Cat’s nasal bleeding a matter for specialist
Our 10-year-old cat had some bleeding from her nose for several weeks so we took her to our vet. He took some X-rays but they turned out to be inconclusive, although he thought there might be a tumour present, he could not be 100-per-cent certain. He has suggested that our cat be referred to a specialist for a second opinion and, if necessary, surgery. We are not sure what to do next. What are the chances our cat could have a tumour in her nose and, if there is, what are our treatment options?
When there is bleeding from one or both nostrils, it is called epistaxis. Epistaxis can be due to many reasons besides tumours, including bloodclotting disorders, trauma to the nose, fungal infections and foreign bodies. X-rays are often diagnostic, but since they were inconclusive in your case, further diagnostic tests will be necessary. A referral to a specialist would certainly help, not only to get another pair of eyes looking at the X-rays, but also to get another opinion.
The main rule-outs for epistaxis in your cat would be a tumour, a fungal infection, or a foreign body (i.e. an object that has been aspirated up the nostrils). To rule out a fungal infection, it would be necessary to do a biopsy and tissue culture. To rule out a tumour or foreign body, further diagnostic tests would be needed, such as rhinoscopy (a tube attached to a video camera is passed up the nose to visualize the nasal cavities), a CT scan, or an MRI. Any one of these techniques would provide an accurate diagnosis.
Nasal tumours in cats are usually lymphomas or carcinomas (e. g. sarcomas). More than 90 per cent tend to be malignant, but the rate of metastasis (i.e. spreading to the rest of the body) is quite low. More often, the tumour tends to invade the local tissues around the nose. Nasal tumours are rare and only account for one per cent of cancers in both cats and dogs. Unfortunately, if left untreated, the average survival rate after diagnosis is three to five months. Treatment for nasal tumours tends to be multi-modal, using either radiation therapy alone or in combination with chemotherapy and/or surgery, depending on the extent and invasiveness of the mass. Since the structures in the nose are very complex, it is very difficult to surgically remove a tumour completely from inside the nose. A procedure called a “rhinotomy” is used to remove as much of the tumour mass as possible via an incision through the bridge of the nose.
Usually, radiation therapy provides the longest survival time (one to three years average, depending on the type of tumour) with or without surgery and/or chemotherapy.
Ask your veterinarian to refer your cat to a specialist. This way, you can get a definitive diagnosis and decide on your course of action. Treatment of nasal tumours is not always the most appropriate option for every pet. It can be very expensive and requires a big commitment of both time and emotion, so it is worthwhile to discuss the various treatment options with the specialist.