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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 23839
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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Yellow discharge with some blood from nose, swollen snoot,

Customer Question

yellow discharge with some blood from nose, swollen snoot, eye goo in dog.
treated with antifugal med...which made dog worse causing hearing loss and blindness. Stopped antifugal 18 days later hearing and site returned. Sinus on both sides drain 24/7...swollen snoot size varies day to day.
Teeth that could be cause were removed many years.
Swollen snoot started mid Dec 2015.
Before antifugal med, ear on side which was/is swollen developed huge ear wax problem. Ear wax was like peanut butter, thick gooey and wetter than usual dog ear wax.
Ear wax on this side is now like normal dog ear wax and does not require 2 a day cleaning.
Because this sinus problem has been present since mid Dec we assume it is not cancer because sinus cancer kills quickly.
Dog licks floor. Has done this for a number of years. Likely because his sinus drains. Now I believe other sinus is affected due to this behavior.
Will I have to risk effects of antifugal meds to see improvement in dog?
? Other meds give the dog relief?
? Is there a Vet that just handles eye, ears and throat?
Submitted: 6 months ago.
Category: Dog Veterinary
Customer: replied 6 months ago.
Note 2 other 2 dogs and 2 cats are not having problems.
Expert:  Dr. Michael Salkin replied 6 months ago.
Yes, a specialist veterinary internist (please see here: would be the specialist of choice. Which breed is your dog, please? Which testing was performed that prompted prescribing a systemic antifungal drug? A specialist would scope and biopsy your dog's nose. X-rays of both the upper and lower respiratory tracts would be performed. A cytology (microscopic exam of the cells and infectious agents if any) would be performed on the exudate or scrapings of the inside of a nasal passage. Primary bacterial infections are uncommon in the nose and sinuses but can be seen secondary to many disease processes including the underdiagnosed lymphocyctic/plasmacytic rhinitis which should be an important differential diagnosis in a dog such as he.
Customer: replied 6 months ago.
Mutt part beagle, seen by VET 4 times since mid lab work was done, xrays they said would not show snoot cancer. Last visit I was told there is no specialist for dog nose. Yes we were told bacterial are very uncommon, because he need antibotic for paw pad infection and this rarely decreased snoot swelling they suggested trying antifugal without any pre testing. Dog slept 24/7 and within 3 day's both sinus's were swollen the entire lengths shaped like a gun barrel. Dog lost hearing 100% and total blindless. We used antifugal few more days then stopped. within a week drainage started that is almost 24/7. But oddly 3 weeks from stopping antifugal... his site and hearing has returned. But he avoids walking upstairs because drainage makes him gasp. He will go out down stairs 12 steps to the yard. The antifugal did clear up his one sided ear wax which was thick and gooie wet like peanut butter. Unlike just thick wax in any dogs ear.
Customer: replied 6 months ago.
The new drainage after antifugal included yellow tinge and with sneezing some giant yellow green buggers would come out.
His lungs and heart were listened to an patted down and Vets said they were clear.
Customer: replied 6 months ago.
From the website YES to the following except xed outdiopathic origin include:1. Trial therapy with ivermectin (0.2 mg/kg subQ or PO, 2 treatments 3 weeks apart) for nasal mites2. Trial therapy with itraconazole (5 mg/kg PO q12hrs for a minimum of 3-6 months) for possible low grade fungal infection or fungal-triggered hypersensitivity reactions
3. Immunosuppressive steroid therapy (prednisone, 1 mg/kg q12 hours PO initially) or topical steroid administration with nasal drops or aerosolized preparations via metered dose inhaler4. Alternative immunosuppressive therapy with azathioprine (1 - 2 mg/kg/day PO)5. Antiinflammatory therapy with piroxicam (0.3 mg/kg/day PO)6. Immunomodulating antibiotics such as doxycycline (3 – 5 mg/kg q12 hrs) or azithromycin (5 mg/kg q24 hrs PO) in combination with daily piroxicam; if improvement is noted,combination therapy is continued but with a reduction in frequency of antibiotic administration (doxycycline – SID or azithromycin – twice weekly)7. Ancillary therapy with humidification of airways, elimination of environmental irritants, and intranasal salineMost dogs with L-PR have some degree of persistent clinical signs although the majority of patients can be managed successfully long-term with medical treatment.Foreign BodiesNasal foreign bodies should be suspected with the following circumstances:1. Known opportunity for foreign body inhalation with a sudden onset of compatible signs2. Sudden onset of paroxysmal sneezingNOPE 3. Pawing at the nose NOPE.....legs too short to reach nose4. Unilateral nasal discharge, especially mucopurulent discharge with occasional hemorrhage5. Persistent gagging, retching, or reverse sneezing6. Persistent nasal discharge which follows an acute onset of sneezingAlso I note he had at least a year ago "Persistent gagging, retching, or reverse sneezing" when he at to fast.Since is has always been a floor licker and could he have snooted wood up his sinus?
