Maisie has been awarded the Fromus Vet Group’s

DECEMBER 2006 PET OF THE MONTH AWARD

Nobody knows quite what breed Maisie might be – a little bit of German Shepherd, a lot of Collie, a splash of Shar Pei perhaps? – but her wagging tail and playful personality were easy to see. As a puppy she was a little bundle of energy, but at about 6 months old, her personality started to change. She became quiet and withdrawn, yelped in pain when her owners touched her face, and developed a thick, crusty discharge from both of her nostrils.

She was brought to see the vet, who initially suspected a bacterial infection and prescribed a course of antibiotics. These helped a little but the discharge was no better, so it was decided that more investigation was needed to determine the cause of the problem.

Maisie came into the surgery and was given a general anaesthetic, and X-rays were taken of her nasal cavity. Normally the nasal cavity is radiolucent (black) on an X-ray, as it contains air, but Maisie’s nasal cavity contained radioopaque (white) material, which made us suspect an infection. So a sample of this material was collected. A small soft catheter (tube) was put into Maisie’s nostrils, and saline was squirted in. This saline, mixed with mucus from her nasal cavity, was collected at the back of her throat, and sent away to a laboratory.

The laboratory analysed the fluid and found that Maisie was suffering from a condition called Aspergillosis. This is a severe infection caused by a fungus called Aspergillus Fumigatus, which normally grows in dust, grass clippings and hay. But in Maisie’s case it was growing in her nose and sinuses, gradually destroying the fine bones of her airways. Antibiotics would not work for this infection, as they do not kill fungi. Aspergillus is a very difficult infection to treat - the only way to kill the fungus is to treat it directly with an antifungal drug, but as it was growing inside Maisie’s nose, this was not going to be easy! 

Maisie was given a second general anaesthetic, as well as strong painkillers to prepare her for the operation ahead and antibiotics to minimise the risk of infection. An endotracheal tube was placed in her trachea (windpipe), to give her oxygen and anaesthetic gas. Her head was shaved and cleaned to remove any bacteria from the skin. Two small incisions were made over her frontal sinuses, just above each eye. Her skin was carefully and gently peeled back, so that the bone of her skull could be seen.

A special surgical drill, with a very small drill bit, was used to make a small hole into each sinus, and a catheter (tube) was gently inserted into each one. First of all her sinuses were flushed with warm saline, to remove as much mucus as possible. Her throat was packed with swabs to make sure that she didn’t inhale any fluid. After the saline, both sinuses were slowly flushed with antifungal liquid. Finally, antifungal cream was put into each sinus and the catheters were removed. Maisie’s skin was then stitched back over each small hole to seal it.

Maisie recovered very well from the operation, but continued to have a runny nose for a few days, except now the nasal discharge also contained sticky white antifungal cream! For the first 24 hours Maisie’s head was very swollen and painful from the surgery, and she was given strong painkillers. But after 24 hours she began to look much brighter, and after 48 hours she was discharged to recover at home.

After 10 days, when she came in to have her stitches removed, the vet couldn’t believe the difference! Instead of a sad, sore, snotty-nosed puppy, Maisie was back to her usual happy playful self! The treatment had worked very well, and her nose was clean for the first time in several months. Maisie made a full recovery, and her owners are very pleased to have their old dog back!
 

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