Nasal melanosis in three dogs

Cytologically and histologically confirmed nasal melanosis was detected by rostrocaudal rhinoscopic evaluation of three dogs with unilateral nasal discharge caused by a chronic and severe odontopathic rhinitis. The extraction of affected teeth and prolonged antibiotic therapy led to a complete resolution of nasal disease. The nasal melanosis could be considered a partial metaplastic transformation of mucosal respiratory cells with accumulation of intracytoplasmic melanin.     

Inflammatory myofibroblastic tumour in the nasal cavity of a dog

A 4·5‐year‐old, female neutered Leonberger was presented with a 2‐month history of sneezing, nasal discharge and epistaxis. A presumptive diagnosis of nasal aspergillosis was made based on a suspected (fungal) granuloma on rhinoscopic examination and fungal hyphae on cytological examination. A poor response to targeted therapy was observed and computed tomography 16 months after initial presentation revealed a progressive, locally invasive mass lesion. Histopathological and immunohistochemical analysis of deep surgical biopsies revealed a spindle cell population and a plasma cell rich inflammatory infiltrate, with diffuse expression of vimentin, supporting a diagnosis of inflammatory myofibroblastic tumour. Complete resolution of the nasal discharge and reduced sneezing frequency was reported 9 months post‐surgical debridement via rhinotomy. To the authors’ knowledge, this is the first report of IMT in the nasal cavity of a dog. IMT should be considered when presented with a nasal mass lesion, particularly if histopathological features and clinical course are inconsistent.     

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.     

Treatment of canine nasal aspergillosis with a new non-invasive technique. Failure with enilconazole

A new, non-Invasive technique recently described for the treatment of canine nasal aspergillosis was performed on four dogs. The antimycotic agent used was a 10 per cent enilconazole suspension, with the drug left in situ for a period of one hour. None of the dogs responded to single treatment. One dog died from an acute septic response secondary to pyelonephritis and bacterial endocarditis eight days after a second treatment. A second dog responded completely to a second treatment and remained free of fungal disease for a follow-up period of H months. In the remaining two dogs, extensive and profuse fungal growth was seen on rhinoscopic reexamination. Conventional treatment, with tube Implantation into the frontal sinuses and nasal irrigation for two weeks, was performed. Successful resolution of infection was obtained. Although the new, non-invasive technique was simple to carry out and well tolerated by the dogs, instillation of 10 per cent enilconazole appears to have poor therapeutic efficacy and exacerbated fungal growth in two of the animals.     

Intranasal infusion of enilconazole for treatment of sinonasal aspergillosis in dogs

OBJECTIVE: To determine effectiveness of infusion of 1 and 2% enilconazole for treatment of nasal and sinusal aspergillosis, respectively, in dogs. DESIGN: Case series. ANIMALS: 26 client-owned dogs with aspergillosis. PROCEDURE: All dogs had typical clinical signs of aspergillosis and rhinoscopically visible intrasinusal or intranasal fungal plaques associated with turbinate destruction. During rhinoscopy, affected nasal cavities and frontal sinuses were debrided meticulously. Nineteen dogs (group A) were treated with 1% enilconazole by use of a modified noninvasive infusion procedure. Seven dogs (group B) were treated with 2% enilconazole via catheters that were placed via endoscopic guidance into the frontal sinuses. All dogs underwent follow-up rhinoscopy for determination of further treatment until cure was established. RESULTS: Age, disease duration, clinical score, and rhinoscopic score were similar for both groups before treatment. In group A, 17 of 19 dogs were cured; 9, 6, and 2 dogs were cured after 1, 2, or 3 treatments, respectively. The remaining 2 dogs were euthanatized before the end of the treatment protocol. In group B, all dogs were cured; 6 dogs and 1 dog were cured after 1 or 2 treatments, respectively. Only minor adverse effects such as nasal discharge, epistaxis, and sneezing developed. CONCLUSIONS AND CLINICAL RELEVANCE: After extensive rhinoscopic debridement, 1 and 2% enilconazole infused into the nasal cavities and the frontal sinuses, respectively, were effective for treatment of aspergillosis in dogs. Intrasinusal administration via endoscopically placed catheters appeared to require fewer infusions for success. Follow-up rhinoscopy is strongly advised.     

