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VM 536 Day 8 Nasal Disease Cases post class 2021 (1)

Canine and Feline Nasal Disease: Case Study Overview

Case 1: Crystal

  • Profile: 3-year-old Domestic Medium Hair (DMH) cat

  • Background: Found as a stray; Positive for Feline Leukemia Virus (FeLV)

  • Clinical Signs:

    • Unilateral mucopurulent nasal discharge, occasionally hemorrhagic

    • Facial deformity and exophthalmos

    • Proliferative retinal lesions diagnosed via fundoscopic exam

Diagnostic Assessment

  • Feline Fundoscopic Exam: Shows abnormal findings consistent with the disease.

Case Study Clinical Pathogen Investigation

  • Polypoid Nasal Mass: Indicative of possible fungal involvement.

Potential Pathogens and Sources

Organism Identification

  • iClicker Question: What is the organism likely identified?

    • A. Coccidioides immitis

    • B. Aspergillus fumigatus

    • C. Cryptosporidium parvum

    • D. Cryptococcus neoformans

Exposure Sources

  • iClicker Question: Where did Crystal get exposed?

    • All options are likely (ubiquitous exposure from soil, environment, and pigeon droppings).

Infection Factors

  • iClicker Question: Why did Crystal get infected?

    • B. Immunosuppression from retroviral infection

    • Increased risk factors: proximity to other cats and pigeons.

Clinical Impact of Cryptococcus Neoformans

  • Opportunistic Infection:

    • Source: Ubiquitous organism found in pigeon droppings.

    • Commonly affects cats over dogs; leading cause of fungal rhinitis in felines.

Pathophysiology

  • Characteristics:

    • Saprophytic budding yeast with a polysaccharide capsule

    • Strategy to evade phagocytosis and contributes to immune dysfunction

Clinical Presentation

  • Symptoms:

    • Sneezing, nasal discharge, airflow obstruction

    • Distortion of the nasal bridge, ulcers (40-50%) of nasal planum

    • Potential retinal granulomas (20%) and CNS involvement (20%).

Treatment Approaches

  • Nasal Cryptococcosis:

    • Primary treatments:

      • A. Topical antifungal therapy

      • B. Surgical removal of nasal granulomas

    • Systemic antifungal therapy as adjunctive treatment.

Case 2: Dutch

  • Profile: 6-year-old Male German Shepherd Dog (GSD)

  • Background: Working drug sniffer at Port Huron Border Patrol

  • Clinical Signs:

    • 3-month history of progressive left unilateral nasal discharge, episodic epistaxis

    • Mild laryngeal cough and nasal planum depigmentation.

Diagnostic Imaging

  • CT Findings:

    • Left-sided turbinate loss, thickening, and opacity in the left frontal sinus.

Rhinoscopy Findings

  • Observations:

    • White colonies along the nasal mucosa and in the frontal sinus.

    • Plaques observed.

Cytology Results

  • Nasal Cytology:

    • Neutrophilic inflammation with numerous septate branching hyphae indicating a fungal infection.

Possible Pathogen Identification

  • iClicker Question: What is this organism?

    • A. Dictyocaulus arnfeldi

    • B. Coccidioides immitis

    • C. Cryptococcus neoformans

    • D. Aspergillus fumigatus

Infection Origin

  • iClicker Question: How did Dutch get this infection?

    • Likely from the environment or other infected dogs.

Aspergillus Fumigatus Overview

  • Profile:

    • Septate and branching hyphae associated with fungal infections.

    • Common in young to middle-aged dolichocephalic breeds, particularly GSDs.

    • IgA deficiency noted in some affected dogs.

Clinical Presentation of Aspergillosis

  • Symptoms:

    • Mucopurulent nasal discharge (unilateral or bilateral)

    • Epistaxis, sneezing, nasal pain, pawing/rubbing behavior

    • Facial deformity and nasal planum depigmentation.

Treatment for Nasal Aspergillosis

  • Therapeutic Options:

    • A. Topical antifungal therapy (Clotrimazole, Enilconazole)

    • B. Surgical debridement of frontal sinus granulomas

    • Systemic antifungal therapy as needed.

Surgical Interventions

  • Specific Procedures:

    • Frontal sinusotomy for severe sinus involvement

    • Endoscopic investigations.

    • Address local immune deficiencies in predisposed breeds.

