p.1

Riley Girl, is a 10 yr old female spayed mixed breed dog who got into some cactus that may have led to reverse sneezing and right-sided nasal discharge.

p.2

Dr. Allen wants to find the cause of the reverse sneezing and to see if there are any cactus pieces inside the dog's nose.
The dog was given dexdormitor to decrease the gag reflex and make the dog tolerate the scope in her nose with less inhaled anesthesia.
With her 6 mm Pentax endoscope, she first examines the oropharynx.
Everything seems normal in the oral cavity. No cactus spines in the tonsils.

p.3

Now Dr. Allen examines the nasopharynx.
She mentions seeing the light over the soft palate helps show the scope is in the right place.
She spots some nasal discharge. Both eustachian tubes look normal.
She mentions that the area is very fragile and bleeding is common when the endoscope is going in or out.

p.4

Dr. Allen moves forward with the Rhinoscopy to find the cause of the nasal discharge and reverse sneezing.
First thing she does is check to be sure the cuff is holding pressure at 20 mm of mercury.
This is important to keep saline from going into the trachea.
Then she packs the back of the throat with a lap sponge.
Packing the throat prevents saline going into the throat and causing aspiration.
She then adds a bag of saline to help visualize the nose.

p.5

She pushes the endoscope in medially to get around the alar fold of the nose.
She uses the flexible option for her scope but mentions its important to remember the meatus you are in.
She spots a wisp of discharge which makes her think there is something going on in this side of the nose.
She sees discharge on both sides of the nose.
The turbinates look normal.

p.6

Dr. Allen uses a smaller, fiberoptic scope to reach further depths in the nose.
As she gets closer to the nasal pharynx, it opens up, which is normal.
She spots mucus and wants to explore further.

p.7

Dr. Allen flushes out the dog's nose with a catheter before re-inserting the endoscope.
The back of the nose looks normal. She notices there's some early turbinate destruction present.
Dr. Allen then instructs her assistant on how to perform the biopsy.
She mentions that you need to hold your scope where you want to biopsy then back it up and straighten he tip so that the instrument can pass.
Then you can return to where you want to biopsy.
The assistant shuts off the saline and passes the instrument using small pushes at a time.
They use saline to spray the biopsy off so as not to damage the tissue.
She continues to push for better biopsy samples because she was only pulling out blood clots and fleshy bits of the nose.

p.8

Dr. Allen lifts the intos neck so the saline and blood will drain out the nose.
The biopsys are finished and no signs of tumors or anything of concern.
No fungal plaque or any foreign bodies present.

p.9

At the end they pull the dog towards the edge of the table and let its head hang.
She pulls the lab sponge out and then lets the dog's nose drain out.
If the dog is bleeding a lot they will use epinephrine or yunnan baiyao to help stop the bleeding.
Riley had negligible amounts of blood. She then deflates the cuff to remove the tube.
But she does this only after she notices the dog gets a couple of good swallows.