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I have a 9 year old cat who stopped breathing well through his nose about a year ago. It sounds like he's snoring all the time. We have taken him to a lot of vets and they aren't sure what the issue is. He's been acting normal other than that though. Has anyone else had this problem before? What should I do?

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There are a number of reasons why cats can develop chronic nasal sound. Sometimes but not always there is an increase in sneezing that accompanies this sound. It can be a result of chronic viral or bacterial infection leading to rhinitis and/or sinusitis, fungal infection, nasopharyngeal polyps, nasal mass or tumor, and tooth root infection or abscess to name a few possible causes.

Unless there are very obvious external signs it is unlikely your vet will be able to diagnose this simply from looking at the cat. Further diagnostics would be needed. Diagnostic options to consider:

  • sedated exam to look behind the soft palate, to see if there is a polyp hiding there. Dental x-rays to assess the health of the teeth are not a bad idea while the cat is sedated as the maxillary teeth are in very close proximity to the nasal cavity and tooth infections can lead to nasal problems.
  • infectious disease testing – PCR panels are available from a number of labs in particular to test for viral diseases, fungal serology may be relevant depending on your location
  • x-rays of the skull may provide some useful information but unlikely to give a definitive diagnosis without further diagnostics unless there are further changes
  • rhinoscopy would allow visualisation and possibly biopsy of the nasal cavity. For full evaluation ideally anterograde rhinoscopy is performed, but not all vets may be equipped with a small enough endoscope for this purpose in cats. Retrograde rhinoscopy with a flexible to look at the nasopharynx can often be helpful.
  • CT to evaluate the nasal cavity may be necessary in some cases to assess for or rule out tumors

If diagnostics are not pursued, which is unfortunately the reality of veterinary medicine in many cases, then empirical treatment with antibiotics, antivirals, non-steroidal anti-inflammatories, and/or steroids may be attempted, but the best treatment plans are formulated on the basis of diagnostics.

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