Cat with odd nose

Re: Cat with odd nose

Utlendigur — Tue, 22 May 2012 18:53:46 GMT

Update on case - no evidence of neoplasia Suspected post-viral rhinitis (lymphocytic-plasmacytic infiltrate with glandular hyperplasia on biopsy). The strange nasal bone was thought to be a separate centre of ossification and not pathological.

Thank you all for your help and suggestions

Re: Cat with odd nose

Kate Richardson — Mon, 30 Apr 2012 21:01:23 GMT

[quote user="Utlendigur"]Would the serology for cryptococcus work for a non-systemic problem? [/quote]

yes

Re: Cat with odd nose

Utlendigur — Mon, 30 Apr 2012 20:56:14 GMT

Thanks for all the advice. Referral sent off this evening - I'll update with results when the report comes back. The bump on the nose is not that apparent when you look at the cat in real life - in fact the owners weren't sure whether it had been there since they got the cat.

Would the serology for cryptococcus work for a non-systemic problem?

I did consider trying nasal hydropulsion but chickened out, it just seemed a bit brutal in a little cat "Tissue from the table and the oropharynx" . I think you can even get special gizmo's now that look a bit like a small uripet to collect the sample from the oropharynx.

The xray was a fluke they don't usually come out that well. We've got a standard xray machine and a digital processor/digital plates - doesn't take intra-oral size plates. Given how happy the boss was to get rid of the chemical developer, I don't think I'd be popular if I blacked out the toilet again and ordered more of the stuff!

Just fingers crossed now...

Re: Cat with odd nose

Evelyn Barbour-Hill — Mon, 30 Apr 2012 19:29:36 GMT

[quote user="Laurence Webb"]

[quote user="Utlendigur"]

[quote user="Evelyn Barbour-Hill"]

Oh yes, and intra-oral radiographs.

[/quote]

Unfortunately we can't with our set up [/quote]

Fortunately we've got dental X-ray so I've never had to try, but is there a reason not to use dental X-ray film with a fixed X-ray head? Positioning may be a bit of a pain but I can't see any reason why, in theory, it should not be possible.

Developing is easy - stick some developer, water and fixer in pots deep enough to cover the films and do it manually.

Any experience of doing this, Evelyn?

[/quote]

Yes, sure.

And if you have a Velopex automatic developer you can put dental films through it.

But I agree the open-mouth shot is quite impressive.

Re: Cat with odd nose

Laurence Webb — Mon, 30 Apr 2012 18:47:19 GMT

[quote user="Utlendigur"]

[quote user="Evelyn Barbour-Hill"]

Oh yes, and intra-oral radiographs.

[/quote]

Unfortunately we can't with our set up [/quote]

Developing is easy - stick some developer, water and fixer in pots deep enough to cover the films and do it manually.

Any experience of doing this, Evelyn?

Re: Cat with odd nose

Evelyn Barbour-Hill — Mon, 30 Apr 2012 17:08:47 GMT

All the above comments useful, but why not try and get it eyeballed first?

Re: Cat with odd nose

Neil Wheadon — Mon, 30 Apr 2012 16:50:57 GMT

You could try this

Nasal Hydropulsion.

Vigorous flushing of the affected and non affected side with 20-60ml of saline using a large syringe. Tissue from the table and the oropharynx were submitted for histopathology and remarkably all 7 cats in the study harvested diagnostic samples.

I haven't tried it but would give it a go, if you do let me know

Neil

PS Lovely X-Ray and add Adenocarcinoma to the commoner lymphoma - all reported and locally invasive

Re: Cat with odd nose

Ian Battersby — Mon, 30 Apr 2012 14:47:35 GMT

Neoplasia is certainly a differential but i would also consider cryptococcuss infection.

Can diagnose with Biopsy etc but can do serological testing.

Ian

Re: Cat with odd nose

Richard Fox — Mon, 30 Apr 2012 14:15:09 GMT

In my experience of nasal biopsies 3/4 of chronic Ab responsive bx often with radiographic changes are non-specific unless a big unilateral space occupying and lytic lesion is present so I would also include lymphoma as a ddx but would not anything at the top of my list - I'd go for cyto or bx

Re: Cat with odd nose

Andrew Kent — Mon, 30 Apr 2012 12:33:14 GMT

I believe best survival times are with a combination of radiation and chemo, but I have had cases that have failed to respond to either.

Andy

Re: Cat with odd nose

Kate Richardson — Mon, 30 Apr 2012 11:30:00 GMT

Another vote for lymphoma, so biopsy the way forward. If it is, of all lymphomas, they are probably have the best prognosis with regards to response to chemotherapy.

Re: Cat with odd nose

Martin Atkinson — Mon, 30 Apr 2012 10:52:04 GMT

[quote user="Evelyn Barbour-Hill"]

Oh yes, and intra-oral radiographs.

[/quote]

I'm impressed with these X-rays, can't see how intra-oral would improve upon it.

Re: Cat with odd nose

Busybee — Sun, 29 Apr 2012 22:19:57 GMT

Another vote for lymphoma. Had an almost identical case a few weeks ago, very obvious bony destruction on xray and FNA also said most likely nasal lymphoma.

Re: Cat with odd nose

Julian Earl — Sat, 28 Apr 2012 20:25:38 GMT

Cat with odd nose...

how does it smell?

Oh, hang on...

Sorry. someone had to.

Re: Cat with odd nose

Dagmar Steele — Sat, 28 Apr 2012 20:21:56 GMT

I'm thinking neoplasia rather than anything else. Density differs from right to left on the rads, that makes me suspicious. Biopsy if possible or ct/MRI should provide an answer. Let us know if you find out.

Re: Cat with odd nose

Mark Hedberg — Sat, 28 Apr 2012 20:20:00 GMT

I rather liked the open mouth shot!

Re: Cat with odd nose

Utlendigur — Sat, 28 Apr 2012 19:44:06 GMT

[quote user="Evelyn Barbour-Hill"]

Oh yes, and intra-oral radiographs.

[/quote]

Unfortunately we can't with our set up

My plan was to refer for endoscopy next week - then keep everything crossed that it isn't neoplasia.

Thanks for the help

Re: Cat with odd nose

Utlendigur — Sat, 28 Apr 2012 19:32:58 GMT

[quote user="Andrew Kent"]think neoplasia likely in particular nasal lymphoma[/quote]

Bugger! Lovely owners - the sort who seem permanently unlucky with their pets

Re: Cat with odd nose

Evelyn Barbour-Hill — Sat, 28 Apr 2012 19:28:16 GMT

Oh yes, and intra-oral radiographs.

Re: Cat with odd nose

Evelyn Barbour-Hill — Sat, 28 Apr 2012 19:26:25 GMT

I think you've covered the differential diagnosis. Dental disease is always a possibility but these radiographs show no sign of it.

Try and get endoscopy done. If a lesion can be visualised then a good biopsy can probably be obtained. I wouldn't worry about MRI until endoscopy has failed.

Re: Cat with odd nose

Andrew Kent — Sat, 28 Apr 2012 18:24:49 GMT

I would biopsy, think neoplasia likely in particular nasal lymphoma in a cat of this age. If funds allow CT/MRI would help give further info and direct biopsy location. Andy