Remus, a 6-year-old male castrated mixed breed dog presents with chronic sneezing and bilateral nasal discharge that now has blood. What diagnostics would you perform?

• A. CT, rhinoscopy, biopsy, histopath
• B. CT, rhinoscopy, biopsy, cytology
• C. MRI, rhinoscopy, biopsy, histopath
• D. CT, biopsy, histopath, radiography

Answer: (A)

In canine chronic nasal disease with epistaxis, you want imaging that shows bone detail, a direct look inside the nasal passages, and a definitive tissue diagnosis. CT provides excellent cross-sectional images of the skull and nasal cavity, revealing turbinate destruction, bone loss, masses, and the extent of disease that would be easy to miss on regular radiographs. Rhinoscopy lets you inspect the nasal passages directly for abnormalities such as masses, ulceration, or discharge, and it also allows targeted sampling from suspicious areas. Obtaining a biopsy and sending it for histopathology gives a definitive diagnosis by preserving tissue architecture, helping distinguish neoplasia from fungal infections or inflammatory processes, which cytology alone often cannot reliably differentiate. While MRI can be useful for soft-tissue assessment and intracranial extension, it’s not as informative for the bony changes that CT excels at in this setting. Radiography is much less sensitive for intranasal disease and would not provide the same level of detail or targeted sampling.

So the best approach combines CT, rhinoscopy, biopsy, and histopathology to accurately diagnose and guide treatment.