Quick check of some head Xrays please!

Re: Quick check of some head Xrays please!

Birte Toft — Sat, 01 Feb 2014 17:50:26 GMT

I had a very similar case last year. The owners declined advanced imaging and rhinoscopy due to the cat's age and financial constraints, which was fair enough, but it would have been nice to have had a diagnosis. A good flush and a course of prednisolone turned out to be curative.

Re: Quick check of some head Xrays please!

Evelyn Barbour-Hill — Sat, 01 Feb 2014 17:09:48 GMT

[quote user="ChrisBVSc"] 'further up' (not very scientific I know)[/quote]

No, your impression of the type of noise and where it's coming from is very important.

[quote user="ChrisBVSc"] and if there's a foreign body it seems odd that he fully recovered for 2 months after the last episode.[/quote]

Very true. And the same would probably go for stenosis.

Re: Quick check of some head Xrays please!

ChrisBVSc — Sat, 01 Feb 2014 16:29:49 GMT

Thanks for the feedback. Had a good look behind the soft palate - all appeared normal. To be honest I was half expecting something to be going on in this area based on the sound he was making & level of dyspnoea prior to the steroid injection - the last one I had like this had a tumour behind the soft palate. You could be right about the noise being more tracheal, although it does sound 'further up' (not very scientific I know). If it doesn't resolve I'll try flushing, or see if they want to refer for scope/scan. However the response to steroids has been surprisingly good so far.. and if there's a foreign body it seems odd that he fully recovered for 2 months after the last episode.

Re: Quick check of some head Xrays please!

Evelyn Barbour-Hill — Sat, 01 Feb 2014 16:12:09 GMT

PS You sure the noise is nasal, not tracheal?

Re: Quick check of some head Xrays please!

Evelyn Barbour-Hill — Sat, 01 Feb 2014 16:06:53 GMT

I can't see any abnormality connected with the symptoms. (Interesting healing effect in the upper canine sites). No real sign of anything to do with the 208 (although a dental xray of its site would be nice).

Is the sneezing from both nostrils or only one? Have you tried occluding each in turn?

Foreign body or polyp have to be in the differential list. While under GA, did you get a look behind the soft palate? If you get a good light and a good hook and haul it hard you can see quite an area of the nasopharynx.

Tympanic bullae look clear on the Xrays.

Endoscopy (both retrograde and orthograde) of course would be highly desirable, essential for some diagnoses, but if this can't be arranged then a good plan is to flush both nasal passages copiously and rather forcibly. Of course, you must have a proper throat pack in place! What comes out the other end could be of considerable diagnostic value (you may even get bits of tissue, which you can rescue for histopathology); even if it's just thick purulent mucus it tells you something. And it's not unknown for the procedure to be curative.

Re: Quick check of some head Xrays please!

ChrisBVSc — Sat, 01 Feb 2014 13:20:43 GMT

Yes, I'm still getting used to our new digital system & the level of detail can sometimes be an issue when trying to rule out subtle changes!

Re: Quick check of some head Xrays please!

Beats — Sat, 01 Feb 2014 13:15:16 GMT

[quote user="ChrisBVSc"]Can anyone see anything on these x-rays that I've missed?[/quote]

If there is something relevant to see then I've missed it too

PS - nice detail in the xrays

Re: Quick check of some head Xrays please!

ChrisBVSc — Sat, 01 Feb 2014 13:11:50 GMT

Also as you can see he's missing almost all his teeth, I extracted the 1 remaining upper tooth (208) as it was in a pretty bad state, but I don't think it was linked to his other issues.