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Compendium September 2007 (Vol 29, No 9)

Abstract Thoughts — Chronic Nasal Discharge in Cats

    Demko JL, Cohn LA: Chronic nasal discharge in cats: 75 cases (1993-2004). JAVMA 230:1032-1037, 2007.

    Abstract: In this retrospective university study, the medical records of 75 cats with nasal discharge for 1 month or longer were reviewed. The goal of the study was to identify the most common cause(s) of the condition as well as important diagnostic variables.

    The median age of the cats was 6.8 years. The duration of the nasal discharge varied from 1 month to 4 years, and the discharge was most frequently (30 cases) mucopurulent. Complete blood counts yielded an abnormality in less than 10% of the cases, and serum biochemical analysis results were normal in all 41 cats tested. Forty-one of 52 cats tested negative for FIV, FeLV, or both. Forty-seven percent of cats (32) that underwent thoracic radiography and four of six cats that underwent skull radiography had normal results. Computed tomography of the skull was conducted in 23 cats, which all had abnormal results. An etiologic diagnosis was made in 56% of these cats. An etiologic diagnosis was also made in 69% of 29 cats that underwent rhinoscopy and in 68% of cats that underwent biopsy. Cytologic findings supported an eventual diagnosis in only seven of 27 cats. An etiologic diagnosis was recorded in only 27 of 75 (36%) cats. Neoplasia was the most common (15 cases, eight carcinomas) cause of nasal discharge. The authors concluded that the likelihood of making an etiologic diagnosis in cats with chronic nasal discharge is low and that a combination of advanced imaging, rhinoscopy, and biopsy offers the best chance of making a diagnosis.

    Commentary: Chronic nasal discharge in cats is an obvious clinical abnormality that can be difficult to treat due to the low yield of answers from diagnostic tests, as described in this clinical review. As noted by the authors, a confounding feature of this condition is often a transient appearance of improvement secondary to antimicrobial medication(s) despite normal bacterial growth in the nasal passages. It appears from this study that combining computed tomography, rhinoscopy, and biopsy offers the best hope in making an etiologic diagnosis and that neoplasia occurs most frequently. It is interesting that a diagnosis was made more frequently in cats with a long (>6 months) duration of discharge than in those affected for fewer months.

    Infections Associated with Intravenous Catheters in Dogs and Cats in an Intensive Care Unit

    Marsh-Ng ML, Burney DP, Garcia J: Surveillance of infections associated with intravenous catheters in dogs and cats in an intensive care unit. JAAHA 43:13-20, 2007.

    Given that infections associated with intravenous catheter use are a major cause of nosocomial infections in hospitalized animals, this study investigated 101 central and 50 peripheral catheters placed in 113 dogs and 38 cats to determine culture rates and risk factors associated with bacterial colonization. Catheters were placed in the intensive care unit and maintained for at least 48 hours. Crystalloid and colloid fluids, blood products, and intravenous medications were given via all catheters; central catheters were also used for other purposes, such as dextrose infusions and blood sampling.

    Strict protocols were followed for catheter placement and removal. After catheter removal, insertion sites and areas were evaluated for signs of inflammation, tenderness, and phlebitis; development of fever and outcomes were also assessed. Risk factors included blood sampling from catheters, infusate type, duration of placement, case outcomes, and catheter type, location, and complications.

    Key Finding:

    The total positive culture rate was 24.5%; 81.1% of positive culture results were from dogs. No association was found between positive culture results from catheter tips and any risk factors. Ten bacterial species were cultured—most commonly Enterobacter spp found mostly in the first phase of the study. A marked decrease in positive Enterobacter culture results in the second phase of the study suggested a nosocomial source.

    NEXT: American Heartworm Society News Brief

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