Long story ...my old guy had nasal discharge from one side with a nasty smell and enlarged lymph node on same side back in Feb.
Vet came out, teeth had large hooks, power floated and found broken molar on that side. Put him on SMZ for 2 weeks. All went back to normal.
Discharge and lymph node return 2 weeks after I finish SMZ. Did a second round, discharge clears up, lymph node goes back down.
Discharge (not smell) comes back 2 weeks later again. Vet comes back, does radiographs, which are ambiguous. The vets at the practice can't agree on whether it's a mass, sinus infection, tooth, or some combination. They send rads to Cornell. Cornell vets disagree also. The surgeon thinks it looks like an infection, the radiologist thinks mass, the dentist thinks thickened tissue due to tooth/infection.
Vet gave me options of drlling/biopsy/culture, refer to Cornell for flap surgery, wait and see, scope him (but they worry this won't really tell much and will waste $$)
He's 22, no other issues at all. I don't know what to do. Suggestions, advice, ideas ... Please?!
A scope is $50 or so, I would start there. My oldster got a sinus infection after a choke episode that we could not get cleared up. He was on SMZ's, gentocin and penicillin and it still wouldn't go away. Finally my vet made up a nebulizer solution he called killer red. I have no idea what that was but it did the trick.
It sounds defintiely like some kind of infection... being that everytime he's on antibiotics it goes away.
If taking him to Cornell is a realistic option for you, that's what I would do. They have the resources and tools to properly diagnose him. Our local vets are great, but they are obviously limited in what they can do and work with.
They could scope him, and maybe find a pocket of infection, and culture it, and then give you the antibiotic that will be most effective.
If going is not a realistic option for you due to finances, etc. Then I'd put him back on antibiotics for a longer time period.
Here's my quick story. 2 years ago, my mare had a snotty nose and swollen, goopy eye. My regular vet wouldn't come see her, insisting it was allergies. Finally got another vet to come out and he said definitely respiratory infection. He gave her an injection of penicillin and put her on SMZ's for 2 weeks. Within 2 days, she was back to herself. 2 days after the SMZ's stopped, she was inflamed and snotty again. Vet came back out and said we could take her to Ohio state to have her cultured... but this was not an option for me at the time. The trailer ride there alone would have bankrupt me, as I don't have my own. So he said "well, let's just hit this hard then"
He gave her another injection of penicillin, and gave me 2 more to give her over the next week. Along with SMZ's and he wanted her on them for 6 weeks. Well this did the trick. Whatever it was, the long term antibiotics knocked it out. His explanation was that it's really difficult to get oral antibiotics to effectively hit their sinuses, and often by the time they have enough in their system to get there and kill the bacteria... you're done with your 2 weeks, and there are always a few bacteria that survive and colonize. He said giving them to her over a long period of time would kill anything that was there and make a hostile environment for anything new to grow.
Strong promoter of READING the entire post before responding.
Having just gone through this......I would suggest that you actually go on antibiotics for at least 30 days possibly 60 to 90 days. My vet felt even if it was teeth with a long enough stretch of antibiotics that if it was a tooth due to her age she that the tooth might be able to repair itself as horses teeth are a living entity.
My girl who is just turned 5 had a very slight discharge out of her right nostril with a slight smell.......vet came out and concluded her teeth needed doing but found nothing a miss other wise......we put her on 30 days of TMZ and about 3 days after she cam off she had a very small amount of intermittent discharge....we made and appointment with the specialist for x-rays and endecscope (she has now been off antibiotics for two weeks).......her x-rays were clean......she had one spot that was slightly suspicous but not enough to conclude anything......the specialist deemed it not teeth and we proceeded with an endescope......everything was clear no tumors or cysts........she still had a lot of brown crustys up in side that we are hoping that she will clear on her own.
The diagnosis was that the sinusitis was the primary problem. A sinus tap may be done later if she is unable to clear the remaining debris.
Thanks for your stories and ideas. My vet didn't even mention long term antibiotics as an option. I wonder why that is? The trip to Cornell is pretty prohibitive right now, so maybe I'll man-up and ask about the antibiotics, and scope him to see what they can see.
Try the long term antibiotics.
If the tooth wasn't involved, I'd say get him scoped NOW. As it is, I'd have him scoped and x-rayed as soon as possible. Mr. Studly had a sinus tumor and flap surgery back in January (he's 23-24). I'd be happy to share that story, but it's pretty long. I won't say it was a snap, but he's doing great!
It's broken at the level of the gumline, so they can't get ahold of it to get it out without surgery. The vet's not sure it IS a bad tooth (maybe a mass, maybe a sinus infection), but she did say that if we went with surgery requiring general anesthesia, they could *possibly* drill out the tooth if they got in there and decided it was bad.
I just *hate* to put him through general anesthesia if there's a reasonable way to resolve things without it.