GRAND ROUNDS

CASE Glen McMahon228276

11 yearBorder CollieMN

HISTORY

Presented after having a large epistaxis episode.

Previously treated for intermittent sneezing, epistaxis and mucoid discharge.

CLINICAL EXAMINATION

No airflow through right nostril Evidence of discharge on hair around nares Symmetrical face, no swellings No lymph node enlargement

Differential Diagnosis

• Neoplasia • Rhinitis

• Aspergillosis• Trauma

• Coagulopathy• Foreign Body

INVESTIGATIONS

CT

GRAB BIOPSY

ULTRASONOGRAPHYLiver Spleen

NASAL CARCINOMADiagnosis

NASAL NEOPLASIA

Accounts for about 1% of all neoplasia in dogs 2/3 carcinoma <1/3 sarcoma Other

Medium to large breed >10 years Male

Locally invasive Initially low metastasis 50% metastasis by time

of death

Carcinoma Lymph nodes

Sarcoma Lungs

CLINICAL SIGNS

Discharge Epistaxis Sneezing Stertor/ stridor Epiphora Asymmetry

Reduced airflow Retropulse globes Facial pain

Subjective Objective

TREATMENT OPTIONS

SurgeryCryosurgeryRadiotherapy

Chemotherapy

PROGNOSIS

Cribiform erosion Lymph node

metastasis Advanced stage >10 years Tumour type

Early stage of disease

No epistaxis

Poor Good

SIDE EFFECTS OF RADIATION THERAPY

Early Oral mucositis Keratoconjunctivitis Rhinitis Skin desqumation Change in coat

colour

Late Cateracts Keratitis/ Uveitis Retinal haemorhage Osteochondrosis Optic nerve

degeneration Necrosis seizures,

OPTED FOR NO FURTHER TREATMENT

For Glen?

TAKE HOME MESSAGE

Nasal carcinoma is a rare and destructive disease.

Need to treat each case as an individual, wont always include treatment.

Multifactorial condition, worsen prognosis.

REFERENCES

Malinowski, C (2006) Canine and Feline Nasal Neoplasia, Clinical Techniques in Small Animal Practice, 21:89-94.

Withrow, S, J. Vail, D, M. Page, R, L. (2013) Small Animal Clinical Oncology, 5th ed. Elsevier Saunders. 23: 435 – 446.

Moores, A. Walker, D. (2013) Canine Nasal Disease: Investigation and Management, In practice, 35: 197 – 211

LaDue, T, A. et al. (1998) Factors Affecting Survival After Radiotherapy of Nasal Tumours in 130 Dogs, Veterinary Radiology and Ultrasound, 40: 312-173.