This article is intended to provide concise information regarding the diagnosis and treatment of intranasal tumors of the dog and cat. Nasal tumors comprise only about 1% of all neoplasms of dogs and are even less common in cats. The average age of patients with this form of cancer is 10 years, and a slight predilection exists for male dogs.
This article is intended to provide concise information regarding the diagnosis and treatment of intranasal tumors of the dog and cat. Nasal tumors comprise only about 1% of all neoplasms of dogs and are even less common in cats. The average age of patients with this form of cancer is 10 years, and a slight predilection exists for male dogs.
This article is intended to provide concise information regarding the diagnosis and treatment of intranasal tumors of the dog and cat. Nasal tumors comprise only about 1% of all neoplasms of dogs and are even less common in cats. The average age of patients with this form of cancer is 10 years, and a slight predilection exists for male dogs.
Dogs and cats of our society have outgrown their status as merely pets and are now considered our close companions and even family members. This shift in their roles has led to pet owners seeking improved preventative medicine for their four-legged friends. Sub- sequently, dogs and cats are living longer lives than ever before and developing more old-age-related diseases. One of the most devastating diseases of older animals is cancer. Once a veterinarian has detected cancer in a pet, pet owners seek advice on their next course of action. This article is intended to provide concise information regarding the diagnosis and treatment of intranasal tumors of the dog and cat. This article outlines the forms of nasal tumors that are the most common, the recommended imaging and biopsy techniques to diagnose the tumor, and the most appropriate treatments of them. Clin Tech Small Anim Pract 21:89-94 2006 Elsevier Inc. All rights reserved. KEYWORDS intranasal neoplasia, nasal carcinoma, nasal sarcoma, nasal lymphoma, nasal turbinate destruction, epistaxis, rhinoscopy, rhinotomy, radiation therapy I ntranasal tumors comprise only about 1% of all neoplasms of dogs and are even less common in cats. 1 Speculation has been made, although no proof has been offered, to suggest that dolichocephalic, long-nosed, breeds of dogs or those animals living in urban environments with relatively high amounts of air pollution are more predisposed to developing this type of cancer. 1 Dogs Nasal Carcinoma Incidence and Clinical Signs Carcinomas, including adenocarcinoma, squamous cell car- cinoma, and undifferentiated carcinoma, comprise two- thirds of intranasal cancer in dogs. 1 The average age of pa- tients with this form of cancer is 10 years, and a slight predilection exists for male dogs. 1 Medium- to large-breed dogs seem to also be at a greater risk. 1 The most common clinical signs secondary to intranasal carcinoma are epistaxis, mucopurulent nasal discharge, facial deformity, and occasionally epiphora. 1,2 Potential differential diagnoses for dogs with these clinical signs include systemic hypertension, fungal or bacterial infections, and develop- mental anomalies. 1 However, a strong presumptive diagnosis of intranasal neoplasia can be formed for an older dog who presents with a history of intermittent and progressive, uni- lateral epistaxis or nasal discharge. 1 Certain dogs may present with concurrent neurologic decits as well, which is consis- tent with extension of the cancer into the central nervous system. 1 Staging and Diagnosis A denitive diagnosis of intranasal cancer requires evaluation of a tissue biopsy. Before a biopsy procedure, a complete work-up should be performed to rule out other forms of systemic disease. A complete physical examination including an ocular examination should be completed looking for evi- dence of retinal hemorrhage or tortuous retinal vessels. Ac- curate systemic blood pressure should be assessed along with a complete blood count (CBC), serum biochemistry prole, urinalysis, and clotting prole (PT/PTT or ACT). 