Help - cat with purulent sinusitis!

Re: Help - cat with purulent sinusitis!

Robin Grimmer — Thu, 30 Apr 2015 19:43:30 GMT

Is it worth checking felv/fiv?

Re: Help - cat with purulent sinusitis!

Tim Charlesworth — Thu, 30 Apr 2015 19:35:35 GMT

[quote user="Niall Taylor"]

Thanks both, I was a bit hesitant about just going back in an having an even more vigorous hack around than I did previously so the replies have helped greatly. They're not loaded with money but I might have to suggest an MRI scan as the first step to try to get to the bottom of this, just to discover the full extent of the infection.

[/quote]

I'd go for CT instead of MRI is you are suspicious of bony pathology (sounds most likely) - will be a lot cheaper for the owner. We've seen a few cats like this that had large abscesses within the nasal passages and spilling out/up into the sinuses. If there is no neoplasia then at the very least you prob have a very established osteomyelitis so debriding further will prob be required. I would def go for imaging as I would be worried about a blockage of the nasofrontal ostium if the pus is pushing through the sinus roof rather than dripping out the cat's nose! Could just be thick gloopy gubbins bunging things up but I would check before going to surgery. Scopes/rads would be good if they can't afford advanced imaging. You should be able to flush the sinus and see the saline come out of the nares at surgery, if you can't then something is not right...

Re: Help - cat with purulent sinusitis!

Martin Atkinson — Thu, 30 Apr 2015 19:13:18 GMT

[quote user="Niall Taylor"]how would a foreign body get into the frontal sinus? (I'm probably being a bit dim here![/quote]Not being dim but I have seen two grass seeds in cat's frontal sinuses, one was a veritable bush! Plus an airgun pellet - there was no history of an external wound for that.

Re: Help - cat with purulent sinusitis!

Evelyn Barbour-Hill — Thu, 30 Apr 2015 19:03:06 GMT

Have you some radiographs you can post?

Have you a 4mm endoscope you can put into the sinus? Have you an endoscope you can get up the nostrils with?

Foreign bodies can get anywhere! But it wouldn't have to be in the sinus.

Re: Help - cat with purulent sinusitis!

Sammy82 — Thu, 30 Apr 2015 19:01:05 GMT

Was the initial hole big enough for an air gun pellet?

Re: Help - cat with purulent sinusitis!

Niall Taylor — Thu, 30 Apr 2015 18:47:54 GMT

I agree about the possibility of neoplasia or a boney sequestrum; but how would a foreign body get into the frontal sinus? (I'm probably being a bit dim here!)

Thanks again,

Niall

Re: Help - cat with purulent sinusitis!

Evelyn Barbour-Hill — Thu, 30 Apr 2015 12:27:36 GMT

Radiographs?

Endoscopy?

The primary cause might not be in the frontal sinus itself. Anything that blocks the drainage of the sinus could be the cause and result in the single big blob of mucopurulent material.

Foreign body? Neoplasia?

Re: Help - cat with purulent sinusitis!

Martin Atkinson — Thu, 30 Apr 2015 10:19:48 GMT

Sounds like the sensible plan but are you sure that there isn't a foreign body in the sinus? And it may be sensible to send some fragments of bone and soft tissue for histology - I had something not dissimilar that was neoplastic.