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'&-*/& 3)*/*5*4 611&3 3&41*3"503: %*4&"4& ] DIAGNOSTICS Feline URT infection is usually a clinical diagnosis based on history and physical examination (ocular and nasal discharge, stertor, etc). FOCUSED DIAGNOSTICS FIV/FeLV Test UÊ vÊÌhiÊV>ÌÊh>ÃÊnoÌÊLiinÊÀiVinÌlÞÊÌiÃÌi`Ê>n`ÉoÀÊÀiÃkÊ factors exist, this test should be performed since URT diseases are associated with immunosup- pression. UÊ >ÀÞn}i>lÊnio«l>Ãi>ÊiÃÊ>lÃoÊVommonÊinÊ 6Ê«oÃi- tive cats. CBC & Serum Biochemical Profile UÊ/hiÃiÊÌiÃÌÃÊ>ÀiÊnoÌÊÕÃÕ>llÞÊin`iV>Ìi`ÊinÊV>ÌÃÊÜiÌhÊ acute URT signs in the absence of systemic illness. UÊ oÜiÛiÀ]ÊÌhiÞÊ>ÀiÊÀiVommin`i`ÊinÊV>ÌÃÊÌh>ÌÊ>ÀiÊ systemically unwell or have chronic clinical signs. Polymerase Chain Reaction UÊ*olÞmiÀ>ÃiÊVh>inÊÀi>VÌionÊ* ,®ÊiÃÊÌhiÊ«ÀiviÀÀi`Ê method for virus detection in cats with URT signs; however, it is not standardized among laborato- ries (and, thus, sensitivity and specificity vary). UÊ 88Êi`iÝÝ°Vom®Êh>ÃÊ >Ê iliniÊ1««iÀÊ,iëiÀ>- ÌoÀÞÊ iÃi>ÃiÊ1, ®Ê,i>l* ,Ê*>nilÊÌh>ÌÊÌiÃÌÃÊvoÀÊ FHV, FCV, Chlamydophila felis, M felis, B bron- chiseptica, and H1N1 influenza (requires a deep pharyngeal swab and conjunctival swab). Other Methods Other methods for virus and antigen detection include virus isolation and indirect immunofluorescence anti- body assay; however, these are more time consuming >n`Ê«oÌinÌi>llÞÊliÃÃÊÃinÃiÌiÛiÊÌh>nÊ* ,°5 FURTHER DIAGNOSTICS i>}noÃÌiVÃÊ voÀÊ V>ÌÃÊ ÜiÌhÊ VhÀoniVÊ 1,/Ê Ãi}nÃÊ >n`ÉoÀÊ localizing signs should be more thorough given the broad range of differential diagnoses.1,15 Oral Examination under Anesthesia UÊ ÕllÞÊ >ÃÃiÃÃiÃÊ iÝÌinÌÊ ovÊ `inÌ>lÊ `iÃi>ÃiÊ >n`Ê iÌÃÊ potential contribution to URT signs and the larynx UÊ n`iV>Ìi`Ê inÊ V>ÌÃÊ Ìh>ÌÊ h>ÛiÊ iÛi`inViÊ ovÊ `inÌ>lÊ abnormalities during awake oral examination and those with stridor or other clinical signs attribut- able to the larynx Upper Airway Imaging UÊ n`iV>Ìi`ÊinÊV>ÌÃÊinÊÜhiVhÊ>Êë>ViÊoVVÕ«Þin}ÊliÃionÊ or bony lytic lesion is suspected UÊ iÀÛiV>lÊÀ>`io}À>«hÃÊV>nÊLiÊÛiÀÞÊÕÃivÕlÊvoÀÊi`inÌi- fying laryngeal masses in cats with signs attribut- able to the larynx. UÊ1lÌÀ>ÃoÕn`Ê ii]Ê iVhol>ÀÞn}o}À>«hÞ®Ê i`inÌiviiÃÊ laryngeal masses and dysfunction.23 UÊ inÌ>lÊÀ>`io}À>«hÃÊV>nÊi`inÌivÞÊ>n`Ê>ÃÃiÃÃÊ ÌooÌhÊ root abscesses. UÊ om«ÕÌi`Ê Ìomo}À>«hÞÊ /®Ê >n`ÉoÀÊ m>}niÌiVÊ ÀiÃon>nViÊ im>}in}Ê , ®Ê iÃÊ noÜÊ ÕÃi`Ê ÜhiÀiÊ available) instead of traditional skull radiographs to assess nasal passages and bullae for potential masses, lytic lesions, or polyps. CT remains the preferred modality given its greater bony detail; , ÊiÃÊ«ÀiviÀ>LliÊvoÀÊ>ÃÃiÃÃin}ÊÃovÌÊÌiÃÃÕi°24 Note: Imaging should always be performed prior to sampling procedures. Rhinoscopy & Nasal Flush UÊ1Ãi`Ê ÌoÊ >ÃÃiÃÃÊ n>Ão«h>ÀÞn}i>lÊ m>ÃÃiÃ]Ê voÀii}nÊ bodies, and stenosis UÊ nÌi}À>`iÊÀhinoÃVo«ÞÊiÃÊVh>llin}in}ÊinÊV>ÌÃÊ}iÛinÊ the small diameter of the nasal passages but can be performed with narrow rigid scopes. UÊ,iÌÀovliÝÊÀhinoÃVo«ÞÊiÃÊmoÀiÊVommonlÞÊ«iÀ- voÀmi`Ê ÌoÊ >ÃÃiÃÃÊ ÌhiÊn>Ão«h>ÀÞnÝ°Ê vÊ >Ê ÃVo«iÊ iÃÊ not available, it can be visualized with a spay hook and dental mirror. UÊ >Ã>lÊ vlÕÃhiÃÊ V>nÊLiÊÕÃi`Ê ÌoÊoLÌ>inÊ Ã>m«liÃÊ voÀÊ cytology and bacterial or fungal culture. Tissue samples can be submitted for culture if obtained. While primary bacterial infection is a rare cause of chronic URT signs in cats, identification and treat- ment of secondary bacterial infection can amelio- rate clinical signs, particularly in cats with chronic disease. UÊ disease in the nasal passages and can be done Llin`Ê oÀÊ }Õi`i`Ê ÜiÌhÊ im>}in}°Ê io«ÃÞÊ iÃÊ in`iV>Ìi`Ê inÊ V>ÃiÃÊ ovÊ Ã«>ViÊ oVVÕ«Þin}Ê io«ÃÞÊ oÀ]ÊmoÀiÊ commonly, fine-needle aspiration is indicated in cats with structural laryngeal disease (notably laryngeal inflammation or mass) identified during laryngeal examination and imaging. Note: Assessment of coagulation status should be done prior to biopsy procedures. Other A latex cryptococcal agglutination test can be per- formed when an index of suspicion for fungal rhinitis July/August 2012 Today's Veterinary Practice 17