Expert:  Dr. Michael Salkin replied 6 months ago.
If only because of the adverse effects you saw from the antifungal drug, I won't prescribe such a drug without confirming that it's indicated. X-rays can't clarify the cause but can narrow down the possibilities. For example, if I see bony involvement, I need to think of osteomyelitis (bone infection) and/or cancers.1. I've never seen mites cause such extensive pathology. Sneezing and reverse sneezing are most common.2. I won't perform such a trial unless my diagnostics haven't been definitive. There haven't been any diagnostics performed in this case.3. This is the treatment for lymphocytic/plasmacytic rhinitis to which I alluded above. Biopsy is necessary for confirmation of this disorder assumed to be immune-mediated. 4.-7. above refer to this rhinitis as well. An internist is considered a specialist of all the parts of our dogs...nose included. When both sides of the nose are affected, a foreign body becomes very unlikely. I don't believe that we should incriminate his floor licking. Once again, however, scoping his nose would tell us if foreign bodies are well as polyps, tumors, or fungal granulomas. Please continue our conversation if you wish.
Customer: replied 6 months ago.
The second side of nose only was impacted after drainage and after antifugal. Wood floors are not finished but raw wood.
My Vets did not offer scoping sinus. Which to me makes sense if only to see if something is up in there. They first suggested a bad root from a pulled tooth but said xrays may or may not show if this was cause.
So I am to look for a Vet who will scope nose? Yes no way would I ever give a dog antifugal again. He had full blood work up last July as part of yearly check up and I was told he had very good blood work for his age. At that time he was wheezing when he ate to fast. Walked when not to hot 2 miles a day and swam or waded without concerns when we went in a lake.
Customer: replied 6 months ago.
I am to ask them to determine
foreign object
boney mass
fugal gunt
Expert:  Dr. Michael Salkin replied 6 months ago.
Yes, but a generalist vet isn't likely to have the flexible endoscope necessary to scope the nasal cavities and nasopharynx properly; scopes can't reach into the sinuses - we need to rely on X-rays or CT. Consider a specialist - who will know what to look for. Yes, dental X-rays would show a tooth root abscess and would show infection from that abscess invading the bone and nasal passage(s) if present. I suspect that the second side of the nose becoming involved simply represented extension of the original disease process rather than being related to draining and antifungal medication. My goodness, you've received some bad information...
Customer: replied 6 months ago.
And I am a retired Chem/math teacher. So I thought I could ask enough questions. Now while I was awaiting your answer I did learn where close to me are specialists...phew not easy. Interesting because of the 6 vets in the practice I go to the first vet suggested exray to find root abscess. But said this would be iffy. My Vet practice does offer full surgery so I assumed they could handle almost anything. None of the 6 offered or suggested what you have. Which is why I did not go back to them.
Thank you for helping to describe what I want checked on Jake. To see Jake lose his sight and hearing was hard but when we stopped antifugal med and both senses came back I was livid that I agreed to give Jake this med without realizing what could happen. I felt if I had just left the nasal drip alone he wouldn't have suffered.So my plan now is to make a specialist appointment
first asking how they treat nasal problems
before I commit
and never ever assume a practice with 6 vets can solve problems
Expert:  Dr. Michael Salkin replied 6 months ago.
...that sounds good. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience.
Customer: replied 6 months ago.
Made an appointment at special vet they are request Jake's records to be sent over.
Yes they do scopes...extra
He will see internal VET first to determine if he needs to see derma Dr for fugal or referred out for dental surgery
Expert:  Dr. Michael Salkin replied 6 months ago.
Well done! Keep me posted, please.

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