Veterinary Endoscopy for the Small Animal Practitioner E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 1750

Veröffentlichungsjahr: 2021

Beschreibung

Veterinary Endoscopy for the Small Animal Practitioner, Second Edition, gives veterinarians guidance in incorporating diagnostic endoscopy, interventional endoscopy, and minimally invasive soft tissue surgery into their small animal practices. This highly practical reference supports practitioners in adding and effectively using endoscopy techniques in their practices. With a clinically oriented approach, it focuses on applications for rigid and flexible endoscopy, making comprehensive information on these techniques easily accessible. The book covers soft tissue endoscopy, including airway endoscopy, gastrointestinal endoscopy, diagnostic and operative laparoscopy, diagnostic and operative thoracoscopy, urogenital endoscopy, and otoscopy. Thousands of images, including endoscope images and clinical photographs, enhance the text. * Covers diagnostic endoscopy, interventional endoscopy, and minimally invasive soft tissue surgery * Includes thousands of images to illustrate endoscopy concepts for veterinarians * Provides a clinically oriented reference book for using rigid and flexible endoscopy in a small animal practice * Supports veterinarians who are seeking to increase their services and enhance their revenue streams Any practitioner who is using or preparing to use endoscopic techniques will find Veterinary Endoscopy for the Small Animal Practitioner an essential practice resource.

Leseprobe

Table of Contents

Cover

Title Page

Copyright Page

Dedication Page

List of Contributors

Preface

Acknowledgments

About the Companion Website

1 Introduction and History of Endoscopy

1.1 Introduction

1.2 The History of Endoscopy

1.3 Clinical Application in Veterinary Medicine

References

2 Instrumentation for Endoscopy

2.1 Endoscopy Room Setup and Organization

2.2 Instrumentation for Small Animal Endoscopy

3 Gastrointestinal Endoscopy

3.1 Equipment

3.2 Technique

3.3 Esophagoscopy

3.4 Gastroscopy and Duodenoscopy

3.5 Colonoscopy/Ileoscopy

3.6 Therapeutic Flexible GI Endoscopy

3.7 Additional Techniques in GI Endoscopy

3.8 Care and Cleaning of GI Endoscopic Equipment

References

4 Rhinoscopy

4.1 Introduction

4.2 Indications

4.3 Instrumentation

4.4 Preparation of the Patient

4.5 Technique

4.6 Normal Nasal Cavity and Frontal Sinuses

4.7 Nasal Pathology

References

5 Bronchoscopy

5.1 Introduction

5.2 Equipment

5.3 Indications and Contraindications of Bronchoscopy

5.4 Anesthesia for Bronchoscopy

5.5 Bronchoscopic Training

5.6 Bronchoscopic Procedure

5.7 Normal and Abnormal Bronchoscopic Findings

5.8 Sample Procurement and Handling

5.9 Summary

References

6 Cystoscopy

6.1 Introduction

6.2 Cystoscopy Indications

6.3 Instrumentation for Cystoscopy

6.4 Techniques for Transurethral Cystoscopy

6.5 Normal Endoscopic Anatomy of the Lower Urinary Tract

6.6 Diagnoses with Cystoscopy

6.7 Interventional and Operative Cystoscopy

References

7 Vaginal Endoscopy in the Bitch

7.1 Canine Vaginal Anatomy

7.2 Instrumentation

7.3 Cleaning and Sterilization of Equipment

7.4 Procedures in the Bitch

7.5 Conclusion

References

8 Laparoscopy

8.1 Introduction

8.2 Indications for Laparoscopy

8.3 Instrumentation for Small Animal Laparoscopy

8.4 Laparoscopy Technique

8.5 Normal Laparoscopic Anatomy

8.6 Laparoscopic Abdominal Abnormalities

8.7 Diagnostic Laparoscopy and Biopsy Techniques

8.8 Minimally Invasive Abdominal Surgery

References

9 Thoracoscopy

9.1 Introduction

9.2 Indications

9.3 Thoracoscopy Instrumentation

9.4 Thoracoscopy General Technique

9.5 Thoracoscopy: Normal Thoracic Anatomy

9.6 Thoracic Pathology

9.7 Diagnostic Thoracoscopy Procedures

9.8 Thoracic Operative Procedures

9.9 Contraindications for Thoracoscopy

9.10 Complications of Thoracoscopy

9.11 Conclusions

References

10 Video Otoscopy

10.1 Normal Anatomy of the Ear as Seen Through the Video Otoscope

10.2 Pathophysiology of the Ear as Seen Through the Video Otoscope

10.3 Video Otoscopes

10.4 Video Otoscope Instrumentation

10.5 Video Otoscopy as a Diagnostic Aid – “In Examination Room” Use

10.6 Video Otoscopy Procedures

Suggested Reading

11 Otheroscopies

11.1 Introduction

11.2 Instrumentation for Otheroscopy in Small Animals

11.3 Transabdominal Nephroscopy and Ureteroscopy

11.4 Transabdominal Cholecystodocoscopy

11.5 Transabdominal Gastrointestinal Endoscopy

11.6 Prepuceoscopy

11.7 Laceroscopy

11.8 Drain Retrieval

11.9 Fistuloscopy

11.10 Oculoscopy

11.11 Oncoscopy

11.12 Oraloscopy

11.13 Laryngoscopy

11.14 Dermoscopy

11.15 Analsacoscopy

References

Index

End User License Agreement

List of Tables

Chapter 2

Table 2.1 Video systems for small animal endoscopy.

Table 2.2 Rigid telescopes used for small animal endoscopy.

Table 2.3 The 2.7 mm MPRT with available sheath selection.

Table 2.4 Flexible endoscopes commonly used in small animal practice.

Chapter 3

Table 3.1 Sampling recommendations for GI biopsies.

Table 3.2 Advantages and disadvantages of endoscopic or laparoscopic biopsies...

Table 3.3 Skills that trainees need to become proficient.

Table 3.4 Abnormalities found during esophagoscopy.

Table 3.5 GI diseases without significant structural abnormalities for which ...

Table 3.6 Definition of mucosal appearances evaluated endoscopically.

Table 3.7 User‐related damage due to inappropriate handling and cleaning.

Table 3.8 Troubleshooting guide for endoscopes.

Chapter 4

Table 4.1 Common presenting complaints associated with nasal disease.

Table 4.2 Historical information that is obtained for nasal disease.

Table 4.3 Diagnostic approach to nasal disease.

Table 4.4 Nasal and frontal sinus disease rule outs.

Table 4.5 Rigid telescopes and sheaths used for rhinoscopy.

Table 4.6 Rigid sample collection and operative instruments for rhinoscopy to...

Table 4.7 Flexible sample collection and operative instruments for rhinoscopy...

Table 4.8 Diagnoses of nasal diseases with rhinoscopy.

Table 4.9 Tumor types diagnosed in the nasal cavity using rhinoscopy in 100 c...

Chapter 5

Table 5.1 Indications, contraindications, and potential complications of bron...

Table 5.2 Differential cell counts from bronchoalveolar lavage fluid from nor...

Chapter 6

Table 6.1 Cystoscopy procedures.

Table 6.2 Diagnoses with cystoscopy.

Table 6.3 Indications for cystoscopy.

Table 6.4 Cystoscopic findings in dogs and cats with pelvic fractures.

Table 6.5 The 2.7 mm multipurpose rigid telescope and sheaths for transurethr...

Table 6.6 Two additional telescopes and sheaths for transurethral cystoscopy ...

Table 6.7 Sample collection of operative instruments for transurethral cystos...

Table 6.8 Continuous flow cystoscopy telescopes and sheaths available for tra...

Table 6.9 Deflecting mechanisms (Albarran levers) available for use in small ...

Table 6.10 Instrument set for transurethral viscous fluid injection.

Table 6.11 Resectoscope systems for transurethral cystoscopy in dogs and cats...

Table 6.12 Flexible endoscopes for transurethral cystoscopy in male dogs.

Table 6.13 Materials needed to establish a urethral percutaneous perineal por...

Chapter 8

Table 8.1 Indications for diagnostic laparoscopy in small animal practice.

Table 8.2 Minimally invasive abdominal surgery procedures performed in small ...

Table 8.3 Laparoscopic‐assisted techniques performed in small animal practice...

Table 8.4 Equipment for abdominal insufflation in small animals.

Table 8.5 Telescopes for laparoscopy in small animal practice.

Table 8.6 A single puncture or operating laparoscope for use in small animal ...

Table 8.7 Additional optional telescopes for small animal laparoscopy.

Table 8.8 Trocar‐cannulas for laparoscopy in small animal practice.

Table 8.9 Five millimeter CLICKline instruments for minimally invasive surger...

Table 8.10 Instruments for laparoscopic biopsies in small animals.

Table 8.11 Five millimeter instrument for minimally invasive surgery in small...

Table 8.12 Ten millimeter diameter minimally invasive instruments for abdomin...

Table 8.13 Three millimeter operative instruments for minimally invasive surg...

Table 8.14 Ovary stabilization options and tissue extractors for use in small...

Table 8.15 Minimally invasive surgery needle holders for intracorporeal sutur...

Table 8.16 Handpieces for the LigaSure and ForceTriad vessel sealing devices.

