Examining Nasal Discharge

A common clinical sign of nasal disease is nasal discharge. With the exception of unilateral hemorrhagic discharge commonly associated with intranasal neoplasia, little data compare the discharge characteristics of different underlying intranasal diseases. In this retrospective study, the medical records of 105 dogs with discharge caused by nasal disease (ie, nonspecific rhinitis [n = 41], nasal neoplasia [n = 23], foreign body [n = 21], nasal mycosis [n = 7], miscellaneous causes [n = 13]) were reviewed. Dogs with foreign bodies or nasal mycosis were significantly younger than dogs with other diseases. Dogs with nasal foreign bodies and nasal neoplasia mainly showed unilateral nasal discharge. Sneezing was common in dogs with foreign bodies. Nasal stridor was significantly more common in dogs with nasal neoplasia as compared with other dogs. Mucoid discharge was significantly more common in dogs with nonspecific rhinitis and nasal neoplasia as compared with other groups, while pure or mixed hemorrhagic discharge was significantly less common in the nonspecific rhinitis group as compared with dogs with foreign bodies, nasal neoplasia, or nasal mycosis. Purulent discharge was most often associated with nonspecific rhinitis and foreign bodies.

Commentary

The standard diagnostic approach to nasal discharge in dogs is a CT scan followed by rhinoscopy and nasal biopsy. While this approach is diagnostic in most cases, the cost associated with these procedures is not feasible for some owners and not all veterinarians have access to CT and rhinoscopy. This study evaluated clinical signs and diagnostic test results in an effort to correlate these findings with specific nasal diseases. The study results concluded that consideration of the age and history of the patient and findings on thorough physical examination may aid in prioritizing the differential diagnosis and subsequent decisions regarding diagnostics. Unfortunately, radiographic features often were not helpful in differentiation, although some aspects of nasal CT were significantly associated with specific diseases (rhinitis, nasal neoplasia). Based on my clinical experience, many of the clinical aspects of nasal disease that help prioritize my differentials were confirmed by the findings of this study.—Laura Nafe, DVM, DACVIM

Source

Characteristics of canine nasal discharge related to intranasal diseases: A retrospective study of 105 cases. Plickert HD, Tichy A, Hirt RA. J SMALL ANIM PRACT 55:145-152, 2014.