Correlation of rhinoscopic signs of inflammation with histologic findings in nasal biopsy specimens of cats with or without upper respiratory tract disease

OBJECTIVE: To investigate the correlation of cumulative rhinoscopic findings of hyperemia, mucus accumulation, and turbinate destruction with the type and severity of inflammatory infiltrates in nasal biopsy specimens of cats with or without upper respiratory tract disease. DESIGN: Prospective study. ANIMALS: Cats with (n = 11) and without (6) upper respiratory tract disease and cats with unknown medical histories (27). PROCEDURES; Lesions of hyperemia, mucus accumulation, and turbinate destruction detected rhinoscopically were each scored (scale, 0 [absent] to 3 [severe]), and a cumulative rhinoscopic score for each nasal cavity was calculated. Fifty biopsy specimens were examined histologically, and inflammatory infiltrates (lymphoplasmacytic or neutrophilic) were graded as absent, mild, moderate, or severe. Cumulative rhinoscopic scores and inflammation grades were compared for each specimen-cavity combination. RESULTS: In cats of known disease status, there was a positive but weak correlation between cumulative rhinoscopic scores and inflammation grades in biopsy specimens. In cats of unknown disease status, there was no similar correlation. Biopsy specimens with minimal inflammation were commonly obtained from nasal cavities with low rhinoscopic scores; specimens with moderate or severe inflammatory changes were frequently obtained from cavities that appeared normal rhinoscopically. Type of inflammatory infiltrates was not correlated with rhinoscopic signs of inflammation. CONCLUSIONS AND CLINICAL RELEVANCE: The correlation of rhinoscopic findings with inflammation severity in nasal biopsy specimens (determined histologically) was weak or lacking in cats of known and unknown disease status, respectively. Results indicated that rhinoscopy with biopsy provides more complete evaluation of nasal disease than rhinoscopy alone in cats.     

Prophylactic use of a lyophilized platelet product for rhinoscopic diagnosis and treatment of sinonasal aspergillosis in a dog with a P2Y12 platelet receptor mutation

Objective

To describe the periprocedural use of a lyophilized platelet product during rhinoscopic diagnosis and treatment of sinonasal aspergillosis in a Greater Swiss Mountain Dog with a P2Y12 platelet receptor disorder.

Case Summary

After the development of severe epistaxis, a Greater Swiss Mountain Dog was diagnosed with thrombopathia secondary to a P2Y12 receptor gene mutation. Concurrent primary nasal disease was also suspected due to persistent mucopurulent nasal discharge. One month after the initial presentation for epistaxis, the dog was readmitted for workup of nasal disease. Computed tomography of the head showed turbinate lysis and regional lymphadenopathy. Because of concern for a high risk of bleeding in a thrombopathic patient subjected to rhinoscopy and nasal biopsies, a lyophilized platelet product was administered prior to the procedure. Rhinoscopic exam revealed fungal plaques consistent with Aspergillus spp. that were later confirmed on fungal culture to be Aspergillus fumigatus. Rhinoscopic biopsies were performed as well as debridement of the fungal plaques, followed by topical administration of clotrimazole solution. Bleeding was minimal during and after the procedure, and the dog recovered uneventfully.

New or Unique Information Provided

This is the first report of the prophylactic use of lyophilized platelets in a thrombopathic patient undergoing an invasive procedure with potential for significant hemorrhage. Minimal bleeding occurred during the procedure, suggesting that lyophilized platelets could be used for the prevention of bleeding in thrombopathic patients undergoing invasive procedures.     

