Diagnosis and outcome of nasal polyposis in 23 dogs treated medically or by endoscopic debridement

This study describes the clinical, diagnostic, and pathological characteristics of canine nasal polyps and how they responded to medical, endoscopic, and surgical treatments. The database of a multi-center veterinary endoscopy group was searched from 2010 to 2018. All dogs with a histological diagnosis of nasal polyposis that were undergoing endoscopic investigation (N = 23), were included. Clinical signs at presentation were sneezing (91%), nasal discharge (83%), stertor (74%), and frontonasal deformation (17%). Skull radiography on 13 dogs had alterations in 77% of cases, including turbinate lysis (6/13), increased radiopacity of one (4/13) or both (6/13) nasal cavities, and lysis of the nasal vomer bone (3/13). Nasal polyposis had a characteristic endoscopic appearance. There were clinical and diagnostic similarities between this cohort of dogs and dogs with nasal neoplasia, although dogs with nasal polyps were often younger and polypoid tissue was external to the nose. Steroid therapy alone was not effective in treating polyposis in dogs; however, endoscopic debulking with a laser and forceps was more effective.     

Use of topical povidone-iodine dressings in the management of mycotic rhinitis in three dogs

Three dogs with mycotic rhinitis were treated with a proprietary wound dressing product intended to produce a sustained release of povidone-iodine. All of the dogs had been refractory to other treatments. One dog had extensive soft tissue involvement, including extension into the orbital tissues, and another had evidence of involvement of the supporting bones of the nose. In all cases, the affected nasal cavity and/or frontal sinus was exposed via a dorsal approach and partial turbinectomy was performed. The wound dressing was applied and retained with a 'tie-over' dressing. The dressing was replaced every 48 to 72 hours until all exposed tissue was covered by healthy granulation tissue, at which time the rhinotomy was closed by soft tissue reconstruction. There was no evidence of recurrence of the fungal infection at follow-up times of up to 20 months postsurgery.     

Surgical treatment of canine nasal aspergillosis by rhinotomy combined with enilconazole infusion and oral itraconazole

OBJECTIVES: To evaluate the effectiveness of rhinotomy and surgical debridement associated with topical administration of 2 per cent enilconazole and oral itraconazole in dogs with severe or recurrent sinonasal aspergillosis. METHODS: A standard rhinotomy was performed on seven dogs. In the initial study, the bone flap was left attached cranially and replaced at the end of the procedure. In the main study group, the bone flap was discarded. Nasal passages were debrided and irrigated with enilconazole solution for one hour. Oral itraconazole was administered to four dogs for one month postoperatively. Follow-up rhinoscopy was performed in all dogs. RESULTS: All three dogs in the initial study had recurrence of the disease and two dogs had a second surgery to remove the flap. The main study group included four dogs in which the flap was initially removed, and the two dogs from the initial study that required a second surgery. At follow-up rhinoscopy, five dogs were free of aspergillus but had bacterial or inflammatory rhinitis and one dog had a small aspergilloma but was subsequently asymptomatic. Telephone follow-up revealed that four dogs were asymptomatic, one dog had intermittent sneezing and serous nasal discharge, and one dog had intermittent epistaxis. CLINICAL SIGNIFICANCE: Rhinotomy with removal of the flap combined with one-hour infusion of 2 per cent enilconazole and oral itraconazole resulted in satisfactory outcome in dogs with severe or recurrent aspergillosis.     

Nasal adenocarcinoma metastatic to bone in two dogs

Diagnosis of nasal adenocarcinoma was made in a 6-year-old 35-kg neutered Golden Retriever and a 6-year-old 8-kg spayed mixed-breed dog with chronic bilateral nasal discharge unresponsive to antibiotics. Treatment for the Golden Retriever consisted of bilateral rhinotomy, curettage, and postoperative fractionated 48-Gy orthovoltage irradiation. The mixed-breed dog was treated with cisplatin. After complete remission of the primary neoplasm, the dogs were reevaluated because of acute lameness. Radiography of the right stifle of the Golden Retriever revealed soft tissue swelling, extensive bony destruction of the distal femoral metaphysis and epiphysis, and pathologic fracture involving the medial condyle. Radiography of the left scapula of the mixed-breed dog revealed lysis of the glenoid cavity and subchondral scapular bone. Diagnosis of metastatic carcinoma was made in both dogs. With treatment improvements and longer survival time of affected dogs, sinonasal neoplasia may be observed to develop in similar life-threatening metastatic sites.     