Table 8.17 Minimally invasive surgery clip applicators and linear stapling de...

Table 8.18 Single incision laparoscopic surgery (SILS) access systems.

Table 8.19 Five millimeter diameter curved instruments for use with single‐po...

Table 8.20 Physiologic effects of abdominal insufflation.

Chapter 9

Table 9.1 Indications for diagnostic thoracoscopy.

Table 9.2 Indications for minimally invasive thoracic surgery.

Table 9.3 Telescopes used for thoracoscopy in small animal practice.

Table 9.4 Reusable trocar–cannulas for small animal thoracoscopy.

Table 9.5 Disposable trocar–cannulas for thoracoscopy in small animal practic...

List of Illustrations

Chapter 1

Figure 1.1 The first rigid endoscope, built by Bozzini in the early 1800s. T...

Figure 1.2 A major step in advancing technology or endoscope development was...

Figure 1.3 Representation of a light beam being bent as it passes from one m...

Figure 1.4 As the angle of incidence of the light waves “α” increases, so do...

Figure 1.5 Total internal reflection of light in a fiberoptic glass fiber oc...

Figure 1.6 A coherent fiber bundle used for image transmission in flexible f...

Figure 1.7 An image through a coherent fiber bundle of a flexible fiberoptic...

Figure 1.8 An image through a coherent fiber bundle of a flexible fiberoptic...

Figure 1.9 The light transmission system for a rigid endoscopic telescope wi...

Figure 1.10 A small lightweight endoscopy video camera head with a separate ...

Figure 1.11 An endoscopy video camera head coupled to a 10 mm diameter lapar...

Figure 1.12 A surgery team utilizing video for laparoscopic surgery where al...

Figure 1.13 A video gastroscope with a video camera chip at the tip of the e...

Figure 1.14 An image of the duodenum in an 8‐year‐old neutered male 10 kg mi...

Chapter 2

Figure 2.1 A double wide video tower with room for a large amount of equipme...

Figure 2.2 A smaller video tower setup for small animal rigid endoscopy with...

Figure 2.3 The video endoscopy tower used by the author in a private referra...

Figure 2.4 A Karl Storz Endoscopy IMAGE 1 FULL HD Three‐Chip Camera Head H3‐...

Figure 2.5 An endoscopic video camera head attached securely to a 10 mm lapa...

Figure 2.6 A Karl Storz Endoscopy Tele Pack Vet X LED self‐contained endosco...

Figure 2.7 A Xenon Nova 300‐W light source.

Figure 2.8 A Xenon 100 light source for gastrointestinal endoscopy with inte...

Figure 2.9 A 300‐W LED light source.

Figure 2.10 The FlexXC video cystourethroscope with an internal LED light so...

Figure 2.11 A battery‐powered LED light source attached to an otoscope.

Figure 2.12 A minimally invasive surgery instrument with a connection post f...

Figure 2.13 A minimally invasive surgery bipolar vessel sealing and cutting ...

Figure 2.14 The ForceTriad vessel sealing device with standard monopolar rad...

Figure 2.15 A 10 mm diameter 37 cm long “Atlas” vessel sealing instrument fo...

Figure 2.16 An open‐surgery handpiece for use with the ForceTriad that seals...

Figure 2.17 An open‐surgery handpiece for use with the ForceTriad that seals...

Figure 2.18 An intravenous fluid administration set with a filter in the cap...

Figure 2.19 A Vet Pump 2 fluid management system with irrigation and suction...

Figure 2.20 A manual Tankersley tilt table (TTT) designed for performing lap...

Figure 2.21 The Tankersley table tilted 45° in the position used for laparos...

Figure 2.22 A large dog fixed in place on the TTT ready for performing a lap...

Figure 2.23 A DRE Panomed operating table for small animal use shown with th...

Figure 2.24 The DRE Panomed powered operating table for small animal practic...

Figure 2.25 The same patient as seen in the Figure 2.24 tilted to the right ...

Figure 2.26 Telescopes available for use in small animal practice including ...

Figure 2.27 A diagram showing the angle of view of rigid telescopes used in ...

Figure 2.28 The ENDOCAMELEON telescope for laparoscopy with variable angles ...

Figure 2.29 A diagram of the Hopkins rod lens system shown in the telescope ...

Figure 2.30 The 2.7 mm diameter, 18 cm long, 30° multipurpose rigid telescop...

Figure 2.31 A one‐piece cystoscope incorporating the telescope and sheath in...

Figure 2.32 A 10 mm diameter, 0° operating laparoscope with a working length...

Figure 2.33 The Veterinary Otoscope for ear examination in awake patients wi...

Figure 2.34 The anatomy of a flexible fiberoptic gastrointestinal endoscope....

Figure 2.35 (a) An assembled cystoscope for performing transurethral cystosc...

Figure 2.36 Round and oval sheaths for the 2.7 mm MPRT. The round sheath on ...

Figure 2.37 Locking mechanism designs for attaching sheaths to telescopes. F...

Figure 2.38 A trocar‐cannula for laparoscopy. (a) An 11 mm diameter, 10.5 cm...

Figure 2.39 A 6 mm diameter, 10.5 cm long Ternamain Endo TIP cannula, with a...

Figure 2.40 A 3.9 mm diameter, 5.0 cm long lightweight trocar‐cannula with a...

Figure 2.41 Flexible instruments for use with flexible endoscopes and rigid ...

Figure 2.42 An example of rigid instruments used with rigid telescopes. The ...

Figure 2.43 An example of a rigid 5 mm diameter, 36 cm long minimally invasi...

Chapter 3

Figure 3.1 Silverline video‐gastroscope from Karl Storz, Tuttlingen, with 1....

Figure 3.2 A veterinary‐specific feline video gastroscope (outer diameter 5....

Figure 3.3 Schematic figure of four‐way tip deflection with at least one way...

Figure 3.4 Schematic drawing of the handpiece of a video‐gastroscope.

Figure 3.5 Distal tip of video endoscope; note the working channel (a), fibe...

Figure 3.6 Commonly used accessory instruments for flexible GI endoscopy: (f...

Figure 3.7 Different types of biopsy forceps (top to bottom): smooth‐edged, ...

Figure 3.8 Four‐wire basket, alligator grasper, and rat tooth (top to bottom...

Figure 3.9 Foreign body grasping instrument (length 60 cm) that is used alon...

Figure 3.10 Cytology brush with protective tubing to obtain cytology samples...

Figure 3.11 Holding the handpiece of the endoscope with the left hand. The i...

Figure 3.12 The rubber cap on the instrumentation channel of a rigid endosco...

Figure 3.13 Foreign body grasper that is integrated into the sheath of a rig...

Figure 3.14 Histopathology of two endoscopically taken duodenal biopsies. Sa...

Figure 3.15 Obstructed view of gastric mucosa in a dog that has recently ing...

Figure 3.16 Drawing showing a dog in left lateral recumbency with normal ori...

Figure 3.17 Self‐made model for training of flexible endoscopy. Plastic tube...

Figure 3.18 Ex‐vivo stomach model of a pig. The stomach is obtained from the...

Figure 3.19 Training of flexible esophago‐gastro‐duodenoscopy in a live anim...

Figure 3.20 (a) Plain thoracic radiograph of an eight‐year‐old male Cairn Te...

Figure 3.21 Normal appearance of upper esophageal sphincter in a dog.

Figure 3.22 Pictures of normal esophagus: (a) normal esophagus of a dog with...

Figure 3.23 Typical appearance of normal esophagus of a cat with “herringbon...

Figure 3.24 Trachea is visible over the base of the heart at 7 o'clock posit...

Figure 3.25 At the cardia, the gastric mucosa can be seen extending into the...

Figure 3.26 Examples of open cardia and Z‐line in two French Bulldogs. This ...

Figure 3.27 Pictures of mild‐to‐severe esophagitis. (a) Mildly irregular muc...

Figure 3.28 Pictures of esophageal strictures. (a) A seven‐month‐old Doberma...

Figure 3.29 Esophageal stenosis in a three‐month‐old kitten which looks endo...

Figure 3.30 Pictures of esophageal foreign bodies: (a) nine‐year‐old Papillo...

Figure 3.31 Pictures of esophageal tumors: (a) adenocarcinoma of the esophag...

Figure 3.32 A gastric leiomyosarcoma protruding into the esophagus in a 12‐y...

Figure 3.33 Two images of

Spirocerca lupi

with a granuloma in the esophagus ...

Figure 3.34 Pictures of a vascular ring anomaly: (a) a typical band seen in ...

Figure 3.35 Gastroesophageal intussusception in a 12‐year‐old 27 kg mixed br...

Figure 3.36 A nine‐year‐old Border Collie with chronic vomiting and signs of...

Figure 3.37 Anatomy of the stomach and cranial duodenum. It is important to ...

Figure 3.38 (a) With a dog placed in left lateral recumbency, the tip of the...

Figure 3.39 (a) The normal stomach with the animal in left lateral recumbenc...

Figure 3.40 Various pictures of the normal, closed, or partly open pylorus: ...

Figure 3.41 Examples of iatrogenic damage of duodenal mucosa after the biops...

Figure 3.42 The normal stomach with the patient in left lateral recumbency a...