VM 536 Day 8 Nasal Disease Cases post class 2021 (1)

Canine and Feline Nasal Disease: Case Study Overview

Case 1: Crystal

  • Profile: 3-year-old Domestic Medium Hair (DMH) cat

  • Background: Found as a stray; Positive for Feline Leukemia Virus (FeLV)

  • Clinical Signs:

    • Unilateral mucopurulent nasal discharge, occasionally hemorrhagic

    • Facial deformity and exophthalmos

    • Proliferative retinal lesions diagnosed via fundoscopic exam

Diagnostic Assessment

  • Feline Fundoscopic Exam: Shows abnormal findings consistent with the disease.

Case Study Clinical Pathogen Investigation

  • Polypoid Nasal Mass: Indicative of possible fungal involvement.

Potential Pathogens and Sources

Organism Identification

  • iClicker Question: What is the organism likely identified?

    • A. Coccidioides immitis

    • B. Aspergillus fumigatus

    • C. Cryptosporidium parvum

    • D. Cryptococcus neoformans

Exposure Sources

  • iClicker Question: Where did Crystal get exposed?

    • All options are likely (ubiquitous exposure from soil, environment, and pigeon droppings).

Infection Factors

  • iClicker Question: Why did Crystal get infected?

    • B. Immunosuppression from retroviral infection

    • Increased risk factors: proximity to other cats and pigeons.

Clinical Impact of Cryptococcus Neoformans

  • Opportunistic Infection:

    • Source: Ubiquitous organism found in pigeon droppings.

    • Commonly affects cats over dogs; leading cause of fungal rhinitis in felines.

Pathophysiology

  • Characteristics:

    • Saprophytic budding yeast with a polysaccharide capsule

    • Strategy to evade phagocytosis and contributes to immune dysfunction

Clinical Presentation

  • Symptoms:

    • Sneezing, nasal discharge, airflow obstruction

    • Distortion of the nasal bridge, ulcers (40-50%) of nasal planum

    • Potential retinal granulomas (20%) and CNS involvement (20%).

Treatment Approaches

  • Nasal Cryptococcosis:

    • Primary treatments:

      • A. Topical antifungal therapy

      • B. Surgical removal of nasal granulomas

    • Systemic antifungal therapy as adjunctive treatment.

Case 2: Dutch

  • Profile: 6-year-old Male German Shepherd Dog (GSD)

  • Background: Working drug sniffer at Port Huron Border Patrol

  • Clinical Signs:

    • 3-month history of progressive left unilateral nasal discharge, episodic epistaxis

    • Mild laryngeal cough and nasal planum depigmentation.

Diagnostic Imaging

  • CT Findings:

    • Left-sided turbinate loss, thickening, and opacity in the left frontal sinus.

Rhinoscopy Findings

  • Observations:

    • White colonies along the nasal mucosa and in the frontal sinus.

    • Plaques observed.

Cytology Results

  • Nasal Cytology:

    • Neutrophilic inflammation with numerous septate branching hyphae indicating a fungal infection.

Possible Pathogen Identification

  • iClicker Question: What is this organism?

    • A. Dictyocaulus arnfeldi

    • B. Coccidioides immitis

    • C. Cryptococcus neoformans

    • D. Aspergillus fumigatus

Infection Origin

  • iClicker Question: How did Dutch get this infection?

    • Likely from the environment or other infected dogs.

Aspergillus Fumigatus Overview

  • Profile:

    • Septate and branching hyphae associated with fungal infections.

    • Common in young to middle-aged dolichocephalic breeds, particularly GSDs.

    • IgA deficiency noted in some affected dogs.

Clinical Presentation of Aspergillosis

  • Symptoms:

    • Mucopurulent nasal discharge (unilateral or bilateral)

    • Epistaxis, sneezing, nasal pain, pawing/rubbing behavior

    • Facial deformity and nasal planum depigmentation.

Treatment for Nasal Aspergillosis

  • Therapeutic Options:

    • A. Topical antifungal therapy (Clotrimazole, Enilconazole)

    • B. Surgical debridement of frontal sinus granulomas

    • Systemic antifungal therapy as needed.

Surgical Interventions

  • Specific Procedures:

    • Frontal sinusotomy for severe sinus involvement

    • Endoscopic investigations.

    • Address local immune deficiencies in predisposed breeds.

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