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Treating Chronic Rhinosinusitis in a Cat with the Assisi Loop

Jun 22, 2018

Dr. Contreras with cat - distant .pngIn 2015, Cabo was surrendered to the animal shelter at about age 12, having lived in the house of a presumed animal hoarder. He was in rough shape: He only weighed about 8 pounds, had no teeth, and had a range of physical ailments from a matted coat to an upper respiratory infection.

He was transferred from the animal shelter to the Colorado State University teaching hospital for a trial to treat his respiratory infection, during which nothing worked, whether a traditional antiviral or antibiotic medication or something more out-of-the-box.

But remember what we said about patience? Dr. Contreras was his medical foster, and decided to adopt Cabo after caring for him, despite his medical issues remaining unresolved. In addition to the chronic rhinosinusitis, he also had chronic otitis; both his ears and his nose were generally inflamed, giving him what Dr. Contreras lovingly began referring to as his “skull ‘o’ inflammation.”

image.3.jpgFrom 2015 to 2017, Dr. Contreras writes that she tried just about everything to treat his inflammation, from antihistamines to probiotics. While some treatments provided relief, none of the effects were lasting. Additionally, due to the complication that the chronic condition was not caused by bacteria or viral infection, but rather by years of disease resulting in damaged nasal passages, antibiotics or antiviral medications would not only be ineffective, but also not recommended.

Every few weeks, Dr. Contreras writes, Cabo’s nasal discharge would become thick and colored (the non-technical term Dr. Contreras uses is “snot rockets”), at which time she’d administer an antibiotic and/or anti-inflammatory medication into his nose. Once it cleared, it was just a waiting game until it happened again. Needless to say, this wasn’t a very enjoyable cycle for anyone involved.

That being said, Dr. Contreras writes, “Cabo otherwise became a beautiful, self-groomed and allo-groomed, long-coated, happy and healthy geriatric cat with … a bright and playful attitude, and engaging, gregarious demeanor. Cabo was enjoying a good quality of life. … He played with and was bonded with the other cats in the household, and he was a happy, loveable cat who seemed adapted to his CRS.”

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After about two years of providing Cabo a permanent home, “in late 2017, I was introduced to the Assisi Loop at the American Association of Feline Practitioners Annual Conference,” Dr. Contreras writes. “I had long been wanting to trial laser therapy and acupuncture for Cabo’s skull o’ inflammation.” So, using the Assisi Loop as a different non-invasive, non-pharmaceutical method of treatment, and it appealed greatly to her..

“Targeting and upregulating anti-inflammatory molecules and processes, while also promoting tissue regeneration and remodeling, seemed exactly what Cabo’s skull ‘o’ inflammation needed,” she writes. “And considering the Loop also had the NPAID seal, it overall seemed a safe and promising avenue to explore.”

The beginning of the evaluation of the 20 cm Assisi Loop wasn’t easy. Cabo wasn’t a big fan of having it around his head, and he moved often during treatment. Dr. Contreras tried following him around the house, but this grew understandably tiring and resulted in only two 15-minute treatments a day, on average. She attempted to have Cabo wear an e-collar with the Loop attached, but, in her words, he was “very displeased” with the e-collar (as most cats are). As a result, for the months of February and March of 2018, treatments were sporadic and results were negligible.

In April, Dr. Contreras opted instead for the 10 cm Loop, as it was smaller, more like a collar, and perhaps Cabo would be more amenable to it. She was right, but she was concerned the treatment field didn’t fully reach his nasal cavity. After trial and error, she rigged it to a collar in a way that she believed the treatment field would be more appropriately placed, and provided plenty of treats when the collar was on to make Cabo more comfortable with it.

image.4.jpgOnce the placement issue was figured out, Dr. Contreras writes, and Cabo was using the Loop consistently for about four weeks, “receiving at least three treatments per day, his nasal discharge very definitively improved. He has not had any purulent nasal discharge during this time period. ... Cabo has been intranasal-medication-free for over a month, which is a record amount of time for him. … Of course he still sneezes and shoots out a daily snot-rocket, but that is to be expected, considering his very likely years and years of chronic inflammation, turbinate damage, and maladaptive remodeling.” His otitis also improved greatly in this time. After eight weeks of use, his CRS continued to improve, and snot rockets rarely occurred.

In conclusion, Dr. Contreras writes, “The Loop has provided relief from the severity of his CRS and chronic otitis clinical signs without the need for additional medication. While using the neck-brace-assisted 10 cm Assisi Loop at least three times per day for 15-minute sessions, his CRS clinical signs have stabilized to a state in which his nasal discharge has not progressed to the thickened, mucopurulent character that would prompt other treatment interventions as discussed above. ... It is now the only treatment modality that I consider safe and appropriate to use long-term for Cabo’s conditions.”

She further writes that she will be purchasing additional Loops for Cabo. “Although I do not expect resolution of his CRS, I am optimistic that, with continued use, his clinical signs will continue to decrease further. And because the Loop also has some tissue regeneration and remodeling capabilities, my hope is that, with continued use, improved function might eventually be restored to his nasal turbinate passages. Only time will tell.”


 

Dr. Contreras-close up with cat .pngDr. Elena Contreras, DVM, MS, is currently completing a PhD in Veterinary Clinical Sciences at Colorado State University (CSU); her dissertation topic is feline upper respiratory tract disease focusing on novel preventives and treatments. Dr. Contreras completed a Small Animal Shelter Medicine and Surgery Internship and a Shelter Research Fellowship at CSU after receiving her DVM degree in 2013 from Ross University, which she attended via the university’s Eliza Anna Grier Full Tuition Scholarship.

Also in 2013, Dr. Contreras received an American Society for the Prevention of Cruelty to Animals (ASPCA) scholarship and earned Maddie’s Graduate Certificate in Shelter Medicine from the University of Florida. Dr. Contreras is the 2017 recipient of the Winn Feline Foundation/Miller Trust New Feline Investigator Award. She is also currently pursuing board certification in the American College of Animal Welfare (ACAW). 

Dr. Contreras lives in Wellington, Colorado with her five adopted cats and three adopted dogs (and a human husband). 




Category: Cats, Patient Stories

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