Figure 3.43 (a) Clearly visible rugal folds seen upon entering a normal part...

Figure 3.44 Various pictures of normal duodenal mucosa: (a) 2‐year‐old 22 kg...

Figure 3.45 Various pictures of normal duodenal papillae: (a) 3‐year‐old Bri...

Figure 3.46 Gastric erosions (a) in a nine‐year‐old Border Collie and (b) in...

Figure 3.47 Gastric friability in a 12‐year‐old European Shorthair cat with ...

Figure 3.48 Gastric granularity (a) in a six‐year‐old giant Schnauzer with h...

Figure 3.49 Gastric ulcers (a) in a 13‐year‐old Domestic Shorthair cat with ...

Figure 3.50 Gastric masses (a) in a 12‐year‐old mixed breed dog with a polyp...

Figure 3.51 Duodenal mucosal friability (a) in a five‐year‐old Jack Russel T...

Figure 3.52 Duodenal granularity of various severities: (a) mild granularity...

Figure 3.53 Duodenal erosion in a four‐year‐old Bichon Frise with hypoadreno...

Figure 3.54 Duodenal lymphatic dilation of various severities: (a) mild lymp...

Figure 3.55 Pictures of various gastric foreign bodies: (a–c) crown caps in ...

Figure 3.56 Endoscopic picture from the stomach of a dog with a single

Physa

...

Figure 3.57 Normal variations of the ileocolonic sphincter: (a) 12‐year‐old ...

Figure 3.58 Taking blind biopsies through the iliocolonic sphincter when the...

Figure 3.59 Retroflexed view in the descending colon in a great Dane to bett...

Figure 3.60 Pictures of normal colonic mucosa: (a) 9‐year‐old German Shepher...

Figure 3.61 Colonic erosions (a) in a 7‐year‐old German Brake with mild coli...

Figure 3.62 Two examples of colonic friability (a) in a nine‐year‐old Golden...

Figure 3.63 Colonic granularity examples: (a) an 11‐year‐old mixed breed dog...

Figure 3.64 An ulcerated ilieocolonic sphincter in a three‐year‐old Leonberg...

Figure 3.65 Histiocytic ulcerative colitis in (a) an 8‐month‐old Boxer and (...

Figure 3.66 Colonic masses in (a) a 6‐year‐old Border Collie (histologically...

Figure 3.67 Whipworms (

Trichuris vulpis

) in a six‐year‐old German Shepherd d...

Figure 3.68 A plastic “overtube” with an endoscope inside to protect the end...

Figure 3.69 Esophageal fishhook removal: (a) a lateral radiograph of a nine‐...

Figure 3.70 Marked esophageal irritation after removal of a deeply seated bo...

Figure 3.71 Typical foam and saliva obstructing the view of an esophageal fo...

Figure 3.72 Various forms of low‐profile feeding tubes, also called buttons....

Figure 3.73 Components of a commercial human PEG tube set (Freka), 16 Fr siz...

Figure 3.74 Placement of a commercial PEG tube: (a) generous clipping of lef...

Figure 3.75 (a) Materials used for a “home‐made” PEG tube using a Pezzer ure...

Figure 3.76 (a) Low‐profile feeding tube (button) in a cat; (b) pet body cov...

Figure 3.77 Guide wire with a balloon placed over the guide wire in a strict...

Figure 3.78 Balloon catheter (length 4 cm, inflated to width 10 mm) used for...

Figure 3.79 Manometer for use during balloon dilation of esophageal strictur...

Figure 3.80 Mucosal tear in an esophageal stricture after balloon dilation (...

Figure 3.81 Metallic stent in the esophageal lumen of a cat in which balloon...

Figure 3.82 Manometer or pressure tester to use before each cleaning procedu...

Figure 3.83 Example of a plastic tub filled with cleaning detergent in which...

Figure 3.84 Cleaning of all channels with a cleaning brush.

Figure 3.85 Plastic tubes attached with adapters to the instrumentation chan...

Figure 3.86 Washing machine with endoscope ports attached to tubes for flush...

Figure 3.87 Endoscope storage options: (a) one example of a cabinet for stor...

Figure 3.88 Plastic tube attached to wall for disinfection of flexible endos...

Chapter 4

Figure 4.1 Direct visual and physical access to the nasal cavity is achieved...

Figure 4.2 The working tips of the two rigid biopsy forceps most commonly us...

Figure 4.3 Rigid biopsy and operating forceps for turbinectomy are larger an...

Figure 4.4 Five millimeter diameter Ferris‐Smith arthroscopy rongeurs with 5...

Figure 4.5 Lateral radiograph of a normal dog showing the area of the skull ...

Figure 4.6 Positioning for lateral radiographic projection of the nasal cavi...

Figure 4.7 Lateral radiograph of a normal dog showing the area of the skull ...

Figure 4.8 Positioning for ventral 20° rostral dorsocaudal oblique open mout...

Figure 4.9 Ventral 20° rostral dorsocaudal oblique open mouth projection of ...

Figure 4.10 Positioning for rostrocaudal projection of the skull for frontal...

Figure 4.11 Rostrocaudal projection of the skull demonstrating normal fronta...

Figure 4.12 HemaBlock

®

placed in the nasal cavity to arrest an otherwis...

Figure 4.13 Nasal tumor biopsy using the 3.0 mm rigid biopsy forceps passed ...

Figure 4.14 The 3.0 mm rigid biopsy forceps positioned for biopsy of a nasop...

Figure 4.15 Five French flexible biopsy forceps passed through the working c...

Figure 4.16 A 1000 μm laser fiber used to vaporize tissue and control bleedi...

Figure 4.17 A small quantity of mucus in the nasal cavity that is a normal f...

Figure 4.18 Nasal mucosal appearance through air with a bright red color. Hi...

Figure 4.19 Nasal mucosal appearance through liquid at the same location and...

Figure 4.20 Turbinates are not well developed in the rostral nasal cavity ap...

Figure 4.21 Normal pigment extending into the rostral nasal passage.

Figure 4.22 Gently curving smooth turbinates in the rostral nasal cavity tha...

Figure 4.23 Branching of the ventral nasal conchae seen from the middle meat...

Figure 4.24 Ethmoidal turbinates with the normal crumpled appearance with mi...

Figure 4.25 Thick ethmoidal turbinates approaching the upper end of normal....

Figure 4.26 Ethmoidal turbinates at the thin end of normal with midrange int...

Figure 4.27 Minimal interturbinate space in the ethmoidal turbinates at the ...

Figure 4.28 Ethmoidal turbinates with midrange interturbinate space.

Figure 4.29 Wide ethmoidal interturbinate space at the upper limit of normal...

Figure 4.30 The same area of the nasal cavity as in Figure 4.22 with more in...

Figure 4.31 The area on the nasal septum caudally that is normally roughened...

Figure 4.32 The normal curved caudal margin of the nasal septum.

Figure 4.33 Normal nasolacrimal duct opening in the rostral nasal cavity.

Figure 4.34 Air bubbles seen during examination of a normal nasal cavity. Th...

Figure 4.35 The normal nasopharynx seen with the telescope passed from the n...

Figure 4.36 In this image, the endotracheal tube is seen in the right side o...

Figure 4.37 A normal nasopharynx with subtle vasculature visible in the muco...

Figure 4.38 Prominent vasculature visible in the mucosa of a normal nasophar...

Figure 4.39 The opening of a eustachian tube in the nasopharynx at the appro...

Figure 4.40 A small hard protrusion that is a common finding on the dorsal w...

Figure 4.41 A wider view of the nasopharyngeal protrusion seen in the Figure...

Figure 4.42 An air–liquid interface interfering with visualization of the na...

Figure 4.43 The smooth discolored, greenish‐brown appearance of the mucosa i...

Figure 4.44 Roughening of the mucosal surface in the discolored area of the ...

Figure 4.45 An area of disrupted mucosal discoloration due to contact with t...

Figure 4.46 An area of the nasal cavity with mild roughening of the mucosal ...

Figure 4.47 Small random blood vessels visible in the normal nasal mucosa.

Figure 4.48 Larger visible blood vessels at the margin of the olfactory orga...

Figure 4.49 A normal frontal sinus lined with a thin transparent membrane an...

Figure 4.50 A bone ridge extending into a normal frontal sinus. Highlights i...

Figure 4.51 An air–water interface in a normal frontal sinus interfering wit...

Figure 4.52 Active bleeding encountered at the beginning of rhinoscopy in a ...

Figure 4.53 Fresh blood adhered to the surface of a visible tumor in the nas...

Figure 4.54 A fresh blood clot from a recent bleeding episode that has not u...

Figure 4.55 Abnormal material in the nasal cavity of a 12‐year‐old Brittany ...

Figure 4.56 Clotted blood from a recent bleeding episode that formed into a ...

Figure 4.57 Clotted blood in the same patient as Figure 4.56 in a different ...

Figure 4.58 A smooth mass of clotted blood that has changed from red to a br...

Figure 4.59 This clotted blood has changed from red to purple forming a larg...

Figure 4.60 A purple blood clot that has formed a lobulated structure.

Figure 4.61 A small blood clot‐like structure protruding between turbinates ...

