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Dr Karina Graham, a specialist veterinarian has undertaken advanced training in interventional rhinoscopy with Professor Gerhard Oechtering, a world leader Otolaryngologist (ENT: Ear, Nose, Throat), at the Vet Endoscopy Training Centre in Bucharest. Bringing this expertise back to Sydney, she has established VSOS as the only referral centre in Australia offering a combination of advanced rhinoscopy, high-suction tumour debulking, minimally invasive embolisation, and laser-assisted turbinectomy (LATE).
Nasal Disease in Dogs - Referral Guide for Veterinarians
Why VSOS?
This means your patients gain faster relief, fewer anaesthetics, and access to options that were previously unavailable in Australia. By referring cases to VSOS promptly, you give dogs the best chance at early, accurate diagnosis and same-session treatment. Improving outcomes, reducing stress, and providing their owners with answers and relief straight away.
1) Nasal Cancer (Nasal Tumours)
Clinical signs to look for
- Persistent nasal discharge (often unilateral, sometimes blood-stained)
- Epistaxis (nosebleeds)
- Facial swelling or asymmetry
- Sneezing, stertor or obstruction noises
- Ocular discharge or secondary facial deformity in advanced cases
Traditional limitations
Most referral pathways separate diagnosis (CT + biopsy) from the actual treatment. Patients often endure a week’s wait for histopathology before being offered direct therapy, with multiple anaesthetics required. Surgical resection is rarely feasible due to anatomical constraints.
VSOS approach
- CT and rhinoscopy under one anaesthetic
- High-suction tumour debulking is performed at the same time, reducing tumour bulk and immediately restoring airflow
- Histopathology will be collected concurrently for confirmation and prognostication
- For highly vascular tumours: fluoroscopy-guided arterial embolisation to cut the blood supply, followed by safe debulking
- Ongoing plan may include re-scoping, repeat debulking, or referral for targeted radiation where appropriate
Why it matters
Dogs wake up breathing more comfortably after one procedure, owners gain clarity immediately, and future treatment decisions can be made from a stronger baseline. Importantly, early debulking reduces clinical signs and may extend survival compared with other treatment alone.
2) Nasal Fungal Disease (Aspergillosis)
Typical presentations
- One-sided chronic discharge (often purulent, sometimes with blood)
- Pain or irritation in the nose
- Depigmentation or ulceration of the nasal planum
- More common in dolichocephalic breeds
Challenges with recurrence
Standard antifungal infusions may fail because necrotic bone fragments harbour residual infection. Biopsy-only approaches diagnose but do not resolve the obstructive pathology.
VSOS approach
- CT + rhinoscopy in one session to fully define disease extent
- Direct suction removal of fungal plaques and necrotic bone fragments - addressing the root cause of recurrence, then antifungal soaks can be applied
- Targeted antifungal therapy as needed
- Same-day discharge in most cases
Why it matters
This comprehensive clearance results in significantly lower recurrence rates, sparing patients repeated anaesthetics and improving long-term comfort.
3) Brachycephalic Obstructive Airway Syndrome (BOAS) - Including LATE
Understanding the five points of obstruction
BOAS involves a spectrum of intranasal and pharyngeal abnormalities:
- Stenotic nares
- Elongated soft palate
- Everted laryngeal saccules
- Hypoplastic trachea
- Aberrant intranasal turbinates
Traditional BOAS surgery addresses the first three points (nostrils, palate, saccules). The turbinate obstruction has historically been left untreated — yet it can significantly impact airflow.
VSOS approach
- Laser-Assisted Turbinectomy (LATE): Endoscopic laser removal of aberrant nasal turbinates, restoring airflow through intranasal passages
- Always performed in collaboration with our surgical and anaesthesia specialists to determine the need for concurrent soft palate or nares surgery
- Patients typically recover the same day or with one overnight stay, depending on concurrent procedures
Why it matters
Flat-faced breeds are already high-risk anaesthesia patients. By performing comprehensive airway assessment and treatment under one roof, VSOS can address multiple obstruction points, giving patients a meaningful improvement in quality of life and reducing the need for staged surgeries.
Referral Benefits
- Single anaesthetic for diagnosis and treatment in most cases
- Advanced interventions not available elsewhere in Australia (embolisation, LATE)
- Specialist anaesthesia oversight for high-risk patients (brachycephalics, geriatrics, oncology cases)
- Collaborative care model. We handle the intervention and return ongoing case management to you, with clear reports and follow-up recommendations
When to Refer
- Any patient with persistent or bloody nasal discharge, facial deformity, or unexplained snoring
- Dogs not responding to repeated antibiotic or antifungal courses
- Brachycephalic patients with ongoing clinical signs despite prior BOAS surgery
The sooner the referral, the more options we can offer. Early diagnosis and intervention can extend life, reduce recurrence, and improve welfare.
Always Beyond Possible
At VSOS, we challenge the limits of what’s possible in veterinary specialist care. By integrating world-class training, advanced imaging, and minimally invasive interventions, we are creating new standards of care for dogs with nasal disease. Together with referring veterinarians, we go Beyond Possible for our patients.
