Treatment options for dogs diagnosed with sinonasal aspergillosis



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PICO question 

In dogs diagnosed with SNA, does inclusion of debridement in the treatment protocol improve clinical outcomes compared to dogs treated without debridement? 


Clinical bottom line 

Category of research question  



The number and type of study designs reviewed 

No papers that directly addressed the PICO were reviewed. Four retrospective case series which partially addressed the PICO question were discussed in the appraisal.


Strength of evidence  



Outcomes reported  




No conclusions can be made based on the current level of evidence, however the studies discussed in the appraisal suggest that there may be an association between the inclusion of debridement in the treatment protocol for SNA and an improved clinical outcome. Undertaking further higher-level studies (comparative, blind, prospective, randomised) would be required to confirm this. Ethical implications would not preclude such studies, for there is evidence that treatment protocols including topical deposition of antifungal agents alone are efficacious.


How to apply this evidence in practice

The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.

Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.


Ballber, C., Hill, T.L. & Bommer, N.X. (2018). Minimally invasive treatment of sino-nasal aspergillosis in dogs. Journal of Veterinary Internal Medicine. 32(6), 2069–2073. DOI:

Belda, B., Petrovitch, N. & Mathews, K.G. (2018). Sinonasal aspergillosis: Outcome after topical treatment in dogs with cribriform plate lysis. Journal of Veterinary Internal Medicine. 32(4), 1353–1358. DOI:

Billen, F., Guieu, L. V., Bernaerts, F., Mercier, E., Lavoué, R., Tual, C., Peeters, D. & Clercx, C. (2010). Efficacy of intrasinusal administration of bifonazole cream alone or in combination with enilconazole irrigation in canine sino-nasal aspergillosis: 17 cases. Canadian Veterinary Journal. 51(2), 164–168.

Hazuchova, K., Neiger, R. & Stengel, C. (2017). Topical treatment of mycotic rhinitis-rhinosinusitis in dogs with meticulous debridement and 1% clotrimazole cream: 64 cases (2007–2014). Journal of the American Veterinary Medical Association. 250(3), 309–315. DOI:

Vangrinsven, E., Girod, M., Goossens, D., Desquilbet, L., Clercx, C. & Billen, F. (2018). Comparison of two minimally invasive enilconazole perendoscopic infusion protocols for the treatment of canine sinonasal aspergillosis. Journal of Small Animal Practice. 59(12), 777–782. DOI:

Vedrine, B. & Fribourg-Blanc, L. (2018). Treatment of Sinonasal Aspergillosis by Debridement and Sinonasal Deposition Therapy with Clotrimazole Under Rhinoscopic Guidance. Journal of the American Animal Hospital Association. 54(2), 103–110. DOI:

Vol. 8 No. 4 (2023): The fourth issue of 2023

Section: Knowledge Summaries

Categories :  Small Animal  /  Dogs  /  Cats  /  Rabbits  /  Production Animal  /  Cattle  /  Sheep  /  Pig  /  Equine  /  Exotics  /