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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
Q

in nasal sampling, what is nasal flushing used for?

A

dislodging tissues & removing foreign bodies

26
Q

what are the potential complications of nasal biopsies?

A

aspiration, bleeding, trauma to the brain, & non-diagnostic samples

27
Q

how can aspiration be prevented in nasal biopsies?

A

ET tube in place, pharynx packed with gauze, suction & clearing back of throat afterward, & removing the ET tube partially inflated

28
Q

how can bleeding be prevented in nasal biopsies?

A

dilute epinephrine

cold saline infusion or icepack

unilateral carotid artery ligation - very rare

29
Q

what dog breeds are predisposed to aspergillus infections?

A

dolichocephalic dog breeds

30
Q

what is the treatment of choice for aspergillus infections?

A

topical clotrimazole infusion

maybe give oral antifungal treatment in combo with local therapy

31
Q

T/F: aspergillus fumigatus is a normal inhabitant of the nasal cavity

A

true

32
Q

what is a nasopharyngeal polyp?

A

benign growth of inflammatory tissue, fibrous connective tissue, & epithelium

33
Q

what causes nasopharyngeal polyps?

A

cause unknown - infection or congenital is suspected

34
Q

where do nasopharyngeal polyps originate?

A

tympanic bulla, nasopharynx, & auditory tube

35
Q

what animals are typically affected by nasopharyngeal polyps?

A

cats older than 5 years old

36
Q

what are the typical clinical signs associated with nasopharyngeal polyps in cats?

A

stertor, upper airway obstruction

less common - mucopurulent discharge & otitis

37
Q

how are nasopharyngeal polyps diagnosed?

A

signalment, visual exam - deep otoscopic exam & patient under anesthesia in dorsal recumbency

polyp may displace soft palate

38
Q

how are nasopharyngeal polyps treated?

A

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
Q

what are the potential complications of removing a nasopharyngeal polyp?

A

horner’s syndrome & recurrence

40
Q

what are the signs of horner’s syndrome?

A

ptosis, miosis, enophthalmos, & elevation of the 3rd eyelid

41
Q

what are the common signs of idiopathic chronic rhinitis?

A

bilateral mucoid or mucopurulent discharge that can be blood tinged, sneezing, mucosal inflammation, turbinate destruction, & patient is otherwise healthy

42
Q

how is idiopathic chronic rhinitis diagnosed?

A

diagnosis of exclusion

43
Q

how can signs improve in idiopathic chronic rhinitis?

A

humidification, intranasal saline drops, prednisone, NSAIDs not at the same time as steroids, & eliminate environmental irritants

44
Q

how is idiopathic chronic rhinitis cured?

A

it’s not - very frustrating for owners

45
Q

what is the only indication to run a cytology of a nasal swab in cats?

A

when looking for cryptococcus

46
Q

if you think your patient may have a tooth root abscess, what diagnostics should you do?

A

radiograph

47
Q

T/F: with a few exceptions, rhinoscopy isn’t diagnostic unless coupled with CT

A

true

48
Q

what must be known prior to obtaining a nasal biopsy in terms of bleeding status?

A

clotting status

49
Q

what is the caudal limit of where the biopsy instrument can go? why?

A

never deeper than the level of the medial canthus

avoid penetrating the cribiform plate

50
Q

what is the most common complication of nasal biopsies?

A

hemorrhage

51
Q

T/F: bacterial rhinitis occurs secondary to other nasal disorders

A

true

52
Q

when may a deep nasal biopsy be taken for culture?

A

looking for aerobic, anaerobic, & fungal organisms & mycoplasma

53
Q

what clinical signs & response to treatment are suggestive of bacterial rhinitis?

A

mucopurulent nasal discharge that resolves or becomes serous after antibiotics are started

54
Q

what antibiotics may be tried empirically for treatment of bacterial rhinitis?

A

amoxicillin, amoxicillin-clavulanate, doxycycline, trimethoprim-sulfa, or clindamycin

55
Q

how is cryptococcus treated?

A

oral itraconazole or fluconazole for at least 1-2 months beyond the resolution of clinical signs

56
Q

pain on palpation of the face & depigmentation of the nasal planum are highly suggestive of what disease in dogs?

A

nasal aspergillosis

57
Q

how is idiopathic chronic rhinitis characterized?

A

off of predominant population of inflammatory cells present

58
Q

with the exception of polyps, nasal neoplasms in dogs & cats are almost always what?

A

malignant

SA DX & TX I (59 decks)

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