Computed tomography or rhinoscopy as the first-line procedure for suspected nasal tumor: A pilot study

There are no evidence-based guidelines as to whether computed tomography (CT) or endoscopy should be selected as the first-line procedure when a nasal tumor is suspected in a dog or a cat and only one examination can be performed. Computed tomography and rhinoscopic features of 17 dogs and 5 cats with a histopathologically or cytologically confirmed nasal tumor were retrospectively reviewed. The level of suspicion for nasal neoplasia after CT and/or rhinoscopy was compared to the definitive diagnosis. Twelve animals underwent CT, 14 underwent rhinoscopy, and 4 both examinations. Of the 12 CT examinations performed, 11 (92%) resulted in the conclusion that a nasal tumor was the most likely diagnosis compared with 9/14 (64%) for rhinoscopies. Computed tomography appeared to be more reliable than rhinoscopy for detecting nasal tumors and should therefore be considered as the first-line procedure.     

Rhinoscopy: a diagnostic aid?

Sixty dogs with confirmed chronic nasal disease were examined rhinoscopically. The relative merits of the otoscope, an arthroscope and a flexible bronchoscope as instruments are discussed. Rhinoscopy has a limited place in the investigation of chronic nasal discharge in the dog due to the volume of discharge present and induced haemorrhage. It is most useful in cases of destructive rhinitis (including aspergillosis) and foreign body obstruction.     

Nasal polyps in dogs: five cases (2005 to 2011)

This series describes five dogs with nasal polyps diagnosed between 2000 and 2011. Clinical signs included reverse sneezing, nasal discharge, epistaxsis, and stertor when breathing. Computerised tomographic findings included soft tissue mass, turbinate destruction, extension through the bony nasal septum and partial lysis of bones surrounding the nasal cavity. Three dogs were treated by dorsal rhinotomy, one dog was treated by ventral rhinotomy, and in one dog the polyp tissue was removed during nasal flushing. Three dogs have no clinical signs of nasal disease. One dog had confirmed recurrence of nasal polyps and was successfully treated with megavoltage radiation. One dog had recurrent nasal disease eight months after dorsal rhinotomy. Nasal polyps are a possible cause of nasal disease in dogs with nasal discharge, epistaxsis and stertor, and a differential diagnosis for dogs with extensive soft tissue lesions of the nasal cavities on computerised tomography. Nasal polyps can be treated successfully by rhinotomy in some cases but may reoccur.     

Results of rhinoscopy alone or in conjunction with sinuscopy in dogs with aspergillosis: 46 cases (2001-2004)

OBJECTIVE: To determine results of diagnostic testing, including detection of nasal or frontal sinus fungal plaques, in dogs with nasal aspergillosis. DESIGN: Retrospective case series. ANIMALS: 46 dogs with nasal aspergillosis. PROCEDURES: Medical records were reviewed for information on computed tomographic findings; rhinoscopic findings, including whether fungal plaques were seen in the nasal cavity; results of frontal sinus trephination and sinuscopy, including whether fungal plaques were seen in the frontal sinus; and results of histologic examination of biopsy specimens. RESULTS: In 38 (83%) dogs, fungal plaques were seen in the nasal cavity during rhinoscopy, whereas in the remaining 8 (17%), fungal plaques were not seen in the nasal cavity but were seen in the frontal sinus. Duration of clinical signs, proportions of dogs in which the referring veterinarian had performed a nasal examination prior to referral, proportions of dogs with computed tomographic evidence of nasal cavity cavitation or sinus involvement, and proportions of dogs with rhinoscopic evidence of destructive rhinitis were not significantly different between dogs with nasal fungal plaques and dogs with fungal plaques only in the frontal sinus. CONCLUSIONS AND CLINICAL RELEVANCE: Results confirm that frontal sinus involvement is common in dogs with nasal aspergillosis and suggest that frontal sinus trephination and sinuscopy may aid in the diagnosis of aspergillosis in dogs, particularly dogs with rhinoscopic evidence of destructive rhinitis and computed tomographic evidence of sinus involvement that lack detectable fungal plaques in the nasal cavity.     

Experimental respiratory disease in dogs due to Bordetella bronchiseptica.