Figure 4.62 An organized blood clot‐like structure that appears encapsulated...

Figure 4.63 A dark blood clot‐like structure with a ragged surface and stran...

Figure 4.64 Ragged vascular appearing tissue that is mostly white structure ...

Figure 4.65 Blood clot‐like material with three different appearances in one...

Figure 4.66 The internal appearance of a blood clot‐like structure following...

Figure 4.67 The internal appearance of a blood clot‐like mass with organized...

Figure 4.68 Free mucopurulent exudate obscuring visibility of tumor surface ...

Figure 4.69 Free bloody exudate in the nasal cavity of a dog with a nasal ma...

Figure 4.70 Mucopurulent exudate that is adherent to the surface of a neopla...

Figure 4.71 Large numerous blood vessels visible on the surface of a smooth ...

Figure 4.72 Numerous small irregular blood vessels on the surface of a solid...

Figure 4.73 Sparse small blood vessels in a solid smooth mass in the nasal c...

Figure 4.74 Red coloration of a solid smooth nasal mass indicating significa...

Figure 4.75 A smooth solid avascular‐appearing neoplastic mass in the nose o...

Figure 4.76 A solid smooth avascular‐appearing neoplastic nasal mass in a do...

Figure 4.77 An irregular solid nasal mass with an avascular appearance.

Figure 4.78 A pink irregular solid neoplastic mass in the nasal cavity of a ...

Figure 4.79 A dense red solid irregular mass in the nasal cavity of a dog.

Figure 4.80 An irregular neoplastic nasal mass in a dog with sparse small bl...

Figure 4.81 Numerous small irregular blood vessels in a solid irregular nasa...

Figure 4.82 Numerous large prominent blood vessels in an irregular solid neo...

Figure 4.83 A lobulated avascular appearing neoplastic nasal mass in a 14‐ye...

Figure 4.84 The roughened surface of a neoplastic nasal mass.

Figure 4.85 An unusual striated surface of a neoplastic mass in the nasal ca...

Figure 4.86 A ragged tumor surface of a squamous cell carcinoma immediately ...

Figure 4.87 A large neoplastic nasal mass with a red polypoid surface. Also ...

Figure 4.88 A small polypoid neoplastic mass in the nasal cavity of an eight...

Figure 4.89 A fimbriated neoplastic nasal mass with large blood vessels in t...

Figure 4.90 A fimbriated neoplastic nasal mass with small blood vessels in t...

Figure 4.91 A smooth cystic avascular neoplastic nasal mass with clear appea...

Figure 4.92 A smooth cystic avascular neoplastic nasal mass with blue colora...

Figure 4.93 A close‐up image of an avascular cystic mass showing that there ...

Figure 4.94 A small avascular clear cystic projection from a nasal neoplasti...

Figure 4.95 A sheet of avascular blue cystic‐appearing neoplastic tissue in ...

Figure 4.96 A turbinate‐shaped avascular blue cystic structure in a dog with...

Figure 4.97 A white avascular‐appearing cystic neoplastic lesion in the nasa...

Figure 4.98 A pink cystic avascular‐appearing structure in the nasal cavity ...

Figure 4.99 A red neoplastic cyst filled with fresh blood in the nasal cavit...

Figure 4.100 Small sparse blood vessels in the wall of a neoplastic cyst in ...

Figure 4.101 Numerous larger blood vessels visible in a neoplastic nasal cys...

Figure 4.102 Large prominent blood vessels in the wall of a cystic neoplasti...

Figure 4.103 Nasal neoplasia with solid vascular and solid avascular portion...

Figure 4.104 Cystic avascular and solid vascular neoplastic tissue adjacent ...

Figure 4.105 Solid vascular and solid avascular tissue in the same neoplasti...

Figure 4.106 Cystic vascular tissue, solid irregular vascular tissue, and ro...

Figure 4.107 Solid smooth avascular‐appearing neoplastic nasal tissue adjace...

Figure 4.108 A cystic avascular‐appearing nasal tumor with an area of cyst w...

Figure 4.109 Greenish coloration of a neuroendocrine tumor in the area of th...

Figure 4.110 An area of gray tumor appearing in an area of normally pigmente...

Figure 4.111 A nasal tumor with an unusual speckled surface.

Figure 4.112 Internal tumor tissue following biopsy of a mass revealing a fr...

Figure 4.113 Solid white internal tumor tissue exposed with biopsy of a nasa...

Figure 4.114 A nasal tumor that has ruptured prior to rhinoscopy exposing in...

Figure 4.115 A smooth vascular red‐appearing nasopharyngeal polyp in a one‐y...

Figure 4.116 A smooth avascular white appearing nasopharyngeal polyp in a fo...

Figure 4.117 An irregular vascular purple‐appearing nasopharyngeal polyp in ...

Figure 4.118 A multicolored nasopharyngeal polyp visible in the nasopharynx ...

Figure 4.119 A nasopharyngeal polyp attached to the stalk where it exits the...

Figure 4.120 Two‐millimeter biopsy forceps passed from the nasopharynx into ...

Figure 4.121 The eustachian tube after removal of the nasopharyngeal portion...

Figure 4.122 The middle ear portion of a nasopharyngeal polyp seen with a 1....

Figure 4.123 A small nasal tumor that is extending between turbinates with l...

Figure 4.124 The site or origin of a nasal tumor, or invasion of tumor into ...

Figure 4.125 A unilateral nasal tumor extending caudally into and completely...

Figure 4.126 Extension of unilateral nasal neoplasia caudal to the septum as...

Figure 4.127 A solid irregular avascular‐appearing unilateral mass extending...

Figure 4.128 A cystic avascular bluish extension of a unilateral neoplasia c...

Figure 4.129 A smooth neoplastic mass extending caudal to the nasal septum t...

Figure 4.130 Adhesions of turbinates to the nasal septum in the contralatera...

Figure 4.131 Displacement of the nasal septum to the contralateral side by a...

Figure 4.132 A view of the contralateral nasal cavity with invasion of the n...

Figure 4.133 Penetration of the nasal septum into the contralateral nasal ca...

Figure 4.134 Penetration of the nasal septum into the contralateral nasal ca...

Figure 4.135 Biopsy forceps placed to remove solid tumor tissue under endosc...

Figure 4.136 Biopsy forceps placed to remove an area of cystic tumor tissue ...

Figure 4.137 Tumor tissue is removed with biopsy forceps or rongeurs until t...

Figure 4.138 Using the diode laser to control bleeding during tumor debulkin...

Figure 4.139 The diode laser being used to vaporize tissue as part of the tu...

Figure 4.140 Completed resection of a nasal tumor with a narrow attachment a...

Figure 4.141 The diode laser has been used to provide hemostasis and vaporiz...

Figure 4.142 Using biopsy forceps to remove additional tissue following diod...

Figure 4.143 A large nasal septal defect created by debulking a tumor that h...

Figure 4.144 An adequate airway has been re‐established by removal of tumor ...

Figure 4.145 Completion of nasal tumor debulking when adequate neoplastic ti...

Figure 4.146 Completion of nasal tumor debulking when a total turbinectomy h...

Figure 4.147 Completion of a nasal tumor debulking procedure due to inabilit...

Figure 4.148 Continued active bleeding after extensive tumor debulking and t...

Figure 4.149 Application of a hemostatic powder achieved immediate hemostasi...

Figure 4.150 A neoplastic clear‐walled irregular avascular‐appearing cyst wi...

Figure 4.151 Rapid drainage of the cyst following laser penetration. The cys...

Figure 4.152 Drainage of the cyst allows the cyst wall to shrink changing fr...

Figure 4.153 A solid smooth nasal mass with varied coloration but no visible...

Figure 4.154 At reoperation three weeks after the initial procedure in the c...

Figure 4.155 Reoperation of a nasal tumor that at initial operation was an e...

Figure 4.156 A large quantity of mucopurulent exudate in the nasal cavity of...

Figure 4.157 Thick viscous mucopurulent exudate seen between nasal turbinate...

Figure 4.158 Mucopurulent exudate covering and adhering to a fungal colony o...

Figure 4.159 Thick viscous mucopurulent exudate extending caudal to the nasa...

Figure 4.160 Decreased turbinate thickness with increased interturbinate spa...

Figure 4.161 Early mild change in turbinate shape due to mycotic rhinitis in...

Figure 4.162 Mild loss of turbinate height with turbinate thickening in a do...

Figure 4.163 Mild loss of turbinate bulk with loss of both height and thickn...

Figure 4.164 Marked turbinate distortion in a dog with mycotic rhinitis.

Figure 4.165 Marked distortion of the ethmoidal turbinates in a dog with an

Figure 4.166 Turbinate destruction and loss of turbinate support from remain...

Figure 4.167 An end‐stage nasal cavity with a nasal fungal infection and alm...

Figure 4.168 Marked hyperemia of the nasal turbinate mucosa and mild turbina...

Figure 4.169 Fine roughening of the nasal turbinate mucosa in response to a ...

Figure 4.170 A patient with a nasal

Aspergillus

infection showing coarse rou...

Figure 4.171 Variable mucosal roughening on the nasal septum of the dog seen...

Figure 4.172 Fine uniform roughening of the nasal septum mucosa of a dog wit...

