Case Of The Month
Lexi, a 2 year old spayed female Maltese mix, presented to us one warm August evening for episodes of acute sneezing. Her owner reported that Lexi had been playing outside and chewing on a toy when she suddenly began violently sneezing. Lexi had been a very healthy dog prior to this time with no other previous medical concerns.
There is a wide array of causes of sneezing in veterinary medicine. Generally we categorize causes of sneezing as either being inside the nose (intranasal) or outside the nose (extranasal). Intranasal causes of sneezing can include nasal foreign bodies (such as plant material, a nasal polyp, or other foreign material) or viral, bacterial, or fungal infections of the nose. There are also chronic disease conditions of the nasal passages that can cause sneezing.
Extranasal causes of sneezing can be oral cavity disease or diseases that affect an animal’s blood pressure or blood clotting abilities, such as renal or liver disease.
When we have a patient that presents for sneezing we want to know certain things. Has the patient ever had a prior history of sneezing? Is there any nasal discharge? Does the patient’s nose seem painful or is she rubbing her face on the ground or with her paw? Does the patient have a bloody nose?
Next we proceed by looking at the patient. We pay close attention to the patient’s nose and head and look for symmetry of the patient’s muzzle, mouth and eyes. Although we can rarely see into a patient’s nostrils without sedation or a special scope, occasionally we will see a lesion or material that will cause sneezing. Because severe periodontal disease can also affect the nasal passages via oronasal fistulas, we also want to ensure a patient’s teeth appear healthy.
Finally we look at the rest of the patient. Do the heart and lungs sound appropriate? Is there any evidence of renal or liver disease? Is the patient bright and alert?
When we saw Lexi she was bright, alert, and playful. Her examination was unremarkable except for a small piece of grass protruding from her right nostril. Much to our surprise, when we grabbed the piece of grass with forceps it ended up being nearly 5 inches long! It is rare to inhale a piece of grass this long and, in this case, we suspect Lexi was chewing on a piece of grass that moved into her nasal passages from her oral cavity.
No further treatment was necessary after we removed the piece of grass from Lexi’s nose. She trotted out our front door and into the warm August evening.