Chronic nasal discharge in a ten year old Border Collie

Abstract

Zak, a 10 year old male castrated Border Collie presented to the Cornell University Small Animal Internal Medicine Service on 11/4/08 for evaluation of chronic nasal discharge. His owners reported a left unilateral serous discharge beginning in June of 2008 that became mucopurulent in nature with occasional epistaxis. Past medical therapy included Clavamox and enrofloxacin, both with minimal effect. Skull radiographs, rhinoscopy, and fungal culture from a nasal swab were performed by the referring veterinarian. This information was forwarded along with Zak to Cornell for further investigation an evaluation. Physical examination revealed a left unilateral sanguinopurulent discharge from the nostril. Decreased airflow of the left nostril, depigmentation of the left nasal passage and rhinarium, pain on palpation of the muzzle, and occasional sneezing were noted. Hematology, serum chemistry, urinalysis, and clotting profile were within normal limits except for a mild hypoalbuminemia. Thoracic radiographs revealed no abnormalities. Review of the referring veterinarian's radiographs demonstrated increased soft tissue/fluid density in the left nasal cavity and frontal sinus. Computer tomography revealed left-sided turbinate obliteration, thickened nasal mucosa, and mild frontal bone lysis. Rhinoscopy, cytologic fluid analysis, and histopathology revealed fungal plaques containing branching septate hyphae with a supparative exudate, associated with the left frontal sinus. These findings were found to be consistent with a sinonasal aspergillosis and a one time invasive Clotrimazole therapy was instituted at Cornell resulting in a nearly complete resolution. Zak is currently doing well and continues to periodically have a mild serous nasal discharge.