Young dogs of two age groups, six weeks and 12 weeks respectively, were infected by aerosol with a strain of Bordetella bronchiseptica which had been isolated from a dog with pneumonia. Clinical respiratory disease characterised by coughing and in some cases purulent nasal discharge was induced in both groups of infected dogs and also in dogs kept in contact. B bronchiseptica was recovered from the nasal cavity, trachea, bronchi and lung parenchyma of infected and contact animals. At necropsy, masses of Gram-negative bacteria were found trapped in the cilia of the respiratory epithelia and there was an exudate containing neutrophils in the mucosae of the respiratory tract at all levels. A close similarity was noted between the lesions produced in the dog and those described in pertussis infection in man. Experimental respiratory disease in the dog due to B bronchiseptica may offer a model system for the study of the human disease.     

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.     

A retrospective study of non-specific rhinitis in 22 cats and the value of nasal cytology and histopathology

Case records from 40 cats subjected to rhinoscopic examination for investigation of chronic nasal disease were reviewed. Cases in which no specific underlying cause (eg neoplasia) was detected were further selected for detailed retrospective study. In these 22 cats (55% of the initial population), a final diagnosis of non-specific chronic nasal disease was made. The radiographic, rhinoscopic, cytological and histopathological findings were reviewed. Mucosal biopsy specimens were obtained in 20 cases. Despite clinical signs of more than 4 weeks duration, histopathology indicated acute inflammation in four cases. Two cases had chronic lymphoplasmacytic inflammation and 14 had mixed (lymphoplasmacytic and neutrophilic) inflammation. Specimens for cytology were obtained from 17 cases by brush sampling. Three of these samples were not diagnostic due to the poor quality of the slides; one showed normal cytology. Acute inflammation was diagnosed by cytology (n=11) more commonly than chronic (n=1) or mixed inflammation (n=1). Concurrent samples, of quality suitable for both histopathological and cytological interpretation, were collected from 12 cases only. Cytological results were in agreement with the histological results in 25% of these cases, the main discrepancy being the nature of the dominant inflammatory cell type. Therefore cytology does not appear to be a reliable means for detection of chronic inflammation. Further studies are needed in order to investigate the correlation between the nature of mucosal inflammation as defined by both histological and cytological evaluation, and the relationship of these test results to prognosis and therapy.     

Granulomatous disease associated with Bartonella infection in 2 dogs

Shortly after removal of an engorged tick from the left ear, a 4-year-old Greyhound was referred for evaluation of fever and a rapidly enlarging mass in the region of the left submandibular lymph node. Histopathologic evaluation of the lymph node resulted in a diagnosis of severe granulomatous lymphadenitis. An 11-year-old mixed-breed dog was referred for evaluation of a 6-week history of serous nasal discharge. Histologic examination of a surgical biopsy from a nasal mass indicated multifocal granulomatous inflammation with fibrosis. Serum samples obtained from both dogs were reactive by immunofluorescent assay to Bartonella vinsonii subsp. berkhoffii antigens (reciprocal titers of 128). Although Bartonella organisms were not isolated by lysis centrifugation blood culture, Bartonella DNA was amplified from tissue samples obtained from each dog (lymph node biopsy from dog 1 and nasal biopsy from dog 2) using primers that amplify a portion of the 16S rRNA gene followed by Southern blot hybridization using a genus-specific probe. Additionally, restriction fragment length polymorphism (RFLP) analysis of a Bartonella-specific citrate synthase gene product obtained from dog 2 resulted in a restriction pattern identical to B. vinsonii subsp. berkhoffii. This is the 1st report of granulomatous disease in dogs associated with Bartonella infection.     

COMBINATION OF COMPUTED TOMOGRAPHIC IMAGING CHARACTERISTICS OF MEDIAL RETROPHARYNGEAL LYMPH NODES AND NASAL PASSAGES AIDS DISCRIMINATION BETWEEN RHINITIS AND NEOPLASIA IN CATS

