Prednisone for dogs ear infection.Treating Otitis Externa in Dogs
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Prednisone for dogs ear infection. The Challenge of Chronic Otitis in Dogs: From Diagnosis to Treatment
Search for:. Home Care. Facebook Twitter Email Print. Skip To. Chronic ear infections may involve bacterial or yeast overgrowth in the external, middle, or inner ear. Chronic infection can permanently damage the ear canal and cause pain, neurologic signs, and deafness. Ear infections are usually secondary to an underlying condition that allows for an unhealthy ear environment. Treatment is based on eliminating the bacteria or yeast with antibiotics or antifungal medication while working to resolve the underlying condition.
Regular ear cleanings and resolution of the underlying condition help to prevent recurrence. What Is a Chronic Ear Infection?
Ear infections are usually secondary to inflammation of the external ear canals the tube-shaped part of the ear visible under the ear flap. Inflammation of the canals leads to the reproduction of normal bacteria and yeast that live in the ear to the point where the body is unable to control their numbers called overgrowth. Other bacteria can also take advantage of the inflammation and unhealthy environment inside the ear to establish infection.
The overgrowth of these organisms causes more inflammation. Inflammation of the ear canal causes swelling, making the tube narrower than usual.
Inflammation also causes an increase in the production of wax. The ears become very itchy and painful. Severe ear infections can lead to eardrum rupture and middle and inner ear infections. Deep infections can lead to deafness and neurologic signs. Certain disorders or diseases may be the primary reason ear infections develop. These conditions include: Allergies environmental and food Ear mites Foreign bodies Skin disorders like seborrhea Thyroid disease in dogs Tumors or polyps in the ear Ear infections may recur because of the inability to control the original infection or treat the underlying cause.
Chronic changes lead to future infections, and scar tissue and permanent narrowing of the ear canals can make future infections difficult to treat. What Are the Signs of an Ear Infection? An external ear infection first shows signs of local inflammation redness, discharge. Pets may shake their heads, scratch their ears, or rub their ears against furniture or the floor. Some pets with severe infections may cry or groan as they rub and scratch their ears. Some pets scratch so severely that their nails create wounds on the skin around their face, neck, and ears.
External ear infections may progress to involve the middle and inner ear, leading to more serious signs of disease: External ear infection otitis externa Itchy or painful ears Head shaking Discharge and odor from the ears Narrowing or even closing of the canals Middle ear infection otitis media Paralysis of the nerves in the face Dry eye Hearing loss Abnormal pupil size Inner ear infection otitis interna Inability to keep balance, stand, or walk Nausea Head tilt How Is an Ear Infection Diagnosed and Treated?
During a physical examination, your veterinarian will look in the ear for the presence of inflammation, redness, discharge, growths, or other findings that may indicate an ear infection.
Sometimes, a cotton swab is used to collect debris from the ear. This material can be placed on a slide and examined under a microscope to determine if the infection is due to yeast, bacteria, or mites. Your veterinarian may also collect a sample of ear debris for culture and sensitivity testing, which identifies the exact organisms present and helps your veterinarian select the best antibiotic to use.
In severe cases, or if the animal is in too much pain to permit an examination of the ears, sedation may be needed to evaluate the ears, collect samples of discharge, clean the ears, and initiate treatment. With the pet sedated, the ears can be gently flushed to remove debris and facilitate better examination of the ear. Radiographs X-rays and other diagnostic tests can be performed while the pet is sedated to determine if the middle or inner ear are also involved.
Once the infection has been identified, most animals with chronic ear infections can be treated at home. Ear mites are relatively easy to treat with medication placed directly into the ear or applied topically between the shoulder blades. Most yeast and bacterial infections can be treated with regular cleanings and topical or oral medication. When inflammation is severe, a steroid may be needed to give comfort to your pet and decrease the swelling around the ear canals.
If there are underlying problems such as thyroid disease or seborrhea, these must also be addressed to clear the infection and reduce the chances of recurrence. If the ear canals have been permanently narrowed or damage is otherwise severe, surgery may be recommended to allow for drainage and application of medication.
