Respiratory 1

Question 1

what are common signs of nasal disease?

Answer 1

nasal discharge, sneezing, stertor sometimes

others less common: pawing at muzzle, facial deformity, CNS signs

Question 2

true or false, reverse sneezing is pathologic

Answer 2

false!

Question 3

you see a dog named Nick who has some nasal discharge. you are a smart doctor so youre thinking about all the places the discharge could be coming from which are…

Answer 3

the nasal cavity, the frontal sinuses, the nasopharynx, the oral cavity (fistula), vomiting or regurg, systemic disease like hemostatic defects

Question 4

tumors most commonly have a history of ____ discharge that may progress to ______ with chronicity

Answer 4

unilateral, bilateral

Question 5

a thorough oral examination requires

Answer 5

anesthesia

Question 6

you are doing a detailed oral examination of a dog and you notice the ocular retropulsion on the left eye is decreased. what does this mean?

Answer 6

could be indicative of neoplasia, an abscess, or fungal disease

Question 7

there are a lot of diagnostics you can do for nasal disease, but what are the 3 gold standard ones needed, especially for chronic cases?

Answer 7

CT, rhinoscopy, and biopsy

Question 8

true or false: primary bacterial rhinitis is uncommon in cats and dogs

Answer 8

true! there are likely other diseases happening if you see mucopurulent nasal discharge. if it is a bacterial pathogen, this is more common in cats compared to dogs

Question 9

a german shepherd named Terry presents to you with unilateral muco-hemorrhagic nasal discharge and has also been sneezing lately. this is what the inside of the nose looks like. what is this? what diagnostics should you perform for this dog?

Answer 9

canine sinonasal aspergillosis caused by aspergillus fumigatus

CT or rads to check for bony destruction or possible invasion of the cribiform plate, could do serology but its not good as screening test. diagnosis is made via rhinoscopy, and then a biopsy of the fungal plaques: cytology and histopath

Question 10

why do dogs with canine sinonasal aspergillosis sometimes present with nasal depigmentation in chronic cases?

Answer 10

the fungal toxin causes depigmentation

Question 11

How will you treat terry with the canine sinonasal aspergillosis?

Answer 11

debridement, topical antifungals in the nasal cavity and sinuses (flush or cream), often need multiple treatments

Question 12

what are the two classifications of canine inflammatory rhinitis?

Answer 12

eosinophilic and lymphoplasmacytic

Question 13

a dog named Rufus comes to you because he has been sneezing, and has bilateral mucoid nasal discharge with no other signs of systemic illness. differential? what diagnostics would you like to perform?

Answer 13

canine inflammatory rhinitis

CT, rhinoscopy, biopsy

Question 14

what is one important thing to remember about canine inflammatory rhinitis

Answer 14

you need to rule out other treatable diseases such as neoplasia, fungal disease, FBs, or dental disease

Question 15

for Rufus, you have ruled out all other diseases that could cause inflammation and you decide he has canine inflammatory rhinitis. While you wait for the biopsy to come back, you start thinking of treatment for him. what treatments are available (for both lymphoplasmacytic and eosinophilic/allergic)?

Answer 15

lymphoplasmacytic: air humidification, steroids or immunosuppressions, address any dental disease, allergy testing, NO NSAIDs

eosinophilic: air humidifcation, steroids, ahtihistamines, allergy testing, and JUST IN CASE give them anti parasitics

Question 16

what is the species of mite that infects nasal passages of dogs? what are clinical signs of this?

Answer 16

pneumonyssoides caninum

sneezing, mild serous nasal discharge

Question 17

how do you treat canine nasal mites?

Answer 17

milbemycin oxime
ivermectin
selamectin

Question 18

you see a mastiff dog with an ACUTE onset of sneezing and pawing at the face, with a little bit of unilateral epitstaxis. differential?

Answer 18

a nasal foreign body

Question 19

true or false, FURD is not a diagnosis

Answer 19

true, it is an umbrella term: feline upper respiratory disease, which can have many causes such as infectious, neoplastic, inflammatory

Question 20

clinical signs of FURD

Answer 20

ocular or nasal discharge, epistaxis, sneezing, conjunctivitis

Question 21

what are the primary agents involved in URI in cats

Answer 21

upper respiratory infection

calicivirus, herpesvirus 1, mycoplasma, bordetella bronchoiseptica, chlamydophila felis, strep sp, usually multiple pathogens involved at one time

Question 22

what factor increases the incidence of URI in cats the most?