1 If these diagnostic tests are otherwise normal, three-view thoracic radiographs should be completed and possibly skull radiographs to assess the nasal cavity. 1 The most benecial of the skull radiographs is commonly the open-mouth DV view performed under anesthesia. 1 In capturing this view, the ex- posure lm is placed inside the mouth of the patient and exposed in the DV plane. This view allows initial evaluation of the nasal turbinates for extent of disease and for detection of asymmetrical turbinate destruction. 1 Other benecial views include the following: lateral, dorsoventral (entire skull), ventro 15 rostral-dorsocaudal oblique, dorso 60 right-ventral left oblique, and dorso 60 left-ventral right oblique. 1,3 Thoracic radiographs are most often normal at the time of diagnosis. 1 Skull radiographs have an additional benet in that they offer direction as to where the most benecial biopsy site should be. A soft-tissue opacity superimposed over an area of turbinate destruction in the caudal half of the nose most often indicates nasal neoplasia. 1 Nevertheless, the benets of skull Michigan State University, Department of Small Animal Clinical Sciences, Lansing, MI. Address reprint requests to: Dr. Christine Malinowski, Michigan State Uni- versity, Department of Small Animal Clinical Sciences, 2016 Clifton Avenue, Lansing, MI 48910. E-mail: cmmalinowski@michvet.com. 89 1096-2867/06/$-see front matter 2006 Elsevier Inc. All rights reserved. doi:10.1053/j.ctsap.2005.12.016 radiographs are surpassed by computed tomography (CT). CT is the ideal diagnostic tool to assess for the extent of disease and the degree of bony involvement. This technology has the capability of dorsal and sagittal reconstructions that can show tumor/uid-to-air interfaces that are completely obscured in conventional radiographs. 4 CT can indicate cause of change more reliably than conventional radio- graphs 1,3,4 (Fig. 1). Magnetic resonance imaging (MRI) certainly has the po- tential to be an important imaging modality for intranasal cancer, as well. However, at this time, its limited availability in veterinary medicine limits its practicality. While the patient is still under anesthesia from its imaging procedures, rhinoscopy can be used to visualize the tumor before a biopsy procedure. Although tissue samples are rela- tively easy to obtain through most endoscopes, this method is not a recommended sampling procedure. Samples from en- doscopically introduced forceps are generally limited to the supercial layer of tissue due to the small size of the instru- ment. 1,2 The supercial layer of most nasal neoplasms con- sists of septic inammation and does not yield a diagnostic sample of the tumor itself. 1,2 Therefore, rhinoscopy should be utilized as a visual tool only, and a nasal biopsy should be collected using a closed nasal biopsy technique: a closed suction technique, a bone curette, or alligator forceps. 1 With the closed suction technique, a large-bore (3 to 5 mm) plastic cannula is directed into the nasal cavity and the tumor while the patient is under anesthesia. 1 Negative pres- sure is applied as the cannula is redirected at multiple an- gles. 1 Care should be taken during any biopsy procedure not to advance the biopsy tool beyond the level of the medial canthus of the eye to prevent entering the cribriform plate and the brain. 1,2 This precaution can be taken by premeasur- ing the tool from the naris to the medial canthus and placing a mark on the instrument. Mild-to-moderate hemorrhage is a secondary complication of this and other biopsy procedures and should be avoided in any patient for which there are concerns about coagulopathies or high risk for anesthesia. 2 Cytological analysis can be facilitated by using a small cylindrical brush that is introduced into the nasal cavity via endoscope and then brushed against the lesion. 2 This pro- cedure is less invasive than the previously mentioned biopsy techniques, but again requires an anesthetic event. Unfortu- nately, the brush technique also has a higher likelihood of being nondiagnostic as compared with evaluation of a biopsy or an impression smear from a biopsy sample. 1,2,5 More spe- cically, brush cytology can fail to reveal malignancy versus benign disease in specimens with low cellularity. 