What is Catheterization and Flushing of Guttural Pouch?
Horses are one of a number of species that has guttural pouches. These are air sacs connected to the eustachian tubes located beneath the ear. They are lined with a thin membrane, and major arteries and nerves supplying the head run underneath this membrane, making disorders of the guttural pouch dangerous if not treated appropriately. If fluid builds up in these air sacs and becomes infected, referred to a guttural pouch empyema, catheterization and aggressive flushing of the guttural pouch with pressure and large quantities of sterile fluid is usually required, along with antibiotic treatment to resolve the condition. The procedure will have to be repeated multiple times to be effective. Chondroids, which are buildups of pus, can also develop, requiring surgical removal if flushing out is not successful. Guttural pouch infection may occur secondary to the disease, strangles. Treatment and hospitalization to perform repeated procedures by a veterinarian is usually required.
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Catheterization and Flushing of Guttural Pouch Procedure in Horses
Catheterization and flushing of the guttural pouch may be required daily for 5 to10 days. Anti-inflammatories and systemic antibiotics will also be administered. These procedures are often performed during hospitalization or on repeated visits to your horse's location. During irrigation of the guttural pouch, your horse will be sedated so they can be restrained and their head kept in a lowered position. A catheter will be passed into the nasal cavity, through the nasopharynx and into the guttural pouch. Once the catheter is correctly placed, a large amount of sterile electrolyte is flushed into the pouch under pressure. Pressure can be achieved with a pump, manually or with a fluid pressure bag. The procedure may take 30 to 60 minutes. Sometimes, antibiotics are added to the solution for flushing. After flushing procedure, the catheter is removed, multiple procedures may be required over several days along with antibiotic and anti- inflammatory therapies.
Efficacy of Catheterization and Flushing of Guttural Pouch in Horses
The majority of of horses, 80%, with infection of the guttural pouches are successfully treated with catheterization and flushing. Although repeated procedures over 5 to 10 days may be required and additional treatment with antibiotics and antiinflammatories is required. For those horses not successfully addressed with this therapy, endoscopic surgery to remove chondroids or remove infected tissues may be required.
Catheterization and Flushing of Guttural Pouch Recovery in Horses
Nasal discharge may continue after treatment. Continued monitoring to ensure discharge does not show signs of remaining infection or other symptoms of infection do not re-manifest is required.
Cost of Catheterization and Flushing of Guttural Pouch in Horses
Treatment for guttural pouch infection can be expensive. Catheterization and flushing of the guttural pouch may require hospitalization or multiple trips to the home site by your veterinarian over several days. Including sedation, multiple procedures, antibiotics and anti-inflammatories the total cost of treatment can range from $2,000 to $4,000. In some cases, treatment may go on longer than initially anticipated.
Horse Catheterization and Flushing of Guttural Pouch Considerations
Repeated treatments, hospitalization, and expense may not be practical in some cases. In addition, 20% of cases requiring flushing of the guttural pouches will require more invasive therapies to resolve. There is a risk of damage to nerves and arteries from repeated catheter placement and flushing. In addition, a risk for aspiration pneumonia and lymph node abscesses is present. Careful veterinary care and monitoring is required for successful treatment.
Catheterization and Flushing of Guttural Pouch Prevention in Horses
As infection can occur from inhalation of bacteria or fungus, keeping your horse's housing environment clean and free from infestations will reduce the likelihood of this occurring. Vaccination for diseases, such as strangles, may prevent secondary infection of the guttural pouches in horses. Careful monitoring of your horse to obtain veterinary treatment if sign of guttural pouch infection occurs will minimize the severity of infection if early treatment is received.