Answer 22

the number of cats! more cats/multiple cat environments=more disease

Question 23

a cat comes to see you with acute depression, a fever, oral ulceration, hypersalivation, and some mild sneezing. top differential?

Answer 23

feline calicivirus

Question 24

a cat comes to see you with sneezing, seros ocular and nasal discharge, anorexia, fever, and has conjunctivitis as well. top differential?

Answer 24

feline herpesvirus 1

Question 25

briefly describe the clinical signs associated with:
chlamydophila
mycoplasma
bordetella bronchiseptica

in cats with nasal disease

Answer 25

chalmydophila: usually just conjunctivitis
mycoplasma: conjunctivitis and other upper resp infections
bordetella: if primary, nasal discharge and pneumonia. if secondary it is mostly a predisposing factor to other infections

Question 26

with nasal disease in small animals, further diagnostics are not often done and culture and PCR are not that useful due to the nose having lots of other contaminants. when would you consider obtaining a definitive diagnosis?

Answer 26

cases with unusual or severe clinical signs
monitoring hospital changes
legal issues
detecting carriers of disease

Question 27

cats with FURD or URI, what is the appropriate treatment?

Answer 27

usually self limiting and just need supportive care. can do nebulization, probiotics, stress relief management, antivirals, lysine, appetite stimulants, clean the nasal secretions, fluids, etc.

Question 28

are antibiotics often used for FURD or URI?

Answer 28

most of the time they are not indicated, but can use them if C/S last more than 10 days, or if there is fever, lethargy, mucopurulent discharge that is severe

Question 29

what antibiotic is a good first choice for nasal disease in cats (if indicated)?

Answer 29

doxycyline

Question 30

what is the cause of feline chronic rhinosinusitis?

Answer 30

chronic means more than 1 month

viral most commonly: FHV1, epithelial/tubinate damage
bacterial infections: can happen due to viral dz
immune is posible

Question 31

what are some expected clinical signs of feline chronic rhinosinusitis?

Answer 31

sneezing, stertor (super congested), nasal discharge, otherwise healthy

Question 32

canine inflammatory rhinitis is a diagnosis of exclusion. what is the nasal disease in cats that is also a diagnosis of exclusion?

Answer 32

feline chronic rhino sinusitis

Question 33

list some possible treatments for feline chronic rhinosinusitis

Answer 33

antibiotics, humidifcation of air, lysine, antivirals, probiotics, nasal flushing, dental disease treatments, could consider nasal vaccine or steroids. you cannot cure this, only control it.

Question 34

what feline nasal disease is spread by pigeons? what are some clinical signs?

Answer 34

feline nasal cryptococcus (neoformans and gatti)

upper resp tract signs, granulomatous lesions on nasal bones or extending from nasal cavity, can be neurological, can also cause systemic and ocular disease

Question 35

if you suspect a cat has nasal cryptococcus, how do you diagnose this?

Answer 35

LCAT: latex capsular agglutination test, run it on serum or CSF, the result is a titre

can also do cytology if you want

Question 36

treatment of a cat with nasal cryptococcus?

Answer 36

oral or injectable antifungals like fluconazole or itraconazole
theraputic monitoring of titres using LCAT test

prognosis good if no neurologic involvement

Question 37

a 10 yo white haired cat named Snowy comes to you because the owner says theyve noticed a “weird” change in Snowy’s nose. It looks like the nasal phalanum if affected, and it looks red. differential? what diagnostics would you like to do and what will you tell the owner?

Answer 37

squamous cell carcinoma.
these are usually slow to metastasize

could do a biopsy but it might just cause inflammation. Snowy needs surgery and/or a referral to an oncologist (radiation commonly used)

Question 38

which diseases fall under the “unilateral discharge” column and which fall under “bilateral”?

Answer 38

unilateral: FB, tooth root abscess, neoplasia, inflammatory, fungal

bilateral: inflammatory, infectious, fungal, systemic, progressive neoplasia