Computed tomography as an aid in the diagnosis of chronic nasal disease in dogs

OBJECTIVES: To assess the use of computed tomography (CT) in the diagnosis of chronic nasal disease in dogs. METHODS: A retrospective study of 85 dogs with chronic nasal discharge due to primary nasal disease, which had undergone nasal CT and biopsy, was carried out. Medical records were reviewed for signalment, clinical signs, CT findings, endoscopic findings and histopathology. The results obtained via CT were correlated with nasal histopathology and gross anatomical observations were recorded at the time of rhinoscopy. RESULTS: Neoplasia was diagnosed in 37 dogs for which CT typically revealed a soft tissue density associated with extensive turbinate destruction. Inflammatory rhinitis was diagnosed in 40 dogs. CT disclosed either normal turbinate structures or mild to moderate turbinate destruction, with or without the presence of soft tissue densities (mucopus) within the nasal passages. Fungal rhinitis was diagnosed in seven dogs for which CT disclosed extensive turbinate destruction with hyperlucency of the nasal passages. One dog had normal CT and histopathology findings. CLINICAL SIGNIFICANCE: CT greatly enhanced the ability to diagnose chronic nasal disease in dogs, providing detailed Information regarding the extent of the disease, accurate discrimination of neoplastic versus non-neoplastic diseases, and identification of areas of the nose to examine rhinoscopically and suspicious regions to target for biopsy.     

Nasopharyngeal diseases in cats: a retrospective study of 53 cases (1991-1998)

The records of 53 cats with nasopharyngeal disease were examined. Of the cats with nasopharyngeal disease, 49% had lymphosarcoma and 28% had polyps. Clinical signs in these cats were compared to 24 cats with nasal disease alone. Cats with only nasal disease more commonly had historical nasal discharge and sneeze, whereas cats with nasopharyngeal disease more often had stertorous respiration, phonation change, and typically reported less nasal discharge or sneeze. It is important to include nasopharyngeal disease in the differential diagnosis for cats with nasal discharge, sneeze, stertor, or phonation change.     

Comparison of serologic evaluation via agar gel immunodiffusion and fungal culture of tissue for diagnosis of nasal aspergillosis in dogs

OBJECTIVE: To compare the sensitivity and specificity of serologic evaluation and fungal culture of tissue for diagnosis of nasal aspergillosis in dogs. DESIGN: Prospective study. ANIMALS: 58 dogs with nasal discharge and 26 healthy dogs. PROCEDURES: Dogs with nasal discharge were anesthetized and underwent computed tomography and rhinoscopy; nasal tissues were collected for histologic examination and fungal culture. Sera were assessed for antibodies against Aspergillus spp (healthy dog sera were used as negative control specimens). Nasal aspergillosis was diagnosed in dogs that had at least 2 of the following findings: computed tomographic characteristics consistent with aspergillosis, fungal plaques detected during rhinoscopy, and histologically detectable fungal hyphae in nasal tissue. Histologic characteristics of malignancy were diagnostic for neoplasia. Without evidence of neoplasia or fungal disease, nonfungal rhinitis was diagnosed. RESULTS: Among the 58 dogs, 21 had nasal aspergillosis, 25 had nonfungal rhinitis, and 12 had nasal neoplasia. Fourteen aspergillosis-affected dogs and 1 dog with nonfungal rhinitis had serum antibodies against Aspergillus spp. Fungal culture results were positive for Aspergillus spp only for 17 dogs with aspergillosis. With regard to aspergillosis diagnosis, sensitivity, specificity, and positive and negative predictive values were 67%, 98%, 93%, and 84%, respectively, for serum anti-Aspergillus antibody determination and 81%, 100%, 100%, and 90%, respectively, for fungal culture. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that seropositivity for Aspergillus spp and identification of Aspergillus spp in cultures of nasal tissue are highly suggestive of nasal aspergillosis in dogs; however, negative test results do not rule out nasal aspergillosis.     

