Page 1349 - Cote clinical veterinary advisor dogs and cats 4th

Nasopharyngeal Polyps 681

• Icing the muzzle on the medication. They typically resolve than pursuing nasal radiographs (can save
time and money).
• Packing the nasal cavity with gauze in 1-2 days with supportive care. The most • Nasal tumors are rarely cured but are often
VetBooks.ir • Transfusion (p. 1169) for anemia due to days after treatment and neutropenia or well managed. The primary goal is controlling Diseases and Disorders
common include gastrointestinal upset 2-3
• Ligation of the ipsilateral carotid artery for
life-threatening hemorrhage
discomfort and morbidity from local disease.
thrombocytopenia 5-7 days after treatment.
blood loss is rarely required.
Serious complications, including septic
neutropenia, are possible. • In dogs, distant metastasis develops late in
the course of disease, and most dogs are
Chronic Treatment euthanized due to failure of local disease
External beam radiation therapy: Recommended Monitoring control rather than for signs related to
• Definitive-intent radiation is the most effec- Recheck every 3 months. Monitor clinical signs, metastatic disease.
tive treatment option for dogs and cats with and do routine imaging (chest radiographs in • In cats with nasal lymphoma, local control
nasosinal tumors. dogs, abdominal ultrasound in cats) to monitor can result in prolonged survival. However,
• Palliative-intent radiation provides less for systemic spread. systemic involvement develops in 15% of
durable tumor control, but the acute side cases. Cats can come out of remission even if
effects are reduced. PROGNOSIS & OUTCOME there is no evidence of systemic involvement
Chemotherapy: at the time of diagnosis. Cats with systemic
• For dogs, chemotherapy can palliate clinical A range of median survival times (MST) are involvement should be treated with a CHOP-
signs. Most protocols combine nonsteroidal provided below to reflect the results of multiple based chemotherapy. Radiation can be used
antiinflammatory drugs (NSAIDs) with studies. concurrently for palliation of nasal signs.
carboplatin, doxorubicin, or Palladia. Dogs: Survival time depends on the organ systems
• For cats with nasal lymphoma, combining • The overall median survival time (MST) with involved and the response to chemotherapy.
irradiation with chemotherapy does not definitive radiation is ≈12 months. MST is
improve survival compared with radiation ≈24 months for tumors limited to the nasal Technician Tips
therapy alone. With systemic involvement, cavity, ≈10 months with SQ/oropharyngeal/ • Oronasal fistulas may be present and cause
a CHOP-based chemotherapy protocol is orbital involvement, and ≈6 months with an increased risk of aspiration.
the primary treatment modality (p. 607). brain involvement. • Draw blood only from the jugular vein during
Surgery: • MST with palliative radiation therapy is the 72 hours before IV chemotherapy to
• Surgery alone is not effective for controlling ≈6-7 months. spare peripheral veins for catheter placement.
nasal tumors. • MST with chemotherapy is ≈5-7 months.
• Exenteration of the nasal cavity after radiation • MST with palliative medical management Client Education
can improve survival but also increases side is ≈4 months. • Persistent or recurrent nasal discharge often
effects significantly. Cats: requires advanced imaging and a biopsy to
Palliative medical management: • MST for nasal lymphoma treated with defini- obtain a diagnosis.
• Pain management, antiinflammatory agents tive radiation is ≈18 months. With complete • Nasal tumors are treatable but not curable.
(prednisolone in cats, NSAIDs in dogs), and remission (CR), MST is ≈3 years; partial The side effects of treatment options are
antibiotics (e.g., clindamycin, amoxicillin remission (PR) MST is ≈4 months. usually temporary and can be well controlled
plus clavulanic acid) • MST for nasal lymphoma treated with with oral medications at home.
chemotherapy alone is 4-5 months. With
Possible Complications CR, MST is ≈2 years, and PR MST is ≈2 SUGGESTED READING
• Acute radiation side effects develop 2-3 weeks months. Vail DM, Page RL: Nasosinal Tumors. In Withrow
into radiation and resolve after 2-3 weeks. • MST for nonlymphoma nasal tumors treated & MacEwen’s Small animal clinical oncology, St.
They include mucositis, conjunctivitis, and with definitive radiation is ≈12 months. Louis, 2013, Saunders.
moist desquamation. Typically, well con- • MST for all nasal tumors with palliative AUTHORS: Sarah B. Rippy, DVM; Melanie Moore,
trolled with pain medications, antibiotics, medical management is ≈2-4 months. BVM&S, DVM
and comfort care EDITOR: Megan Grobman, DVM, MS, DACVIM
• Chronic radiation side effects are rare but PEARLS & CONSIDERATIONS
can develop after 6-12 months. They can
include bone necrosis, oronasal fistulas, kera- Comments
toconjunctivitis sicca (KCS), and secondary • If an animal owner is considering radiation
tumor formation. therapy for treatment of a pet with possible
• Chemotherapy side effects are uncommon nasal neoplasia, early referral for advanced
(20%-25% of patients) and vary depending imaging (e.g., CT scan) is suggested rather

Nasopharyngeal Polyps Client Education Bonus Material
Sheet
Online
Epidemiology
BASIC INFORMATION drainage are proposed; may have a congenital
SPECIES, AGE, SEX origin.
Definition Well-recognized disorder in young adult cats
Non-neoplastic pedunculated mass originating but can occur at any age; rare in dogs ASSOCIATED DISORDERS
from the middle ear or auditory tube epithelium • Otitis media, interna, or externa
RISK FACTORS • Horner’s syndrome
Synonym Chronic inflammation of the upper respiratory
Inflammatory polyp tract or any process that obstructs middle ear

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