Diagnosis and Management of Space Occupying Lesions in Upper Respiratory Tract of Farm Animals.
Space occupying lesions like granulomas, polyps etc. were recorded in cow (n=1), bullocks (n=6), she buffaloes (n=2) and ethmoid tumor in a ewe (n=1). Bilateral nasal granulomas were positive for nasal schistosomiasis. Epistaxis was observed in buffaloes with nasal granuloma. Surgical extirpation and electro cautery were adopted to excise the growths. Following excision, no recurrence was observed. Histologically, severe inflammatory infiltrate, fibroplasia and densely packed collagen fibres were observed.
Keywords: Ethmoid tumor; granuloma; nasal polyp; schistosomiasis.
The need for surgery in ailments of respiratory tract in farm animals appears comparatively less (Anderson and Jean 1997). Occasionally space occupying lesions like granuloma, polyps, tumors etc. are reported in cattle, buffaloes, sheep and goat. These masses may either be neoplastic or non neoplastic in origin. Incidence of non neoplastic growths is higher as compared to neoplastic. Due to vicious nature of buffaloes and indigenous cattle, application of nose string for restraining is a common practice in Andhra Pradesh.
Occasionally, irritation caused by nose string also can lead to production of granulation tissue. Parasitic diseases like nasal schistosomiasis are also sporadically reported. Though not frequently reported, nasal lesions due to Rhinosporidia, cryptosporidium, Nocardia etc. are also documented. In present report, ten farm animals with lesions in upper respiratory tract were reported and managed.
History and Diagnosis
Two cows, six bullocks, two she buffaloes and one ewe were presented with signs of illness of upper respiratory tract like snoring, inspiratory dyspnoea, sero sanguineous to mucopurulent discharges with or without visible growths.
In one cow, there was a solitary nasal polypoid growth with smooth surface and it was found protruding out of left nostril (Fig. 1). The animal had snoring and inspiratory dyspnoea at time of presentation. In one bullock, growth was seen completely occluding the left nostril (Fig. 2) and there was significant respiratory discomfort in animal. In remaining five bullocks, there were bleeding granulomatous lesions (Fig. 3) unilaterally (two) and bilaterally (three). The bilateral cases were positive and unilateral cases negative for nasal schistosomiasis.
There was epistaxis with moderate flow of fresh blood coupled with unilateral mucous discharges from left nostril in one buffalo (Fig. 4). Upon palpation, no palpable swelling could be noticed except inflammatory granuloma over the mucous membrane. In second buffalo, there was a visible granuloma in right nostril without causing any significant respiratory obstruction or dyspnoea (Fig. 5). The nasal discharges were examined under microscope to rule out nasal schistosomiasis. Both the buffaloes were found negative for nasal schistosomiasis.
In one ewe, there was diffuse swelling of head with characteristic dorsal bulging of nasal bones along with deviated nasal septum (Fig. 6). On percussion over the head region, dull sounds were audible indicating some space occupying lesion. The owner of the animal was reluctant for further investigations and treatment and opted for salvaging.
Treatment and Discussion
The bullocks with nasal schistosomiasis were given Lithium antimony thiomalate injection @ 15 ml deep IM injection once in a week for three occasions. They were also given Levamisole hydrochloride suspension @ 7.5 mg/kg b. wt. orally once in a week for three occasions.The management practices to prevent the recurrence of disease were explained to the owners.
The cow, bullocks and buffalo with growths in nostrils were operated in standing position under infra orbital nerve block using 2 percent Lignocaine hydrochloride. The pedunculated growths were excised after clamping at base. The bleeding points were arrested using Adrenaline drops. In bullocks without a stalk at the end of growth, electro cautery was employed (Fig. 7) to remove the polyp. Cautery appeared more effective in arresting the bleeding points as artery forceps could not be used in such a delicate place. This was more so, when growth involved a part of nasal septum. Following either of these procedures, a course of Streptopenicillin @ 5 gm IM for a period of one week and Meloxicam (Melonex (a)) injection @ 0.2 mg/kg SC for three days were administered. There were no complications and animals recovered normally.