2,5 Research examining the reliability of brush cytology found that the most accurate results came from cell-rich samples. 5 In the case of a low cell harvest, the procedure should be repeated or a histological biopsy recommended. 2,5 Nasal ushing and swabbing are additional although generally unreliable cyto- logic techniques and should not be used as a sole means of diagnosis. 1,5 Nasal carcinomas are locally aggressive tumors, as is dem- onstrated by their ability to extend through the cribriform plate into the brain. 1 Any patient with central nervous system signs should have a sample of cerebrospinal uid collected and evaluated. Increased protein or cellularity is suggestive of brain involvement. 1 Although these tumors are rarely meta- static, local lymph node aspiration is diagnostic in about 10% of patients with nasal carcinoma. 1 Treatment Treatment of nasal neoplasia is focused on local control in a critical location, being adjacent to the brain and eyes. 1 Clin- ical signs are not usually observed and a diagnosis is not usually made until the tumor is advanced. Although surgery alone has been attempted, it is rarely curative. 1,3 Rhinotomy Figure 1 (A) CT scan of a 9-year-old, neutered male Rottweiler with a 2-month history of unilateral epistaxis. Diagnosis of a nasal tran- sitional cell carcinoma was made based on histopathology of a bi- opsy sample obtained with alligator forceps. Notice the mass in the dorsal aspect of the left side of the nasal cavity with the additional uid opacity in the ventral aspect. (B) The same Rottweiler with a view of the nasal cavity at the level of the eyes. Notice that the mass completely obstructs the passage of air on the left side. This nding corroborated with physical examination ndings. 90 C. Malinowski has the additional downfall of a high level of acute and chronic morbidity. 1 Case reports reveal patient survival times are not signicantly different if surgery is performed or if no treatment is offered. 1 The mean survival time after diagnosis of intranasal carcinoma with no further treatment is 3 to 6 months due to progression of local disease. 1 Immunotherapy and cryosurgery have also been used for a small number of dogs but have done nothing to improve survival times. 1 Radiation therapy is the most effective treatment available at this time. 1 Used either alone or in combination with rhi- notomy, survival times are increased to 8 to 25 months de- pending on the treatment protocol followed. 1 In one study of 42 dogs with intranasal tumors, the disease-free interval for dogs treated with radiotherapy alone was shorter than for dogs treated with surgery and radiotherapy; however, the overall survival times of the two groups were not signicantly different. 6 On retrospective analysis, the researchers of that study concluded that radiation treatment alone caused less patient morbidity than rhinotomy and radiation combined despite the earlier recurrence of clinical signs. 6 In a more recent retrospective analysis, dogs that underwent surgery followed by radiation therapy were signicantly more likely to develop rhinitis or osteomyelitis than dogs treated with radiation therapy alone. 7 Also noted in that study was that the rate of local recurrence of neoplasia was not signicantly different between the two groups. The median survival time for dogs in the radiotherapy-only group was signicantly shorter (68% alive after 1 year) than for the radiotherapy and surgery group (77% alive after 1 year). 7 Treatment with orthovoltage, high-energy megavoltage and cobalt radiation have been used individually and in com- bination. 1 Overall, adenocarcinomas respond better to radi- ation therapy than squamous cell carcinoma or undifferenti- ated carcinoma and have a relatively better long-term prognosis. 1 Unfortunately, no single protocol has been em- braced by the veterinary community, which complicates ap- propriate comparison of survival times. 1 Chemotherapeutic agents such as cisplatin seem to be effective adjunctive treat- ments, improving survival times when used as a radiation sensitizer. 