Lecture 11

Question 1

What are some common nasal diseases?

Answer 1

Feline URTD
Nasal tumors
Nasopharyngeal polyps
Foreign bodies
Fungal disease
Rhinitis
Tooth root abscess
Nasal pharyngeal obstruction
Nasal parasites

Question 2

What signs localize disease to nose/nasopharynx

Answer 2

Stertor
Nasal discharge
Sneezing
Open mouth breathing

Question 3

What are viral causes of feline URTD

Answer 3

Feline herpes virus (most common)
Feline calicivirus (most common)
Influenza (rare)

Question 4

What are bacterial causes of feline URTD

Answer 4

Chlamydia felis (common)
Bordatella bronchiseptica
Mycoplasma
Streptococcus (canis or zooepidemicus)

Question 5

How is feline URTD spread

Answer 5

Close contact- actively infected, carrier cats, contaminated fomites
Will see in multicat environments

Question 6

Which is more common form of feline URTD- acute or chronic

Answer 6

Acute

Question 7

What classic sign will you see with FHV-1

Answer 7

Corneal ulceration, abortion, neonatal death

Question 8

What classic signs will you see with FCV

Answer 8

Oral ulceration, pneumonia, polyarthritis

Question 9

What classic sign will you see with chlamydophila

Answer 9

Conjunctivitis, chemosis, nasal discharge, sneezing

Question 10

What signs will you see of chronic feline URTD

Answer 10

Most are asymptomatic

May see secondary bacterial infections due to irreversible damage done to mucus

Question 11

What signs will you with mycoplasma

Answer 11

Conjunctivitis

Question 12

What signs will you with bordetella in cats

Answer 12

Coughing, tachypnea, cyanosis

Question 13

How to diagnosis feline URTD

Answer 13

If clinical signs and history point you in this direction…then do PCR

Question 14

What do you have to have for a postive PCR

Answer 14

Have to have a live active infection

If it’s latent, PCR will always be negative

Question 15

What if a cat has been vaccinated or immunized against URTD?

Answer 15

Doesn’t rule it out!

Question 16

How to treat acute feline URTD

What is contraindicated?

Answer 16

Most cases are self limiting

Need to make sure the cat keeps eating or starts eating again

Give fluids

Isolation

Nebulizer

Antibiotics in severe cases of secondary infection

Corticosteroids are contraindicated

Question 17

How to treat chronic feline URTD

Answer 17

Similar to acute therapy

No cure, so just supportive care

Can do turbinectomy and frontal sinus ablation as a salvage procedure

Question 18

Why should you not use corticosteroid in chronic feline URTD

Answer 18

Increase viral shedding
Worsen secondary infections
Mask underlying diseases

Question 19

How to prevent feline URTD

Answer 19

Vaccinate individual cats and avoid exposure with other cats

Isolate new cats coming into the household for a few weeks

Question 20

Describe nasal tumors

Answer 20

Locally aggressive
Distal metastasis is uncommon, but should still check
Uncommon in cats

Question 21

What type of nasal tumors happen dogs?

Cats?

Answer 21

Most are malignant.
Will see carcinoma and sarcoma in dogs
Will see lymphoma, adenocarcinoma, and sarcoma in cats

Question 22

Who is most at risk for nasal tumors

Answer 22

Middle aged to older dogs and cats

Dolichocephalic and mesencephalic are at increased risks

Increased risk in male cats compared to females

Question 23

How to diagnose nasal tumors

Answer 23

History and physical exam
Blood pressure
Coag profile
Airflow detection
Imaging- CT is gold standard
Rhinoscopy and biopsy

Question 24

How to treat nasal tumors

Answer 24

Limited treatment options- not responsive to chemo unless lymphoma
Surgical excision if benign
Radiation therapy

Can also give analgesics, NSAIDs, and antibiotics

Question 25

What are nasopharyngeal polyps? Who do they infect?