Body cavity lipomas in six dogs

Histologically confirmed lipomas were surgically removed from the thoracic or abdominal cavities of six dogs. Three dogs had a large intra-abdominal mass causing severe abdominal distension. Two dogs had a mass extending into the pelvic canal, compressing the colon and causing obstipation. One dog with an intrathoracic mass had a history of coughing and intermittent cyanosis. All dogs had complete resolution of signs after surgical resection of the tumour. Recurrence occurred in one dog with an abdominal lipoma, two years after the initial surgery. This recurrent lipoma was treated successfully by surgical resection.     

Failure to identify an association between serologic or molecular evidence of Bartonella infection and idiopathic rhinitis in dogs

OBJECTIVE: To determine whether infection with or exposure to Bartonella spp was associated with idiopathic rhinitis in dogs. DESIGN: Case-control study. ANIMALS: 44 dogs with idiopathic nasal discharge and 63 age- and weight-matched control dogs without nasal discharge and no clinical signs of bartonellosis. Procedures-Serum was tested for antibodies against Bartonella henselae and Bartonella vinsonii subsp berkhoffii with indirect fluorescent antibody assays. Blood was tested for Bartonella DNA with a PCR assay. RESULTS: Results of the antibody and PCR assays were negative for all 44 dogs with idiopathic nasal discharge. One control dog had antibodies against B henselae; a second control dog had positive PCR assay results. We did not detect a significant association between assay results and group designation. CONCLUSIONS AND CLINICAL RELEVANCE: The present study failed to confirm an association between idiopathic rhinitis and exposure to or infection with Bartonella spp in dogs. Findings do not rule out the possibility that Bartonella infection may cause nasal discharge in some dogs, but the failure to find any evidence of exposure to or infection with Bartonella spp in dogs with idiopathic nasal discharge suggested that Bartonella infection was not a common cause of the disease.     

Ventricular pneumocephalus and septic meningoencephalitis secondary to dorsal rhinotomy and nasal polypectomy in a dog

CASE DESCRIPTION: A 4-year-old sexually intact female French Bulldog was evaluated because of lethargy, anorexia, and chronic rhinitis-sinusitis. The dog had nasal discharge of 18 months' duration; dorsal rhinotomies were performed 3 months and 2 weeks prior to referral. CLINICAL FINDINGS: On initial evaluation, intraventricular pneumocephalus and sinusitis were diagnosed; CSF analysis revealed high total protein concentration and mononuclear pleocytosis. The dog's condition improved with treatment. Two weeks after discharge, it was treated by a local veterinarian because of upper airway obstruction; 3 days later, the dog was referred because of seizures. Computed tomography revealed a large fluid-filled, left lateral ventricle and a soft tissue mass protruding through a cribriform plate defect. The mass was histologically consistent with brain tissue. Findings of clinicopathologic analyses were unremarkable. Results of cytologic examination of a CSF sample were indicative of septic, suppurative inflammation, and bacteriologic culture of CSF yielded Escherichia coli. TREATMENT AND OUTCOME: Amputation of the herniated olfactory bulb and antimicrobial treatment resolved the septic meningoencephalitis, but neurologic deficits recurred 6 weeks later. Definitive correction of the cribriform plate defect with bone and fascial grafts was attempted. Postoperative rotation of the bone graft resulted in cerebral laceration and hemorrhage, and the dog was euthanized. CLINICAL RELEVANCE: Findings suggest that following dorsal rhinotomy and nasal polypectomy surgery, the dog developed herniation of the left olfactory bulb, intra-ventricular pneumocephalus, and septic meningo-encephalitis because of a cribriform plate defect. Care must be taken to prevent rotation of bone grafts used in cribriform defect repair.     

