Page 73 - Problem-Based Feline Medicine

5 – THE DYSPNEIC OR TACHYPNEIC CAT 65

GRASS AWNS, FOREIGN BODIES Diagnosis
Nasal and nasopharyngeal foreign bodies often result
Classical signs in little change on radiographs other than a unilateral
fluid density. Rhinoscopy is often both diagnostic and
● Sneezing (nasal foreign bodies), coughing
therapeutic, if the foreign body can be retrieved.
(tracheobronchial foreign bodies).
● Inspiratory/expiratory dyspnea, depending Tracheal foreign bodies may be seen radiographically.
on location. Rigid tracheoscopy allows for larger retrieval instru-
● Nasal discharge. ments to be utilized than with flexible endoscopy.

Bronchial foreign bodies may cause complete lobar
Pathogenesis atelectasis or abscessation radiographically. Right cau-
dal and accessory lobes are most often affected
Foreign bodies are usually inhaled or regurgitated with inhalation foreign bodies. Right middle lobe is
and rarely penetrate through the skin. Barbed grass affected commonly with aspiration of vomitus.
awns or seeds or blades of grass favor one-way migra-
tion (i.e., difficult to expel backwards). Differential diagnosis

Inhaled foreign bodies tend to lodge in the nasal cav- Other nasal diseases, such as infectious (especially fun-
ity in cats. gal), nasal cuterebriasis or neoplastic disease, tend to have
● As cats rarely mouth-breathe, inhaled tracheal for- a more insidious onset. Upper respiratory tract viral infec-
eign bodies occur much less commonly than in tion, especially calicivirus, causes acute paroxysms of
dogs. sneezing, which in the early stages could appear similar to
a nasal foreign body.
Penetrating foreign bodies can lodge in the nasal cavity,
such as pellets or a tooth broken from an opponent dur- Nasopharyngeal polyps tend to have a more insidious
ing a cat fight. onset.
Nasopharyngeal foreign bodies may lodge above the Tracheal or bronchial neoplasia have a more insidious
soft palate after vomiting. Food, hairballs and blades onset.
of grass are more common than grass seeds in this area.
Treatment
Tracheobronchial foreign bodies are often the result
Effective treatment involves removal of the foreign
of aspiration of regurgitated ingesta.
body and most can be removed endoscopically. Nasal
foreign bodies may be endoscopically retrieved or
Clinical signs hydropulsed. Occasionally, rhinotomy is required,
especially for foreign bodies that have migrated into the
Nasal foreign bodies create intense sneezing, pawing frontal sinuses.
or rubbing the nose along the ground, and nasal dis-
If a lung lobe is abscessed with a bronchial foreign
charge (often unilateral) with stridorous (whistling)
body, lobectomy may be required.
nasal breathing.
Nasopharyngeal foreign bodies cause gagging, dys- Prognosis
phagia and reverse sneezing. Coughing may occur
Prognosis is excellent with removal of the foreign body.
secondary to post-nasal drip (aspiration of caudal nasal
discharge). Stertorous breathing (snoring) may occur.
Prevention
Tracheobronchial foreign bodies cause coughing and
Appropriate hairball prophylaxis with combing and
signs of fixed obstruction (i.e., both inspiratory and
oral lubricant/laxatives reduces the likelihood or vomit-
expiratory dyspnea).
ing and aspiration of vomitus or the hairball.
● The coughing is often harsh and productive, and
may be elicited with tracheal palpation. Avoidance of grass fields during seed time.