Flashcards in Unit 3 - Nasal and Large Airway Disease Deck (63)
Excessive mucus in the nasal cavity will cause which abnormal respiratory sound?
Disease narrowing the intrathoracic trachea could cause which kind of dyspnea?
You are evaluating a 10 year old MN domestic shorthair cat for a chronic cough that has not responded to antibiotics. Chest radiographs show diffuse abnormalities. You recommend airway sampling next. What airway sampling options for this patient?
Endotracheal wash or bronchoalveolar wash (not necessary)
What clinical findings are consistent with nasal disease?
sneezing, nasal discharge, stertor, pawing/rubbing face, masses/facial distortion, nasal planum ulceration, seizures, mentation changes
What can cause unilateral nasal discharge?
neoplasia, tooth root abscess, foreign body, fungal, and trauma
What can cause bilateral nasal discharge?
inflammatory rhinitis, systemic disease, neoplasia, fungal, viral, or trauma
What is serous/serosanguineous nasal discharge often associated with?
viral, allergic, or inflammatory rhinitis
What does sanguineous discharge typically indicate?
the process is progressive and erosive
What does mucopurulent nasal discharge typically indicate?
a secondary bacterial infection
What can cause hemorrhagic nasal discharge?
severely erosive disease or systemic disease
What erosive disease can cause hemorrhagic nasal discharge?
neoplasia or aspergillosis
What systemic disease can cause hemorrhagic nasal discharge?
coagulopathy or hypertension
When doing a PE to determine the underlying cause of nasal discharge, what should you examine?
visual exam mouth/nose, palpate bones/muscle, ocular retropulsion, nasal patency, fundic exam, lymph node palpation, and neurologic exam
What 'first tier' diagnostic testing should be done for nasal discharge?
CBC, cytology, thoracic rads, coagulation profile, and blood pressure
What 'second tier' diagnostic testing should be done for determining the underlying cause of nasal discharge?
anesthetized oral examination, nasal CT, and rhinoscopy with biopsy
When measuring instruments for rhinoscopy, what should you measure the instrument to?
the medial canthus of the eye
What are the most common nasal diseases in dogs?
lymphoplasmacytic rhinitis, aspergillosis, and neoplasia
What are the most common nasal diseases in cats?
viral rhinitis, chronic rhinosinusitis, and nasopharyngeal polyps
What breeds typically get lymphocytic-plasmacytic rhinitis?
dolicephalics - Daschunds and Whippets
What clinical signs are associated with lymphocytic-plasmacytic rhinitis?
chronic nasal discharge, nasal congestion (stertor), and sneezing
How common is lympho-plasmacytic rhinitis?
It is approximately 1/3 of canine nasal disease referrals
How is lympho-plasmacytic rhinitis diagnosed?
It is based on diagnosis of exclusion - nasal biopsy, rule out infectious causes with culture
What is important to know about the treatment of lympho-plasmocytic rhinitis?
it is difficult to manage and you will not be able to cure it
What is the treatment of choice for lympho-plasmacytic rhinitis?
anti-inflammatories (immunomodulatory antibiotic and NDSAID), anti-histamines, and possibly itraconazole
What causes fungal rhinitis?
cryptococcus neoformans and Aspergillus fumigatus
What forms of Cryptococcus neoformans infections occur in cats?
nasal, cutaneous, and CNS
What forms of Cryptococcus neoformans infections occur in dogs?
Disseminated disease (more common) and subclinical nasal disease
How is Cryptococcus diagnosed?
organism identification (cytology, histopathology, culture) or antigen assay
How is Cryptococcus neoformans infection treated?
Fluconazole and Amphotericin B + 5-flucytosine (cats) or fluconazole