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Upper Respiratory Endoscopy in Cats

Clinician's Brief (Capsule)

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Cats often present with subtle respiratory signs, including nasal discharge, sneezing, ocular discharge, epistaxis, dyspnea, coughing, gagging, wheezing, decreased appetite, or difficulty swallowing. Feline nasal, pharyngeal, and laryngeal anatomy is similar to that of the dog but more compressed. A 2.7-mm, 30° endoscope in a pediatric cannula allows for a laminar flow of irrigant fluid. A protective arthroscopy sheath is narrow but may be more traumatic and has no operating channel for instruments for foreign body removal. A smaller, 1.9-mm, 30° scope is easier to fit but is more fragile and offers decreased optical quality. A flexible endoscope is useful for retroflexed J-maneuver pharyngoscopy and tracheoscopy, offering 360° visualization of the pharynx. Rostral rhinoscopy allows for visualization of the dorsal and ventral nasal meati. Diode lasers are also useful for endoscopic surgery. Endoscopic approach to the frontal sinus can be done by making a hole in the frontal sinus bone with a drill or trephine. Visual examination of the trachea is accomplished with a flexible fiberoptic 2-way deflection endoscope. Tracheoscopy is also useful in tracheal foreign body removal. Endoscopic examination and minimally invasive surgery is a useful area that is becoming more available with new equipment and technology.

Global Commentary

Feline size prohibits the use of many endoscopes, and cats are particularly sensitive to nasal damage. This review emphasized the importance of screening prospective patients carefully with radiographs and other investigations before attempting endoscopy. This is sound advice: A tooth root abscess cannot be diagnosed with an endoscope. The value of advanced diagnostic imaging is briefly mentioned and, in my experience, is quicker and better than obtaining several radiographic views, including dental radiographs. While only hospitals with large caseloads are likely to use all the techniques described, knowledge of what is possible will be useful to all who treat cats.

Tracheoscopy produces some of the best moments of endoscopy—the coughing cat that turned out to have a fish bone stuck in the trachea was one of the quickest and yet most satisfying cases that we have treated at Glasgow. Once mastered, retroflexing the scope to examine the nasopharynx is a simple and gratifying step for finding inhaled blades of grass. Rhinoscopy is challenging—the mucosal surface bleeds so easily and the pathological changes are frustratingly similar in appearance in many cases. Warnings about the risk for aspiration pneumonia should be heeded by all who attempt this, especially if performing a biopsy.—Ian Ramsey, BVSc, PhD, DSAM, FHEA, MRVCS, DECVIM-CA


Upper respiratory endoscopy in the cat: A minimally invasive approach to diagnostics and therapeutics. Sobel DS. J FELINE MED SURG 15:1007-1017, 2013.

This capsule is part of the WSAVA Global Edition of Clinician's Brief.

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