Treatments Of Nasal Disease Flashcards
How can you treat nasal aspergillosis?
Iatramazole - oral antifungal - expensive for 3-6m
Topical antifungal - administered during flush
Non-surgical flush
1h surgical flush and trephining
10-14 days of flushing via catheters
How should you treat nasal tumours?
Palliative
Antibiotics for secondary infection
NSAIDS and pain management
RT
Chemo - feline nasal lymphoma
How can you treat non-infectious inflammatory rhinitis?
Chronic serous/ mucopurulent nasal discharge
With no other illness
Though to be associated with food allergy
Remove allergen - hypoallergenic diet
Antibiotic - amoxicillin
Mucolytics - Bromhexine, bisolvon
Prednisolone
How can you treat a nasal foreign body?
Acute onset sneezing and facial irritation - progressing to mucopurulent discharge
Nasal flush
Rhinoscopic removal - look around the back of the soft palate
Rhinotomy
How should yo treat a nasal polyp in a cat?
Surgical removal
Good prognosis
What are the components of BOAS?
Overlong soft palate
Stenotic nares
Tracheal hypoplasia
Laryngeal hypoplasia
Ever sign of the laryngeal saccules
Tracheal collapse
Tonisillar enlargement
Laryngeal collapse
(also prone to regurgitation, oesophagitis and hiatal hernia)
How should you treat a boas attack?
Hyperthermia, tachypnoea, collapse, cyanosis?
Oxygen Keep cool ACP + Butorphanol sedation Dexamethasone IV Anaesthetise and intubate
How can you diagnose boas?
Breed
Examine airways under ga - stenotic nares, everted laryngeal saccules, overlong soft palate
Radiography
Lateral view of the pharynx - little air in pharynx, soft palate overlying pharynx, overlong soft palate
Lateral thorax - hypoplastic trachea
Endoscopy
What component of BOAS is commonly seen in the CKCS?
Eosinophillic stomatitis and tonsillitis
Middle aged, present with stertor and stridor
How can you treat boas?
Surgery in early life Shorten soft palate Remove everted laryngeal saccules Nasoplasty Tonsillectomy Permanent tracheostomy if hypoplastic trachea
What is the presentation of laryngeal paralysis in the dog and how can you treat it?
Idiopathic - Labrador
Congenital - Dalmatian
CP - bilateral paralysis - syncope, cyanosis, exercise intolerance
Dx- exam under v light GA, radiographs to rule out retropharyngeal lymphadenopathy, thymoma and bloods to rule out hypothyroidism / Cushings
Tx: laryngeal tie back or permanent tracheostomy
How can you temporarily relieve upper airways obstruction?
Tracheotomy
- incision into the trachea
- a tracheotomy tube can be used in the short term
What is it called when there is a permanent stoma made in the trachea?
Tracheostomy
- permanent stoma made in the trachea
- indicated in URT airway obstruction that can’t be resolved
How can you treat / manage tracheal stenosis?
Weight loss Exercise on a harness Treat lower airway disease - antibiotics, NSAIDs, bronchodilators, cough suppressants Intra-luminal or extra-luminal stenting
What commonly causes tracheal tears and how can you treat them?
Cervical tears - bite, choke chain, et tube cuff
Thoracic tears - avulsion in cats
Treatment - allow to heal if small or surgical repair
How can you treat tracheal stenosis?
Tracheal resection
- no more than 5-6 rings
When is a lung lobectomy indicated?
Lung lobe torsion
Lung abscessation / solitary neoplasia / bullae
Severe lung trauma
Bronchoesophageal fistula
List common common injuries to the thorax.
Pneumothorax Lung contusions Rib fractures Haemothorax Pneumomediastinum Diaphragmatic rupture Airway obstruction Shock
What can you do to help you diagnose pathology in the thorax?
Thorax radiography
Therapeutic and diagnostic thoracocentesis
What can you do to manage a recurrent pleural effusion / pneumothorax?
Tube thoracostomy
How should you treat a rib fracture?
Suspect pulmonary contusions
Analgesia, rest and oxygen supplementation
If very displaced it requires internal fixation - high risk of pulmonary contusion
What is a flail chest and how should it be treated?
Complete fracture of the rib in two places, so that the rib moves independently to the rest of the thorax
- paradoxical movement compromises ventilation
- surgical stabilisation required
How does diaphragmatic hernia present and how must it be treated?
Acute - traumatic
Chronic - hiatal hernia or PPDH
Diagnosis - respiratory compromise, GI signs and abdominal content in thorax on radiograph
Tx- surgical repair
