Inflammatory Polyp in the Middle Ear With Secondary Suppurative Meningoencephalitis in a Cat

Abstract

Nasopharyngeal polyps are non-neoplastic masses, originating from the mucosa of the nasopharynx, the tympanic bulla or the Eustachian tube. Inflammatory polyps extending into the tympanic bulla cavity are a common cause of otitis media in cats. In dogs, however, occurrence of middle ear polyps has rarely been reported. The present report describes the findings of the clinical examination, diagnostic imaging and histopathological appraisal of a ten year old male dog with an inflammatory middle ear polyp arising from the mucosa of the Eus-tachian tube. Clinically, the dog displayed a peripheral vestibular syndrome. Magnetic resonance imaging revealed a hyperintense soft tissue mass filling the right middle ear cavity. Following ventral bulla osteotomy, a polypoid growth with a stalk arising from the auditory tube was surgically excised from the tympanic bulla. Histologically, the polyp was composed of a fibrous connective tissue stroma with discreet infiltration of inflammatory cells and an overlying surface layer of partially ulcerated respiratory epithelium. Similarities and differences between the histological appearance of the present case and the few previously reported records of canine middle ear polyps are discussed, along with a comparative review of etiological, pathogenetic and therapeutic aspects of middle ear polyps in cats and dogs

Association Between Clinical Characteristics, Computed Tomography Characteristics, and Histologic Diagnosis for Cats With Sinonasal Disease

“…Several cats with rhinitis had concurrent nasopharyngeal conditions that were believed to have contributed to, or developed as a result of chronic rhinitis including: inflammatory polyps, acquired nasopharyngeal stricture or cicatrix formation, mucosal hyperplasia, and lymphoid follicular hyperplasia. These conditions have been associated with chronic nasal or nasopharyngeal inflammation in cats, dogs, and humans and may be mistaken for neoplasia on gross examination 17,24–29 . Inflammatory polyps were considered the source of rhinitis in one cat (1.5 years of age) and chronic rhinitis was considered contributory to polyp formation in two cats (5.5 and 10 years of age, respectively).…”

Ear

“…87 Diagnosis via otoscopy may be possible if the tympanic membrane is irregular, bulging or ruptured. Clinical signs may progress to otitis interna or otitis externa, facial nerve paralysis, laryngeal paralysis, Horner's syndrome, keratoconjunctivitis sicca, and exposure keratitis, and may rarely extend into the pharynx.…”

Meningoencephalomyelitis Caused by Pasteurella multocida in a Cat

“…In 10 cats for which the outcome was reported, 2/10 (20%) recovered with no residual neurologic deficits, 2/ 10 (20%) recovered with persistent neurologic deficits, 4/ 10 (40%) were euthanized because of clinical deterioration, and 2/10 (20%) died. 6,[11][12][13][14][15][16][17] The high mortality associated with bacterial CNS infections is because of the difficulty of diagnosing the disease, which results in delayed or inappropriate therapy. One recent study of cats with inflammatory CNS disease found that an antemortem diagnosis could not be made in 18/62 (29%) cases.…”

“…19,20 In a literature review of feline CSF bacterial culture, antemortem CSF cultures were attempted in 2/ 15 cats and positive in 1/2 cats with CNS disease. 12,14 Several factors likely contribute to poor culture performance in veterinary medicine. Only small volumes of CSF are collected for culture, the organisms are in the brain parenchyma and thus are present in the CSF in small numbers, some organisms are slow growing or require nonstandard culture techniques, and animals often receive antibiotic therapy before sampling.…”

“…CSF results are available for 5 cats with bacterial CNS infection, and all of these cases had increased numbers of WBC (75-42,750/mL) and neutrophilic pleocytosis (55-100%), with increased protein concentrations (94-620 mg/dL) in their CSF. 10,12,14,15,17 The association between suppurative inflammation and bacterial CNS infection leads many clinicians to treat patients empirically with antibiotics, even when CSF cultures are negative. The choice of antibiotic is complicated by the fact that many species of bacteria can cause CNS infections in cats.…”