ISSN 2398-2969      

Nose: nasal discharge - overview

Clapis

Synonym(s): Rhinitis, snot, allergic rhinitis


Introduction

  • Cause: may be a primary problem originating in the nasal passage or a presenting sign potentially caused by a variety of different disease processes.
  • Signs: nasal discharge is a commonly seen presenting sign in pet rabbits. It is important to note the type of discharge present: serous, mucous, bloody, or purulent, and which nostril(s) is/are affected (uni- or bilateral).
  • Diagnosis: risk factors identified from history, clinical examination, hematology, nasal culture and sensitivity, nasolacrimal flush, radiography, endoscopy/rhinoscopy, nasal mucosal biopsy, and CT scan.
  • Treatment: husbandry corrections (diet, temperature, substrate), antimicrobial therapy, non-steroidal therapy, nebulization, nasal flushing, mucolytics and surgical flushing where needed.
  • Prognosis: dependent on severity and cause of clinical signs. With chronic cases, complete resolution of clinical signs may not be possible.
  • Respiratory disease is very common in pet rabbits and is a major cause of morbidity and mortality.
  • Prompt treatment is required.
  • Upper respiratory tract disease, if left untreated, can spread to a number of different sites in the body.

Print off the Owner factsheet on Nasal discharge to give to your clients.


Presenting signs

  • Nasal discharge: serous, mucoid or purulent secretions visible from the nares. Discharges from the nasal passage can vary in color and consistency. Fur often appears matted at the nares.
  • Matted fur may be seen on the medial forelimbs and paws, the 'handkerchief' area,  after being used by the rabbit to wipe away nasal secretions.
  • Dyspnea Dyspnea can include noticeable abdominal effort when breathing, or flailing nostrils. As obligate nasal breathers, in cases of severe nasal discharge, rabbits can present with dyspnea.
  • Sneezing.
  • Coughing.
  • Open-mouth breathing.
  • Inappetence.
  • Anorexia Anorexia.
  • Weight loss Weight loss.
  • Lethargy.
  • Exercise intolerance.
  • Depression.
  • Epistaxis.
  • Increased breath sounds, sneezing and coughing may be noticed.
  • In extreme cases of nasal congestion, open-mouth breathing may be evident; this is a poor prognostic indicator.
  • Dyspnea means grooming may become difficult simultaneous to breathing, and an unkempt coat may result.

Acute presentation

  • Sudden presence of nasal discharge; often serous at first, progressing to purulent.
  • Signs, if noticed, include:
    • Increased respiratory noise.
    • Sneezing.
    • Dirty 'hankies' on forepaws.
    • Lethargy.
    • Inappetence/anorexia.
    • Weight loss.

Geographic incidence

  • Infectious causes of upper respiratory disease are more prevalent in high temperatures and with inadequate ventilation. Hutch-living rabbits are at greater risk.
  • House rabbits can potentially be kept at too high a temperature due to central heating.
  • Nasal foreign bodies are uncommon, but rabbits kept outdoors and allowed to forage or housed on hay are at marginally greater risk.

Age predisposition

  • Risk increased with:
    • Infectious causes: young and old.
    • Nasal tumors: middle-aged to older rabbits.
    • Nasal foreign body: any age.
    • Dacryocystitis and dental disease: any age, but more common in middle-age and older rabbits.
    • Myxomatosis: any age.
    • Trauma: any age.
    • Allergy: rare, any age, but more commonly first noticed when young.

Breed predisposition

  • It is thought that Dwarf breeds Dwarf Lop Netherland Dwarf are more susceptible due to the shortened maxilla and mandible, leading to a reduction in nasal passage size and length. These breeds are also more prone to dental disease, which can lead to secondary nasal disease.

Public health considerations

  • Theoretically a rabbit bite could lead to a Pasteurella wound infection in humans; however, it is rare for a bite from a rabbit to become infected, providing the wound is cleaned thoroughly.

Cost considerations

  • To obtain a diagnosis from radiology in cases of advanced disease, multiple views are often required. For similar costs, a CT scan can be more cost-effective.
  • CT scanning has a higher sensitivity than radiography at detecting subtle changes to the nasal architecture.

Special risks, eg anesthetic

  • Patients with nasal discharge are at a greater risk of anesthetic complications. Prior to anesthetic the patient should be pre-oxygenated for 3-5 min and once anesthetized, an endotracheal tube should be placed as quickly as possible to facilitate breathing.
  • If the patient is housed with other rabbits, the owner should be particularly vigilant for spread if the causal agent is infectious.

Pathogenesis

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Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Miwa Y, Nakata M, Takimoto H et al (2020) Spontaneous intranasal tumours in rabbits: 7 cases (2007-2019). JSAP PubMed.
  • Summa N M, Sanchez-Migallon Guzman D, Keller K A et al (2020) Bilateral pararhinotomy with middle meatal antrostomy of the maxillary sinus in a rabbit (Oryctolagus cuniculus) with chronic rhinitis. JAVMA 254 (11), 1316-23 PubMed.
  • Wright L & Mans C (2018) Lateral rhinostomy for treatment of severe chronic rhinosinusitis in two rabbits. JAVMA 252 (1), 103-7 PubMed.
  • Rougier S, Galland D, Boucher S et al (2006) Epidemiology and susceptibility of pathogenic bacteria responsible for upper respiratory tract infections in pet rabbits. Vet Microbiol 115 (1-3), 192-198 PubMed.

Other sources of information

  • Meredith A & Lord B (2014) BSAVA Manual of Rabbit Medicine and Surgery. BSAVA, UK.
  • Lennox A M (2011) Rhinostomy: Adjunct Treatment for Treatment of Chronic Rhinitis in Rabbits. In: Proc of the AEMV Congress. Seattle, USA. pp 141-143. 
  • Oglesbee B L (2011) Blackwell's Five Minute Veterinary Consult: Small Mammal. Wiley-Blackwell, UK.
  • Divers S J (2011) Rabbit Rhinitis: The Good, The Bad and The Ugly! In: Proc AAV Congress. Seattle, USA. pp 391-402.
  • Harcourt-Brown F (2002) Cardiorespiratory Diseases. In: Textbook of Rabbit Medicine. Elsevier Health Sciences. pp 324-326. 

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