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VET433: Cardio/Respiratory > Acute and Chronic Nasal Disease > Flashcards

Acute and Chronic Nasal Disease Flashcards

1
Q

what are the 3 main points that can be used to narrow down a differential list

A
  1. local vs systemic
  2. unilateral vs bilateral
  3. congenital vs acquired
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2
Q

what are the differential categories for nasal disease

A

infectious
inflammatory
neoplastic
misc - foreign body, etc

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3
Q

what should always be asked in a history for a nasal disease presentation

A

nasal discharge characterization and chronicity

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4
Q

how to classify nasal discharge

A

serous
mucoid
hemorrhage

unilateral vs bilateral

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5
Q

what diagnostics should be run for epistaxis

A

CBC
BMBT
aPTT (intrinsic pathway)
PT (extrinsic pathway)

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6
Q

pseudo-nasal discharge

A

discharge that comes from the lower airways NOT the nose

ex. regurgitation or reflux from GERD or hiatal hernias

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7
Q

steps of a clinical exam for nasal disease

A
  1. observation
  2. hands-on
  3. oral exam
  4. neurologic exam
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8
Q

observation part of clinical exam

A
  • stridor, stertor
  • congestion
  • signs of distress
  • pawing
  • facial asymmetry (and discoloration)
  • nasal discharge
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9
Q

hands on part of clinical exam

A
  • LN palpation
  • ocular retropulsion
  • aural exam
  • Horner’s syndrome
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10
Q

what to check for in an oral exam

A
  • pain on extension
  • depigmentation
  • dental disease
  • mass lesions
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11
Q

what to check for in a neuro exam

A

Horner’s syndrome
- miosis
- ptosis
- enophthalmos
- 3rd eyelid protrusion

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12
Q

acute nasal diseases

A
  • foreign body
  • feline upper respiratory tract infection
  • canine infectious respiratory disease complex
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13
Q

foreign body - chronicity, discharge, clinical signs

A

acute onset
+/- hemorrhage
paroxysmal reverse sneezing
facial pain and rubbing

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14
Q

foreign body - diagnosis and treatment

A

dx: sedated nasal exam + probe

tx: remove the foreign body + NSAIDs
- flush nasal cavity
- often does NOT require antibiotics

complications: FB can migrate –> pneumo or pyothorax; sinonasal aspergillosus

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15
Q

FURTI - etiologies

A

feline herpesvirus
feline calicivirus
chlamydia
bordetella
mycoplasma

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16
Q

FURTI - chronicity, discharge, clinical signs

A

acute onset
intermittent or recurrent

sneezing
nasal discharge
ocular discharge/conjunctivitis
fever
anorexia

FHV: ocular lesions (dendritic ulcers) + facial dermatitis

FCV: oral ulcers + lameness

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17
Q

feline herpesvirus

A

establishes latency in the trigeminal nerve and recrudesces during times of stress

infection with herpes is lifelong

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18
Q

feline calicivirus

A

most cats are able to clear infection

only a few become carriers

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19
Q

FURTI - diagnosis and treatment

A

dx: RARE - only for severe systemic signs or chronic/unresolving cases
- conjunctival and nasal PCR

tx: supportive care
- nasal flushes
- nebulization
- nutritional support
- if not improved in 10 days –> doxycycline + famciclovir

20
Q

CIRDC - etiologies

A

many
viral: rota, corona, influenza, parainfluenza, adeno, herpes, distemper, pneumovirus

bacterial: bordetella, mycoplasma, streptococcus

21
Q

CIRDC - chronicity, discharge, clinical signs

A

acute onset

cough (bordetella)
fever
anorexia
dehydration
tracheal irritation
tachypnea

22
Q

CIRDC - diagnosis and treatment

A

dx: RARE - only for severe systemic signs or chronic and unresolving cases
- PCR for mycoplasma + bordetella
- thoracic rads if chronic, severe, recurrent

tx: supportive care
- can give doxycycline

23
Q

chronic nasal diseases

A
  1. dental disease (abscess, fistula)
  2. feline chronic rhinosinusitis
  3. canine lymphoplasmocytic rhinitis
  4. canine sinonasal aspergillosis
  5. feline fungal disease
  6. nasal neoplasia
24
Q

