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Repeated rhinoscopic and serologic assessment of the effectiveness of intranasally administered clotrimazole for the treatment of nasal aspergillosis in dogs

Jill S. Pomrantz DVM, DACVIM1 and Lynelle R. Johnson DVM, PhD, DACVIM2
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  • 1 Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 2 Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

Abstract

Objective—To determine the role of rhinoscopic evaluation and repeated serologic testing in assessing the success rate of intranasally administered clotrimazole for treatment of dogs with nasal aspergillosis.

Design—Prospective case series.

Animals—23 dogs with nasal aspergillosis.

Procedures—Dogs with nasal aspergillosis were treated with an intranasal infusion of 1% clotrimazole solution. Response to treatment was assessed with repeated rhinoscopic evaluation, with histologic examination and fungal culture when available. Results of repeated serologic testing for aspergillosis were monitored throughout the treatment course.

Results—11 of the 23 (48%) dogs had no rhinoscopic evidence of disease after the first treatment. Three of 7 dogs were free of disease after the second treatment, and 1 of 3 dogs was free after the third treatment. Presence or absence of nasal discharge and results of repeated serologic testing were not consistent with disease status. Overall, the efficacy of intranasally administered clotrimazole for treatment of nasal aspergillosis could be confirmed in 15 of 17 dogs. Delayed recurrence or reinfection was confirmed in 3 of 15 dogs. When recurrences were taken into account, the success rate was 67% (12/15 dogs).

Conclusions and Clinical Relevance—Clinical signs were not predictive of disease state, and follow-up rhinoscopy is recommended to assess response to treatment. The success rate of intranasally administered clotrimazole was similar to rates in previous reports; however, the number of dogs with recurrent disease was relatively high. Monitoring of the results of serologic testing is not recommended for use in determining response to treatment.

Abstract

Objective—To determine the role of rhinoscopic evaluation and repeated serologic testing in assessing the success rate of intranasally administered clotrimazole for treatment of dogs with nasal aspergillosis.

Design—Prospective case series.

Animals—23 dogs with nasal aspergillosis.

Procedures—Dogs with nasal aspergillosis were treated with an intranasal infusion of 1% clotrimazole solution. Response to treatment was assessed with repeated rhinoscopic evaluation, with histologic examination and fungal culture when available. Results of repeated serologic testing for aspergillosis were monitored throughout the treatment course.

Results—11 of the 23 (48%) dogs had no rhinoscopic evidence of disease after the first treatment. Three of 7 dogs were free of disease after the second treatment, and 1 of 3 dogs was free after the third treatment. Presence or absence of nasal discharge and results of repeated serologic testing were not consistent with disease status. Overall, the efficacy of intranasally administered clotrimazole for treatment of nasal aspergillosis could be confirmed in 15 of 17 dogs. Delayed recurrence or reinfection was confirmed in 3 of 15 dogs. When recurrences were taken into account, the success rate was 67% (12/15 dogs).

Conclusions and Clinical Relevance—Clinical signs were not predictive of disease state, and follow-up rhinoscopy is recommended to assess response to treatment. The success rate of intranasally administered clotrimazole was similar to rates in previous reports; however, the number of dogs with recurrent disease was relatively high. Monitoring of the results of serologic testing is not recommended for use in determining response to treatment.

Contributor Notes

Dr. Pomrantz's present address is Bergh Memorial Animal Hospital of the American Society for the Prevention of Cruelty to Animals (ASPCA), 424 E 92nd St, New York, NY 10128.

Supported by the Center for Companion Animal Health, University of California-Davis, and the Bailey Wrigley Fund.

Presented in part at the 25th Annual Forum of the American College of Veterinary Internal Medicine, Seattle, June 2007.

Address correspondence to Dr. Johnson (lrjohnson@ucdavis.edu).