Middle ear disease associated with congenital palatine defects in seven dogs and one cat

Medical records of eight dogs and one cat with congenital palatine defects were reviewed retrospectively. Five of the dogs had nasal discharge and seven had radiographic signs of middle ear disease, but no clinical signs of ear disease were identified in any of the dogs, nor were any reported by their owners during a one- to five-year follow-up period. One dog had an ipsilateral impairment of hearing detected by brainstem auditory evoked responses. The cat had clinical and radiographic signs of middle ear disease. These findings suggest that, as in humans, congenital palatine defects in dogs and cats may predispose to middle ear disease. Any associated deafness could cause problems for working dogs.     

Idiopathic osseous hyperplasia of the nasal turbinates in a Welsh terrier

A three-year-old Welsh terrier was presented with a 6-month history of progressive stertor, exercise intolerance and sneezing which was unresponsive to symptomatic treatment. A large calcified mass occupying the entire rostral right nasal cavity was defined with computed tomography. The mass was completely removed via a dorsal rhinotomy. Histopathological examination of the mass revealed osseous hyperplasia of the nasal turbinates. The excision led to complete resolution of clinical signs and there has been no recurrence 18 months after surgery.     

Ventral rhinotomy in the dog and cat

The nasal cavities of 14 dogs and three cats were explored surgically using a ventral rhinotomy. The exposure achieved through this approach was considered to be equal to a dorsal rhinotomy. One animal died during the immediate postoperative period from perforation of a gastric ulcer. The other animals recovered well and had no significant complications. The long-term survival of the animals was consistent with previous reports for their diseases. Ventral rhinotomy is no more difficult than dorsal rhinotomy, has less patient morbidity and fewer postoperative complications, and is more cosmetically acceptable.     

Ventral Rhinotomy in the Dog and Cat

The nasal cavities of 14 dogs and three cats were explored surgically using a ventral rhinotomy. The exposure achieved through this approach was considered to be equal to a dorsal rhinotomy. One animal died during the immediate postoperative period from perforation of a gastric ulcer. The other animals recovered well and had no significant complications. The long-term survival of the animals was consistent with previous reports for their diseases. Ventral rhinotomy is no more difficult than dorsal rhinotomy, has less patient morbidity and fewer postoperative complications, and is more cosmetically acceptable.     

Neurologic abnormalities as the predominant signs of neoplasia of the nasal cavity in dogs and cats: seven cases (1973-1986)

Neurologic abnormalities were the predominant historic and physical findings in 5 dogs and 2 cats with primary nasal cavity tumors that had invaded the cranial vault. Seizures, behavior changes, and obtundation were the most common signs. Other neurologic signs included paresis, ataxia, circling, visual deficit, and proprioceptive deficit. Although 1 dog and 2 cats had historic findings of mild respiratory disease, no physical abnormalities related to the respiratory tract were found in any of the 7 animals. Nasal cavity neoplasia was suggested by radiographic and computed tomographic studies and was confirmed histopathologically in each case. The nasal tumor types in the 5 dogs were epidermoid carcinoma (n = 1), adenocarcinoma (n = 2), solid carcinoma (n = 1), and anaplastic chondrosarcoma (n = 1). An esthesioneuroblastoma was found in each cat. Radiation therapy was effective for 3 months in palliating the clinical signs in the 2 dogs in which it was used. Neoplasia of the nasal cavity should be considered in the differential diagnosis for animals with neurologic signs suggestive of cerebral disorders.     