1 During and after the completion of radiation therapy, acute phase side effects are often noted. Specically, rhinitis and mucositis can be severe and can last up to 4 to 8 weeks after treatment. 1 Keratoconjunctivitis sicca, corneal ulcer- ation, and cataracts are common secondary ocular changes. 1 Nasal Sarcoma Incidence and Clinical Signs Sarcomas, including brosarcoma, chondrosarcoma, osteo- sarcoma, and undifferentiated sarcoma, comprise the re- mainder of common intranasal tumors in dogs. 1 The average age of patients with this form of cancer is again about 10 years; however, chondrosarcoma has been shown to occur commonly in young dogs. 1 Medium- to large-breed dogs seem to be at a greater risk as well. 1 The most common clinical signs occurring secondary to intranasal sarcoma are epistaxis, mucopurulent nasal dis- charge, facial deformity, and occasionally epiphora 1 (Fig. 2A and B). The differential diagnoses for intranasal neoplasia were listed in the Incidence and Clinical Signs of nasal carcinoma. 1 As before, a strong presumptive diagnosis for intranasal neoplasia can be formed for an older dog who presents with a history of intermittent and progressive, uni- lateral epistaxis or nasal discharge. 1 Concurrent neurologic decits are consistent with extension of the neoplasia into the central nervous system. 1 Staging and Diagnosis A complete physical examination including an ocular exam- ination should be completed. Accurate systemic blood pres- sure should be assessed along with complete blood work, urinalysis, and a clotting prole. 1 If these diagnostic tests do not suggest underlying metabolic disease, three-view tho- Figure 2 (A) An example of a nasal chondrosarcoma in a 12-year-old, neutered male American Foxhound. Notice the asymmetry of the left side of the face, rostral to the zygomatic arch that is visible on close observation. (B) The same American Foxhound diagnosed with a nasal chondrosarcoma metastatic to the lungs. Notice the soft-tissue swelling to the left of midline and at the caudal aspect of the hard palate that is visible on oral examination. (Color version of gure is available online.) Tumors of the nasal cavity 91 racic radiographs and imaging of the nasal tumor should be completed. 1 As with nasal carcinomas, thoracic radiographs are often within normal limits at the time of diagnosis. 1 CT is the ideal diagnostic tool available to assess for the extent of disease and the degree of bony involvement, but skull radio- graphs can be very benecial in directing a biopsy proce- dure. 1 A denitive diagnosis of intranasal cancer requires evalu- ation of a tissue biopsy. Rhinoscopy and endoscopic biopsy instruments are limited in their function as it relates to nasal sarcomas as well as nasal carcinomas. A nasal biopsy should be collected using a closed nasal biopsy technique. 1 Mild-to- moderate hemorrhage should be expected; therefore, a bi- opsy procedure should be avoided in any patient for which there are concerns about coagulopathies or high risk for an- esthesia. 2 Special attention should be given during any bi- opsy procedure not to advance the biopsy tool beyond the level of the medial canthus of the eye to prevent entering the cribriform plate and the brain. 1,2 Local lymph node aspiration has had a limited amount of success in detecting nasal sarcomas as these tumors are rarely metastatic. 1 Fluid analysis, nasal washing, and brush cytol- ogy have a high likelihood of being nondiagnostic when mes- enchymal tumors are present as compared with evaluation of a biopsy. 1,2 These methods can fail to reveal malignancy ver- sus benign disease. 2 Treatment Treatment of nasal sarcomas is focused on local control. 1 As is the case with nasal carcinoma, patient survival times are not signicantly different if surgery is performed or if no treat- ment is offered. Bone invasion occurs early, and although surgery alone has been attempted, it is rarely curative and has a high level of acute and chronic morbidity. 1 The mean sur- vival time is 3 to 6 months due to progression of local dis- ease. 1 Radiation therapy is the most effective treatment available at this time. 1,6 Used either alone or in combination with rhi- notomy, survival times are increased to between 8 and 25 months depending on the treatment protocol followed. 