Page 37 - Problem-Based Feline Medicine

3 – THE CAT WITH SIGNS OF CHRONIC NASAL DISEASE 29

Differential diagnosis Clinical signs

Chronic bacterial rhinitis secondary to viral upper Typically there is chronic snuffling, sneezing and nasal
respiratory infection may produce similar laboratory discharge in a cat that sustained facial injuries in a fall
findings with neutrophils and bacteria, and no neoplas- or car accident.
tic or fungal elements. However, the discharge is typi-
Examination reveals a split hard palate either cen-
cally bilateral, whereas with a foreign body it is
trally along the palatine symphysis, or laterally
typically unilateral.
adjacent to the teeth along the maxillary symphysis.
Neoplasia and cryptococcosis may have similar
Signs often resolve spontaneously with spontaneous
signs, and the discharge is initially often unilateral.
healing of the cleft.
Positive diagnosis can be difficult with neoplasia and
foreign bodies, and may require a rhinotomy.
Diagnosis
Diagnosis is based on a history of trauma, signs of
Treatment nasal disease and visual evidence of the cleft.
Treatment involves removing the foreign body by
flushing, or grasping with forceps via the nares, Differential diagnosis
nasopharynx or rhinotomy.
Congenital cleft palate may look similar, but usually
signs are present from a few weeks of age, rather than
a recent onset following trauma.
Prognosis
Oronasal fistula associated with dental disease may
The prognosis is excellent if the foreign body can be
produce similar signs; evidence of advanced peri-
entirely removed.
odontal disease and lack of history or evidence of
facial trauma should allow differentiation.
ORONASAL FISTULA OR NASAL Treatment
FRACTURES FOLLOWING TRAUMA
If spontaneous resolution does not occur in 2–3 weeks,
Classical signs surgical repair is necessary.
● Chronic snuffling, sneezing and nasal
Prognosis
discharge.
● Cleft hard palate (lateral or midline). Good.

CHLAMYDOPHILA FELIS
(CHLAMYDOPHILA FELIS PSITTACI) AND
Pathogenesis
MYCOPLASMA
Cats that have been hit by a car, or have jumped out
of a high-rise building often have splitting of the Classical signs
hard palate along the symphyses.
● Chronic ocular-nasal discharge.
Signs of chronic nasal discharge and sneezing result ● Chronic conjunctivitis.
when food and water enter the nasal cavity. ● Chronic sneezing.

Spontaneous healing of the cleft often occurs within
See main references on page 13 for details (The Cat
2–3 weeks.
With Acute Sneezing or Nasal Discharge) and Page
If the hard palate is shattered into several pieces, necrosis 1215 (The Cat With Ocular Discharge or Changed
of a fragment may occur, forming an oronasal fistula. Conjunctival Appearance).