1. Diseases of the nasal cavity and pharynx in dogs and cats

Question 1

History and cause, systemic diseases, Physical exam?

Answer 1

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

Question 2

Special diagnostics Procedures?

Answer 2

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

Question 3

Diseases of nasal cavity;

Answer 3

1. Congenital
2. Rhinitis: Viral, bacterial, mycotic and specific
3. Tumours
4. Epistaxis
5. Trauma

Question 4

Viral Rhinitis?

Answer 4

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

Question 5

Bacterial Rhinitis?

Answer 5

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

Question 6

Mycotic Rhinitis?

Answer 6

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

Question 7

Specific Rhinitis (neurogenic)?

Answer 7

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

Question 8

Foreign Body and allergic Rhinitis?

Answer 8

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

Question 9

Tumours of the Nasal Cavity?

Answer 9

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

Question 10

Epistaxis?

Answer 10

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

Question 11

Pharynx?

Answer 11

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)

Question 12

Diseases of the Pharynx?

Answer 12

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

Question 13

Soft Palate abnormalities?

Answer 13

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