nasal disease of cats and dogs Flashcards
Nasopharyngeal polyp: tx
Removal through mouth or external ear canal with avulsion/traction
Nasopharyngeal polyp: px
Good
Can recur in up to 1/3 of cases
Higher rate with bulla involvement
Ventral bulla osteotomy is more invasive
Contra lateral polyp occurs
nasal FB
Uncommon
Plant awns, grass, small sticks, etc
Nasal FB: Clin sxs
Acute onset of sneezing, after rooting in soil or playing in field
Sneezing is persistent and paroxysmal
Pawing at nose, possible epistaxis
Symptoms lessen as FB object migrates caudally
Chronicity leads to nasal d/c and sneezing
nasal fb: dx & tx
Immediate rhinoscopy, small biopsy instruments can grasp and remove the material
Aggressive nasal flush may remove object that cannot be visualized
Advanced imaging- do at a later date if rhinoscopy comes up negative but symptoms persist
Surgical rhinotomy is rare
lymphoplasmacytic rhinitis: causes
Idiopathic, possibly immune mediated
inhaled allergens or irritant
chronic in nature
Lymphoplasmacytic rhinitis: clin sxs
Chronic nasal discharge, either unilateral or bilateral- typically mucoid or mucopurulent
Coughing
less common: reverse sneezing, stertor, ocular dc
lymphoplasmacytic rhinitis: dx
Exclude other causes of inflammation
Advanced imaging is recommended: fluid accumulation, soft tissue opacification, turbinate destruction, less commonly frontal sinus involvement, changes bilateral despite unilateral symptoms
rhinoscopy: nasal d/c, red/inflamed/edematous mucosa, turbinate atrophy/destruction
biopsy: lymphoplasmacytic infl
Lymphoplasmacytic rhinitis: tx
Glucocorticoids-systemic or topical
Other immune modulating medications
Antihistamines
Abx- doxy
NSAIDs
allergic rhinitis
Uncommonly dx
Type 1 hypersensitivity
clinical signs may be seasonal
Allergic rhinitis dx
bx will show eos
allergic rhinitis: tx
Avoid environmental allergens, antihistamines, steroids initially
Good response to tx
nasal aspergillosis
Ubiquitous soil saprophyte
Endogenous flora in nasal cavity?
Inf may occur following inhalation of a large number of fungal spores
Toxins and metabolites decreased mucociliary and phagocytic function
Dz spreads throughout the nasal cavity and often into frontal sinuses
Rarely disseminates-except German shepherds
aspergillosis: signalment, hx and sxs
Young to middle age dogs
Rare in cats
Unilateral nasal dc-progress to bilateral, starts as mucopurulent to hemorrhagic
Sneezing, epistaxis
Pawing at noses
Ulceration and depigmention of nasal planum
Facial deformity in advanced cases
Lethargy and anorexia
aspergillosis: dx
Suspect based on signalment, hx, clinical signs
ID of fungal plaques or fungal organisms
Advanced imaging (high sens & spec)-Frontal sinus involvement?
rhinoscopy: turbinate atrophy, fungal plaques
aspergillosis: tx oral antifungals
Req prolonged administration
Oral fungicide not good success rate
Newer antifungals (voriconazole, posoconazole)-very expensive
Used for patients with cribiform plate destruction
Adjunctive therapy
nasopharyngeal polyp definition
benign tumor composed of granulation tissue
covered with respiratory epithelial layer
surface may be ulcerated
nasopharyngeal polyp: signalment
kitten and young adult cats
very rare in dogs
median onset: 3 mo to 6.1 years
range: 3 mo to 18 years
nasopharyngeal polyp: cause
not known
may be congenital defect of 1st pharygneal pouch
may be due to chronic inflammation of middle ear
nasopharyngeal polyp: location
usually originates in the middle ear and extends down a stalk to eustachian tube to reach the nasopharynx
extension through tympanic membrane into external ear canal may occur
nasopharyngeal polyp: clin sxs
loud, stertorous breathing
sneezing
serous to mucopurulent nasal d/c
otitis externa or otitis media may develop-Horner’s syndrome, facial nerve paralysis
nasopharyngeal polyp: dx
ID to tumor: oral or otoscopic exam
rads
CT scan or MRI-preferred (bulla involvement?)
caudal rhinoscopy
lymphoplasmacytic rhinitis: signalment
middle age to older dogs (mean 8)
german shepherds and dachshund
aspergillosis: cyto/histopath
direct endoscopic guidance is best
mucosal brush or impression smears
bx of plaque and adjacent mucosa
surrounding infl
aspergillosis: culture
fungal culture of plaque
results takes 1-2 weeks
high spec
not always performed
aspergillosis: serology
AGID
poor sens, good spec
rule in if pos, cannot rule out if neg
aspergillosis: debridement of plaques
destroy all plaques! Destroy all plaques!
frontal sinus: trephination and curettage or open surgical debridement
aspergillosis: tx
topical treatment
clotrimazole-infused slowly as 1% solution
destroy fungal plaques-then treatment with med
