Upper Respiratory Tract: Small Animals Discharge

Question 1

what is acute nasal discharge

Answer 1

< 3 weeks

Question 2

what is chronic nasal discharge

Answer 2

>3 weeks

Question 3

what is epistaxis

Answer 3

bleeding from the nose

Question 4

what is rhinoscopy

Answer 4

video-endoscopy of nasal cavity

Question 5

what considerations should be taken with history (7)

Answer 5

1. duration and progression of signs
2. unilateral or bilateral
3. nature of discharge
4. sneezing or coughing
5. head shyness or reluctance to eat
6. history of dental disease, trauma
7. infectious etiology

Question 6

what does the nature of the discharge tell you

Answer 6

blood, pus or serous

blood indicates aggressive disease and very significant finding

Question 7

what does sneezing indicate

Answer 7

irritation

Question 8

what does head shyness indicate

Answer 8

evidence of facial pain

indicates destructive painful processes such as neoplasia or fungal disease

Question 9

what should you assess on clinical exam (6)

Answer 9

1. facial asymmetry or focal swelling
2. facial pain
3. nasal airflow
4. character or depigmentation of the rhinarium
5. intraoral exam: dental disease, holes, masses
6. ocular ulceration, oral ulceration (cat flu)

Question 10

what radiographic view is used to assess the nasal sinus

Answer 10

dorsal ventral intral oral view

Question 11

what do you assess on radiograph in the sinuses (4)

Answer 11

1. symmetry
2. turbinates
3. air
4. vomer bone

Question 12

what does a rhinoscopy evaluate

Answer 12

1. nasal meatuses
2. nasopharynx

Question 13

what can acute nasal discharge be due to

Answer 13

acute rhinitis

often self limiting and low grade

Question 14

what are the signs of rhinitis (3)

Answer 14

1. bilateral nasal discharge
2. serous
3. sneezing

Question 15

what are the triggering factors of acute rhinitis

Answer 15

1. inhaled allergens
2. foreign body

Question 16

how is acute rhinitis treated

Answer 16

1. antihistamines
2. steroids
3. mucolytics (bromohexine)

treat symptomatically

don’t use antibiotics in dogs

antibiotics in cat flu: secondary bacterial infection

Question 17

what are the causes of chronic rhinitis in dogs (4)

Answer 17

1. fungal disease
2. neoplasia (including nasal polyp)
3. chronic trigger fractors: chronic foreign body
4. lymphocytic/plasmacytic rhinitis

Question 18

what fungal diseases cause chronic rhinitis in dogs

Answer 18

sino-nasal aspergillosis

Question 19

what are the causes of chronic rhinitis in cats (3)

Answer 19

1. neoplasia (including polyps)
2. chronic trigger factors (foreign body)
3. lymphocytic/plasmacytic rhinitis

Question 20

what causes sino-nasal aspergillosis

Answer 20

aspergillosis fumigatus

common airway commensal fungus

Question 21

what does sino-nasal aspergillosis cause

Answer 21

bone destruction

turbinate destruction

severe cases maxilla, orbit, cribriform plate

Question 22

what are the signs of sino-nasal aspergillosis (8)

Answer 22

chronic, progressive signs

1. unilateral or bilateral discharge
2. epistaxis
3. sneezing
4. head shyness
5. +/- rhinarial depigmentation
6. +/- reduce nasal airflow (fungal granulomas blocking cavity)
7. +/- sinus tracts
8. +/- periocular swelling

Question 23

how is sino-nasal aspergillosis diagnosed (6)

Answer 23

1. imaging
2. rhinoscopy
3. biopsy plaques
4. fungal culture
5. biopsy turbinates
6. nasal flush looking for large numbers of fungal elements

Question 24

what can be seen on radiography in sino nasal aspergillosis

Answer 24

destruction of turbinates

Question 25

why is culture of sino nasal aspergillosis of no use

Answer 25

aspergillosis is a normal commensal organisms

Question 26

how is diagnosis of sino nasal aspergillosis reached

Answer 26

characteristic destructive rhinitis with severe signs and demonstration of fungal plaques or elementrs on histopathology

Question 27

what are the treatment options for sino nasal aspergillosis (2)

Answer 27

1. anti-fungal agents: enilconazole; clotrimazole topically: nasal instillation + trephination of frontal sinuses systemically: systemic side effects 2. supportive therapy: feeding tube, analgesia

Question 28

why is the prognosis guarded with sino nasal aspergillosis

Answer 28

recurrence common expensive severe clinical signs protracted treatment required

Question 29

what are the nasal neoplasia

Answer 29

1. lymphoma 2. adenocarcinoma 3. nasal polyp (common in cats, rare in dogs)

Question 30

what are the clinical signs that are highly suggestive of nasal neoplasia

Answer 30

1. obstruction of airflow 2. facial pain 3. facial deformatiy 4. +/- sinus tracts

Question 31

what are the non-specific signs of nasal neoplasia (5)

Answer 31

1. discharge: purulent or hemorrhagic, unilateral or bilateral 2. +/- sneezing 3. +/- coughing 4. lymph node enlargement 5. cachexia

Question 32

what are the signs of nasal foreign body

Answer 32

1. unilateral discharge 2. sneezing 3. +/- epistaxis 4. +/- facial pain

Question 33

what are the chronic signs of nasal foreign body

Answer 33

mucopurulent nasal discharge

Question 34

what are treatments of nasal foreign body

Answer 34

1. retrieval from nasopharynx 2. rhinoscopic retrieval 3. flushing nasal cavity 4. surgery

Question 35

how is lymphocytic plasmacytic rhinitis diagnosed (4)

Answer 35

chronic nasal discharge diagnosis by exclusion 1. non-hemorrhagic, bilateral nasal discharge 2. no rhinarial ulceration 3. no facial deformity 4. no facial pain

Question 36

how is lymphocytic/plasmacytic rhinitis treated

Answer 36

antimicrobial therapy corticosteroids

Question 37

what is the prognosis of lymphocytic/plasmacytic rhinitis

Answer 37

prognosis for resolution of signs poor prognosis for survival is good

Question 38

what are oronasal fistulas caused by

Answer 38

1. dental disease 2. oral neoplasia 3. cleft palate