Figure 4.173 Increased vascularity of the turbinate mucosa in a dog with myc...

Figure 4.174 An increased visible vascular pattern in the nasopharynx of a d...

Figure 4.175 Replacement of nasal mucosa with granulation tissue in direct c...

Figure 4.176 An adhesion between a nasal turbinate and the nasal septum in a...

Figure 4.177 Individual small white nodules representing inflammatory polyps...

Figure 4.178 Inflammatory polyps on the dorsal wall of the nasopharynx appea...

Figure 4.179 White nodular inflammatory polyps coalesced into a solid layer ...

Figure 4.180 Two small irregular inflammatory polyps in the nasal cavity of ...

Figure 4.181 A cluster of small irregular polyps in a dog with a nasal Asper...

Figure 4.182 Large inflammatory polyps coalescing into a solid irregular mas...

Figure 4.183 A tumor‐like mass in the nasal cavity of a dog with a nasal fun...

Figure 4.184 A larger tumor‐like mass in the nasal cavity secondary to a nas...

Figure 4.185 An area of septal destruction due to a nasal fungal infection. ...

Figure 4.186 The bright iridescent metallic appearance of a small fungal col...

Figure 4.187 A medium‐sized fungal colony showing the bright iridescent meta...

Figure 4.188 A large fungal colony with areas of the bright iridescent metal...

Figure 4.189 A small spherical dull fungal colony sitting directly on the mu...

Figure 4.190 A small white smooth shiny fungal colony sitting on a bed of gr...

Figure 4.191 A small white fuzzy fungal colony in the frontal sinus of a dog...

Figure 4.192 An upright spherical nasal fungal colony partially obscured wit...

Figure 4.193 An irregular fungal colony with a smooth surface in the frontal...

Figure 4.194 A fuzzy fungal colony in the nasal cavity of the dog in Figure ...

Figure 4.195 A fungal colony in the nasal cavity of a dog with fuzzy white a...

Figure 4.196 A large black

Aspergillus niger

colony in the nasal cavity of a...

Figure 4.197 Mucopurulent drainage in the caudodorsal nasal cavity of a dog ...

Figure 4.198 Mucopurulent drainage from the frontal sinus of a dog with a fu...

Figure 4.199 Thickening of the lining membrane and increased vascular patter...

Figure 4.200 Removing fungal colony material from the nasal cavity of a dog ...

Figure 4.201 Using a stone basket to remove a fungal colony from the frontal...

Figure 4.202 A frontal sinus after complete removal of a fungal colony with ...

Figure 4.203 Correct placement of nasopharynx occlusion catheters for use wi...

Figure 4.204 Foreign material in the nasal cavity of a dog with an Aspergill...

Figure 4.205 Fungal material surrounding a tooth foreign body in the nasal c...

Figure 4.206 Thickening of the lymphatic tissue on the dorsal wall of the na...

Figure 4.207 A nasopharyngeal mass partially filling the nasopharynx in a ca...

Figure 4.208 A cryptococcal mass completely filling the nasopharynx of a cat...

Figure 4.209 A nasal cavity cryptococcal mass in a cat with chronic nasal di...

Figure 4.210 Mucopurulent nasal discharge in the nasal cavity of a cat with ...

Figure 4.211 Turbinate distortion and loss of turbinate mass in a cat with a...

Figure 4.212 Mucopurulent exudate in the nasal cavity of a dog with allergic...

Figure 4.213 Hyperemic turbinate mucosa in a case of allergic rhinitis. Ther...

Figure 4.214 Roughening of the turbinate mucosa in a case of allergic rhinit...

Figure 4.215 A case of allergic rhinitis with roughening of the septa mucosa...

Figure 4.216 Roughening of the dorsal surface of the nasopharynx in a dog wi...

Figure 4.217 Friable mucosa damaged by minimal endoscope contact during rhin...

Figure 4.218 Turbinate swelling with loss of interturbinate air space in a d...

Figure 4.219 Mild turbinate distortion in a dog with allergic rhinitis.

Figure 4.220 An inflammatory nodule on a turbinate in a dog with allergic rh...

Figure 4.221 Multiple small inflammatory nodules on the dorsal wall of the n...

Figure 4.222 Inflammatory nodules coalesced into a solid sheet on the dorsal...

Figure 4.223 A solitary irregular inflammatory polyp in the nasal cavity of ...

Figure 4.224 A cluster of small irregular inflammatory polyps in the nasal c...

Figure 4.225 Inflammatory polyps appearing as large contiguous masses.

Figure 4.226 A grass awn foreign body in the nasal cavity of a dog.

Figure 4.227 A blade of grass in the nasal cavity of a dog. There is thick i...

Figure 4.228 A metallic bullet fragment in the nasal cavity of a dog.

Figure 4.229 An Oregon grape leaf in the nasal cavity of a dog.

Figure 4.230 Unidentified amorphous organic material in the nasal cavity of ...

Figure 4.231 Unidentifiable inorganic material in the nose of a dog.

Figure 4.232 Unidentifiable friable inorganic material in the nasal cavity o...

Figure 4.233 Thick inspissated exudate completely hiding the foreign body in...

Figure 4.234 Mucopurulent exudate containing blood surrounding a nasal forei...

Figure 4.235 Removing a nasal foreign body with standard alligator forceps. ...

Figure 4.236 Undisturbed exudate adjacent to an abscessed tooth root in a do...

Figure 4.237 Cyst‐like structures in the ventrolateral nasal cavity over inv...

Figure 4.238 A fractured upper fourth premolar tooth associated with the cys...

Figure 4.239 White turbinates in a cat with turbinate infarction and complet...

Figure 4.240 Pale turbinates in a cat with decreased vascular supply due to ...

Figure 4.241 White distorted turbinates in a cat with chronic turbinate infa...

Figure 4.242 Turbinate destruction in a case of turbinate infarction with a ...

Figure 4.243 Biopsy of infarcted turbinates produces minimal or no bleeding....

Figure 4.244 Mild turbinate damage to an infarcted turbinate caused by conta...

Figure 4.245 No bleeding even with significant iatrogenic turbinate trauma c...

Figure 4.246 Mucopurulent exudate in the nasal cavity of a cat with turbinat...

Figure 4.247 White avascular turbinates on one side of the nasal cavity in a...

Figure 4.248 Normally vascularized turbinate tissue in the contralateral nas...

Figure 4.249 An area of completely infarcted turbinate in the foreground wit...

Figure 4.250 An area of white completely infarcted tissue on the right and a...

Figure 4.251 Turbinate distortion and destruction in a chronic case of turbi...

Figure 4.252 Inflammatory nodule formation in a cat with chronic turbinate i...

Figure 4.253 A large irregular inflammatory polyp in a cat with chronic turb...

Figure 4.254 An area of turbinates with loss of cartilage support in a cat w...

Figure 4.255 A nasal airway stricture immediately caudal to the nares in an ...

Figure 4.256 Laser correction of the stricture seen in Figure 4.255.

Figure 4.257 Turbinate inflammation and distortion visible through the corre...

Figure 4.258 Recurrence of the nasal stricture in Figures 4.255–4.257 two we...

Figure 4.259 Laser ablation of the recurrent stricture in Figures 4.255–4.25...

Figure 4.260 Turbinate inflammation, distortion, and destruction visible cau...

Figure 4.261 Fibrosis and inflammation in the nasal cavity at the level of a...

Figure 4.262 Inflammatory nodules in the nasal cavity of the dog with the in...

Figure 4.263 Turbinate distortion and loss of turbinate mass in a dog with a...

Figure 4.264 A grass awn in the deep horizontal ear canal that has penetrate...

Figure 4.265 Marked hyperemia of the ipsilateral wall of the nasopharynx in ...

Figure 4.266 An eight‐month‐old DSH cat with a middle ear polyp visible thro...

Figure 4.267 The normal middle ear visible through a normal translucent tymp...

Figure 4.268 A typical nasopharyngeal polyp seen in an 11‐year‐old DLH cat t...

Figure 4.269 An atypical nasopharyngeal polyp visible in the ear canal of a ...

Figure 4.270 A carcinoma in the ear canal of an eight‐year‐old DSH cat with ...

Figure 4.271 Removing the external ear canal portion of a nasopharyngeal pol...

Figure 4.272 A middle ear cavity that has had a polyp debrided with biopsy f...

Figure 4.273 Three parts of a nasopharyngeal polyp removed from a cat. Rhino...

Figure 4.274 An unusual extension of a malignant middle ear canal tumor thro...

Figure 4.275 A small inflammatory lesion protruding from the eustachian tube...

Figure 4.276 A close-up endoscopic view of the dorsal view of the nasal mite...

Figure 4.277 A close-up lateral endoscopic view of the nasal mite “Pneumony...

Figure 4.278 A solitary nasal mite in the nasal cavity of an eight-year-old...

Figure 4.279 A solitary nasal mite in the frontal sinus of a dog.

Figure 4.280 A solitary nasal mite in the nasopharynx of a dog.

Figure 4.281 A herd of nasal mites in the nasopharynx of a three-year-old Go...

Figure 4.282 An inflammatory reaction of the lymphatic tissue on the dorsal...

