Case Study

CT – Unspecific unilateral chronic, mildly destructive rhinitis with secondary frontal sinusitis in a dog

This Labrador mix dog presented with shifting leg lameness of 3 weeks duration,moderately responsive to pain medications. Unilateral nasal bleeding post NSAIDs,(also post trauma) has progressed to constant blood dripping from left nares.

Physical exam: overweight, left nares bleeding, grade 2/4 lameness right front

CBC/Chem: HCT 34%, non-regenerative, PLT 69,000, PT/PTT elevated prior to startng Vit K.

Physical exam: overweight, left nares bleeding, grade 2/4 lameness right front

CBC/Chem: HCT 34%, non-regenerative, PLT 69,000, PT/PTT elevated prior to startng Vit K.

DX

The computed tomographic findings are compatible with unspecific unilateral leftsided chronic, mildly destructive rhinitis. Emerging ipsilateral secondary frontal sinusitis is present too.

Image Interpretation

CT of the head, plain and post contrast – There is an area of mild nasal turbinates destruction within the rostral and mid third of
the left nasal cavity noted. Within the ventral aspect of the left nasal cavity regional
thickening of the mucosal lining of the remaining turbinates as well as localized ventral
accumulation of inflammatory exudate is seen. Mild thickening of the mucosal lining
of the left nasal cavity is present too. Mild proliferation of the mucosal lining is noted
within the left frontal sinus. There is no fluid accumulation within the left or right
frontal sinus.
There is no mass lesion identified. A foreign body is not seen.
The right nasal cavity is within normal limits.
The lymph nodes of the head are within normal limits.

Outcome

Potential underlying causes include viral and bacterial rhinitis as well as a nasal foreign
body – note that macerated organic foreign material typically cannot be detected using
CT. Although typical findings are lacking here emerging fungal rhinitis or
superinfection definitely has to be considered a potential too.
Rhinoscopy with sampling to obtain bacterial and fungal cultures & histopathology
and to rule out a foreign body induced rhinitis is strongly advised for further definition
and to adjust the therapeutic management appropriately.