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Rhinotomy plus azoles in canine nasal aspergillosis
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The diagnosis of nasal aspergillosis in dogs is very difficult, and the therapy can be very frustrating. Is the combination of oral itraconazole, local enilconzole and rhinotomy the therapy of choice? An interesting study from Belgium.
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The effectiveness of rhinotomy and surgical debridement associated with topical administration of 2 per cent enilconazole and oral itraconazole in dogs with severe or recurrent sinonasal aspergillosis was evaluated in this study.
Methods: A standard rhinotomy was performed on seven dogs. In the initial study, the bone flap was left attached cranially and replaced at the end of the procedure.
In the main study group, the bone flap was discarded. Nasal passages were debrided and irrigated with enilconazole solution for one hour. Oral itraconazole was administered to four dogs for one month postoperatively. Follow-up rhinoscopy was performed in all dogs.
Results: All three dogs in the initial study had recurrence of the disease and two dogs had a second surgery to remove the flap.
The main study group included four dogs in which the flap was initially removed, and the two dogs from the initial study that required a second surgery. At follow-up rhinoscopy, five dogs were free of aspergillus but had bacterial or inflammatory rhinitis and one dog had a small aspergilloma but was subsequently asymptomatic.
Telephone follow-up revealed that four dogs were asymptomatic, one dog had intermittent sneezing and serous nasal discharge, and one dog had intermittent epistaxis.
Rhinotomy with removal of the flap combined with one-hour infusion of 2 per cent enilconazole and oral itraconazole resulted in satisfactory outcome in dogs with severe or recurrent aspergillosis.
Source: Claeys, S., Lefebvre, J. -B., Schuller, S., Hamaide, A. & Clercx, C. (2006): Surgical treatment of canine nasal aspergillosis by rhinotomy combined with enilconazole infusion and oral itraconazole. In: Journal of Small Animal Practice 47 (6), 320-324
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