Figure 4.283 Reactive hyperemic lymphoid tissue on the dorsal wall of the na...

Figure 4.284 Solid thickened lymphatic tissue on the dorsal wall of the naso...

Figure 4.285 A large mass originating on the dorsal wall of the nasopharynx ...

Figure 4.286 An area of hyperemic lymphatic tissue representing the “felenoi...

Figure 4.287 Thickened lymphatic tissue on the dorsal wall of the nasopharyn...

Figure 4.288 A smooth mass on the dorsal wall of the nasopharynx of a 13‐yea...

Figure 4.289 An irregular mass on the dorsal wall of the nasopharynx in a 11...

Figure 4.290 An irregular enlarged nasal turbinate that histopathology revea...

Figure 4.291 Septal thickening in the nasal cavity of the dog in Figure 4.29...

Figure 4.292 Large hamartoma ridges extending from the right nasal cavity in...

Figure 4.293 A nasopharyngeal hamartoma in a cat.

Figure 4.294 Vascular dysplasia in a 14‐year‐old neutered male West Highland...

Figure 4.295 Vascular dysplasia in a 12‐year‐old neutered male Schipperke. T...

Figure 4.296 A close‐up of the vascular appearance in a free‐floating turbin...

Figure 4.297 Mucosal hyperemia in a patient with rhinitis of undetermined or...

Figure 4.298 Roughened nasal mucosa in a Great Dane dog with rhinitis with a...

Figure 4.299 Enlarged prominent blood vessels in the nasal turbinate mucosa ...

Figure 4.300 Enlarged blood vessels in the nasopharynx of a dog with rhiniti...

Figure 4.301 Swollen thickened turbinates in a dog with rhinitis of undeterm...

Figure 4.302 Numerous small inflammatory nodules.

Figure 4.303 Pedunculated polyps in the nasal cavity of a dog with rhinitis ...

Figure 4.304 An irregular cluster of inflammatory tissue.

Figure 4.305 A large inflammatory tumor‐like mass in the nasal cavity of a d...

Figure 4.306 Thickened turbinates seen in a rhinitis case with no documented...

Figure 4.307 An area of decreased turbinate bulk in the same case as Figure ...

Figure 4.308 A white mass‐like lesion in the nasal cavity of the same case a...

Figure 4.309 A red mass‐like lesion in the nasal cavity of the same case as ...

Figure 4.310 An area of mucosal hyperemia in the nasal cavity of the case in...

Figure 4.311 Hyperemia and thickening of the caudal portion of the nasal sep...

Figure 4.312 Inflammatory nodules scattered over the area of the “catenoid” ...

Figure 4.313 An increased number of enlarged blood vessels on the lateral wa...

Figure 4.314 A hamartoma like mass in the nasopharynx of this same case as i...

Figure 4.315 Contact between rostral turbinates in a brachiocephalic dog see...

Figure 4.316 Contact between rostral turbinates in a brachiocephalic dog see...

Figure 4.317 An area of turbinates in a brachiocephalic dog where there is a...

Figure 4.318 The nasopharynx of a French Bulldog with extension of the ethmo...

Figure 4.319 The ethmoidal turbinates are seen bending around the dorsal mar...

Figure 4.320 The normal nasopharynx of the above case caudal to the abnormal...

Figure 4.321 A completed partial turbinectomy in the French Bulldog seen in ...

Figure 4.322 A nasopharyngeal stricture in an eight‐year‐old DSH cat present...

Figure 4.323 A long tapering nasopharyngeal stenosis ending in a blind pouch...

Figure 4.324 A small open communication in the center of a thin wall of tiss...

Figure 4.325 A large residual lumen in a nasopharyngeal stenosis with reflec...

Figure 4.326 A smaller residual lumen in a nasopharyngeal stricture obscured...

Figure 4.327 Unidentified material occluding the residual lumen of a nasopha...

Figure 4.328 Inflammatory nodules in the nasopharynx caudal to a nasopharyng...

Figure 4.329 A cluster of inflammatory polyps in the nasopharynx rostral to ...

Figure 4.330 Preparing to pass a 5 Fr biopsy forceps through a small residua...

Figure 4.331 The dilated stricture from Figure 4.330 after passage of the bi...

Figure 4.332 A 5 Fr red rubber catheter passed through the working channel o...

Figure 4.333 Positioning of a nasopharyngeal stent using rhinoscopy with the...

Figure 4.334 In this image, the stent has been retracted until it is fully w...

Figure 4.335 The inflated balloon after expansion of the stent. The balloon ...

Figure 4.336 A fully expanded nasopharyngeal stent sitting tightly against t...

Figure 4.337 A nasopharyngeal stent in a cat two years after placement that ...

Figure 4.338 Removal of the exudate in the case shown in Figure 4.337 reveal...

Figure 4.339 The central portion of the stent in Figures 4.337 and 4.338 was...

Figure 4.340 Multiple white raised avascular appearing masses in the nasopha...

Figure 4.341 Multiple small white raised avascular appearing elongated nodul...

Figure 4.342 A mass in the nasal cavity partially covered with exudate.

Figure 4.343 Another mass in a different area of the same nasal cavity.

Figure 4.344 An irregular deformed turbinate in this case of lymphoid hyperp...

Figure 4.345 Irregular turbinates with loss of bulk and support.

Figure 4.346 Thickened swollen puffy irregular turbinates.

Figure 4.347 Roughened mucosa on the surface of an otherwise unchanged turbi...

Figure 4.348 The fractured internal structure of one of the masses after bio...

Figure 4.349 An area of white solid tissue in the nasal cavity of an eight‐y...

Figure 4.350 Another area of the same case that has a cystic avascular appea...

Figure 4.351 Completion of the debridement procedure with minimal residual a...

Figure 4.352 Rostral turbinates with mild loss of bulk and distortion in the...

Figure 4.353 Extensive mucopurulent exudate in the nasal cavity of the same ...

Figure 4.354 A white lobulated avascular appearing mass in the caudolateral ...

Figure 4.355 Debulking the recurrent mass from the nasal cavity of the same ...

Figure 4.356 Completion of the debulking process with laser charred tissue o...

Figure 4.357 Completion of the scheduled debulking two weeks after the previ...

Figure 4.358 A nasal mass protruding from the right nares of an eight‐year‐o...

Figure 4.359 An elongated pink solid mass in the right nasal cavity in the p...

Figure 4.360 A white avascular cystic or edematous mass in another part of t...

Figure 4.361 A dark cystic mass and an irregular solid mass in the same pati...

Figure 4.362 Another area of the same nasal cavity with long vascular floati...

Figure 4.363 The tissue displaced from the nasopharynx into the oral cavity ...

Chapter 5

Figure 5.1 Flexible endoscopes: a 3.7 mm and a 5 mm bronchoscope with three ...

Figure 5.2 Bronchial mucosal folding indicating bronchospasm.

Figure 5.3 An anesthesia “T” adapter attaches to the endotracheal tube and a...

Figure 5.4 (a) One method used to provide oxygen supplementation during bron...

Figure 5.5 Oxygen supplementation is provided during bronchoscopy by connect...

Figure 5.6 Artist's representation of the canine tracheobronchial tree using...

Figure 5.7 All necessary equipment is set out ahead of time in preparation f...

Figure 5.8 Appearance of the normal canine glottic lumen and larynx followin...

Figure 5.9 C‐shaped tracheal cartilaginous rings visible through the mucosa ...

Figure 5.10 The presence of either edema as shown by the glistening appearan...

Figure 5.11 Normal circular shape of the tracheal rings in a dog; note the t...

Figure 5.12 Dorsoventral flattening of the trachea demonstrating a Grade 2–3...

Figure 5.13 A misshapen and narrowed tracheal lumen associated with tracheal...

Figure 5.14 Severe foaming of airway secretions that is commonly encountered...

Figure 5.15 Appearance of the distal airway in a normal dog; note the smooth...

Figure 5.16 A tracheal stricture causing altered airway caliber in a dog.

Figure 5.17 An intraluminal tumor obstructing the trachea and thus altering ...

Figure 5.18 External tracheal compression caused by a ventral mediastinal ma...

Figure 5.19 Bronchiectasis and chronic severe bronchitis with inflammatory n...

Figure 5.20 A structural or fixed collapse of the left principal bronchus ca...

Figure 5.21 Decreased airway caliber in the dog due to dynamic tracheal coll...

Figure 5.22 A normal dorsal tracheal membrane in a one‐year‐old German Sheph...

Figure 5.23 An example of significant large airway collapse commonly seen se...

Figure 5.24 The appearance of healthy tracheobronchial mucosa in a dog; note...

Figure 5.25 Mucosal edema is visible in this dog with bronchiectasis as it i...

Figure 5.26 Polypoid mucosal nodules, seen on the dorsal wall of the upper b...

Figure 5.27 The appearance of excess secretions associated with bacterial pn...

Figure 5.28 The appearance of secretions associated with allergic lung disea...

Figure 5.29 The endobronchial appearance of bronchiectasis in a dog. Note th...

Figure 5.30 A gross lung specimen from a dog with bronchiectasis following l...

Figure 5.31 Mucosal irregularity (the granular appearance) and blood on the ...

Figure 5.32 Large mucosal nodules just anterior to and nearly obstructing th...

