Bastian the cat had been sneezing occasionally for a couple of weeks when he came to us. He was otherwise in great shape. When he later started sneezing blood, we examined his nasal cavity with a scope – and found the cause: a blade of grass far inside. Grass in the nose is more common in cats than many people think, and it is not always easy to detect.
Symptoms of grass in the cat's nose
A foreign body in the nose presents a recognizable picture. The cat has a sneezing attack – strong, repeated sneezing and snorting – and paws or rubs its snout a lot. There is often snorting, vomiting and repeated swallowing movements, because the straw irritates the transition to the throat. Some have discharge from the nose, and some eat less than usual.
If the straw has been lying around for a while, you may sneeze with blood, or have a distinct bad smell from your nose and breath. Plant material breaks down where it is, and both the smell and the blood are signs that the mucous membrane is damaged.
The picture is also similar to what we see with inflammation of the nose and with tumors in the nasal cavity. This is one of the reasons why we ultimately perform rhinoscopy rather than treating further based on suspicion – we want to see what is actually there.
Sneezing occasionally
When Bastian first came in, he had been sneezing occasionally for a couple of weeks. He was eating, in good general condition and otherwise seemed unaffected. It is a typical description, and it points in several directions at once: it could be an inflammation of the nasal mucosa, and it could be a foreign body.
The blood test showed clear inflammation. The white blood cell count was above the reference range, with an increase in both neutrophils and eosinophils. This confirmed that the body was reacting to something, but not what.
With intermittent sneezing and a cat in good shape, it's best to start cautiously. Bastian was put on anti-inflammatory and painkiller treatment for a few days, with instructions to come back if it didn't work.
When the blood came
It didn't work. When Bastian came back, he was still sneezing – and now with blood. That changes the assessment. Blood means that something is mechanically damaging the mucous membrane, and then it is no longer safe to treat without seeing.
It is worth noting: grass in the nose does not necessarily cause dramatic symptoms right away, and a course that has lasted for a while does not rule out a foreign body.
Rhinoscopy – how we found the grass
Bastian was sedated, put under anesthesia and given an intravenous cannula so that we could give him fluids and medication along the way. Then we did a rhinoscopy – an examination of the nasal cavity with a scope. Rhinoscopy can be performed with several types of scopes; we use a flexible fiberscope from Karl StorzIt's thin enough for a cat, and the tip can be steered and bent, so we can see around in there instead of just straight ahead.
The blade of grass was visible on the screen.
It is not a given that you will see what you are looking for. The nasal cavity is narrow and full of thin bone lamellae, and a blade of grass is narrow, pale and tends to stick to the mucous membrane. Without optics, the alternative is to rinse blindly and hope that it will come loose.
How we pulled the straw out
Grass in the nose is rarely removed without instruments. The scope has a working channel – a thin channel along the optic through which instruments can be passed. We inserted a pair of forceps into the channel, grabbed the blade of grass while watching it on the screen, and pulled it out in one piece.
The point of the working channel is that the manipulation takes place under direct visibility. We see what we are grasping, and we see that it comes out with it. A blade of grass that blows and leaves a piece inside the nasal cavity causes new inflammation and new symptoms a few weeks later – so it matters that it comes out completely.
The entire procedure took around twenty minutes.
Why does grass get stuck in a cat's nose?
Cats chew on long grass, and a straw can follow it up into the nasal cavity from behind – either during swallowing, or when the cat vomits the grass back up. Therefore, the straw often lodges at the back of the nose, at the transition to the throat, and not at the nostrils.
This is also why you rarely see anything by looking into your nostril from the outside. Grass in your nose is usually out of reach of the naked eye.
When should you contact a veterinarian?
Contact us if your cat suddenly sneezes a lot, paws at your muzzle, or has a discharge from the nose. If there is blood in the sneeze, or the symptoms persist after a round of treatment, the nasal cavity should be examined with a scope.
Grass in the nose causes more inflammation the longer the straw is left, and the more difficult it becomes to both see and get hold of. Bastian's progress also shows that it is not urgent by the minute – but that it will not go away on its own either.
read more about Endoscopy of dogs and cats, and what investigations we use the equipment for.
