A 5-year-old, 3.2-kg, spayed female domestic shorthair presented with a history of chronic nasal discharge that had not responded to empiric treatment. The cat was thin (body condition score 1.5/5), had mild nasal discharge, and stertorous breathing. A small mass was protruding from the left nares. Computed tomography of the nasal passages and skull showed increased density throughout the left frontal sinus and nasal cavity. No bony changes were seen, although the septum was pushed toward the right. Because the cat was small, attempts to debulk the large mass using endoscopic instruments via nasopharyngoscopy were unsuccessful. The owners declined rhinotomy because of concerns about postoperative morbidity. The cat presented again a few months later, and a novel approach was instituted. The cat was anesthetized and placed in dorsal recumbency. The abdomen was opened and the stomach exteriorized. A 2-cm gastrotomy was performed in a nonvascular area in the fundus, and a sterile endoscope was inserted and passed orad through the cardia into the esophagus until the oral cavity was reached; a large polyp and several smaller ones were then removed. As much tissue as possible was also removed. Hemostasis was controlled with topical iced saline and dilute phenylepinephrine solution infused via the endoscope. The gastrotomy site was closed in 2 layers. Histologic examination of the mass showed that it was an inflammatory polyp. Such polyps are a well-documented cause of upper respiratory signs in young cats and have recently been seen in middle-aged to older cats as well.
COMMENTARY: Going from the stomach to the nasopharynx allowed the polyps to be removed in this cat. This novel approach provided more exposure of the polyps than could have been obtained by any other method. The cat tolerated the procedure well and went home 2 days after surgery.
Endoscopic removal of nasal polyps in a cat using a novel surgical approach. Esterline ML, Radlinsky MG, Schermerhorn T. J FELINE MED SURG 7:121-124, 2005.