Hazuchova Katarina, Neiger Reto, Stengel Christiane
J Am Vet Med Assoc. 2017 Feb 1;250(3):309-315. doi: 10.2460/javma.250.3.309.
OBJECTIVE To evaluate outcomes for dogs with mycotic rhinitis-rhinosinusitis (MRR) treated by meticulous debridement and topical application of 1% clotrimazole cream and investigate potential prognostic factors that could help predict whether 1 or multiple treatments would be needed for clinical resolution of the condition. DESIGN Retrospective case series. ANIMALS 64 dogs. PROCEDURES Medical records were reviewed to identify dogs treated for MRR by meticulous debridement and topical application of 1% clotrimazole cream. Signalment, clinical signs, previous treatments, CT findings, presence of unilateral or bilateral disease, predisposing factors, number and type of treatments, and complications were recorded. Outcome information was obtained from records or by telephone interview with owners. Association of selected factors with the number of treatments needed for clinical resolution was evaluated. RESULTS Clotrimazole was instilled via the trephination site (n = 42) or under endoscopic guidance (22). Thirteen dogs underwent a 5-minute flush with 1% clotrimazole solution prior to cream application, and 34 received adjunctive oral itraconazole treatment. The MRR was deemed resolved in 58 dogs, and clinical signs persisted in 1 dog. Five dogs died (2 of causes unrelated to MRR) ≤ 1 month after treatment. The first treatment was successful in 42 of 62 (68%) dogs; overall success rate was 58 of 62 (94%). No prognostic factors for the number of treatments needed to provide clinical resolution were identified. Seven dogs with reinfection were successfully retreated. CONCLUSIONS AND CLINICAL RELEVANCE Topical treatment by meticulous debridement and 1% clotrimazole cream application had results similar to or better than those described in other studies of dogs with MRR. Trephination or adjunctive itraconazole treatment did not influence the number of treatments needed for a successful outcome.
目的 评估经细致清创并局部应用1%克霉唑乳膏治疗的霉菌性鼻-鼻窦炎（MRR）犬的治疗效果，并调查可能有助于预测临床治愈该病需要1次还是多次治疗的潜在预后因素。 设计 回顾性病例系列研究。 动物 64只犬。 方法 查阅病历以确定经细致清创并局部应用1%克霉唑乳膏治疗MRR的犬。记录品种、临床症状、既往治疗情况、CT检查结果、单侧或双侧疾病情况、诱发因素、治疗次数和类型以及并发症。通过查阅记录或电话采访主人获取治疗结果信息。评估所选因素与临床治愈所需治疗次数之间的关联。 结果 通过环钻部位（n = 42）或在内镜引导下（22）滴注克霉唑。13只犬在涂抹乳膏前用1%克霉唑溶液冲洗5分钟，34只犬接受了辅助口服伊曲康唑治疗。58只犬的MRR被判定治愈，1只犬的临床症状持续存在。5只犬在治疗后≤1个月死亡（2只因与MRR无关的原因）。62只犬中的42只（68%）首次治疗成功；总体成功率为62只中的58只（94%）。未发现临床治愈所需治疗次数的预后因素。7只再次感染的犬成功接受了再次治疗。 结论及临床意义 经细致清创并局部应用1%克霉唑乳膏的治疗效果与其他关于MRR犬的研究中描述的效果相似或更好。环钻或辅助伊曲康唑治疗并不影响成功治疗所需的治疗次数。