Figure 5.33 A bronchial foreign body (small rock) being retrieved with endos...

Figure 5.34 Severe airway narrowing secondary to external compression due to...

Figure 5.35 Mucosal involvement seen as a primary squamous cell carcinoma in...

Figure 5.36 Typical appearance of primary lung tumors in dogs that start in ...

Figure 5.37 Endoscopic view of the sharp “V” shaped appearance of a normal c...

Figure 5.38 The endoscopic appearance of the normal carina in a cat. The muc...

Figure 5.39 Hilar lymphadenopathy compressing the right mainstem bronchus in...

Figure 5.40 Endoscopic appearance of normal spurs or bronchial bifurcations ...

Figure 5.41 Appearance of a blunted spur in a dog. Blunting occurs when the ...

Figure 5.42 Performing a BAL using 20 ml of sterile saline flushed through t...

Figure 5.43 Performing a BAL using 20 ml of sterile saline and hand suction ...

Figure 5.44 Photomicrograph of canine BALf; note the predominance of normal ...

Figure 5.45 Photomicrograph of a squamous epithelial cell and two

Simonsiell

...

Figure 5.46 Blood agar culture plate with TNTC (too numerous to count) colon...

Chapter 6

Figure 6.1 A continuous flow system for use with the 4.0 cystoscope with two...

Figure 6.2 A deflecting bridge or Albarran lever is used with cystoscopes to...

Figure 6.3 Transurethral viscous fluid injection instrument set for use with...

Figure 6.4 The resectoscope system for transurethral cystoscopy in small ani...

Figure 6.5 A close‐up picture of the cutting loop working tip of the bipolar...

Figure 6.6 Irrigation system for transurethral cystoscopy using a one‐liter ...

Figure 6.7 Anatomy drawing of the relationship of the vulva, vaginal vestibu...

Figure 6.8 The vaginal vestibule distended with saline in an eight‐year‐old ...

Figure 6.9 The vaginal vestibule distended with saline in a three‐year‐old s...

Figure 6.10 The urethral papilla in an eight‐month‐old intact female Vizsla ...

Figure 6.11 An example of a urethral tubercle typically seen in intact femal...

Figure 6.12 When the cystoscope first enters the urethra during transurethra...

Figure 6.13 As the telescope is passed through the urethra, fluid flow begin...

Figure 6.14 Full distention of the urethra occurs in most cases as fluid flo...

Figure 6.15 Yellow urine color with otherwise clear urine has minimal interf...

Figure 6.16 Suspended debris of any kind in the urine creates an opacity tha...

Figure 6.17 Hematuria, unless only microscopic, prevents any examination of ...

Figure 6.18 Crystalluria also interferes with the visual field and may requi...

Figure 6.19 Urine retention allows accumulation of sludge like debris in the...

Figure 6.20 The details of normal and abnormal tissues are clearly visible w...

Figure 6.21 The bladder of a 10‐year‐old spayed female Bouvier des Flanders ...

Figure 6.22 An air–water interface interfering with examination of a bladder...

Figure 6.23 Smoke produced by laser ablation of a transitional cell carcinom...

Figure 6.24 Bleeding from microscopic mucosal tears in the bladder of a five...

Figure 6.25 A Foley catheter with the bulb inflated positioned in the trigon...

Figure 6.26 Five French flexible biopsy forceps passed through the operating...

Figure 6.27 The biopsy forceps are opened and positioned over the selected b...

Figure 6.28 The biopsy forceps are pushed forward into the tissue and closed...

Figure 6.29 The biopsy site after tissue removal in the patient from Figure ...

Figure 6.30 A 5 Fr polypectomy snare positioned on a polyp for partial excis...

Figure 6.31 The polypectomy snare in Figure 6.30 is closed to trap and remov...

Figure 6.32 A stone basket being used for extraction of a TCC mass after tra...

Figure 6.33 A large bladder polyp with the patient positioned so that the le...

Figure 6.34 The same polyp as Figure 6.33 with the patient repositioned so t...

Figure 6.35 A polypectomy snare placed on the base of the polyp in Figure 6....

Figure 6.36 The resection site of the polyp seen in the previous figures aft...

Figure 6.37 The base of a large inflammatory bladder polyp with the patient ...

Figure 6.38 An activated diode laser fiber in contact with the base of the l...

Figure 6.39 Cut progression is assessed by stopping the laser and backing th...

Figure 6.40 Completion of the cut leaves an area of cauterized tissue flush ...

Figure 6.41 A small cystic calculus trapped with a stone basket in a dog wit...

Figure 6.42 A weasel wire passed into an abnormal ureteral ostium prior to p...

Figure 6.43 An image of the nondistended distal penile urethral lumen seen w...

Figure 6.44 The distended distal penile urethral lumen seen when passing the...

Figure 6.45 The narrowest point of the male dog urethra is at the caudal end...

Figure 6.46 The urethra caudal to the os penis is slightly curved and is eas...

Figure 6.47 Insufficient fluid flow allows the urethra to collapse, increasi...

Figure 6.48 The increasing curvature of the urethra as it approaches and pas...

Figure 6.49 Once the ischial arch is passed, the passage of the endoscope be...

Figure 6.50 As the endoscope is passed into the prostatic urethra, distentio...

Figure 6.51 The colliculus seminalis is seen as a prominent dorsal ridge and...

Figure 6.52 The small flexible endoscopes suitable for transurethral cystosc...

Figure 6.53 Adequate illumination is provided by these endoscopes for focal ...

Figure 6.54 During examination of the ureteral openings, time is taken to ob...

Figure 6.55 The ureteral openings are also visible from the cranial directio...

Figure 6.56 Placing the tip of the endoscope close to the bladder wall provi...

Figure 6.57 A urachal diverticulum in a male dog seen with the Flex‐XC with ...

Figure 6.58 The distal urethra of a five‐year‐old intact male Irish Wolfound...

Figure 6.59 The penile urethra of a male cat seen using a 1.0 mm diameter fi...

Figure 6.60 The proximal penile urethra at the level immediately proximal to...

Figure 6.61 The pelvic urethra of the same patient seen in Figure 6.60. The ...

Figure 6.62 The abdominal segment of the urethra in a male cat examined duri...

Figure 6.63 The bladder of a 10‐year‐old neutered male Domestic Shorthair ca...

Figure 6.64 The right ureteral opening in the patient seen in Figure 6.63.

Figure 6.65 A large quantity of sand in the bladder of a four‐year‐old neute...

Figure 6.66 The bladder in the patient seen in Figure 6.65 after removal of ...

Figure 6.67 Irrigation setup for prepubic percutaneous cystoscopy with a con...

Figure 6.68 Puncture locations for prepubic percutaneous cystoscopy. The pun...

Figure 6.69 (a) Trocar position and angle of intersection with the bladder w...

Figure 6.70 The irrigation system setup with liquid inflow through the teles...

Figure 6.71 Bladder and telescope position for placement of a second or oper...

Figure 6.72 A standard open surgical suction tip placed into the bladder thr...

Figure 6.73 Operating room setup drawing with the patient in dorsal recumben...

Figure 6.74 Portal placement for laparoscopic‐assisted cystoscopy in a femal...

Figure 6.75 After placement of both portals, the apex of the bladder is gras...

Figure 6.76 The apex of the bladder is elevated into the operative portal ca...

Figure 6.77 The cannula is removed, and the portal enlarged if needed. In th...

Figure 6.78 Normal mucosa in a moderately distended bladder seen with laparo...

Figure 6.79 The normal trigone in a 15‐year‐old neutered male Miniature Pood...

Figure 6.80 The normal trigone seen through air from the cranial aspect duri...

Figure 6.81 The right ureteral orifice on its papilla with a pulse of clear ...

Figure 6.82 The right ureteral orifice seen with the bladder distended enoug...

Figure 6.83 The caudal end of the pelvic urethra at the ischial arch in a ma...

Figure 6.84 Examination of the pelvic urethra in a five‐year‐old neutered ma...

Figure 6.85 Laparoscopic‐assisted cystoscopy also allows examination of the ...

Figure 6.86 Examination of the urethra in a 16‐year‐old spayed female cat do...

Figure 6.87 The colliculus seminalis seen during examination of the prostati...

Figure 6.88 The openings of multiple prostatic ducts are visible on the righ...

Figure 6.89 The pelvic urethra caudal to the prostate in an eight‐year‐old n...

Figure 6.90 Examination of the pelvic urethra caudal to the prostate in a fo...

Figure 6.91 Irrigation used during LAC dilates the pelvic urethra to form a ...

Figure 6.92 Small sharp transverse circumferential ridges are occasionally s...

Figure 6.93 Laparoscopic‐assisted cystoscopy for stone removal in a seven‐ye...

Figure 6.94 A laser fiber passed through the operating channel of the 2.7 mm...

Figure 6.95 A 5 Fr Foley urethral catheter visible in the pelvic urethra in ...

Figure 6.96 The inflated bulb of an 8 Fr Foley urethral catheter in a 12‐yea...

Figure 6.97 After completion of the procedure in the bladder, the cystotomy ...

Figure 6.98 Multiple residual combination urate and oxalate calculi in the p...

