Outcomes of sinus fungal infection treatments in UK dogs 2011-2021

Abstract

OBJECTIVES: A variety of treatment options for sinonasal aspergillosis have been described, encompassing non-invasive and invasive approaches. To describe the clinical outcomes in dogs treated for sinonasal aspergillosis in the United Kingdom. MATERIALS AND METHODS: A multi-centre retrospective survey was performed involving 23 referral centres in the United Kingdom from January 2011 to December 2021. Cases were reviewed for first treatment success rates, the number of treatments required and overall clinical remission rates. Different treatment approaches were compared, including rhinoscopic debridement (RD), trephination (TR) and sinusotomy/rhinotomy (SR). RESULTS: In a cohort of 436 dogs with sinonasal aspergillosis, the most common first treatment modalities were RD (38%) and TR (32%), with SR used in 7% and oral antifungal monotherapy in 3%. The remaining 20% used a mixture of treatments. First treatment remission rate was 55% with SR, 38% with RD, 29% with TR and 31% with the mixed treatment. Overall remission rate was 67% with SR, 81% with RD and 69% with TR and 59% where different treatments were combined. Oral antifungal monotherapy had no successful outcomes at any time point. Complete debridement significantly improved remission rates of first treatments (54% vs. 21%, P = 0.003). Adverse effects were reported in 24% of cases, most commonly in SR and TR groups. CLINICAL SIGNIFICANCE: Rhinoscopic debridement and trephination remain the predominant treatment options for SNA in UK referral practices, with similar overall clinical remission rates. The degree of debridement significantly influences treatment outcomes, with rhinoscopic debridement in combination with topical antifungals showing the highest success rates.