Triage and approach to the acute abdomen

The presentation of a patient with acute abdominal pain often is both a diagnostic and therapeutic challenge for the veterinary practitioner. Rapid physical examination and assessment of the patient's cardiovascular status are critical to initiating appropriate and often aggressive medical management as diagnostic tests are being performed. A number of diagnostic tests can be performed, including complete blood count, serum biochemistry profile, serum amylase and lipase, abdominal radiographs, abdominal ultrasound, abdominal paracentesis or diagnostic peritoneal lavage, cytology, and fluid analysis. In some cases, surgical exploration may be indicated, depending on each patient's clinical signs and response to therapy. Of the most important aspects of medical management of the patient with acute abdominal pain is to maintain oxygen delivery to tissues and to treat aggressively for pain or discomfort. The initial triage and approach to the patient with acute abdomen are discussed.     

Rhinoscopy

This article presents a diagnostic protocol for nasal disease evaluation that provides consistent success in diagnosis of chronic cases. The protocol includes history, physical examination, blood clinical pathology assessment, radiographs, culture and sensitivity tests, rhinoscopy, histopathology, fungal serology, and allergy screening. The sequence of diagnostic procedures and their techniques are discussed, and rhinoscopic appearance of the normal nasal cavity is presented, along with findings of commonly seen nasal diseases, including neoplasia, mycotic rhinitis and sinusitis, foreign body obstruction, dental disease, allergic rhinitis, bacterial rhinitis, and idiopathic rhinitis. Rhinoscopy is a highly effective diagnostic technique with minimal morbidity and mortality that has virtually eliminated the need for exploratory rhinotomy.     

分泌IgA和IgG的浆细胞在家兔鼻腔中的分布特征

分泌IgA和IgG的浆细胞是黏膜免疫系统中两种重要的效应细胞。本研究旨在探究分泌IgA和IgG的浆细胞在家兔鼻腔中的分布特征。以20只健康成年家兔为研究对象，根据硬腭褶皱和牙齿特征，依次将家兔鼻腔分为Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ 5段，运用组织学、免疫组织化学、图像分析及统计学方法，对分泌IgA和IgG的浆细胞在家兔鼻腔中的分布特征进行了详细的研究。免疫组化结果显示：分泌IgA和IgG的浆细胞在家兔鼻腔每段都有分布，主要弥散分布于鼻黏膜固有层中；其形态呈圆形或卵圆形，核一般位于细胞一侧，胞质丰富呈阳性反应。统计结果显示：分泌IgA和IgG的浆细胞在鼻腔不同段的分布密度由高到低依次是：鼻腔第Ⅳ段、第Ⅴ段、第Ⅲ段、第Ⅱ段、第Ⅰ段。其中分泌IgA的浆细胞在鼻腔Ⅲ、Ⅳ、Ⅴ段的分布密度显著高于鼻腔Ⅰ、Ⅱ段（P<0.05），在上颌鼻甲、鼻中隔和筛鼻甲的分布密度显著高于上鼻甲（P<0.05）；与分泌IgA的浆细胞相比，分泌IgG的浆细胞除鼻腔第Ⅳ段的分布密度显著高于鼻腔Ⅲ、Ⅴ段（P<0.05）外，其分布变化趋势基本与分泌IgA的浆细胞类似。结果证明，分泌IgA和IgG的浆细胞弥散分布于家兔每段鼻腔的鼻黏膜固有层中，有利于SIgA和IgG分子在整个鼻黏膜形成完整的保护屏障；分泌IgA和IgG的浆细胞主要分布在家兔鼻腔Ⅲ、Ⅳ、Ⅴ段及上颌鼻甲、筛鼻甲和鼻中隔，提示这些区域是家兔鼻腔免疫的重要效应部位。本研究为家兔呼吸系统疾病的预防及进一步探讨家兔鼻腔免疫应答的机制提供重要的理论依据。     

Approach to the patient with respiratory distress.

Respiratory emergencies are common presentations to emergency clinicians. Appropriate assessment and timely interventions may be crucial in the stabilization of dyspneic patients. The emergency clinician should be fully prepared and equipped to correctly ascertain and treat the most likely cause of respiratory compromise of a patient. Based on history, signalment, clinical presentation, and brief physical examination findings, the clinician should be able to formulate a plan of action to relieve respiratory distress and communicate with the owner about the diagnostic and therapeutic strategies and overall prognosis of the patient. Prompt recognition of the underlying respiratory disease and complete familiarity with emergency diagnostic and therapeutic procedures can lead to the successful management of many emergency respiratory patients.     

