Page 25 - Problem-Based Feline Medicine

2 – THE CAT WITH ACUTE SNEEZING OR NASAL DISCHARGE 17

Diagnosis ● Radiography demonstrates increased opacity of
the nasal cavity and often destruction of the
Cytological examination of an impression smear, or
turbinates, nasal septum, lateral bone and loss of
biopsy and histological examination of the lesion is
teeth adjacent to the lesion. Radiographic changes
usually diagnostic for squamous cell carcinoma of the
are often unilateral or asymmetrical.
external nares.
● A traumatic flush using a stiff catheter and
Eosinophilic granuloma requires biopsy for diagnosis. syringe (e.g. cut-off dog urinary catheter) yields
better results than an atraumatic flush.
Acute calicivirus infection is diagnosed based on clini-
● A biopsy is often required to obtain tissue for a his-
cal signs, and in some cases PCR.
tological diagnosis. Tissue may be obtained using
biopsy forceps through the external nares or via a
INTRANASAL TUMORS rhinotomy.
Classical signs ALLERGIC RHINITIS
● Chronic nasal discharge and sneezing,
progressing in severity. Classical signs
● Facial distortion.
● Acute or chronic serous or mucoid nasal
discharge, often seasonal.
See main reference on page 23 for details (The Cat
With Signs of Chronic Nasal Disease).

Clinical signs
Clinical signs
Allergic rhinitis appears to be a rare and poorly docu-
Acute sneezing and/or discharge may occasionally mented condition in cats.
occur associated with an intranasal tumor. Suspect
It presents as serous or mucoid ocular and/or nasal dis-
this disease when signs do not resolve over 2–3 weeks,
charge without systemic signs, and may be seasonal in
and instead progress with worsening discharge, and
occurrence.
often nasal distortion.
It has been reported associated with allergy to
Intranasal tumors are associated with chronic sneez-
Japanese cedar (Cryptomeria japonica).
ing and snuffling, which progressively worsen with
time and a purulent or bloody nasal discharge, which
may temporarily respond to antibiotics. The dis- Diagnosis
charge may initially be unilateral and progress to bilat-
Diagnosis is based on exclusion of all other causes of
eral involvement.
nasal discharge, and biopsy results indicating rhinitis
Snoring, snorting, inspiratory stridor, stertor or with no evidence of underlying pathogens. A mixed
dyspnea may result from nasal obstruction. neutrophilic and eosinophilic rhinitis has been reported.

Facial distortion, e.g. elevation of bridge of nose Most cases with similar signs are the result of viral
(Roman nose) or facial swelling may occur. upper respiratory disease, often with chronic bacterial
rhinitis cases.
Diagnosis Treatment

Intranasal tumors usually require an invasive approach A combination of antihistamine and steroid may work
for diagnosis. Cytological examination of the discharge well in some cats. For example, trimeprazine tartrate (5
or atraumatic nasal flush usually reveals evidence of mg) and prednisolone (2 mg) in Temaril-P (1/4 to 1/2
inflammation (neutrophils and bacteria) but no tumor. tablet PO q 12–24 h).