Standing Surgical Removal of Inspissated Guttural Pouch Exudate (Chondroids) in Ten Horses

Abstract

To report use of a modified Whitehouse approach in standing horses for management of inspissated guttural pouch empyema. Retrospective study. Adult horses (n=10) with guttural pouch empyema. Inspissated exudate in 1 or both guttural pouches was removed surgically through a modified Whitehouse approach, with the horses standing and sedated. Medical records of affected horses were reviewed to determine history; physical, endoscopic, and radiological examination findings; surgical technique; complications, and outcome. All horses had purulent nasal discharge; 3 horses had dysphagia, 2 had recurrent laryngeal neuropathy on the side affected by guttural pouch empyema, and 1 had persistent soft palate displacement. Inspissated exudate was removed safely without causing apparent discomfort. Eight horses returned to their previous level of athletic activity after surgery; 1 horse dysphagic before surgery, was euthanatized because of persistent dysphagia after surgery, and 1 horse died 1 week after surgery for unknown reasons. Streptococcus equi subsp equi was isolated from the affected guttural pouch of 3 horses. Inspissated exudate can be removed surgically from the guttural pouch in standing horses through a modified Whitehouse approach. To eliminate risks associated with general anesthesia and avoid surgical suite contamination, removal of chondroids can be performed in standing sedated horses through a modified Whitehouse approach.