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Post-Rhinoscopy

Updated: Jan 15, 2022

Your pet has had three-dimensional advanced imaging of the skull [via a computed tomographic (CT) scan or magnetic resonance imaging (MRI)] and rhinoscopy to try to determine the cause of the clinical signs. Advanced imaging and rhinoscopy are diagnostic procedures and your pet’s medical problem will not be fixed or improved following theses procedures. Only in very rare cases, such as foreign objects and abnormal strictures in the nose, is a treatment for the problem performed simultaneously.


There are many signs that your pet may have, and these are not specific to any one particular disease process but are very similar across all diseases that affect the nose. These signs may include sneezing, nasal discharge of any type (bloody, mucoid, clear), nasal congestion, snorting, gagging, or swelling of the nose or head. Occasionally cats will present with a significant increase in respiratory effort when their nose is congested as they rarely open their mouth to breathe.


Diseases that can affect the nose include nasal cancers, fungal infections, anatomic abnormalities (both congenital and acquired), immune-mediated inflammation, foreign material in the nose, severe dental disease, allergic inflammation, viral infections, and rarely bacterial infections. Nose bleeds can occur in dogs and cats related to diseases outside the nose, so diagnostic tests such as clotting times, platelet count, blood pressure, and certain infectious disease testing may have been performed prior to the recommendation for rhinoscopy.


Basic health screening blood and urine tests are often recommended prior to this procedure and others that requires general anesthesia. Occasionally chest (thoracic) radiographs (x-rays) or an echocardiogram is also recommended as indicated clinically. General anesthesia carries some uncommon risks, including death, esophageal strictures, aspiration pneumonia, and strokes while under anesthesia. These are extremely uncommon, and the highest quality monitoring is provided by a qualified veterinary technician.


A computed tomographic scan or magnetic resonance study are advanced imaging techniques that permit detailed three-dimensional evaluation of bony and soft tissue structures, respectively that are difficult to otherwise image. It allows the radiologist and internist to determine not only where in the nose is the problem located, but also gives some general idea of the class of disease. After advanced imaging if a space occupying mass is seen, a biopsy is performed with rhinoscopic guidance to further evaluate the nose and obtain samples of any lesions. Rhinoscopy is performed with a small flexible fiberoptic scope and a small rigid scope that can be advanced through the nasal cavities of all but the smallest patients. The back of the nose is examined with the flexible scope, and then the throat is packed off with gauze sponges. The scope is then advanced through the nasal structures in a systematic fashion. In order to facilitate visualization through the mucous and blood that are inevitable. A continuous saline flush is often utilized. Foreign material can be removed using a small grasping forceps or may be flushed out during the examination. After a thorough evaluation, nasal biopsies are obtained.


After the procedure it is common to have some increased nasal congestion and bleeding due to biopsies and the presence of the scope. Nasal bleeding is not uncommon for several days following the procedure and patients are typically discharged the same day.

 


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