Page 1346 - Cote clinical veterinary advisor dogs and cats 4th

680 Nasal Neoplasia

discharge is often extremely frustrating for Technician Tips SUGGESTED READING
the veterinarian and pet owner. Physical manipulation of cats with reduced Cohn LA: Canine nasal disease. Vet Clin North Am
VetBooks.ir Prevention Abort handling, and notify a veterinarian if a AUTHOR: Jared Jaffey, DVM, MS, DACVIM
nasal airflow can prompt respiratory distress.
Small Anim Pract 44:75-89, 2014.
cat begins to open-mouth breathe.
Nasal mites are prevented by routine use of
EDITOR: Leah A. Cohn, DVM, PhD, DACVIM
heartworm and ectoparasites prophylactics.

Nasal Neoplasia Client Education
Sheet

BASIC INFORMATION • Round cell hypertension, hyperviscosity syndrome,
○ Rare in dogs; transmissible venereal tumor vasculitis, ehrlichiosis
Definition in dogs living in endemic locations ○ Nasal disease (p. 678)
Neoplastic growth originating in the nasal ○ Solitary nasal lymphoma is the most • Nasal discharge/sneezing (pp. 678 and 1255)
passageways or sinuses common nasal tumor in cats. Some cats • Facial deformity
eventually develop systemic lymphoma. ○ Tooth root abscess
Synonyms Benign: ○ Cryptococcus (cats)
Nasosinal tumor, nasal tumor • Inflammatory polyps (p. 681)
• Oral tumors may also extend into the nasal Initial Database
Epidemiology cavity. • CBC, biochemical profile, and urinalysis
SPECIES, AGE, SEX are typically unremarkable but can indicate
• Nasosinal tumors are ≈2% of canine HISTORY, CHIEF COMPLAINT chronic inflammation/hemorrhage.
neoplasia and are common in older dogs Most patients have had signs for 2-4 months • Mandibular lymph node aspirates (bilateral)
(mean, 9-10 years, youngest reported is before presentation. to screen for local metastasis
1 year). • Unilateral or bilateral epistaxis or nasal • Thoracic radiographs to screen for pulmonary
• Nasosinal tumors are ≈1% of feline neoplasia discharge metastasis (uncommon at diagnosis)
and are common in older cats (mean, 8-10 • Sneezing/reverse sneezing
years, youngest reported is 2 years). • Stertor Advanced or Confirmatory Testing
• Facial deformity or pain • Skull radiographs: not sensitive or specific;
GENETICS, BREED PREDISPOSITION • Dysphagia with invasion of the oral can show evidence of soft-tissue/fluid
More common in dolichocephalic dogs cavity opacity in the nasal passages, displacement
• Seizures with invasion into the brain of midline, or bone destruction. High-quality
RISK FACTORS images require general anesthesia.
Possible association with urban environments PHYSICAL EXAM FINDINGS • CT: preferred over nasal radiographs; allows
and smoke exposure Signs may be unilateral or bilateral, depending tumor staging and treatment planning and
on the stage. extremely useful to distinguish fungal rhi-
CONTAGION AND ZOONOSIS • Decreased nasal airflow nitis from neoplasia. Perform scan before
Transmissible venereal tumor is contagious • Stertor rhinoscopy or biopsy to prevent artifacts.
among dogs. • Epistaxis or nasal discharge • MRI (p. 1132): provides excellent soft-tissue
• Reduced or painful ocular retropulsion detail but not useful for radiation planning
ASSOCIATED DISORDERS • Mass effect above the soft palate • Biopsy (blind, transnasal, guided): if possible,
• If the tumor extends into the brain, neuro- • Facial deformity or pain use the location determined by CT to direct
logic signs such as seizures can occur. • Enlarged mandibular lymph nodes ipsilateral sampling. Be careful not to advance biopsy
• Nasal lymphomas can progress to a systemic to tumor instrument past the medial canthus of the eye.
lymphoma with clinical signs reflecting the • Rhinoscopy (p. 1159): may not visualize
organ systems infiltrated. Etiology and Pathophysiology tumor. Rhinoscopic biopsy specimens are
Exposure to poor air quality (environmental frequently nondiagnostic.
Clinical Presentation contaminants) may increase the risk of neo- • Abdominal ultrasound: for cats with nasal
DISEASE FORMS/SUBTYPES plastic transformation. lymphoma to rule out systemic involvement
Malignant:
• Epithelial DIAGNOSIS TREATMENT
○ Two-thirds of canine nasal tumors; adeno-
carcinoma and, less frequently, squamous Diagnostic Overview Treatment Overview
cell carcinoma and anaplastic carcinoma Further evaluation is indicated if nasal discharge Malignant nasal tumors are rarely cured but
○ Uncommon in cats; adenocarcinoma and persists for more than 2-3 weeks or recurs after are often well managed. The primary goal is
squamous cell carcinoma treatment, or for any pet with epistaxis. controlling discomfort and morbidity.
• Mesenchymal
○ One-third of canine nasal tumors; chondro- Differential Diagnosis Acute General Treatment
sarcoma and, less frequently, osteosarcoma • Epistaxis Urgent or acute treatment is seldom required.
and fibrosarcoma. Olfactory neuroblas- ○ Systemic disorders: coagulopathy (e.g., If epistaxis is profuse or sustained, consider:
toma is rare. thrombocytopathy, thrombocytopenia, • Sedation
○ Rare in cats anticoagulant rodenticide intoxication), • Intranasal epinephrine

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