Treatment of canine aspergillosis rhinitis
A 6 year old female spayed Labrador retriever presented for increased respiratory effort, depression and inappetence of two days duration. Her owners reported severe to moderate mucoid nasal discharge for approximately eight months, with the left appearing more affected than the right. The discharge had become blood tinged one month prior to presentation. Past medical therapy included prednisone, trimethoprim-sulfa, and amoxicillin, all with little effect. Rhinoscopy was performed by the referring veterinarian the day prior to presentation. Formalin-fixed nasal tissue samples and photographs were forwarded for interpretation. Physical examination revealed severe mucohemorrhagic discharge from the left nostril and mucoid discharge from the right. Increased airflow from the left nostril and depigmentation of the nasal philtrum were noted. In addition, temporal muscle atrophy and mandibular lymphadenopathy were present. Hematology and serum chemistry results were within normal limits except for a mild neutrophilic leukocytosis. Cytologic examination of nasal mucosal smears showed suppurative inflammation with many branching septate fungal hyphae, consistent with Aspergillus. In addition, large numbers of a mixed population of bacteria were noted, indicating secondary bacterial rhinitis. Modified topical clotrimazole therapy was instituted resulting in nearly complete resolution of clinical signs within one week. A second noninvasive treatment was administered two weeks later. The patient is currently doing well, although she continues to have mild nasal discharge due to nasoturbinate destruction.