SA Nasal disease

Question 1

What are clinical signs of nasal disease?

Answer 1

*Sneezing
*Snoring or increased respiratory noise
*Nasal discharge
*Epistaxis
*Facial pain

Question 2

What are differential diagnoses for acute nasal disease?

Answer 2

*Nasal foreign body
*Viral URT infection in cats
*Allergic / irritant rhinitis
*Tooth root abscess

Question 3

What are differential diagnoses for chronic nasal disease?

Answer 3

*Unresolved acute disease
*Feline rhinotracheitis
*Neoplasia
*Fungal rhinitis
*Lymphocytic/plasmacytic rhinitis

Question 4

With investigating nasal disease what would you include in your clinical exam?

Answer 4

Inspection of the head
Palpation of the head
Retropulsion of the globe
Assessment of nasal airflow
Oral examination
Mandibular lymph node palpation

Question 5

What tests would you do?

Answer 5

Blood tests
Haematology, biochemistry, clotting profile
Virology
Radiography

Question 6

What should you do to lymph nodes?

Answer 6

*Fine needle aspiration of lymph nodes
*Nasal swabs for bacteriology / cytology
*Exploratory rhinotomy

Question 7

What can cause fungal rhinosinusitis?

Answer 7

Aspergillus fumigatis
Cryptococcus neoformans

Question 8

What are clinical signs of fungal rhinosinusitis?

Answer 8

*Nasal discharge +/- epistaxis
*Facial pain
*Ulceration / depigmentation of nasal
planum
*Dullness and depression

Question 9

How is fungal rhinosinusitis diagnosed?

Answer 9

*History and clinical signs
*Serology (beware false negatives and
rarely positives)
*Diagnostic imaging
*Histopathology

Question 10

What is the treatment of fungal rhinosinusitis?

Answer 10

*Topical antifungals
-Trephination of frontal sinuses and
clotrimazole packing
-Noninvasive clotrimazole soaking
*50% of cases require multiple treatments
*60-80% cure rate

Question 11

What animals does nasal neoplasia affect?

Answer 11

Older medium to large breed dogs

Question 12

What are clinical signs of nasal neoplasia?

Answer 12

*Reduced airflow
*Nasal discharge +/- epistaxisis
*Facial or palate swelling / distortion
*Exopthalmos
*Neurological signs

Question 13

How do you diagnose nasal neoplasia?

Answer 13

*History and clinical signs
*Diagnostic imaging
*Rhinoscopy and biopsy

Question 14

How is nasal neoplasia treated?

Answer 14

*Radiation therapy
-Palliative rather than curative
*Chemotherapy
-Nasal lymphoma

Question 15

How is lymphocytic / plasmacytic rhinitis diagnosed?

Answer 15

*History and clinical signs
*Diagnostic imaging
*Mild loss of turbinate detail
*Increased ST density due to discharge
*Rhinoscopy and biopsy

Question 16

What is the treatment of lymphocytic / plasmacytic rhinitis?

Answer 16

*Environmental modification
-Cleaning and ventilation
-Humidification
*Saline instillation / intermittent nasal
-flushes
*Anti-inflammatories
*Antibacterials
*Mucolytics
*Allergen testing / elimination

Question 17

What are clinical signs of nasal foreign bodies?

Answer 17

*Sudden onset of signs
*Paroxysmal sneezing
*Facial discomfort / pawing
*Eventually purulent nasal discharge

Question 18

How are nasal foreign bodies diagnosed?

Answer 18

*History and clinical signs
*Rhinoscopy
*Diagnostic imaging
*Exploratory rhinotomy

Question 19

How are nasal foreign bodies treated?

Answer 19

*Nasal flushing
*Endoscopic retrieval
*Rostral retraction of soft palate and forceps retrieval
*Rhinotomy

Question 20

How can dental disease lead to nasal disease?

Answer 20

*Abscess rupture into nasal cavity
*Usually in older patients
*Extract affected teeth + treat w antibacterials

Question 21

What are other causes of nasal discharge?

Answer 21

*Cleft palate
*Ciliary dyskinesia
*Parasites
*Dysphagia and nasopharyngeal reflux

Question 22

What is the problem of rhinotomy?

Answer 22

Significant risk of life-threatening haemorrhage