Ketoacidosis: A feature of uncontrolled diabetes mellitus characterized by a combination of ketosis and acidosis. A tumor or other abnormal tissue in an endocrine gland often causes it to produce too much hormone.
Hypertension (blood pressure too high)When an endocrine gland is destroyed, removed, or just stops working, not enough hormone is produced. This blog is written for owners of pets with endocrine disorders, as well as for veterinarians and veterinary staff. For more in-depth discussions of the science behind endocrinology, please read my blog written for veterinarians: Insights into Veterinary Endocrinology. Acarbose is an ?-glucosidase inhibitor used as an anti-diabetic drug used to treat canine diabetes mellitus[1]. This oral medication appears to have reasonable efficacy at reducing hyperglycemia in dogs[2], with efficacy similar to metformin. Few side-effects have been reported with this medication[3] and the recommended dose rate in dogs is 25 - 50 mg orally once daily[4]. Willows website uses cookies - by continuing to browse the website you are agreeing to our use of cookies. Are you sure you wish to cancel your assignment to report on this case – all inputted data will be lost!
Fungal rhinitis is an infection involving the nose and sinuses (air spaces within the skull). Aspergillus fungus is found everywhere in the environment, particularly in soil, with the result that all animals and people are regularly exposed to the organisms and their spores.
Aspergillus most often causes infection in the nasal cavity and in the frontal sinuses of dogs, although it has also been reported as a rare condition in cats.
Aspergillus infection in the nose can cause destruction to the normal bony scrolls (turbinates) that are present in the nose, and the fungus can form mass-like lesions called fungal plaques. In rare situations aspergillosis can become a systemic problem (affecting many different body systems), but this tends only to occur in dogs that have a problem with their immune system or that are receiving treatment to suppress the immune system. Nasal discharge which can be creamy or green in colour and can affect either one or both nostrils.
Fungal rhinitis can be difficult to diagnose because the clinical signs can appear very similar to a number of other nasal diseases (e.g. Blood tests for antibodies to aspergillus fungus can only show that a dog may have been exposed to the fungus, and not necessarily be associated with an active infection. If you are seeing a specialist at Willows, the likelihood of fungal rhinitis or aspergillosis will be discussed with you at the time of the consultation, along with our recommendations for confirming the diagnosis. The findings on a CT scan can often be typical for nasal aspergillosis and allow a provisional diagnosis based on the images alone.

In some cases, a camera is used inside the nasal cavity (rhinoscopy or endoscopy) in order to allow us to see the inside of the nasal cavity and, where necessary, to take biopsies in order to confirm the diagnosis. In some cases, the degree of certainty given by a CT scan can be sufficient for the specialist to recommend treatment of the fungal disease under the same anaesthetic used to perform the diagnostic tests. The majority of the fungal growths sit on the surface of the affected tissues and are not susceptible to treatment using injections or oral medication. The specialist treating your dog will use the information provided by the CT scan, regarding the location and severity of the disease present in your pet, to advise you on what treatment protocol is appropriate. The treatments available at Willows vary from a minimally invasive (keyhole) procedure involving small holes made into the frontal sinuses, through to a full surgical procedure used to remove large quantities of fungal disease from the nose and sinuses prior to treatment with antifungal medication.
If your dog is diagnosed with systemic aspergillosis, then further investigations would need to be performed to establish why this had happened and whether there was evidence of a predisposing immune system problem. Unfortunately, a success rate of approximately 80% does mean that there are some dogs who, despite our best efforts, continue to suffer from the fungal disease, and the clinical signs either do not improve as we would like or they recur at a later date. The damage caused by the fungal infection can render animals more susceptible to bacterial nasal infections in the future.
The outlook for patients with systemic aspergillosis is more guarded and will depend on whether we are able to establish why your dog was predisposed to develop this condition and whether we can deal with these predisposing causes. Fungal spores, including Aspergillus species, are present everywhere (ubiquitous) in the environment and we are all frequently exposed to the organisms. Extreme laziness in dogs is a bad sign as it can symbolize not just diabetes but any sickness that the dog is dealing with. It is not uncommon for the infection to spread from the nose into the frontal sinuses where it can be more difficult to treat effectively.
CT will also help to rule out other conditions such as nasal tumours that can cause similar clinical signs. If there is any uncertainty, or we do not see any fungal plaque lesions, then we may await the result of biopsies before giving treatment.
For this reason, all forms of treatment for nasal aspergillosis will involve the instillation of topical anti-fungal drugs into the nasal cavity and the frontal sinuses, and this must be performed under general anaesthesia. Each treatment regime is tailored to the individual case in order to maximise the likelihood of successful treatment of this challenging condition. Depending on the type of treatment performed, success rates with a single treatment can approach 70 to 80%. In these dogs, repeat treatment can be considered and it is possible that this might involve a prolonged stay with us in the hospital. However, the risk of re-infection cannot be ruled out and therefore owners are advised to be vigilant in the future for signs of the condition. If a nasal infection develops after successful treatment of fungal rhinitis, it is therefore often sensible to visit your primary care practice initially, in case the condition can be treated using antibiotics alone.

For the majority of humans and pets, the risk from contact with a dog or cat suffering from the disease should be very low. The right side (seen on the left in the picture) has a fine lace-like appearance representing the scrolls of bone (turbinates) that are normally present. It is not known why certain individuals develop the disease, when most animals never suffer from the condition.
The specialist will tailor a treatment plan specifically designed for your pet in order to offer the best chances of success, and in some cases this can involve two procedures carried out three to four weeks apart. Persistence of nasal discharge despite antibiotic treament, or the presence of blood within the discharge, is likely to increase the level of concern regarding the presence of an active fungal infection. Standard hygiene measures, including washing your hands after contact with your pet and cleaning up nasal discharge, should be sufficient to maintain the risk at a negligible level.
The arrow is pointing to the left side of the nasal cavity which has suffered from destruction of these turbinates and accumulation of discharge that appears the same shade of grey as the soft tissues of the dog’s head. The frontal sinuses are normally air-filled spaces within the skull, just above and behind the eyes.
If caught early on, its damage can be reversed –  but if not the dog will die or be crippled for life. As with all infectious diseases, individuals who are concerned they may be at risk of infection should discuss the situation with their doctor at their earliest opportunity. These changes are strongly suggestive of fungal rhinitis (aspergillosis) and would be very difficult to identify on normal X-rays.
In this image, the dog’s left frontal sinus (arrowed) has become almost completely filled with fungal growth (Aspergillus). CT images such as this are always displayed as if the head was facing you and therefore the animal’s left appears on the right of the image. If you suspect diabetes in your dog, check with a veterinarian and have them take a look before it is to late. It may require the administration of intravenous fluids, insulin, and glucose, and the institution of changes in the person's diet. See also diabetes mellitus and ketone bodies. In some cases, such as after an endocrine tumor is surgically removed, the remaining gland will recover and hormone replacement will no longer be needed.

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