Welcome to November's Case of the Month! This month we'll look at a cat with a runny nose that was more than just a runny nose.

THE NOSE STILL KNOWS

HISTORY

Maggie was a 4 month old puppy who came to us for heavy discharge from her nose, and frequent sneezing, including some blood.

PHYSICAL FINDINGS

Maggie's initial examination showed some blood-tinged discharge from her nose, and a couple of small sores were visible just inside of her nostrils. She seemed a little lethargic, and didn't seem to be eating as well as usual. Since respiratory infections are fairly common and we had no history of any injuries, we suspected an infection and treated her with antibiotics.

Well, some nasal discharge is not a result of a simple infection (although you might not believe that if you look at our cases here - they're exceptions to the rule!!). She improved somewhat with the antibiotics, but was still sneezing and still "under the weather." Maggie's owners agreed to have her nose scoped to find the source of her problem.

X-RAY RESULTS

We found a couple of things. First, we could get a good look at the sore areas. Fortunately, there were only a couple, and they were both near the opening of the nostril, so could have just been the result of a lot of sneezing.

We also got a close-up look at the discharge. It was spread out pretty evenly, suggesting an irritation of the bulk of the nasal cavity.

We did a couple of things. First, we flushed the debris out of the nose. We also took a culture, which revealed some bacteria trapped in the debris.

TREATMENT

With what we found, we proved there were no tumors or foreign objects. We were left with the possibility of an allergy or irritant, or an infection. Since we did culture bacteria, we started by treating Maggie with an antibiotic suited to the specific bacteria.

She did very well for about a week, then started to have problems again. Addressing another of our possible diagnoses, we started her on prednisone to alleviate any allergy response to irritants.

DISCUSSION

The prednisone worked very well, but we don't want to use it any longer than necessary. We tried to stop the medication but her symptoms flared up again. Some initial antihistamines had limited effects. A subsequent fungal culture revealed 2 types of environmental fungi, suggesting that she may be exposed to these in her normal environment. Her owners are working to reduce and molds that might be in her surroundings, and we're working to find the most effective antihistamine for her.

See you next month.

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