In other cases, more extensive surgery may be recommended to prevent the pet from being in chronic pain due to a permanently deformed, infected ear. Once an infection has been cleared, maintaining a healthy ear environment with regular cleaning helps prevent recurrence. Underlying diseases such as allergies and skin disorders must be identified and resolved in order to help avoid future infections. This article has been reviewed by a Veterinarian.
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❿The Challenge of Chronic Otitis in Dogs: From Diagnosis to Treatment | Today's Veterinary Practice - Types of Otitis Externa and Treatments
Ear infections are a common problem in dogs. Ear infections are not always obvious when looking at the outside of the ears. Dogs will usually scratch at their ears or shake their heads when they have an infection, and you may detect a smell, or see excess wax or discharge in the ear canal.
If you notice any of these signs, it is important to take your dog in to see your vet. Unfortunately ear infections are a recurring problem for some dogs.
The following information is intended to give you an understanding of why ear infections occur, and the best way to treat them. There are a number of factors that can predispose a dog to ear infections. These factors alter the environment in the ear canal, making it more likely to become infected. Common predisposing factors in dogs include:. The conformation of the ear canals, such as narrowed ear canals, the presence of hair, or an abundance of secretory glands.
Certain breeds are more prone to ear problems due to their conformation. Moisture can predispose dogs to ear infections. Increased humidity or swimming can result in increased moisture in the ear canals and maceration of the ear canal, resulting in infection. Trauma from excessive cleaning with ear cleaners or cotton buds, or vigorous hair plucking can also predispose to infection.
There are also primary factors that can directly cause inflammation of the ears otitis externa. The most common primary factors include:. Parasites — ear mites are one of the most common parasites which affect the ears, sometimes they can be seen when your vet examines the ear with an otoscope, but other times we can only identify them by looking under a microscope.
Fleas and ticks are other common parasites which can cause ear problems. Allergies — Atopy is the most common underlying disease in recurring or chronic ear infections. Atopy is a genetically predisposed condition, where inflamed, itchy skin including the skin lining the ears! Dysfunction of the skin barrier is thought to play a role in this process. Dogs can react to many different allergens and if atopy is suspected further investigation and treatment is required.
Food allergies can also commonly result in recurrent otitis externa, and a food trial is recommended. Discharge and odour may be noticeable to people. Bacteria and yeast infections must be treated medically. Ear infections can be a frustrating, recurring problem, and it is important to treat them properly from the start.
To do this we need to know what sort of infection is in the ear, to do proper home care regularly, and to have recheck appointments to ensure that infections have resolved before stopping treatment. In recurrent cases preventative measures are then put in place to help prevent recurrence. This will help us determine the most appropriate ear drop for your dog. In some cases rod infections we can need to send a sample away to be cultured to determine which treatment to use, as resistance to multiple antibiotics is common with these infections.
It is also very important to thoroughly clean the ear canals, as discharge in the ears will prevent medication from working effectively. In the majority of cases an ear cleaner can be used at home. However, as ear infections can be very painful, a general anaesthetic may be necessary to properly assess and clean the ear canals, and this can be an important part of the treatment process.
Different sized dogs have very different sized ear canals and your vet will advise you on the volume of ear drop required. A course of corticosteroid tablets prednisolone is often required to help reduce the inflammation. In severe cases we will also need to use oral antibiotics for a minimum of weeks. We need to look into the ear canals with an otoscope to assess the degree of inflammation and discharge in the canal, and we need to repeat the cytology looking at the discharge under a microscope to assess whether the infection is resolving.
It is very important to treat the ears until we do not see any bacteria or yeast on cytology and usually for 1 week after this. For mild cases that respond quickly to treatment days of treatment may be required, in more severe cases at least weeks of treatment is needed. If we do not treat the ears for long enough, we are likely to get recurrence of the problem, and future treatment can be more difficult.
Middle ear infection otitis media - If the infection reaches the middle ear, affected animals may have a head tilt, a lack of balance, and unusual back-and-forth eye movements called nystagmus. These symptoms are called vestibular signs and can indicate a complication of middle ear infection. Aggressive treatment is required in these cases.
In this specialist surgical procedure, the entire ear canal is removed and healthy tissue is allowed to grow in. These procedures are last resorts after severe infection has made effective medical treatment impossible.