1,6 Nasal sarcoma has been treated with orthovoltage, high-en- ergy megavoltage, and Cobalt radiation alone and in combi- nation as was discussed for nasal carcinoma. 1,6 During and after the completion of these protocols, acute phase side ef- fects of radiation on the mucosal surfaces and eyes were often noted. 1,6 Even if dogs have a resolution of clinical signs, fewdogs are considered cured if followed to necropsy. 1 Despite the rela- tively nonmetastatic nature of nasal sarcoma in untreated animals, metastatic lesions were found beyond the local site in 40% of 285 cases given radiation therapy and followed to necropsy. 1 Most metastatic lesions were found in the lymph node or lungs of those dogs and believed to be due to their prolonged survival times. 1 As more improvements in long- term survival are achieved, the true metastatic potential of nasal neoplasia may be revealed. 1 Chemotherapeutic agents, especially platinum agents, seem to be effective adjunctive treatments improving survival times when used as radiation sensitizers. 1 Overall, nasal sarcomas have a better long-term prognosis than carcinomas, with chondrosarcomas responding the best to treatment. 1,6 Cats Nasopharyngeal Polyps Incidence and Clinical Signs Nasopharyngeal polyps typically occur in cats less than 2 years of age. In one study, greater than 80% of affected cats were less than 1 year of age. 2 The most common clinical signs were sneezing, snufing, and upper airway stridor. 1,2 Less commonly, aural or nasal discharge was noted. This disease of cats is less likely to be of neoplastic origin and more likely of primary or secondary inammatory origin. 1 The polyps generally arise from the mucosa of the tympanic bullae or eustachian tube. The pedunculated mass then extends into the oral cavity or external ear canal. 1 Additional clinical signs to note include head tilt, circling, and possible nystagmus. 2 Staging and Diagnosis Staging includes a minimum database of a CBC, serum bio- chemistry prole, urinalysis, FeLV/FIV serology, T 4 testing, and three-viewthoracic radiographs. In addition, skull radio- graphs can assess for soft-tissue opacities within the tym- panic bullae, indicating uid or mass extension into the area. 1 Open-mouth radiographs to assess each of the bullae are recommended, but can give equivocal information. CT scan of the skull would reveal the full extent of the mass. 2 Treatment Involvement of the bulla is an indication for treatment. 2 In that situation, bulla osteotomy with concurrent appropriate sampling of the contents for bacteriologic culture and sensi- tivity should be performed. The patient should then be treated appropriately in coordination with the results. The owner should be warned about the likely development of Horners syndrome postoperatively, which is likely a tran- sient complication that resolves within a month of surgery. 2 If involvement of the bulla is not noted, removal should be sought by excision, including as much of the pedicle as pos- sible or by placing traction on the mass leading to rupture of the pedicle. 2 Recurrence was noted after surgical removal in about 20% of cases according to one study and can occur anywhere from 1 month to 3 years after surgery. 2 Regrowth can occur multiple times. Benign Nasal Tumors Benign tumors, such as adenomas, bromas, bropapillo- mas, hemangiomas, and chondromas, have been described in various case reports. 2 Such benign tumors, especially papil- lomas and bromas, may be difcult to differentiate from an inammatory nasopharyngeal polyp and vice versa. 2 They most commonly cause sneezing and snufing, but can be associated with facial deformity as well. 2 Surgical removal with histopathology is generally curative as well as diagnos- tic. 2 Nasal Carcinomas Although tumors of the nasal planum, especially squamous cell carcinoma (SCC), should be considered when evaluating a patient with facial deformity, sneezing, or upper airway 92 C. Malinowski stridor, this article describes only tumors of intranasal origin. Carcinomas are the most common form of intranasal neo- plasm of cats second to nasal lymphoma. 