Topical treatment of sinonasal aspergillosis with combined enilconazole infusion and frontal sinus deposition of clotrimazole cream in two cats.

Case series summary: Two cats presenting with chronic sneezing and nasal discharge were diagnosed with sinonasal aspergillosis (SNA) through a combination of CT, rhinoscopy, histopathological analysis and fungal culture of nasal biopsies. Treatment included trephination of the frontal sinuses, followed by a sinonasal flush using a 1% enilconazole solution and the application of 1% clotrimazole cream into the frontal sinuses. In one cat, unilateral treatment resulted in recurrence of SNA 8 months later; however, two bilateral treatments, 1 month apart, proved effective. The second cat underwent a single bilateral treatment. Short-term observations indicate that cats may experience mild to moderate systemic side effects, including anorexia, lethargy and hyperthermia. Clinical cure was achieved in the long term in both cases, although it was not confirmed by follow-up rhinoscopy. Relevance and novel information: To our knowledge, this paper is the first to describe the technique and outcome of depot therapy in cats presenting with SNA. This treatment approach circumvents the need for systemic antifungal therapy, which is often prolonged, costly and potentially associated with toxicity. However, the success rate and tolerance of this method should be evaluated in a larger cohort of cats.