Diseases of the nose and sinuses

This article discusses the diagnosis and management of acute and chronic diseases of the nasal cavity and sinuses. Also discussed are the anatomy of the upper respiratory tract, guidelines for obtaining a thorough history and performing a complete physical examination, and various diagnostic procedures, such as rhinoscopy, culture, and serology.     

Fungal rhinitis and sinusitis in three cats

Localized infection of the nasal or paranasal cavities caused by Aspergillus spp or Penicillium spp was diagnosed in 3 cats. Clinical signs included chronic mucopurulent nasal discharge, epistaxis, and mandibular lymphadenopathy. Rhinoscopic and diagnostic imaging findings were compatible with severe inflammation of the nasal mucosa and destruction of the turbinates. Fungal plaques were observed rhinoscopically in 2 cats, and histologic examination of biopsy specimens revealed fungal colonies with surrounding inflammatory infiltrates in all 3. Results of fungal culture were negative for all 3 cats. Results of serum immunoelectrophoresis for antibodies against Aspergillus spp were positive in 2 cats. Treatment with itraconazole was effective in controlling clinical signs in 1 cat, but hepatotoxicosis developed. A single intranasal infusion of clotrimazole subsequently led to long-term resolution of clinical signs in this cat. Localized aspergillosis-penicilliosis is clinically indistinguishable from other pathologic conditions of the nasal and paranasal cavities in cats and should be considered when examining cats with chronic nasal discharge.     

Treatment of nasal tumours in dogs: a review

Nasal tumours are common neoplasms in dogs and often represent a diagnostic and therapeutic challenge due to their confined location within the nasal cavities. The main goal of this review is to extract the most relevant information from a wide and often confusing evidence-based medicine on the treatment of canine nasal tumours and conclude with current recommendations. This report highlights the different therapeutic modalities available and describes their technical aspects, interests and limitations. Megavoltage radiotherapy, as the most recent treatment and standard of care, is particularly examined, especially the different types of radiotherapy units, the main protocols used and their advantages and limits. Newer and non-conventional treatments are also discussed.     

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.     

Abdominal, thoracic, and pericardial effusions.

The laboratory evaluation of abdominal, thoracic, and pericardial effusions is a useful diagnostic tool for the assessment of disease states that result in fluid accumulation. Although the numeric values pertaining to cell count and protein content are important, the microscopic evaluation is a critical aspect of the diagnostic procedure; not only does it allow complete classification of the fluid but it allows identification of specific cell types or microorganisms that might be responsible for the fluid accumulation. These findings should always be interpreted in conjunction with the history, signalment, physical findings, and other diagnostic aids in making a definitive diagnosis.     

Nasal and oral masses in a dog

A 5-year-old, intact male, stray dog was presented in poor body condition, with pallor, muzzle deformity, multiple oozing fistulas with grass awns, bilateral sanguinopurulent nasal discharge and a fleshy friable mass occupying part of the hard palate. A friable mass occupying both nasal cavities was found on rhinoscopy. The dog had moderate nonregenerative normochromic-microcytic anemia, thrombocytopenia, hyperglobulinemia, and hypoalbuminemia. Cytologic preparations of the nasal and oral masses contained a neoplastic population of round cells with intracytoplasmic and extracellular vacuoles. Leishmania amastigotes also were observed, in the cytoplasm of macrophages and, occasionally, within neoplastic cells. A diagnosis of transmissible venereal tumor and concurrent leishmaniosis was made. Treatment with vincristine and allopurinol resulted in complete resolution of clinical signs and disappearance of the masses. The presence of amastigotes in neoplastic TVT cells may suggest an alternative mode of transmission of canine leishmaniosis where these diseases co-exist.     

The recovery of Bordetella bronchiseptica strains by means of smears from the nasal cavities of pigs

The paper presents results obtained from a study on the recovery of Bordetella bronchiseptica strains from the nasal cavities of pigs by means of tampon smears. There are several important factors influencing the reliability of recovery: restraining of animals, thorough disinfection of the snout about the nostrils prior to the taking of samples, correct method of sample collection using suitable tampons, suitable culture media for cultivation, correct cultivation method and diagnostic procedure for the isolation and identification of grown cultures.     