2 Incidence and Clinical Signs As opposed to nasopharyngeal polyps, intranasal carcino- mas generally affect cats greater than 6 years of age. 2 The most common clinical signs include sneezing, snufing, facial deformity, enophthalmos, exophthalmos, and chronic epiphora. 1,2,8 Unlike nasal neoplasms in the dog, nasal discharge and epistaxis are less common signs in cats, occurring in only about one-third of those affected. 2 Seizures can be an associated sign if the neoplasm has extended beyond the cribriform plate. 2,8 Clinical signs re- lating to a nasal carcinoma can be present for a relatively short period of time, 2 to 4 weeks, to years before a diag- nosis is made. 2 Of the carcinomas reported, about equal proportions have been of adenocarcinoma and undifferentiated carcinoma as well as a small number of SCC. 2 As is the case for dogs, speculation has been made for cats with longer nasal pas- sages, such as the Oriental breeds, to have a predisposition for developing nasal tumor malignancies. 2 No denitive sup- port for such a claim exists in the literature. Staging and Diagnosis The minimum database for a patient with nasal carcinoma includes a CBC, serum biochemistry prole, urinalysis, FeLV/FIV serology, T 4 testing, and three-viewthoracic radio- graphs. 2 In addition, evaluation of local lymph nodes, nasal radiographs, and a CT scan is recommended. 2 Skull radio- graphs may indicate destruction of nasal turbinates with or without a mass lesion and can direct one to an area likely to yield the most diagnostic material from a biopsy. 1,2 Rhinos- copy allows direct visualization of the gross disease present; however, CT is necessary to accurately delineate its full ex- tent. 2 Differential diagnoses in the face of nasal turbinate erosion include severe rhinitis and cryptococcosis as well as intrana- sal neoplasia. However, neoplasia can be considered more likely with the presence of unilateral radiographic lesions, lysis of a lateral bone, or tooth loss. 2 The most accurate method of diagnosis short of rhinotomy is a closed nasal biopsy, which also has the benet of reduc- ing contamination through the skin. 2 Although biopsy dur- ing an endoscopic procedure is relatively easy in cats, unfor- tunately, it is inadequate for accurate diagnosis. 2 As is the situation with dogs, the limited size of the biopsy sample through the endoscope restricts samples to the supercial layer, which usually consists of septic inammation. 2 There- fore, a nasal biopsy should be collected using a closed suction technique, a bone curette, or a small cup biopsy instrument introduced through the nares. With the closed suction technique, a large-bore (3 to 5 mm) plastic cannula is directed into the nasal cavity and the tumor with negative pressure while the patient is under an- esthesia. 1 Care should be taken during the biopsy procedure to not advance the biopsy tool beyond the level of the medial canthus of the eye to prevent entering the cribriform plate or the brain. 1,2 Mild-to-moderate hemorrhage is a secondary complication of this procedure and should be avoided in any patient for which there are concerns about coagulopathies or high risk for anesthesia. 2 Although metastases are uncommon, ne-needle aspira- tion of an enlarged local lymph node can give valuable cyto- logic information in combination with cytology or histopa- thology performed on the gross mass. 1,2 Brush cytology is a fairly noninvasive procedure that can be used in cats to pro- vide valuable information. Caution should be used when interpreting results as is described in Staging and Diagnosis of canine nasal carcinomas. 2,5 Treatment Cats have a poor tolerance for rhinotomy. 1 Surgery alone for nasal carcinoma has been reported in a small number of cats and was correlated with relatively fast tumor recurrence (1 to 12 weeks). 2 When surgery was combined with orthovoltage radiation therapy in six cats with nasal carcinoma, the results were much improved. 2 No recurrence was noted in four of the cats, two of which died 5 months after therapy of unre- lated causes and two of which remained disease-free at 26 and 40 months after therapy. 