Feline nasal diseases are a diagnostic challenge. The objective of this retrospective, cross‐sectional study was to determine whether computed tomography (CT) imaging characteristics of the medial retropharyngeal lymph nodes (MRPLN), alone or in combination with CT imaging characteristics of the nasal passages, could aid in differentiation between rhinitis and nasal neoplasia. Cats were recruited from record archives at two veterinary facilities during the period of 2008–2012. Selection criteria were presentation for chronic nasal discharge, contrast‐enhanced CT of the head that included the MRPLN, and rhinoscopic nasal biopsy resulting in diagnosis of rhinitis or neoplasia. For each CT scan, two board‐certified veterinary radiologists recorded MRPLN size, attenuation, heterogeneity, contrast‐medium enhancement, margination, shape, presence of a lymph node hilus, perinodal fat, turbinate lysis, paranasal bone lysis, and nasal mass. Both readers were unaware of patient information at the time of CT interpretation. Thirty‐four cats with rhinitis and 22 cats with neoplasia were included. Computed tomographic characteristics significantly associated with neoplasia included abnormal MRPLN hilus (OR 5.1), paranasal bone lysis (OR 5.6), turbinate lysis (5.6), mass (OR 26.1), MRPLN height asymmetry (OR 4.5), and decreased MRPLN precontrast heterogeneity (OR 7.0). The combined features predictive of neoplasia were a nasal mass with abnormal hilus (OR 47.7); lysis of turbinates/paranasal bones with abnormal MRPLN hilus (OR 16.2). Findings supported the hypothesis that combining CT features of the nasal passages and MRPLN aided in differentiating rhinitis from neoplasia in cats.     

Combined clotrimazole irrigation and depot therapy for canine nasal aspergillosis

OBJECTIVES: To evaluate the effect of short duration 1 per cent clotrimazole flush when combined with 1 per cent clotrimazole cream instilled into the frontal sinuses for the treatment of nasal aspergillosis in 14 dogs. METHODS: Fourteen dogs with clinical, radiological, serological and rhinoscopic findings consistent with nasal aspergillosis were treated by frontal sinus trephination and a short, five-minute flushing of 1 per cent topical clotrimazole solution followed by a 1 per cent clotrimazole cream instilled as a depot agent. RESULTS: Twelve of the 14 dogs (86 per cent) responded well to treatment and either had no clinical signs after treatment or had signs consistent with mild rhinitis during a minimum follow-up period of six months. Only one dog required multiple treatments. Treatment was well tolerated by all patients, with minimal complications. CLINICAL SIGNIFICANCE: This treatment compares favourably to previously published data using one-hour topical clotrimazole or enilconazole flushing treatment protocols. The treatment technique significantly reduced treatment time under anaesthesia.     

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.     

Delayed recurrence of nasal aspergillosis in a dog

A two-year-old, female spayed Australian cattle dog was diagnosed with nasal aspergillosis. The dog was treated topically with clotrimazole. Clinical signs recurred two months later and the clotrimazole treatment was repeated and 5 mg/kg itraconazole twice daily was added to it. The recommended dose of itraconazole for nasal aspergillosis is 5 mg/kg twice daily administered orally. The dog's symptoms completely resolved, but it developed an adverse febrile reaction to the Itraconazole. The Itraconazole was discontinued and the dog remained asymptomatic for four years. The dog then developed mucopurulent discharge from the right nostril and was diagnosed as having recurrent nasal aspergillosis. Itraconazole at 5 mg/kg twice daily was prescribed, which again induced a fever. When the itraconazole was decreased to 5 mg/kg once daily there were no fever episodes, but the nasal discharge was not completely resolved. The dog was then treated with topical clotrimazole Infusion, and maintained on 5 mg/kg itraconazole daily. To the authors' knowledge, this case is unique because of the delayed recurrence of nasal aspergillosis. Additionally, the idiosyncratic febrile reaction to the itraconazole has not previously been reported in the veterinary literature, but is similar to reports of drug-induced fever in humans.     

Aspergillus niger pulmonary infection in a dog

A 6-month-old male golden retriever was presented with fever, bloody-watery diarrhea and mild cough. Parvovirus and Isospora canis infection was confirmed and successfully treated. Two weeks later, the dog had severe cough and mucopurulent nasal discharge. Aspergillus niger was cultured from endotracheal washings on blood agar at 37 degrees C. Treatment with itraconazole for about 10 weeks resolved the clinical signs.