What factors predispose dogs to ear infections? Common predisposing factors in dogs include: 1. What primary factors can cause ear problems? The most common primary factors include: 1. Foreign bodies — eg. Grass seeds, dirt, sand, hair can induce irritation. What factors perpetuate ear problems? Treatment of ear infections Ear infections can be a frustrating, recurring problem, and it is important to treat them properly from the start.
Helping prevent recurrence 1 Address underlying causes such as allergies 2 If the ear infection is likely to have occurred due to moisture in the ear canals we may recommend a drying agent be used times a week to help prevent recurrence. Complications of Ear Infection Middle ear infection otitis media - If the infection reaches the middle ear, affected animals may have a head tilt, a lack of balance, and unusual back-and-forth eye movements called nystagmus.
❾-50%}Prednisone for dogs ear infection
If a prescription is available at your local pharmacy, you may be able to use your SingleCare card to save. Some medications your veterinarian may prescribe to treat dog ear infection may include:.
Ear drops are often used to treat animals with chronic ear infections. These medications are applied directly into the ear. Some are administered multiple times a day and some are long-acting medications that are administered once by your veterinarian. Many are a combination of an antifungal, corticosteroid, and antibiotic.
Examples of these medications include:. Depending on which type of ear infection your dog has, oral antibiotics may be used to treat certain bacterial infections. Antibiotics used to treat bacterial ear infections in dogs include:.
Oral antifungal medications and topical antifungal ointment or creams may be used to treat dog ear infections that are fungal in nature and may include:. Over-the-counter NSAIDs such as Advil ibuprofen and Aleve naproxen and products containing acetaminophen such as Tylenol should never be given to dogs, as they can cause serious health issues.
NSAIDS are not typically used in combination with corticosteroids due to risk of stomach ulcers when these two types of medications are used together. Because corticosteroids are a common part of combination ear medications, it is important to only use canine NSAIDs after recommendations from your veterinarian. For example, veterinarians may offer a total ear canal ablation TECA , a procedure that removes the vertical and horizontal ear canals down to the level of the middle ear.
Whittenburg says. Richardson says. Keeping the ears clean and dry can help prevent dog ear infections; especially in breeds with floppy ears that can trap moisture such as retrievers, basset hounds, and cocker spaniels—as well as any dog that swims frequently. This usually involves using a cleanser in the ear canal and massaging at the base of the ear. The most common primary factors include:. Parasites — ear mites are one of the most common parasites which affect the ears, sometimes they can be seen when your vet examines the ear with an otoscope, but other times we can only identify them by looking under a microscope.
Fleas and ticks are other common parasites which can cause ear problems. Allergies — Atopy is the most common underlying disease in recurring or chronic ear infections. Atopy is a genetically predisposed condition, where inflamed, itchy skin including the skin lining the ears! Dysfunction of the skin barrier is thought to play a role in this process. Dogs can react to many different allergens and if atopy is suspected further investigation and treatment is required.
Food allergies can also commonly result in recurrent otitis externa, and a food trial is recommended. Discharge and odour may be noticeable to people.
Bacteria and yeast infections must be treated medically. Ear infections can be a frustrating, recurring problem, and it is important to treat them properly from the start.
To do this we need to know what sort of infection is in the ear, to do proper home care regularly, and to have recheck appointments to ensure that infections have resolved before stopping treatment. In recurrent cases preventative measures are then put in place to help prevent recurrence. This will help us determine the most appropriate ear drop for your dog.
In some cases rod infections we can need to send a sample away to be cultured to determine which treatment to use, as resistance to multiple antibiotics is common with these infections. It is also very important to thoroughly clean the ear canals, as discharge in the ears will prevent medication from working effectively.
In the majority of cases an ear cleaner can be used at home. However, as ear infections can be very painful, a general anaesthetic may be necessary to properly assess and clean the ear canals, and this can be an important part of the treatment process.
Malassezia yeast organisms are often secondarily present in patients with chronic ear disease. Malassezia otitis typically results in variable degrees of inflammation and excessive, malodorous, mostly brown to dark-brown, waxy discharge. Of note, however, the number of Malassezia organisms seen during cytologic examination does not always correlate with the severity of clinical signs.
