Page 44 - Problem-Based Feline Medicine

36 PART 1 CAT WITH UPPER RESPIRATORY TRACT SIGNS

Pathogenesis The discharge may initially be unilateral and
progress to bilateral involvement.
Congenital stenosis of the external nares is common in
some breeds, e.g. Persians, Himalayans. Snoring, snorting, inspiratory stridor, stertor or dyspnea
from nasal obstruction are common.
The combined effects of stenosis of the external
nares and reduced nasal air space cause respiratory Facial distortion, e.g. elevation of bridge of nose
obstruction. (Roman nose) or facial swelling may be evident.
Partial obstruction results in increased respiratory effort Epiphora (associated with obstruction of the lacrimal
and stertorous respiration or stridor. duct), or a bloody ocular discharge may occur.
With stress (e.g. visit to veterinarian or cat show), stri- Signs of retrobulbar pressure may be present, e.g.
dor becomes more pronounced, and cats may become exophthalmos and ocular deviation.
severely dyspneic and mouth breath.
Occasionally, central nervous system signs, e.g.
seizures, circling, ataxia, behavioral change occur.
Clinical signs
Nasal signs may be present for days, or in rare cases,
Chronic snuffling and stertorous respiration or stridor.
for as long as 2 years. Usually, signs are present for less
Dyspnea or mouth breathing. than 6 months prior to diagnosis.
Narrow external nares in a brachycephalic cat. Diagnosis

Diagnosis Radiography demonstrates increased opacity of the
nasal cavity and often destruction of the turbinates,
Based on clinical signs and physical examination.
nasal septum, lateral bone and loss of teeth adjacent to
the lesion. Radiographic changes are often unilateral
Treatment
or asymmetrical.
Surgical removal of the wing of the nostril.
Cytological examination of the discharge or atraumatic
nasal flush usually reveals evidence of inflammation
NEOPLASIA ** (neutrophils and bacteria) but no tumor.
A traumatic flush using a stiff catheter and syringe (e.g.
Classical signs
cut-off dog urinary catheter) yields better results than
● Progressively worsening chronic sneezing an atraumatic flush.
and snuffling.
A biopsy is often required to obtain tissue for a histo-
● Purulent or blood-tinged nasal discharge,
logical diagnosis. Tissue may be obtained using biopsy
which may temporarily respond to
forceps through the external nares or via a rhinotomy.
antibiotics.
● Nasal obstruction and epiphora.
● Occasionally facial distortion ± signs of
retrobulbar pressure, e.g. exophthalmos. CRYPTOCOCCOSIS AND OTHER FUNGI**

See main reference on page 23 for details (The Cat Classical signs
With Signs of Chronic Nasal Disease).
● Chronic nasal discharge, stridor and
sneezing, progressing in severity.
Clinical signs ● Soft tissue swelling over the nasal bones
(Roman nose), or polyp-like mass in nasal
Chronic sneezing and snuffling, which progressively
cavity.
worsen with time.
Purulent or bloody nasal discharge, which may tem- See main reference on page 25 for details (The Cat
porarily respond to antibiotics. With Signs of Chronic Nasal Disease).