In bullocks without nasal schistosomiasis, irritation and contact dermatitis associated with the use of nylon ropes was found. In these cases, there was bleeding due to damage caused by movement of nylon rope over the granulation tissue. The owners were advised to discontinue using nylon rope temporarily and they were treated with routine antiseptic dressing and parenteral antibiotic therapy using Streptopenicillin. There was satisfactory regression of granulomatous lesions after one week. The buffalo with epistaxis was treated with Ethamsylate injection @ 500 mg QID for three consecutive days. Botroclot (b) liquid was applied over the bleeding nasal mucosa with encouraging results. Vitamin A injection @ 12 lakh IU IM was administered for all the nine animals. There was no scope for treatment of ewe with tumor in turbinate or ethmoid level. Clinical investigations and diagnostic imaging were not carried out due to decision of owner influenced by poor prognosis.
Incidence of respiratory disorders involving upper respiratory tract including nostrils, nasal cavity, para nasal sinuses, pharynx and larynx are less common in ruminants as compared to other species (Gaughan et al, 2004). The nostrils in buffaloes are comma shaped and are obliquely placed. The sphincter muscles of nostrils can close to prevent entry of dust and sand. The complex arrangement of vomer, turbinates, ethmoid etc further prevent entry of foreign bodies in to respiratory system. Animals continuously lick and clean nostrils and hence presence of any type of discharge suggests abnormality.
The disorders like nasal granuloma, polyp or fibroma etc do not require any special diagnostic aids. The growths have smooth surface and are often unilateral and pedunculated. When unilateral or when present eccentrically without obstructing the nasal passage, animals do not suffer with any respiratory discomfort. But bilateral and complete obstructions can be fatal. In present study, only unilateral and pedunculated obstructions were recorded.
Owing to susceptibility, schistosomiasis was ruled out in granulomas. Presence of palanquin shaped ova confirmed schistosomal parasites (Schistosoma nasale). Sreeramulu (1994) and Ravindran and Kumar (2012) also reported nasal granuloma and snoring disease in cattle due to schistosomal infestation. In the present study, only three out of ten cases (30%) were found positive for schistosomiasis. In some bullocks, atypical aetiology like irritation caused by nylon nose string was found, which however has not reported earlier.
Diaz et al. (2003) reported fatal mycotic bovine nasal granuloma in a ten year old Jersey cow caused by Drechslera halodes and characterized by nasal obstruction with difficult, noisily and strident breath. Nasal granuloma was also reported to have been caused by Rhinosporidia (Londero et al., 1977), Nocardia (Shibahara et al.) etc. The nasal granuloma with epistaxis was observed in two buffaloes. Epistaxis has also been observed by Penrith et al. (1994) in cattle diagnosed with mycotic nasal granuloma caused by Dematiaceous fungi, Bipolaris sp and Drechslera sp. The treatment for nasal schistosomiasis using drugs like Lithium antimony thiomalate is an established protocol.
In ewe with tumor in the region of turbinates, deviation of nasal septum was observed. Similar finding were also observed by Chmid et al. (2014) in 12 out of 50 cattle with fluid filled mass in nasal cavity, conchae and/or paranasal sinuses. The treatment choices adopted in the present report like surgical excision, electro cautery etc. appear to be satisfactory. Chmid et al. (2014) also observed good prognosis with surgical treatment for sinosal cysts.
The prognosis appears to be favourable in nine out of ten cases. Only the ewe with severe facial distortion and deviated nasal septum could not be saved due to advanced nature of condition. Hence, it can be concluded that, in case of nasal polyps or granulomas, surgery or electro cautery can be adopted at the earliest after ruling out nasal schistosomiasis.
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V. Devi Prasad (1), G. Kamalakar (2) and R. Mahesh (2)
Department of Surgery and Radiology
College of Veterinary Science
Sri Venkateswara Veterinary University (SVVU)
Proddatur - 516360 (Andhra Pradesh)
(1.) Associate Professor and Head and Corresponding author. E-mail: firstname.lastname@example.org
(2.) Assistant Professor
(a) - Brand of Intas Animal Health, Ahmedabad
(b) - Brand of Jagdale Industires Ltd., Bengaluru
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|Title Annotation:||Clinical Article|
|Author:||Prasad, V. Devi; Kamalakar, G.; Mahesh, R.|
|Date:||Jul 1, 2016|
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