Dorsal Rhinotomy in Cats

A cat's sinuses may become irritated for many different reasons. Growths, foreign bodies, and infections can all lead to the development of negative symptoms such as sneezing, nasal discharge, and even neurological problems. To identify the cause of symptoms, x-rays, aspirations, and biopsies may need to be performed. Once a cause has been found, all potential treatments should be attempted before surgical intervention is used. 

When surgical treatment is required, a procedure called a dorsal rhinotomy is performed to enter the frontal sinus area. The nasal cavity is opened and parts of the bone are removed so that tumors, foreign objects or severely infected materials can be excised. An ACVS board-certified veterinary surgeon will be needed to perform the operation.

Before surgery can be suggested, in-depth blood work will need to be run. This is because nasal surgery often leads to excessive bleeding due to all of the blood vessels and veins in the face. Diagnostic imaging will be used to locate the area to be addressed. X-rays may be used for this, but a CT scan, if available, provides much more information for the surgery. A biopsy or aspiration may be taken and sent for histopathological examination at this time. If the cat is deemed viable for the procedure, a date will be booked. 

The cat will not be allowed to eat for 12 hours leading up to the surgery. A blood transfusion may be prepared before the surgery commences as a preventative measure against blood loss. An incision will be carefully made to avoid the veins that run down the center of the face. The periosteum will then be incised and raised up for visibility. Stay sutures may be used to secure tissue out of the way. All or part of the bone will then be removed with a sagittal saw. This will allow the sinuses to be accessed and any objects or materials to be excised. If the bone removed is healthy, it can be returned to its position. It will be secured using steel wire run through holes drilled into the bone. The incision will then be closed with sutures.

A dorsal rhinotomy is generally successful at removing whatever has caused the severe irritation in the cat's sinuses. The overall effectiveness of the treatment will vary depending on the underlying cause of the issue. Long-term prognosis is usually quite good in cases of bacterial infection or foreign body presence. In circumstances where cancer has been found, the life-expectancy of the animal is not likely to be increased by the surgery. 

Even in successful surgeries, the face of the cat will be greatly changed, which causes distress to many owners. If possible, ventral entry should be chosen over dorsal entry. Ventral rhinotomy carries fewer risks and is not as invasive, as it is performed through the palate. The face of the animal is also left almost perfectly intact. Ventral entry cannot be used to access the front of the sinuses.

Often a temporary blow hole will be made to ease breathing in the first week of recovery. This hole will have to be kept clean and should heal on its own. Intravenous fluids will be used during the first two days post-surgery to keep the cat hydrated. Dried blood will also have to be removed from the cat's nostrils. 

It is likely that the cat will not be interested in food as its sense of smell has been compromised. Appetite stimulants can be attempted, but syringe feeding or feeding tubes are generally needed. A broad spectrum antibiotic will be prescribed for the two weeks following surgery. A follow-up appointment will also be needed at that time. The cat will have to eat soft food until it has fully healed. It should not be allowed to play with toys during the healing period.

A dorsal rhinotomy can range in price from $1,000 to $2,000. The cost may vary depending on the medications used and the extent of the diagnostic process. Also, the thorough blood work involved can lead to a higher cost than in other procedures. A ventral rhinotomy is very similar in cost but carries higher success rates and is easier on the animal. For this reason, it should be attempted if possible, over a dorsal rhinotomy. 

Certain complications are associated with this procedure. Restricted blood supply during the surgery may result in ischemic injury to the brain, which can leave the cat with permanent neurological damage. There is also the chance that bacterial infections may result after the surgery has been completed. As with any operation, the possibility of severe anesthesia complications exists. In cats who have been diagnosed with cancer, this surgery may not be worth the stress to the animal, as survival rates are no higher in cats who have had nasal tumors removed than in cats who did not receive surgical treatment.

To prevent the need for a dorsal rhinotomy, certain measures may be taken. Keeping your cat indoors will help prevent it from being exposed to cats who carry contagious viruses that result in upper respiratory infections. Any new cat brought into the home should be quarantined until a vet can deem them virus-free. Certain vaccinations may also help in preventing cats from contracting viral infections. 

Keeping your cat indoors will also lower the risk of foreign bodies becoming lodged in the nasal cavity, as the most commonly found items lodged are pieces of grass or plant debris. It is unknown how to prevent many types of cancer, however limiting your cat's exposure to toxins and carcinogens such as cigarette smoke has been found to be effective. Taking your cat in for regular blood work may also help identify diseases like cancer at their earlier and more treatable stages.