A COMPARISON OF RADIOGRAPHIC AND COMPUTED TOMOGRAPHIC FINDINGS IN 31 DOGS WITH MALIGNANT NASAL CAVITY TUMORS

Nasal cavity radiographs and CT images from 31 dogs with nasal cavity cancer were compared. All dogs had abnormal clinical signs relating to -nasal cancer and histologic confirmation of malignant nasal cavity neoplasia. No dog had cyto reductive surgery prior to imaging. All radiographic and CT examinations were abnormal. CT was more accurate than radiographs in identifying unilateral versus bilateral nasal cavity disease and tumor extension into adjacent structures such as the cranial cavity, hard palate, and pterygopala-tine fossa. The improved accuracy of CT in these respects was not of benefit in the confirmation of nasal cavity disease because radiographs were abnormal in every instance. However, CT may be useful for more accurate tumor staging, predicting possible treatment-related complications, and planning of surgery and radiation therapy. It was also determined that one dorsally located radiation therapy portal bounded laterally by the medial ocular canthi, as described in previous reports, would not have been adequate for encompassing all abnormal tissue in 28 of the 31 dogs evaluated.     

Use of cyclosporine to treat granulomatous meningoencephalitis in three dogs

Use of cyclosporine to treat granulomatous meningoencephalitis in three dogs Three dogs with a presumptive diagnosis of granulomatous meningoencephalitis were treated with orally administered cyclosporine. In 2 dogs, cyclosporine administration replaced initial corticosteroid administration, and in 1 dog, cyclosporine was the only treatment used. One dog had the focal form of the disease in the brainstem, 1 dog had the focal form in the forebrain associated with a concurrent ocular form, and 1 dog had the disseminated form of disease. At 12-month follow-up, the 2 dogs with the focal form of the disease had no clinical signs. The dog with the disseminated form improved only partially, and euthanasia was performed 3 weeks after initial evaluation. Cyclosporine was considered effective at an initial dosage of 6 mg/kg (2.7 mg/lb) every 12 hours. Adverse effects associated with cyclosporine administration included transient lymphopenia, excessive shedding, and focal symmetric hair discoloration.     

Intranasal malignant melanoma in a dog

A 10-year-old, female Newfoundland-cross dog was presented for evaluation of chronic intermittent unilateral epistaxis, nasal stertor, and sneezing. Nasal magnetic resonance imaging revealed a 3 x 5-cm mass in the left nasal cavity. Histopathological evaluation of nasal biopsies determined that the mass was a malignant melanoma. The mass was surgically resected and treated with bilateral opposed photon-beam radiation. This is the first report to describe the presentation, diagnosis, and treatment of an intranasal malignant melanoma in a dog.     

Temporary regression of locally invasive polypoid rhinosinusitis in a dog after photodynamic therapy

A 5‐year‐old male cross‐breed dog with chronic rhinosinusitis was presented. Computed tomography (CT) revealed opacities consistent with soft tissue or fluid in the left nasal cavity and frontal sinus. A diagnosis of chronic rhinosinusitis with myxomatous polyps was based on the histology of biopsy samples, so prednisolone treatment was administered for 1 month. Although the clinical signs slightly improved, no changes were observed on the CT images. At 8 months after the initial presentation, the dog was treated with antivascular photodynamic therapy (PDT) using benzoporphyrin derivative monoacid ring A and, 11 days later, CT revealed remarkably decreased soft tissue opacity; the facial swelling and sneezing also resolved. Three additional sessions of PDT were performed at 114, 210, and 303 days after the first PDT because of recurrence of clinical signs. The disease was well controlled for approximately 10 months by antivascular PDT.     

Nasopharyngeal tooth foreign body in a dog

An 8-year-old Shih-tzu dog was presented with a 2-week history of cough and nasal discharge. Upon presentation, the dog had constant open-mouth breathing with stertor and blood-tinged mucopurulent nasal discharge. Oral examination revealed a missing right mandibular second premolar tooth and severe periodontal disease. Computed tomography showed a radiodense, retropharyngeal foreign body. The foreign body was removed using caudal rhinoscopy. The foreign body was the right mandibular second premolar covered by thick calculus.