dental disease (abscess, fistula) - chronicity, discharge, clinical signs

A

chronic
unilateral mucopurulent to hemorrhagic

difficulty eating
halitosis
asymmetry
fractured tooth
pain
ptyalism

25
Q

dental disease - diagnosis and treatment

A

dx: oral probing, dental radiographs, head CT

tx: surgery +/- antibiotics

26
Q

feline chronic rhinosinusitis signalment

A

any age cat
usually young to middle aged

27
Q

feline chronic rhinosinusitis - chronicity, discharge, clinical signs

A

chronic
recurrent to waxing/waning
unilateral or bilateral
variable discharge w/ sneezing

systemically HEALTHY cat with LOCAL signs only
- congested nasal passages
- erythema
- swollen/edematous turbinates

28
Q

feline chronic rhinosinusitis - diagnosis and treatment

A

dx: diagnosis of exclusion
- definitive dx requires BIOPSY
- infectious disease testing only beneficial for viral or fungal (PCR or fungal cultures)

tx: lifelong disease, requires ongoing treatment
- NSAIDs/steroids
- topical (inhaled) decongestants
- nasal flushes
- short term doxycycline if suspect bacterial component

29
Q

predisposing factors to feline chronic rhinosinusitis

A
  1. altered airflow (anatomical)
  2. increased mucus
  3. secondary bacterial infection
30
Q

canine lymphoplasmocytic rhinitis - chronicity, discharge, and clinical signs

A

chronic
recurrent
waxing and waning
unilateral or bilateral discharge

systemically HEALTHY dog with LOCAL signs only

31
Q

canine lymphoplasmocytic rhinitis - diagnosis and treatment

A

dx: diagnosis of exclusion
- definitive: biopsy

tx: meloxicam followed by prednisone (after a washout period)

32
Q

canine sinonasal aspergillosis etiology

A

aspergillus fumigatus

other aspergillus species cause disseminated aspergillosis

33
Q

canine sinonasal aspergillosis - signalment

A

young to middle aged

RARE in brachycephalics

34
Q

canine sinonasal aspergillosis - chronicity, discharge, clinical signs

A

chronic (months to years)
unilateral > bilateral
mucopurulent to epistaxis

sneezing w/ discharge
depigmentation of the nose
facial pain
seizures
LN enlargement
increased airflow

35
Q

canine sinonasal aspergillosis - diagnosis and treatment

A

dx:
- CT & rhinoscopy - lytic changes to conchae
- culture: definitive diagnosis

tx: debridement + azole antifungal topical
- rhinoscopy + debride to clear out the fungal plaques from nasal passages up to sinuses
- administer clotrimazole into the sinus for 20 min contact time

requires 2-3 treatments on average

36
Q

do the destroyed nasal passages reform once canine sinonasal aspergillosis is treated

A

no - will almost always get chronic rhinitis due to decreased nasal conchae

37
Q

what are the most common feline fungal nasal diseases

A

cryptococcus
aspergillus

38
Q

where does crypto and aspergillus affect the cat

A

crypto: sinonasal
aspergillus: sinonasal + sino-orbital

39
Q

clinical signs - feline cryptococcus

A

sneezing
discharge
- bilateral mucopurulent
“roman nose”
seizures
chorioretinitis

40
Q

clinical signs - feline aspergullis

A

erosive/ulcerative facial lesions
exophthalmos

same signs as canine sinonasal aspergillosis

41
Q

diagnosis - feline cryptococcus

A

latex antigen test
+/- retinal exam to evaluate for chorioretinitis

42
Q

diagnosis - feline aspergillus

A

culture

43
Q

treatment - feline cryptococcus

A

fluconazole PO

continue oral antifungals until latex antigen test comes back negative

44
Q

treatment - feline aspergillus

A

debridement + multimodal systemic therapy (ampho, azoles)

45
Q

most common nasal tumors in dogs

A

squamous cell carcinoma
mesenchymal - fibrosarcoma, chondrosarcoma

46
Q

most common nasal tumors in cats

A

lymphoma
mesenchymal - fibrosarcoma, chondrosarcoma

47
Q

palliative treatments for nasal neoplasia

A

SCC: NSAIDs
lymphoma: prednisolone

VET433: Cardio/Respiratory (17 decks)

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