Figure 6.99 A large number of small amorphous silicate calculi in the pelvic...

Figure 6.100 Fluorescence of a transitional cell carcinoma in the bladder of...

Figure 6.101 The urethral tubercle and urethral orifice in a 16‐year‐old spa...

Figure 6.102 The urethral orifice is usually seen as a closed or slightly op...

Figure 6.103 This vaginal vestibule is distended enough to flatten all the m...

Figure 6.104 A single small insignificant crypt of McCarthy in the lateral v...

Figure 6.105 Three small insignificant crypts with easily visible deep walls...

Figure 6.106 The lateral vestibular fossa of a seven‐year‐old spayed female ...

Figure 6.107 A larger number of lateral vestibular fossa crypts involving a ...

Figure 6.108 A double row of multiple crypts distorting the shape of the lat...

Figure 6.109 A small deep crypt on the top of the urethral papilla adjacent ...

Figure 6.110 A large deep crypt in the lateral ventricular fossa of a five‐y...

Figure 6.111 The clitoral fossa in a seven‐month‐old spayed female Labrador ...

Figure 6.112 The cranial wall of the clitoral fossa in a seven‐month‐old spa...

Figure 6.113 The clitoris in a 13‐year‐old spayed female Schipperke. The cli...

Figure 6.114 A particularly prominent vaginovestibular junction in a nine‐mo...

Figure 6.115 The vaginal body of a seven‐month‐old spayed female Labrador Re...

Figure 6.116 The vaginal body of a 13‐year‐old spayed female Schipperke with...

Figure 6.117 The vaginal body in a three‐year‐old intact female 5.5 kg mixed...

Figure 6.118 The vaginal body of a 10‐year‐old spayed female Springer Spanie...

Figure 6.119 The vaginal body of a three‐year‐old spayed female Boxer dog on...

Figure 6.120 The dorsal median fold seen as a prominent fixed ridge of tissu...

Figure 6.121 The dorsal median fold in a seven‐month‐old spayed female Dober...

Figure 6.122 A close‐up image of the cranial end of the dorsal median fold w...

Figure 6.123 When first entering the urethra, when performing transurethral ...

Figure 6.124 With fluid flow through the cystoscopy, the urethra fills to op...

Figure 6.125 The completely distended urethra in a six‐month‐old intact fema...

Figure 6.126 A distended urethra without residual mucosal ridges in a five‐y...

Figure 6.127 A distended urethra with a large prominent dorsal mucosal ridge...

Figure 6.128 An example of distinct narrowing of the cranial urethra in a 16...

Figure 6.129 Partial dilation of an area of cranial urethral narrowing produ...

Figure 6.130 An area of cranial urethral narrowing with blanched blood vesse...

Figure 6.131 A single small urethral diverticulum in an 11‐month‐old intact ...

Figure 6.132 Multiple small urethral diverticula in a five‐month‐old intact ...

Figure 6.133 An unusual large urethral diverticulum in a three‐year‐old spay...

Figure 6.134 The trigone of a collapsed bladder in a seven‐month‐old spayed ...

Figure 6.135 The trigone of a collapsed bladder in an eight‐year‐old spayed ...

Figure 6.136 A partially distended bladder with smooth mucosa and visible bl...

Figure 6.137 A partially distended bladder in a three‐year‐old spayed female...

Figure 6.138 A fully distended bladder with easily visible blood vessels wit...

Figure 6.139 Multiple smoothly branching blood vessels seen in a distended b...

Figure 6.140 Looking cranially with transurethral cystoscopy, the ureteral p...

Figure 6.141 The left ureteral papilla and ostia seen looking cranially with...

Figure 6.142 The left ureteral ostia in an overdistended bladder with the pa...

Figure 6.143 A ureteral ostium appearing as an oval opening that does not ap...

Figure 6.144 Normal urine flow from the right ureteral ostia seen looking cr...

Figure 6.145 Normal urine flow from the left ureteral ostia in the same pati...

Figure 6.146 The left ureteral papilla and ostium with bladder overdistentio...

Figure 6.147 The normal trigone of the bladder in a four‐year‐old neutered m...

Figure 6.148 Normal branching mucosal blood vessels seen with the Flex‐XC du...

Figure 6.149 The urethra of a four‐year‐old neutered male Domestic Shorthair...

Figure 6.150 The urethra of a three‐year‐old neutered male Domestic Shorthai...

Figure 6.151 The prostatic urethra with a prominent colliculus seminalis in ...

Figure 6.152 Glomerulations with scattered uniform distribution and size in ...

Figure 6.153 A minimum number of glomerulations seen in the bladder of a sev...

Figure 6.154 Glomerulations with size variation in the bladder of a 10‐year‐...

Figure 6.155 A focal cluster of uniform‐sized glomerulations in a seven‐year...

Figure 6.156 A sheet of glomerulations in the bladder of a seven‐year‐old sp...

Figure 6.157 A small cluster of brown glomerulations indicating chronicity i...

Figure 6.158 Glomerulations in the urethra of a 14‐year‐old spayed female Do...

Figure 6.159 Close‐up magnified glomerulations with the appearance of petech...

Figure 6.160 Close‐up magnified glomerulations with the appearance of a clus...

Figure 6.161 Multiple hyperemic nodules in the bladder of a five‐year‐old sp...

Figure 6.162 A single nodule in the bladder of a 11‐year‐old spayed female E...

Figure 6.163 A close‐up view of nodules that are a combination of white and ...

Figure 6.164 Three nodules of inflammatory tissue in the bladder of an eight...

Figure 6.165 Multiple white nodules in the urethra of a six‐year‐old spayed ...

Figure 6.166 Many mucosal colored nodules are present in this urethra of the...

Figure 6.167 Numerous follicles in the vaginal vestibule of a dog with a rec...

Figure 6.168 Multiple nodules in the vaginal vestibule and urethral orifice ...

Figure 6.169 Scattered hyperemic nodules in a one‐year‐old intact female Col...

Figure 6.170 A sheet of hyperemic nodules covering the dorsal median fold an...

Figure 6.171 A large inflammatory polyp in the bladder of an eight‐year‐old ...

Figure 6.172 An inflammatory polyp seen through air in a six‐year‐old intact...

Figure 6.173 A small polyp in the bladder of 10‐year‐old spayed female Pug w...

Figure 6.174 A cluster of small polyps around the left ureteral ostium of a ...

Figure 6.175 A cluster of small polyps in and around a urachal diverticulum ...

Figure 6.176 Multiple polyp‐like lesions on the surface of a transitional ce...

Figure 6.177 One of several multipart inflammatory polyps in the bladder of ...

Figure 6.178 Multiple individual polyps of variable size and appearance in t...

Figure 6.179 One of the polyps in the patient in Figure 6.178 with typical n...

Figure 6.180 A small bladder polyp with an unusual blood blister appearance....

Figure 6.181 A small inflammatory polyp seen during transurethral cystoscopy...

Figure 6.182 Mild early cystitis in an eight‐year‐old spayed female wirehair...

Figure 6.183 More pronounced blood vessel tortuosity in the bladder of a sev...

Figure 6.184 An increase in blood vessel numbers in the bladder of a five‐ye...

Figure 6.185 An irregular vascular pattern with a combination of tortuosity,...

Figure 6.186 A focal area of bladder wall vascular pattern change with incre...

Figure 6.187 An increased number of small blood vessels in the proximal uret...

Figure 6.188 Increased size and number of blood vessels with increased branc...

Figure 6.189 An overwhelming increase in blood supply in the urethra of an 1...

Figure 6.190 An example of bladder wall edema seen in a five‐year‐old neuter...

Figure 6.191 An “C” shaped area of bladder wall edema that matches the shape...

Figure 6.192 A large area of hemorrhage in the bladder wall of a five‐year‐o...

Figure 6.193 Ecchymosis in the bladder mucosa of a five‐year‐old neutered ma...

Figure 6.194 Marked hyperemia in the pelvic urethral mucosa of a 13‐year‐old...

Figure 6.195 An area of mild mucosal hyperemia in the urethra of a six‐year‐...

Figure 6.196 Early cellular change in the bladder mucosa of a six‐year‐old s...

Figure 6.197 When seen with the telescope angle position to view the bladder...

Figure 6.198 Early cellular change in the urethral mucosa with similar irreg...

Figure 6.199 Partial loss of visible blood vessels in the pelvic urethra of ...

Figure 6.200 Roughening of the mucosa in the urethra of a seven‐year‐old spa...

Figure 6.201 Irregular patchy areas of mucosal thickening in the proximal ur...

Figure 6.202 Thickened mucosa forming a ridge of abnormal tissue rather than...

Figure 6.203 With progressive chronicity and severity, mucosal involvement e...

Figure 6.204 Continued inflammatory activity produces further proliferation ...

Figure 6.205 An area of the bladder in a seven‐year‐old spayed female Doberm...

Figure 6.206 Large mucosal ridges covered with thickened inflamed mucosa and...

Figure 6.207 A chronically inflamed end‐stage bladder in a 10‐year‐old neute...

Figure 6.208 Visible fibrous bands in the urethra of a five‐year‐old neutere...

Figure 6.209 A mucosal ulcer in the bladder of a 15‐year‐old neutered male M...