Malassezia organisms not only have the ability to increase hyperplasia and secretion by proteins and enzymes they produce but also may be able to trigger an immune response, resulting in severe inflammation and potentially hypersensitive reaction. Fungal culture is not recommended because Malassezia organisms are usually not resistant to antimicrobials such as azoles, the organism does not grow well on regular fungal culture media, and standardized susceptibility testing is not available.
Uncomplicated Malassezia overgrowth can usually be controlled by regular at-home ear cleaning e. For more severe and chronic cases, the authors prefer to use a topical product containing antifungal medication e. Initially, the ear flush is performed daily until the yeast infection is under control 1 to 3 weeks , followed by once weekly for maintenance.
A recent preliminary in vitro study showed that the dexamethasone SP added to several commercially available ear flush products is stable for 21 to 90 days at room temperature.
The normal microflora within the ear canals is characterized by a diverse population of bacteria in phyla such as Proteobacteria, Actinobacteria, Firmicutes, Bacteroidetes, and Fusobacteria. In patients with chronic otitis externa, the microbial populations become much less diverse and are dominated by organisms such as Staphylococcus and Pseudomonas , and to a lesser degree by Corynebacterium , Proteus , Lactobacillus , Streptococcus , Porphyromonas , and Enterococcus. Figure 1.
Suppurative otitis with erythema and purulent discharge in an atopic dog with secondary Pseudomonas otitis. As with Malassezia , bacterial ear infections are considered secondary problems; if bacterial infections are recurring, the patient should be thoroughly investigated for primary underlying diseases, such as allergies. Because bacterial otitis externa is treated topically, bacterial culture and sensitivity is often not necessary because susceptibility testing cannot accurately determine resistance for topically applied antimicrobials.
Minimum inhibitory concentration MIC is the lowest concentration of antibiotic that prevents bacterial growth and helps guide susceptibility testing; however, correctly applied topical antibiotics usually reach MICs of up to to fold. Despite the high MICs, before treatment is started, any debris and purulent discharge must be removed and sufficient ear medication must be applied.
The recommended amount is 0. To increase client compliance with treatment, 1-mL syringes can be sent home with clients so that they can draw up the recommended amount of ear medication. Numerous commercially available ear products contain antibiotics or disinfectants with antibacterial activity TABLE 3. Common antibiotics are aminoglycosides gentamicin, neomycin , fluoroquinolones ciprofloxacin, enrofloxacin, marbofloxacin, orbifloxacin , polymyxins colistin sulfate, polymyxin B , fusidic acid, florfenicol, and silver sulfadiazine.
Many chronic cases of bacterial otitis externa are associated with Pseudomonas organisms; typically effective antibiotics are fluoroquinolones, gentamicin, and polymyxin B. However, treatment can be complicated by development of multidrug resistance as well as the formation of biofilm.
These agents weaken the bacterial cell wall and facilitate penetration of the antibiotic into the bacteria. This action has been demonstrated in vitro for multidrug-resistant Pseudomonas.
It is well tolerated and not ototoxic. Biofilm has been recognized as a major virulence factor in chronic infections. It increases antimicrobial resistance by shielding bacteria from the immune system and topical medication.
Biofilm is an extracellular matrix i. Figure 2. Dark, slimy otic discharge from a dog with Pseudomonas otitis and biofilm. Figure 3. Neutrophils and bacteria surrounded by thick purple staining filaments and lace-like material in otic discharge from dog with Pseudomonas otitis and biofilm. Removing biofilm can be challenging; it needs to be broken down physically by thorough flushing and aspiration. In addition, combination of Tris-EDTA and N-acetylcysteine topical product can help to disrupt and liquify the biofilm.
Various parasites e. In higher numbers, mites are typically associated with dark-brown, granular coffee-ground exudate.
Chronic ceruminous otitis externa is sometimes caused by Demodex mites.
