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SA DX & TX I > Exam 2 - Nasal Disease in Dogs & Cats > Flashcards

Exam 2 - Nasal Disease in Dogs & Cats Flashcards

1
Q

what are some general clinical signs of nasal disease?

A

nasal discharge, sneezing, gagging/retching, stertor, inappetance

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2
Q

what can serous nasal discharge indicate?

A
  • normal
  • viral URT
  • may be early in disease
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3
Q

what can mucopurulent nasal discharge indicate?

A
  • inflammation
  • secondary bacterial rhinitis, fungal rhinitis

-foreign body/mass/polyp/tooth root abscess

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4
Q

what can epistaxis indicate?

A

-trauma
-coagulopathy
-vasculitis
-hypertension
-trauma
-foreign body/neoplasia
-hyperviscosity syndromes

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5
Q

how can you characterize clinical signs of nasal disease in dogs & cats?

A
  1. type of discharge
  2. onset & duration
  3. unilateral, bilateral, or unilateral progressing to bilateral
  4. other - nasal foreign body patients typically rub at their face
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6
Q

if there is an acute onset, what may this characterize the nasal disease into?

A

viral infection or foreign body

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7
Q

if there is an chronic onset, what may this characterize the nasal disease into?

A

neoplasia or fungal infection

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8
Q

if there are unilateral nasal disease signs, how may this characterize the nasal disease?

A

foreign body, polyp, tooth root abscess

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9
Q

if there are bilateral nasal disease signs, how may this characterize the nasal disease?

A

allergic rhinitis & chronic rhinitis

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10
Q

if there are unilateral nasal disease signs that progress to bilateral, how may this characterize the nasal disease?

A

fungal rhinitis & neoplasia

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11
Q

what should be included in your physical exam in a patient with suspected nasal disease?

A

complete physical exam, facial symmetry, ulceration of nasal planum, exophthalmus, patency of nares, fundic exam, & oral exam

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12
Q

what diagnostic tests should I run if a patient presents with epistaxis?

A

blood pressure, CBC for platelet count, BMBT, VWF, PT, PTT, & look for local nasal disease

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13
Q

what systemic evaluation can be done prior to anesthesia or more invasive tests?

A

CBC, chemistry, urinalysis, FeLV/FIV, & tick-borne testing

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14
Q

when should you take thoracic radiographs of a patient with nasal disease?

A

if animal is:

coughing, tachypnic, & has crackles

concern of aspiration pneumonia, cryptococcus

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15
Q

what test is only helpful to evaluate for cryptococcus in cats?

A

cytology of nasal swab

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16
Q

T/F: a cytology run off a nasal swab can help rule out cryptococcus

A

false - can’t rule it out

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17
Q

what is this?

A

cryptococcus

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18
Q

an FNA of the submandibular lymph nodes for cytology can be helpful for evaluating for what?

A

neoplasia & cryptococcus

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19
Q

when is a nasopharyngeal exam typically done?

A

when looking for nasopharyngeal polyps in cats - with a spay hook & dental mirror

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20
Q

why not culture swabs from the nose, oral cavity, tonsils, or nasal flush samples?

A

contaminated by the environment

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21
Q

what is the preferred imaging modality for diagnosing nasal disease?

A

CT

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22
Q

what all does CT evaluate in nasal disease?

A

nasal cavity, sinuses, septum, hard palate, & cribiform plate

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23
Q

what all is rhinoscopy used for in diagnosing nasal disease?

A

foreign body retrieval, assessing mass lesions, fungal plaques, turbinate destruction, & guided biopsies

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24
Q

in nasal sampling, what is cytology used for?

