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"Sam" - Collie with Aspergillosis

Photo: Sam, with drains to administer medicine

Sam
Aspergillosis is a particularly nasty fungal disease which is both rare and aggressive. The last case I saw before "Sam" was referred to me by a veterinary practice in Nuneaton who recognised the difficulties involved in achieving a successful outcome.

"Sam" was presented to Fairfield with a marked swelling close to his eye. Further investigation with radiographs demonstrated a soft tissue mass within his frontal sinus. Blood tests and subsequent biopsies confirmed the diagnosis of invasive fungal sinusitis.

The frontal sinus is one of a number of hollow cavities within the skull which are all linked to the respiratory tract. Most of us at some time will have experienced the facial discomfort which accompanies "sinusitis" associated with the more common respiratory pathogens, bacteria and viruses. The fungus which caused Sam's problem was inhaled by the patient and found it's way into his sinuses where it found a place in which to thrive.Over a period of time the infection caused soft tissue death and bone destruction (necrosis and osteomyelitis).

x-ray of sams' skull

Sams' radiograph

There are 2 main problems with treatment.

Firstly, the "cure" drugs are also particularly toxic and just as good at killing the patient as well as the fungus if taken systemically by injection or tablet. To avoid this problem the medication is given topically to kill the fungus directly on contact rather than being absorbed into the patient's bloodstream.

This brings us to the second problem which is gaining access to the site of infection. Holes had to be drilled into Sam's skull to allow me to remove as much of the infected material as possible. Then 2 tubes are inserted into the sinuses to facilitate the application of the medicine to the areas where it is required.

The medication is then administered daily until the infection is under control. The drains are then removed. As you might imagine this procedure is not without a degree of difficulty and was made all the more easy by the excellent co-operation of "Sam" who I am very pleased to say is making an excellent recovery.

Hospitalised for over a week he quickly became a firm favourite with the nursing staff who feel a great sense of satisfaction in suporting "Sam" through his treatment regime. His owners also feel a great deal of satisfaction in knowing that the insurance company are also providing a different but vital form of support through Sam's illness!!!

 

Terry Dunne BVMS, Cert SAO, MRCVS

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