2 Recurrence was noted in the other two cats 21 and 62 months after therapy. 2 Treatment with surgery and Cobalt-60 irradiation has had less success with tumor recurrence within 1 year of treatment for each of three cats. 2 Cats treated with Cobalt-60, orthovoltage, or megavoltage alone experienced moderate success, but all had either local tumor regrowth or distant metastasis (local lymph node or lungs) within 11 months of treatment. 2 The acute side effects of radiation therapy were mild overall. 2 The degree of moist desquamation and ocular effects were less than those noted in similarly treated dogs. 2 These relatively mild side effects could be a sign that cats may be tolerant of larger doses of radiation. 2 Their higher tolerance for radiation therapy may prove benecial and should be examined in future reports. Multiple chemotherapeutic agents including mitox- antrone, carboplatin, cyclophosphamide, and vincristine have been used without surgery. 2 Unfortunately, the latter two drugs did not cause any noticeable remission. 2 Carbo- platin appears to be the most promising option for chemo- therapeutic treatment of feline nasal carcinoma. Finally, supportive care is an important treatment that should not be overlooked. Affected cats will have a reduced ability to smell and should be treated with appetite stimu- lants and have their food heated to entice them to eat. 1 If oral nutrition is not of an adequate amount, placement of an enteral feeding tube should be considered if therapy is likely to be prolonged. 2 In addition, topical eye care will be neces- sary on a short-termand possibly long-termbasis in conjunc- tion with radiation therapy. 2 Nasal Sarcomas Limited reports of intranasal sarcomas have described intra- nasal brosarcoma, chondrosarcoma, osteosarcoma, heman- giosarcoma, and undifferentiated sarcoma. 2 Two cats with chondrosarcoma were treated with surgery alone and both experienced regrowth of the tumor 6 months later. 2 An in- tranasal osteosarcoma was also treated with surgery alone twice over a 14-week period and was insufcient to control tumor growth. 2 Six cats with nasal brosarcoma or an undif- ferentiated form of sarcoma were treated with radiation ther- apy alone and had good results similar to cats with nasal Tumors of the nasal cavity 93 carcinoma. 2 The median survival for this group was 10 months. 2 As can be speculated for cats with nasal carcinoma, cats with nasal sarcoma that are to be treated with radiation therapy alone may be able to be treated with larger doses of radiation than those previously used. 2 Olfactory Neuroblastoma Also referred to as sympathicoblastoma and esthesioneuro- blastoma, olfactory neuroblastoma appears to be induced by the feline leukemia virus (FeLV). 2 The most common clinical signs in addition to nasal discharge and sneezing are CNS signs including circling, ataxia, behavior changes, and pare- sis. 2 This tumor originates from the neuroectoderm and the clinical signs appear to stem from the extension of the tumor into the CNS. 8 Support for the role of FeLV in the induction of this neoplasmis in the presence of FeLV DNA in the tumor of CNS affected cats correlated with its absence in normal brain tissue of the same cats. 2 As opposed to other intranasal neoplasia, this tumor is highly metastatic. Initial treatment with radiation therapy appears to be the most effective, but early recurrence is expected. 2 Follow-up treatment with che- motherapeutics, doxorubicin and carboplatin, may be effec- tive, but is often complicated by the concurrent FeLV infec- tion. 2 Prognosis is generally poor. Nasal Lymphoma Incidence and Clinical Signs Nasal lymphoma is the most common cause of nasopharyn- geal disease in cats. 2 The median age of affected cats among 60 case reports was 8 years old, but ranged from 2 to 19 years. 2 Clinical signs vary in duration and are similar to those reported for other forms of nasal neoplasia in cats: nasal discharge, dyspnea, epistaxis, stertor, facial deformity, and anorexia. 2,9 Staging and Diagnosis A minimum database including a CBC, serum biochemistry prole, urinalysis, FeLV/FIV serology, T 4 testing, and three- view thoracic radiographs should be collected along with an abdominal ultrasound, nasal CT or MRI, and bone marrow aspiration. 