A

looking for aspergillus

25
in nasal sampling, what is nasal flushing used for?
dislodging tissues & removing foreign bodies
26
what are the potential complications of nasal biopsies?
aspiration, bleeding, trauma to the brain, & non-diagnostic samples
27
how can aspiration be prevented in nasal biopsies?
ET tube in place, pharynx packed with gauze, suction & clearing back of throat afterward, & removing the ET tube partially inflated
28
how can bleeding be prevented in nasal biopsies?
dilute epinephrine cold saline infusion or icepack unilateral carotid artery ligation - very rare
29
what dog breeds are predisposed to aspergillus infections?
dolichocephalic dog breeds
30
what is the treatment of choice for aspergillus infections?
topical clotrimazole infusion maybe give oral antifungal treatment in combo with local therapy
31
T/F: aspergillus fumigatus is a normal inhabitant of the nasal cavity
true
32
what is a nasopharyngeal polyp?
benign growth of inflammatory tissue, fibrous connective tissue, & epithelium
33
what causes nasopharyngeal polyps?
cause unknown - infection or congenital is suspected
34
where do nasopharyngeal polyps originate?
tympanic bulla, nasopharynx, & auditory tube
35
what animals are typically affected by nasopharyngeal polyps?
cats older than 5 years old
36
what are the typical clinical signs associated with nasopharyngeal polyps in cats?
stertor, upper airway obstruction less common - mucopurulent discharge & otitis
37
how are nasopharyngeal polyps diagnosed?
signalment, visual exam - deep otoscopic exam & patient under anesthesia in dorsal recumbency polyp may displace soft palate
38
how are nasopharyngeal polyps treated?
gentle traction through the mouth or ear 1 month course of tapering prednisone - 1-2mg/kg PO every 24 hours for 2 weeks initially
39
what are the potential complications of removing a nasopharyngeal polyp?
horner's syndrome & recurrence
40
what are the signs of horner's syndrome?
ptosis, miosis, enophthalmos, & elevation of the 3rd eyelid
41
what are the common signs of idiopathic chronic rhinitis?
bilateral mucoid or mucopurulent discharge that can be blood tinged, sneezing, mucosal inflammation, turbinate destruction, & patient is otherwise healthy
42
how is idiopathic chronic rhinitis diagnosed?
diagnosis of exclusion
43
how can signs improve in idiopathic chronic rhinitis?
humidification, intranasal saline drops, prednisone, NSAIDs not at the same time as steroids, & eliminate environmental irritants
44
how is idiopathic chronic rhinitis cured?
it's not - very frustrating for owners
45
what is the only indication to run a cytology of a nasal swab in cats?
when looking for cryptococcus
46
if you think your patient may have a tooth root abscess, what diagnostics should you do?
radiograph
47
T/F: with a few exceptions, rhinoscopy isn't diagnostic unless coupled with CT
true
48
what must be known prior to obtaining a nasal biopsy in terms of bleeding status?
clotting status
49
what is the caudal limit of where the biopsy instrument can go? why?
never deeper than the level of the medial canthus avoid penetrating the cribiform plate
50
what is the most common complication of nasal biopsies?
hemorrhage
51
T/F: bacterial rhinitis occurs secondary to other nasal disorders
true
52
when may a deep nasal biopsy be taken for culture?
looking for aerobic, anaerobic, & fungal organisms & mycoplasma
53
what clinical signs & response to treatment are suggestive of bacterial rhinitis?
mucopurulent nasal discharge that resolves or becomes serous after antibiotics are started
54
what antibiotics may be tried empirically for treatment of bacterial rhinitis?
amoxicillin, amoxicillin-clavulanate, doxycycline, trimethoprim-sulfa, or clindamycin
55
how is cryptococcus treated?
oral itraconazole or fluconazole for at least 1-2 months beyond the resolution of clinical signs
56
pain on palpation of the face & depigmentation of the nasal planum are highly suggestive of what disease in dogs?
nasal aspergillosis
57
how is idiopathic chronic rhinitis characterized?
off of predominant population of inflammatory cells present
58
with the exception of polyps, nasal neoplasms in dogs & cats are almost always what?
malignant

SA DX & TX I (59 decks)

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