1. Diseases of the nasal cavity and pharynx in dogs and cats Flashcards
History and cause, systemic diseases, Physical exam?
History & CSx
Discharge; Sneezing; Bleeding (epistaxis); Pain; Stridor; Dyspnoea;
Reverse sneezing
Systemic Diseases
Discharge → May be indicative of Distemper or Rhinotracheitis
Epistaxis → May be indicative of bleeding disorders
Physical Exam
Shape; Nasal stridor; Closing the mouth; Discharge →
Unilateral/bilateral;
Inspection of the mouth; Inspect the teeth; Depigmentation
Special diagnostics Procedures?
Special Diagnostic Procedures
Radiography: Sedation → Positioning; Images are of limited value
Rhinoscopy: Anaesthesia → Tracheal intubation → Sphynx-like
position → Visualisation & biopsy
CT
MRI
Olfactory tests
Diseases of the Nasal Cavity
Congenital diseases:
§ Malformation of the nasal plane
§ Oronasal/oropharyngeal clefts
§ Primary ciliary dyskinesia (PCD): Genetic dysfunction
of the respiratory tract’s cilia → Prevents mucus clearance
from the lungs, paranasal sinuses & middle ear →
Respiratory infections
§ Kartagener’s syndrome: Type of PCD associated with a
“mirror-image” orientation of the heart & other internal
organs
Viral Rhinitis?
Viral Rhinitis
CAT
FHV-1 (Feline Herpesvirus-1); FCV (Feline Calicivirus)
CSx: Paroxysmal sneezing; Serous ocular/nasal discharge →
Mucopurulent within 5 days
Note that the animal may be infected with both concurrently
FHV: Conjunctivitis; Corneal ulceration
FCV: Mild ocular signs; Oral ulcer; Gingivitis; Lameness
Chronic carriers: Ø CSx; Sneezing; Mild nasal discharge; Gingival
ulceration
Chronic viral disease: May lead to nasal destruction & secondary
bacterial infection
Dx: PCR/conjunctival swab
Tx: Prevention; Supportive: Nebulisation; Abx for secondary
infection
DOG
Kennel cough
Canine Distemper: Profuse mucopurulent nasal discharge;
Dx: PCR
CHV (Canine Herpes Virus): Puppies; Mucopurulent nasal
discharge; Dx: Autopsy
Bacterial Rhinitis?
Bacterial Rhinitis
Usually a secondary infection to: Viral infections; Foreign bodies;
Tumour; Disrupted mucosa
Primary infection: Pasteurella spp.; Strep. spp.; Staph. spp.;
Bordetella spp.; Chlamydia spp.
Dx: (Culture of nasal swab); Conjunctival swab; PCR
Tx: Tx of underlying disease; Supportive tx; Abx → Doxycycline for 3 weeks
Mycotic Rhinitis?
Mycotic Rhinitis
Dog > cat
Aspergillus spp. (Aspergillosis)> Cryptococcus spp.
Opportunistic infection; House dust; Bird cages; Large number of spores formed; Foreign bodies
CSx: Nasal discharge; Depigmentation; Pain; Epistaxis
Rhinoscopy: Plaques; Bone resorption; Atrophy of conchae
Tx: Topical clotrimazole gel + PO Itraconazole for 8 weeks
Specific Rhinitis (neurogenic)?
Specific Rhinitis (Neurogenic)
POLYPS
Cat > dog; Can lead to Horner’s syndrome
Location: Unilateral/bilateral; Nasal cavity/nasopharynx
CSx: Extension of the neck & panting
Dx: CSx; Rhinoscopy; Radiography; Biopsy
Tx: Surgery; Polyp recurrence → Bulla osteotomy
Px: Excellent; Any Horner’s syndrome usually resolves within a month
Foreign Body and allergic Rhinitis?
Foreign Body
CSx: Sudden sneezing; Pain; Unilateral serous nasal discharge
Dx: Rhinoscopy; Nasal flush; Scooping; Radiography
Tx: Removal of foreign body; Abx
ALLERGIC RHINITIS
CSx: Serous discharge; Sneezing
Tumours of the Nasal Cavity?
Tumours of the Nasal Cavity
< 5 years old; Squamous cell carcinoma; Adenocarcinoma; Sarcoma; Lymphoma
CSx: Rhinitis; Epistaxis
Dx: Rhinoscopy + biopsy; CT; MRI; Radiography
Tx: Radiotherapy; Chemotherapy; Surgery
Euthanasia is justified in cases of bleeding, dyspnoea or aphagia
Epistaxis?
Epistaxis
Bleeding from the nose
Causes: Aspergillosis; Tumour; Trauma; DIC; Coagulopathy;
Thrombocytopathy; Thrombocytopenia; Hypertension;
Leishmaniosis
Dx: Radiography; Rhinoscopy → Both should be delayed by 48 hours from the point of bleeding
Tx: Nasal tamponade
Pharynx?
Pharynx
General anatomy: Oropharynx; Nasopharynx; Laryngopharynx
History: Dysphagia; Coughing; Gagging; Regurgitation; Salivation
Physical exam: Sedation may be needed; Occasionally intubation
needed
Diagnostic procedures: Pharyngoscopy; Retrograde rhinoscopy;
Video fluoroscopy; CT (middle ear); Ultrasonography (masses)
Diseases of the Pharynx?
Diseases of the Pharynx
FOREIGN BODY
Dogs > Cats
CSx: Sudden salivation after eating bones; Fever; Dysphagia; Dyspnoea
Tx: Removal; Intubation may be necessary
RETROPHARYNGEAL ABSCESS
Migrating foreign body; Difficult to diagnose
CSx: Salivation; Fever; Dysphagia; Painful neck;
Lab. D:↑WBC
NASOPHARYNGEAL POLYPS
See “Polyps” under specific rhinitis
NASOPHARYNGEAL STENOSIS
Young cats; Rare occurrence
CSx: Open mouth breathing (See Fig. 1.2)
Dx: Endoscopy
Tx: Surgery; Balloon dilation
Soft Palate abnormalities?
Soft Palate Abnormalities
ELONGATED SOFT PALATE
Brachycephalic dogs
CSx: Stertorous (noisy/laboured) breathing; Exercise intolerance;
Collapse; Gagging
CLEFT PALATE
Neonatal patients; Leads to milk in the nares → Aspiration
Tx: Surgery
SOFT PALATE HYPOPLASIA
Brachycephalic dogs; Chronic rhinitis
CSx: Gagging; Reverse sneezing