Radiographic signs in cats with nasal disease

Radiographic signs in 64 cats that had radiography as part of the diagnostic work-up for suspected nasal disease were reviewed in a blinded fashion. Final diagnoses in these cats were rhinitis in 27, primary nasal neoplasia in 21 and non-nasal disease in 16. The signs with highest predictive value for nasal neoplasia were displacement of midline structures (73%), unilateral generalised soft tissue opacity (70%), unilateral generalised loss of turbinate detail (69%) and evidence of bone invasion (64%). The only radiographic finding that occurred more frequently in cats with rhinitis was a nasal cavity within normal limits, and the predictive value of this sign was only 38%. Radiographic signs in cats with nasal neoplasia are similar to those reported in dogs, whereas the radiographic signs in cats with rhinitis are variable and non-specific, and may be absent.     

MAGNETIC RESONANCE IMAGING AND CROSS SECTIONAL ANATOMY OF THE NORMAL EQUINE SINUSES AND NASAL PASSAGES

The purpose of this investigation was to define the magnetic resonance imaging anatomy of the rostral part of the equine head. 10 mm-thick, T1-weighted images of two isolated equine cadaver heads were obtained using a 1.5 Tesla magnet and a body coil. MR images were compared to corresponding frozen cross-sections of the cadaver head. Relevant anatomic structures were identified and labeled at each level. The resulting images provided excellent anatomic detail of the oral and nasal cavities, paranasal sinuses and associated structures. Annotated MR images from this study are intended as a reference for clinical MR imaging studies of the equine head.     

鼻腔免疫疫苗的前景和未来面临的挑战

与传统接种方式的疫苗相比,鼻腔免疫疫苗有更多的优势,主要包括:接种方式便捷,无需处理针头,使从业人员免受针刺损伤,接种者对鼻腔疫苗产品的接受度较高等,这令鼻腔免疫技术得到迅速发展.鼻腔免疫疫苗未来面临的主要挑战是:如何将体外试验数据转化为临床效果;制定接种方案时,应特别关注如何让这种独特的黏膜接种途径满足更多疾病、更多...     

COMPARISON OF RADIOGRAPHY AND COMPUTED TOMOGRAPHY FOR THE DIAGNOSIS OF CANINE NASAL ASPERGILLOSIS

To compare the radiographic and computed tomographic (CT) findings and to evaluate the sensitivity of radiography and CT for diagnosis of nasal aspergillosis in dogs, the radiographic and CT studies of 48 dogs with chronic nasal disease were reviewed separately. The radiographic and CT findings were recorded, and a diagnosis was made. The results obtained in the dogs with nasal aspergillosis (n = 25) were used. Based on definite aspergillosis as diagnosis, CT had a sensitivity of 88% and radiography of 72%. Considering definite and probable aspergillosis as equivalent, CT had a sensitivity of 92% and radiography of 84%. The sensitivity was higher in dogs with lesions affecting the entire nasal cavity and frontal sinus on at least one side (n = 20) with a sensitivity of 100% for CT and 90-95% for radiography than in dogs with lesions restricted to the nasal cavities (n = 5) where CT had a sensitivity of 60-80% and radiography of 0-40%. CT was superior to radiography for evaluation of the nasal cavities (mucosal thickening along the nasal bones, surrounding bone hyperostosis/lysis), frontal sinuses (mucosal thickening along the frontal bone, fluid/soft tissue, frontal bone hyperostosis/lysis), and differentiation between a cavitated-like or a mass-like process. This study suggests that CT is more sensitive than radiography for diagnosis of nasal aspergillosis in the dog because of a better demonstration of some changes suggestive of nasal aspergillosis. A diagnosis of a nasal aspergillosis restricted to the nasal cavities or associated with an FB is challenging, even with the use of CT.     

Radiographic techniques of the nasal cavity and sinuses

Diseases of the nasal cavity and sinuses can be frustrating problems for owners and veterinarians alike. Initial physical examination and routine blood work are often unrewarding in directing the clinician at a diagnosis. Diagnostic imaging can help characterize the disease process and direct treatment or further diagnostics. Radiographs of the skull are an excellent first-line diagnostic step in the analysis of nasal disease. The following article reviews basic techniques, positioning, and interpretation of radiographs of the nasal cavity and paranasal sinuses.