Upper Respiratory Tract: Small Animals Discharge Flashcards
what is acute nasal discharge
< 3 weeks
what is chronic nasal discharge
>3 weeks
what is epistaxis
bleeding from the nose
what is rhinoscopy
video-endoscopy of nasal cavity
what considerations should be taken with history (7)
- duration and progression of signs
- unilateral or bilateral
- nature of discharge
- sneezing or coughing
- head shyness or reluctance to eat
- history of dental disease, trauma
- infectious etiology
what does the nature of the discharge tell you
blood, pus or serous
blood indicates aggressive disease and very significant finding
what does sneezing indicate
irritation
what does head shyness indicate
evidence of facial pain
indicates destructive painful processes such as neoplasia or fungal disease
what should you assess on clinical exam (6)
- facial asymmetry or focal swelling
- facial pain
- nasal airflow
- character or depigmentation of the rhinarium
- intraoral exam: dental disease, holes, masses
- ocular ulceration, oral ulceration (cat flu)
what radiographic view is used to assess the nasal sinus
dorsal ventral intral oral view
what do you assess on radiograph in the sinuses (4)
- symmetry
- turbinates
- air
- vomer bone
what does a rhinoscopy evaluate
- nasal meatuses
- nasopharynx
what can acute nasal discharge be due to
acute rhinitis
often self limiting and low grade
what are the signs of rhinitis (3)
- bilateral nasal discharge
- serous
- sneezing
what are the triggering factors of acute rhinitis
- inhaled allergens
- foreign body
how is acute rhinitis treated
- antihistamines
- steroids
- mucolytics (bromohexine)
treat symptomatically
don’t use antibiotics in dogs
antibiotics in cat flu: secondary bacterial infection
what are the causes of chronic rhinitis in dogs (4)
- fungal disease
- neoplasia (including nasal polyp)
- chronic trigger fractors: chronic foreign body
- lymphocytic/plasmacytic rhinitis
what fungal diseases cause chronic rhinitis in dogs
sino-nasal aspergillosis
what are the causes of chronic rhinitis in cats (3)
- neoplasia (including polyps)
- chronic trigger factors (foreign body)
- lymphocytic/plasmacytic rhinitis
what causes sino-nasal aspergillosis
aspergillosis fumigatus
common airway commensal fungus
what does sino-nasal aspergillosis cause
bone destruction
turbinate destruction
severe cases maxilla, orbit, cribriform plate
what are the signs of sino-nasal aspergillosis (8)
chronic, progressive signs
- unilateral or bilateral discharge
- epistaxis
- sneezing
- head shyness
- +/- rhinarial depigmentation
- +/- reduce nasal airflow (fungal granulomas blocking cavity)
- +/- sinus tracts
- +/- periocular swelling
how is sino-nasal aspergillosis diagnosed (6)
- imaging
- rhinoscopy
- biopsy plaques
- fungal culture
- biopsy turbinates
- nasal flush looking for large numbers of fungal elements
what can be seen on radiography in sino nasal aspergillosis
destruction of turbinates
why is culture of sino nasal aspergillosis of no use
aspergillosis is a normal commensal organisms
how is diagnosis of sino nasal aspergillosis reached
characteristic destructive rhinitis with severe signs and demonstration of fungal plaques or elementrs on histopathology
what are the treatment options for sino nasal aspergillosis (2)
- anti-fungal agents: enilconazole; clotrimazole
topically: nasal instillation + trephination of frontal sinuses
systemically: systemic side effects - supportive therapy: feeding tube, analgesia
why is the prognosis guarded with sino nasal aspergillosis
recurrence common
expensive
severe clinical signs
protracted treatment required
what are the nasal neoplasia
- lymphoma
- adenocarcinoma
- nasal polyp (common in cats, rare in dogs)
what are the clinical signs that are highly suggestive of nasal neoplasia
- obstruction of airflow
- facial pain
- facial deformatiy
- +/- sinus tracts
what are the non-specific signs of nasal neoplasia (5)
- discharge: purulent or hemorrhagic, unilateral or bilateral
- +/- sneezing
- +/- coughing
- lymph node enlargement
- cachexia
what are the signs of nasal foreign body
- unilateral discharge
- sneezing
- +/- epistaxis
- +/- facial pain
what are the chronic signs of nasal foreign body
mucopurulent nasal discharge
what are treatments of nasal foreign body
- retrieval from nasopharynx
- rhinoscopic retrieval
- flushing nasal cavity
- surgery
how is lymphocytic plasmacytic rhinitis diagnosed (4)
chronic nasal discharge
diagnosis by exclusion
- non-hemorrhagic, bilateral nasal discharge
- no rhinarial ulceration
- no facial deformity
- no facial pain
how is lymphocytic/plasmacytic rhinitis treated
antimicrobial therapy
corticosteroids
what is the prognosis of lymphocytic/plasmacytic rhinitis
prognosis for resolution of signs poor
prognosis for survival is good
what are oronasal fistulas caused by
- dental disease
- oral neoplasia
- cleft palate
