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Persistent sinus infection, bleeding from both nostrils.

Customer Question
Persistent sinus infection,...

Persistent sinus infection, bleeding from both nostrils. Multiple long term antibiotics no help. Born with cleft palate which was surgically repaired when she was 3 mos old. Now 10 yrs old. Has had 2 recent endoscope exams which found no blockage. X-ray which showed lungs ok

Veterinarian's Assistant: I'll do all I can to help. What sort of animal are we talking about?

Dog , German shorthair pointer

Submitted: 6 months ago.Category: Dog Veterinary
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Answered in 1 hour by:
12/25/2017
Dog Veterinarian: Dr. B., Veterinarian replied 6 months ago
Dr. B.
Dr. B., Veterinarian
Category: Dog Veterinary
Satisfied Customers: 23,182
Experience: Hello, I am a small animal veterinarian and am happy to discuss any concerns & questions you have on any species.
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Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you today. I do apologize that your question was not answered before. Different experts come online at various times; I just came online, read about your wee one’s situation, and wanted to help.

What tests have been done?

When they scoped did they take any tissue from the nostril?

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Customer reply replied 6 months ago
Scoped 2 different times in the past 6 months and did blood tests. Found no cancer. Xrayed 1 month ago and while she was under he flushed out her sinuses and said there was leaking from several places in her palate. When the surgeon operated on her cleft palate 10 yrs ago he said it was the worst one he had ever seen - that it was both her hard and soft palate. She has had nasal infections on and off for her whole life but since last year it has not gone away. And no medicine seems to improve it. The nose bleeding is the worst tho - can it be cauterized.
Dog Veterinarian: Dr. B., Veterinarian replied 6 months ago

Hello again,

While the scoping and the xrays were not able to give a definitive cause for these signs, it is positive to hear that nasty nasal cancers can be excluded and that polyps and fungal infections (that can eat the bone in the nose) are less likely. Though if she has always had nasal signs despite the repaired cleft palate that does suggest to me that its the bacteria from her mouth sneaking into the nasal passage. At this point in her life, we'd hope that the surgical site had healed but it may be that the back of her palate is shorter then it should be (either by birth or surgery) and that is what is allowing them through here.

With that in mind, the tests that have been done are correct but I do see any mention of your vet taking a sample of the discharge for culture. This is where the bacteria in the snot are grown in culture then tested to see what drugs they are vulnerable to. And that is especially important for her if she hasn't been responding to any treatments tried because that suggests to us that this agent is resistant to those drugs. So, that would be our ideal next step here to see what is growing and what drugs will work to clear it.

Finally if there is active bleeding, then it does depend where in the nasal passage it is coming from. Some can be cauterized but more often we need to treat the inflammation/infection (anti-inflammatories as well as targeted antibiotics based on culture results too) of the tissue to get that to heal and stop bleeding.

Kind regards,

Dr. B.

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