Part of caring for your pet is being on the lookout for signs that something may be going on with their health. Those signs may be different from symptoms of the same condition in humans. For example, have you ever noticed your dog shaking its head or repeatedly scratching its ears? This behavior could signal an ear infection, also known as otitis. Dogs are even more prone to ear infections than their owners due to the shape of their ear canals. In fact, dog ear infections are one of the most common reasons for a visit to a veterinarian.
These include:. There are many contributing factors to dog ear infections such as:. Whittenburg, who says she sees five to six dogs with ear infections each week. If your dog is showing signs of painful ear irritation, the problem is not likely to go away on its own. Additionally symptoms of an ear infection mirror other ear issues, such as polyps or tumors, allergies, hematoma, or even neurological disease. A veterinarian will determine what type of ear infection your canine companion has, and that will determine the appropriate treatment.
There are three kinds of dog ear infections; otitis externa outer earotitis media middle earand otitis interna inner ear infection. The most common type of ear infection for a dog is otitis externa or outer ear infection.
Humans and animals metabolize medications differently, and certain human meds can be toxic for animals. Medications for dog ear infections should only be administered as prescribed by your vet. If a prescription is available at your local pharmacy, you may be able to use your SingleCare card to save.
Some medications your veterinarian may prescribe to treat dog ear infection may include:. Ear drops are often used to treat animals with chronic ear infections.
These medications are applied directly into the ear. Some are administered multiple times a day and some are long-acting medications that are administered once by your veterinarian. Many are a combination of an antifungal, corticosteroid, and antibiotic. Examples of these medications include:. Depending on which type of ear infection your dog has, oral antibiotics may be used to treat certain bacterial infections.
Antibiotics used to treat bacterial ear infections in dogs include:. Oral antifungal medications and topical antifungal ointment or creams may be used to treat dog ear infections that are fungal in nature and may include:.
Over-the-counter NSAIDs such as Advil ibuprofen and Aleve naproxen and products containing acetaminophen such as Tylenol should never be given to dogs, as they can cause serious health issues.
NSAIDS are not typically used in combination with corticosteroids due to risk of stomach ulcers when these two types of medications are used together. Because corticosteroids are a common part of combination ear medications, it is important to only use canine NSAIDs after recommendations from your veterinarian.
For example, veterinarians may offer a total ear canal ablation TECAa procedure that removes the vertical and horizontal ear canals down to the level of the middle ear.
Whittenburg says. Richardson says. Keeping the ears clean and dry can help prevent dog ear infections; especially in breeds with floppy ears that can trap moisture such as retrievers, basset hounds, and cocker spaniels—as well as any dog that swims frequently. This usually involves using a cleanser in the ear canal and massaging at the base of the ear.
While it may seem odd, you should know what a healthy, clean, dog ear smells like so you can tell when something may be off. Bottom line: Our pets depend on us for their care.
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Prednisone does not treat infections. Prednisone reduces the inflammation response and may alleviate the symptoms. But it also suppresses the immune response of. localhost › care › chronic-ear-infecti. Depending on the severity of the inflammation and stenosis, oral glucocorticoids may be needed to reduce ear canal inflammation. Prednisolone (1 to 2 mg/kg q12h. The prednisone will help with the itch and inflammation. The Dem-Otic may treat any Yeats or bacterial infection. You should clean your pet's ears out. Can prednisone be used to treat ear infections in dogs?. Peer Reviewed. Sometimes, a cotton swab is used to collect debris from the ear. End-stage otitis.Patrick Hensel is a graduate of the University of Bern, Switzerland. After completing a doctorate thesis and a rotating internship at the University of Zurich, Switzerland, he moved to the United States, where he completed a 3-year veterinary dermatology residency at the University of Georgia in He stayed on as a faculty member until , when he decided to move back to Switzerland to open his own dermatology clinic in his hometown of Basel in Nao Hensel obtained her doctor of veterinary medicine degree from Colorado State University in She then completed a 1-year rotating small animal internship in Massachusetts followed by a 3-year veterinary dermatology residency in Georgia.
A native of Japan, Dr. Hensel subsequently moved to Basel, Switzerland, where she opened a veterinary dermatology practice in Canine otitis externa is a common dermatologic problem in small animal practice.
