Respiratory - Nasopharyngeal Diseases + Rhinitis Flashcards
Embryologically, the lumen of the ______ is an extension of the pharynx.
middle ear
Where does olfaction occur? A) nasal entrance B) meatus nasopharynges C) olfactory chamber D) nasopharynx
C - olfactory chamber
What is a polyp
fibromuscular connective tissue arising from mucosal lining of nasopharynx, auditory tube, or middle ear
more common in cats than dogs
Sneezing
expiratory, usually associated with nasal or sinus disease
Reverse sneezing
inspiratory, usually associated with nasopharyngeal, caudal nasal, or sinus disease
Treatment of polyps
traction avulsion + corticosteroids
ventral bulla osteotomy if bulla involvement
Foreign body
onset of clinical signs may be acute
Diagnosed by direct visualization, endoscopy or CT
Treated - dislodge and extract
Nasopharyngeal stenosis
causes: regurgitation (esp under anesthesia), chronic inflammation, post surgical scarring, trauma, congenital anomaly, mass
diagnosed by endoscopy or CT
treated by balloon dilation
Most common causes of feline fungal rhinitis
cryptococcus
also aspergillus, rhinosporidium
Clinical signs of feline fungal rhinitis
sneezing and nasal discharge
polypoid masses in nares, ulcers and nodules on planet or bridge
decreased or absent nasal airflow, exophthalmos, facial asymmetry, starter, mass/ulcer in pterygopalatine fossa
enlarged lymph nodes, neuro signs
Diagnosis of feline fungal rhinitis
cytology and culture of nasal discharge
serology
CT
thoracic rads
rhinos copy with biopsy - PCR to differentiate Aspergillus spp.
dental probing + dental rads to rule out a dental cause of rhinitis
Treatment of feline fungal rhinitis caused by cryptococcus
oral fluconazole until antigen latex agglutination test is 0, recheck 1m after, then lifelong monitoring because relapse is common
debunk granulomas if obstruction is severe
Treatment of feline fungal rhinitis caused by Aspergillus
oral posaconazol or itraconazole
if disease confined to nasal cavity, also topical treatment and decried plaques
Cause of chronic rhinosinusitis in cats?
unknown
Which is FALSE regarding diagnosing chronic rhinosinusitis in cats?
A) CRS is a diagnosis of exclusion
B) bacterial culture is a must
C) laryngoscopy, rhinos copy, and biopsy of other tissues is useful to rule out other causes
D) dental probing to rule out tooth root abscess
B - bacterial culture is controversial
Treatment of CRS
- antibiotic - based on deep culture or Hx (doxy)
- anti-inflammatory - NSAID (meloxicam or piroxicam), or glucocorticoid (red)
also antiviral - lysine to reduce FHV-1, femciclovir
adjunct tx for nasal discharge (nasal flush, humidification, N-acetylcysteine)
Feline Neoplasia
CS - upper airway obstruction, decreased nasal airflow, epistaxis, sneezing, ocular and CNS signs
lymphoma, adenocarcinoma, SCC, undifferentiated carcinoma, fibrosarcoma
causes of fungal rhinosinusitis in dogs
most common - aspergillus fumigatus
also - penicillium, rhinosporidium seeberi, cryptococcus neoforms (rare)
Clinical signs of nasal aspergillosis in dogs
nasal discharge, sneezing, may see epistaxis, facial pain, depigmentation, ulceration may be present
Which is FALSE regarding the treatment of nasal aspergillosis in dogs?
A) negative serology rules out aspergillosis
B) see significant destruction of turbinates and cavitation on a CT
C) rhinoscopy to visualize and debride fungal plaques
D) see branching hyphae with cytology
A - negative serology doesn’t rule out aspergillosis
Treatment of nasal aspergillosis in dogs
topical infusion if cribriform plate is intact of clotrimzole or enilconazole, oral antifungal added if local bone or soft tissue invaded
oral anti fungal if cribriform plate is not intact - itraconazole or terbinafine for 3-6m
Causes of idiopathic lymphoplasmacytic rhinitis (ILPR)
aberrant immune response
inhaled allergens and irritants
hypersensitivity to native organisms
Signalment of animals that get ILPR
young to middle aged dolichocephalic and mesaticephalic large breeds and dachshunds
Clinical signs of ILPR
nasal discharge, mucoid or mucupurulent, epistaxis possible
excessive mucus or edema may obstruct airflow
Which is FALSE regarding ILPR diagnosis?
A) it is a diagnosis of exclusion
B) history: see lymphoplasmacytic infiltrate
C)CT scan is normal
D) rhinos copy - erythema and edema of mucosa
C - can be normal but can show turbinate lysis and mucus accumulation
Treatment of ILPR?
avoid smoke and other allergens
long term antibiotic with immunmodulatory effects + NSAID - doxy or azithromycin + piroxicam
Canine neoplasia
1/3 of chronic nasal disease in dogs
CS: upper airway obstruction, decreased nasal airflow, epistaxis, sneezing
adenocarcinoma, lymphoma, undifferentiated carcinoma
Ddx for nasal discharge and sneezing
advanced dental disease - rot abscess and/or oronasal fistula
nasal foreign body
nasal regurgitation
