Lecture 11 Flashcards
What are some common nasal diseases?
Feline URTD Nasal tumors Nasopharyngeal polyps Foreign bodies Fungal disease Rhinitis Tooth root abscess Nasal pharyngeal obstruction Nasal parasites
What signs localize disease to nose/nasopharynx
Stertor
Nasal discharge
Sneezing
Open mouth breathing
What are viral causes of feline URTD
Feline herpes virus (most common)
Feline calicivirus (most common)
Influenza (rare)
What are bacterial causes of feline URTD
Chlamydia felis (common)
Bordatella bronchiseptica
Mycoplasma
Streptococcus (canis or zooepidemicus)
How is feline URTD spread
Close contact- actively infected, carrier cats, contaminated fomites
Will see in multicat environments
Which is more common form of feline URTD- acute or chronic
Acute
What classic sign will you see with FHV-1
Corneal ulceration, abortion, neonatal death
What classic signs will you see with FCV
Oral ulceration, pneumonia, polyarthritis
What classic sign will you see with chlamydophila
Conjunctivitis, chemosis, nasal discharge, sneezing
What signs will you see of chronic feline URTD
Most are asymptomatic
May see secondary bacterial infections due to irreversible damage done to mucus
What signs will you with mycoplasma
Conjunctivitis
What signs will you with bordetella in cats
Coughing, tachypnea, cyanosis
How to diagnosis feline URTD
If clinical signs and history point you in this direction…then do PCR
What do you have to have for a postive PCR
Have to have a live active infection
If it’s latent, PCR will always be negative
What if a cat has been vaccinated or immunized against URTD?
Doesn’t rule it out!
How to treat acute feline URTD
What is contraindicated?
Most cases are self limiting
Need to make sure the cat keeps eating or starts eating again
Give fluids
Isolation
Nebulizer
Antibiotics in severe cases of secondary infection
Corticosteroids are contraindicated
How to treat chronic feline URTD
Similar to acute therapy
No cure, so just supportive care
Can do turbinectomy and frontal sinus ablation as a salvage procedure
Why should you not use corticosteroid in chronic feline URTD
Increase viral shedding
Worsen secondary infections
Mask underlying diseases
How to prevent feline URTD
Vaccinate individual cats and avoid exposure with other cats
Isolate new cats coming into the household for a few weeks
Describe nasal tumors
Locally aggressive
Distal metastasis is uncommon, but should still check
Uncommon in cats
What type of nasal tumors happen dogs?
Cats?
Most are malignant.
Will see carcinoma and sarcoma in dogs
Will see lymphoma, adenocarcinoma, and sarcoma in cats
Who is most at risk for nasal tumors
Middle aged to older dogs and cats
Dolichocephalic and mesencephalic are at increased risks
Increased risk in male cats compared to females
How to diagnose nasal tumors
History and physical exam Blood pressure Coag profile Airflow detection Imaging- CT is gold standard Rhinoscopy and biopsy
How to treat nasal tumors
Limited treatment options- not responsive to chemo unless lymphoma
Surgical excision if benign
Radiation therapy
Can also give analgesics, NSAIDs, and antibiotics
What are nasopharyngeal polyps? Who do they infect?
Common benign pedunculated growth (can be progressive and chronic)
Kittens and young cats
What are polyps composed of
Inflammatory tissue, fibrous connective tissue, and epithelium
How to treat polyps
Surgical excision- need to get all the tissue or else will see recurrence
What causes fungal rhinitis in the dog?
Cat?
Aspergillus in dog
Cryptcoccus in cat
How do cats get cryptococcosis
Bird poop or decaying eucalyptus trees
What signs will you see with cryptococcosis in cats?
Naso-facial swelling followed by nonhealing ulceration Nasal discharge Stertor Inspiratory dyspnea Sneezing and snufflinf Submandibular lymphadenopathy
How to diagnose cryptcoccosis
Can diagnose on cytology alone
Also a blood antigen test (how you know to continue treating)
How to treat cryptococcosis
Fluconazole or itraconazole until antigen negative + 2 additional months
Sometimes do surgery if have a big nodule
What is nasal aspergillosis
Opportunistic fungal infection in mesocephalic and dolichocephalic breed less than 7 years old
What are clinical signs of aspergillus
Chronic mucopurulent nasal discharge Nasal pain Nasal ulceration/depigmentation Sneezing Epistaxis
How to treat aspergillus
Challenging to treat
Topical antifungal- multiple treatments with clotrimazole
What is rhinitis
Causes chronic nasal disease but no evidence of any other etiologic process
Unknown etiology
What is lymphoplasmacytic rhinitis?
Affects dogs and cats
Will see chronic nasal disease signs
Diagnoses when can’t find anything else
Caused by inhaled irritants/particulate matter, unknown infection, or possible autoimmune process
What is allergic rhinitis
Uncommon manifestation of allergy
Will see lots of eosinophils
Another case of diagnoses of exclusion (nothing else fits)
Bacterial rhinitis
Usually a secondary disease EXCEPT bordetella, mycoplasma, chlamydia (can cause primary disease)
Nasal foreign bodies- when to suspect?
How to diagnose?
How to treat?
Sudden onset of sneezing and nasal discharge, pawing at the nose
Diagnose with imaging
Remove foreign body and flush nasal passage
Tooth root abscesses- what is it?
Clinical signs?
Diagnoses?
Chronic rhinosinusitis with concurrent visible dental disease
Will see nasal discharge and/or hemorrhage
Full oral exam, probe teeth, imaging
What is nasopharyngeal obstruction
Pathologic narrowing within nasopharynx
Clinical signs of nasopharyngeal obstruction
Resolving stertor with open mouth breathing
Chronic nasal discharge
Gagging
How to treat nasopharyngeal obstruction
Stretch affected tissue
Insert a stint
What causes nasopharyngeal obstruction
Congenital disease
Secondary to: Chronic rhinitis Aspiration rhinitis (most common) Surgical manipulation Trauma Tumor Polyp
What three agents cause nasal parasites
Mite- pneumonyssoides caninum
Nematode- capillaria boehmi
Warbles- cuterebra
How to diagnose nasal parasites
P. Caninum: visualize on rhinoscopy
C. Boehmi: fecal flotation, rhinoscopy
Cuterebra: visualize
How to treat nasal parasites
P. Caninum: ivermectin, milbemycin oxime
C. Boehmi: ivermectin, fenbendazole
Cuterebra: manual removal
