasing daily. Milk was going to the stomach and the trachea. We opted to euthanize because there wasn't an ability to repair everything--laser surgery could open the guttural pouches, but the swallowing was a serious problem that could not be corrected--and pneumonia was always going to be present. The scoping revealed no frenulum problem (problems of impedance with the folds of tissue in this area).

Any input would be greatly appreciated. What causes this, and is there anything that can be done when it presents?

Glenna Bartlett, Hillsboro, Ore.

A. There are times when foals with guttural pouch tympany may be dysphagic (have difficulty swallowing). This can happen for a few reasons: 1) the pouch distention makes breathing, as well as swallowing, difficult just because of the mass effect (pressure on the roof of the throat) within the nasopharynx (throat); and 2) if the foal is having breathing problems the repeated effort to breathe through the decreased airway can cause some edema (fluid swelling) formation in the tissues and inflammation. Theoretically, this may cause some vagal neuropraxia (injury to the nerves that control throat function) and dysphagia.

Frequently, with guttural pouch decompression, the dysphagia resolves with anti-inflammatory therapy (flunixin meglumine or Banamine) and antibiotics. Certainly, some foals are dysphagic after surgery due to guttural pouch trauma. Given some time and antibiotics, many of them recover.

More information on guttural pouch tympany can be found in this article: Common Respiratory Problems 

About the Author

Susan Holcombe, VMD, MS, PhD, Dipl. ACVS, Dipl. ACVECC

Susan Holcombe, VMD, MS, PhD, Dipl. ACVS, Dipl. ACVECC, is a professor at Michigan State University’s College of Veterinary Medicine. She has a special interest in equine emergency and critical care, upper-respiratory tract physiology, and sepsis and endotoxemia in horses.

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