Small Animal Soft Tissue Surgery Q&A 11

This is a skull radiograph of a five-year-old, male German Shepherd Dog that presented for chronic sanguinopurulent nasal discharge, ulceration of the external nares and intermittent epistaxis.

Question	Answer		Article
Based on this radiograph, what is the diagnosis and what signs enable you to be confident of your diagnosis?	Mycotic rhinitis due to Aspergillus spp. (A. fumigatus is the most common isolate) or Penicillium spp. is typical of the pattern present on radiographs. There is marked turbinate destruction and an overall radiolucency of the left nasal chamber. Other diagnostic considerations include intranasal foreign body (although increased opacity is commonly seen around the object) and neoplasia (aggressive destruction of turbinates, vomer bone and/or facial bones is seen, but usually with a homogeneous increase in opacity of the nasal passages).		[[|Link to Article]]
What other diagnostic tests would be useful to perform?	Rhinoscopy may reveal white, yellow or green fungal plaques on the nasal mucosa; concurrent biopsy samples are taken for histologic analysis, culture and cytologic examination. Serologic testing is performed (AGID or ELISA) but cross-reactivity between Aspergillus spp. and Penicillium spp. may make them hard to differentiate by this method.		[[|Link to Article]]
Describe the most non-invasive treatment for this condition. Why does this therapy provide a better prognosis, and what complications can occur?	Treatment of nasal aspergillosis is by infusion of enilconazole or clotrimazole through an 8 French polypropylene catheter placed through the external nares midway along the dorsal nasal meatus on each side. The nares and nasopharynx are occluded using gauze sponges or laparotomy pads and the dog is placed in dorsal recumbency. After injection of the agent, the animal is placed in ventral recumbency and the nose tipped to allow drainage of excess fluid. Complications of this procedure include recurrence from incomplete distribution of the antifungal agent (although less likely to occur than with the surgical technique), and aspiration pneumonia or esophagitis from leakage of the agent if occlusion of the nasopharynx is not performed properly.		[[|Link to Article]]