Answer 25

Common benign pedunculated growth (can be progressive and chronic) Kittens and young cats

Question 26

What are polyps composed of

Answer 26

Inflammatory tissue, fibrous connective tissue, and epithelium

Question 27

How to treat polyps

Answer 27

Surgical excision- need to get all the tissue or else will see recurrence

Question 28

What causes fungal rhinitis in the dog? Cat?

Answer 28

Aspergillus in dog Cryptcoccus in cat

Question 29

How do cats get cryptococcosis

Answer 29

Bird poop or decaying eucalyptus trees

Question 30

What signs will you see with cryptococcosis in cats?

Answer 30

``` Naso-facial swelling followed by nonhealing ulceration Nasal discharge Stertor Inspiratory dyspnea Sneezing and snufflinf Submandibular lymphadenopathy ```

Question 31

How to diagnose cryptcoccosis

Answer 31

Can diagnose on cytology alone | Also a blood antigen test (how you know to continue treating)

Question 32

How to treat cryptococcosis

Answer 32

Fluconazole or itraconazole until antigen negative + 2 additional months Sometimes do surgery if have a big nodule

Question 33

What is nasal aspergillosis

Answer 33

Opportunistic fungal infection in mesocephalic and dolichocephalic breed less than 7 years old

Question 34

What are clinical signs of aspergillus

Answer 34

``` Chronic mucopurulent nasal discharge Nasal pain Nasal ulceration/depigmentation Sneezing Epistaxis ```

Question 35

How to treat aspergillus

Answer 35

Challenging to treat | Topical antifungal- multiple treatments with clotrimazole

Question 36

What is rhinitis

Answer 36

Causes chronic nasal disease but no evidence of any other etiologic process Unknown etiology

Question 37

What is lymphoplasmacytic rhinitis?

Answer 37

Affects dogs and cats Will see chronic nasal disease signs Diagnoses when can’t find anything else Caused by inhaled irritants/particulate matter, unknown infection, or possible autoimmune process

Question 38

What is allergic rhinitis

Answer 38

Uncommon manifestation of allergy Will see lots of eosinophils Another case of diagnoses of exclusion (nothing else fits)

Question 39

Bacterial rhinitis

Answer 39

Usually a secondary disease EXCEPT bordetella, mycoplasma, chlamydia (can cause primary disease)

Question 40

Nasal foreign bodies- when to suspect? How to diagnose? How to treat?

Answer 40

Sudden onset of sneezing and nasal discharge, pawing at the nose Diagnose with imaging Remove foreign body and flush nasal passage

Question 41

Tooth root abscesses- what is it? Clinical signs? Diagnoses?

Answer 41

Chronic rhinosinusitis with concurrent visible dental disease Will see nasal discharge and/or hemorrhage Full oral exam, probe teeth, imaging

Question 42

What is nasopharyngeal obstruction

Answer 42

Pathologic narrowing within nasopharynx

Question 43

Clinical signs of nasopharyngeal obstruction

Answer 43

Resolving stertor with open mouth breathing Chronic nasal discharge Gagging

Question 44

How to treat nasopharyngeal obstruction

Answer 44

Stretch affected tissue | Insert a stint

Question 45

What causes nasopharyngeal obstruction

Answer 45

Congenital disease ``` Secondary to: Chronic rhinitis Aspiration rhinitis (most common) Surgical manipulation Trauma Tumor Polyp ```

Question 46

What three agents cause nasal parasites

Answer 46

Mite- pneumonyssoides caninum Nematode- capillaria boehmi Warbles- cuterebra

Question 47

How to diagnose nasal parasites

Answer 47

P. Caninum: visualize on rhinoscopy C. Boehmi: fecal flotation, rhinoscopy Cuterebra: visualize

Question 48

How to treat nasal parasites

Answer 48

P. Caninum: ivermectin, milbemycin oxime C. Boehmi: ivermectin, fenbendazole Cuterebra: manual removal