1,2 Most affected cats do not have a concurrent FeLV infection; however, those who are FeLV-positive have a higher risk of developing systemic disease. 2 Brush cytology was used in the previously mentioned re- ports to correctly identify nasal lymphoma in ve of six cats. 2 Rhinotomy or nasal biopsy, as described for feline nasal car- cinoma, may still be needed to obtain an accurate diagnosis. 2 Treatment In cats without systemic involvement, radiation therapy can be curative. 2 Radiation therapy and chemotherapeutics have been used alone and in combination to successfully treat feline lymphoma limited to the nasal cavity. 2 A study that compared the efcacy of the two modalities alone or in com- bination in a group of 14 cats revealed no statistically differ- ent survival times. 2 The most important prognostic factor was not the treatment protocol that was followed, but the patients FeLV antigenemia. Immunoblastic histologic phe- notype and FeLV antigenemia were associated with poor sur- vival rates. 2 Patients with systemic disease required chemo- therapy, preferably multidrug treatments, including vincristine, cyclophasphamide, and methotrexate, to achieve long-term survival. 2 As with all feline nasal neoplasms and especially those patients undergoing radiation therapy or chemotherapy, supportive care is key. Maintaining adequate nutrition by supplementing with appetite stimulants, antiemetics, or placing a feeding tube is very important. 1,2 Topical eye care should be maintained in the acute phase of radiation therapy to the head. 2 Conclusion Diagnosis of intranasal neoplasms in our dog and cat patients employs relatively simple diagnostic procedures that can be completed in a general practice. In most instances, the nature of radiation therapy then requires referral of the patient to a specialty facility to administer the most effective treatments. References 1. Lana SE, Withrow SJ: Tumors of the respiratory systemnasal tumors, in Withrow SJ, MacEwen EG (eds): Small Animal Clinical Oncology (ed 3). Philadelphia, PA, Saunders, 2001, pp 370-377 2. Moore AS, Ogilvie, GK: Tumors of the respiratory tract, in Ogilvie GK, Moore AS (eds): Feline Oncology: A Comprehensive Guide to Compas- sionate Care. Trenton, NJ, Veterinary Learning Systems, 2001, pp 368- 384 3. Park RD, Beck ER, LeCouteur RA: Comparison of computed tomogra- phy and radiography for detecting changes induced by malignant nasal neoplasia in dogs. J Am Vet Med Assoc 201(11):1720-1724, 1992 4. Codner EC, Lurus AG, Miller JB, et al: Comparison of computed tomog- raphy with radiography as a noninvasive diagnostic technique for chronic nasal disease in dogs. J Am Vet Med Assoc 202(7):1106-1110, 1993 5. Caniatti M, Roccabianca P, Ghisleni G, et al: Evaluation of brush cytol- ogy in the diagnosis of chronic intranasal disease in cats. J Small Anim Pract 39:73-77, 1998 6. Morris JS, Dunn KJ, Dobson JM, et al: Effects of radiotherapy alone and surgery and radiotherapy on survival of dogs with nasal tumours. J Small Anim Pract 35:567-573, 1994 7. Adams WM, Bjorling DE, McAnulty JF, et al: Outcome of accelerated radiotherapy alone or in accelerated radiotherapy followed by exentera- tion of the nasal cavity in dogs with intranasal neoplasia: 53 cases (1990- 2002). J Am Vet Med Assoc 227(6):936-941, 2005 8. Thon AP, Peaston AE, Madewell BR, et al: Irradiation of nonlympho- proliferative neoplasms of the nasal cavity and paranasal sinuses in 16 cats. J Am Vet Med Assoc 204(1):78-83, 1994 9. Vail DM, Moore AS, Ogilvie GK, et al: Feline lymphoma (145 cases): proliferation indices, cluster of differentiation 3 immunoreactivity, and their association with prognosis in 90 cats. J Vet Intern Med 12:349-354, 1998 94 C. Malinowski
Determinación de La Carga Al Dorso en Caballos de Rodeo Chileno y Comparación Con La Capacidad Máxima de Carga Al Dorso Estimada, de Acuerdo A La Fórmula de Beltrán (1954)
Determinación de La Carga Al Dorso en Caballos de Rodeo Chileno y Comparación Con La Capacidad Máxima de Carga Al Dorso Estimada, de Acuerdo A La Fórmula de Beltrán (1954)