Affected ears are often painful and pruritic e. Therefore, the primary causes of the ear problem must be identified, eliminated, or managed long term. Otitis externa is considered a multifactorial disorder; the most common primary cause is allergy, which is often secondarily accompanied by microbial infections Malassezia and bacteria. The diagnostic workup for otitis externa requires a detailed history, thorough physical and ear examinations, and cytologic evaluation.
Bacterial and fungal cultures are rarely needed unless systemic antimicrobial therapy is necessary for otitis media. Diagnostic imaging e.
Radiographic findings may be falsely negative, but radiographs may also be a cost-effective option in general practice. Whenever possible, the tympanic membrane should be evaluated for any changes e.
Ear cytology, with Diff-Quik staining, is an effective and quick in-house option to confirm and quantify any type of infection and degree of inflammation and should be performed for all dogs with otitis externa. Most otitis externa cases can be sufficiently managed by topical therapy; however, otitis is likely to return after topical treatment if the underlying cause e. Before beginning therapy, ensure that the amount of debris in the ear canal is minimal; excessive ear debris should be removed by a deep ear flush.
If the ear canals are severely inflamed, the authors recommend pretreatment with systemic anti-inflammatory drugs e.
A thorough ear flush will enable visualization of the tympanic membrane but will also prevent trapping and inactivation of ear medication in the debris. After successful treatment of an ear infection and inflammation, regular ear cleaning at home every 7 to 14 days as needed will also help reduce accumulation of otic material and recurrence of infections.
Ear cleaners have different properties e. TABLE 2 lists some of the ear cleaners available on the market. Some cases can be quite painful, and the ear canal can be edematous from the inflammation, which can make an otoscopic examination very difficult, even with the patient under sedation. The otoscopic examination can be facilitated by giving patients a short course of oral glucocorticoids e. A common cause for acute otitis externa is foreign bodies e. Removing the foreign body will result in a fast recovery and eliminate the need for further treatment in the absence of secondary infection.
Ear diseases that have been present for at least 1 month or that recur frequently are considered chronic. Management of chronic cases is more challenging BOX 1. Although it is important to treat the infections, it is also important to address the inflammation and underlying problem. Depending on the severity of the inflammation and stenosis, oral glucocorticoids may be needed to reduce ear canal inflammation.
A pilot study of 5 dogs indicated that cyclosporine may be another potent anti-inflammatory drug and that it may effectively control chronic otitis, especially with long-term use. Many commercially available topical ear medications contain a combination of antibiotics, antifungals, and glucocorticoids and are supplied in different formulations for daily or weekly applications TABLE 3. Malassezia yeast organisms are often secondarily present in patients with chronic ear disease.
Malassezia otitis typically results in variable degrees of inflammation and excessive, malodorous, mostly brown to dark-brown, waxy discharge. Of note, however, the number of Malassezia organisms seen during cytologic examination does not always correlate with the severity of clinical signs. Malassezia organisms not only have the ability to increase hyperplasia and secretion by proteins and enzymes they produce but also may be able to trigger an immune response, resulting in severe inflammation and potentially hypersensitive reaction.
Fungal culture is not recommended because Malassezia organisms are usually not resistant to antimicrobials such as azoles, the organism does not grow well on regular fungal culture media, and standardized susceptibility testing is not available. Uncomplicated Malassezia overgrowth can usually be controlled by regular at-home ear cleaning e.
For more severe and chronic cases, the authors prefer to use a topical product containing antifungal medication e. Initially, the ear flush is performed daily until the yeast infection is under control 1 to 3 weeks , followed by once weekly for maintenance. A recent preliminary in vitro study showed that the dexamethasone SP added to several commercially available ear flush products is stable for 21 to 90 days at room temperature. The normal microflora within the ear canals is characterized by a diverse population of bacteria in phyla such as Proteobacteria, Actinobacteria, Firmicutes, Bacteroidetes, and Fusobacteria.
In patients with chronic otitis externa, the microbial populations become much less diverse and are dominated by organisms such as Staphylococcus and Pseudomonas , and to a lesser degree by Corynebacterium , Proteus , Lactobacillus , Streptococcus , Porphyromonas , and Enterococcus. Figure 1. Suppurative otitis with erythema and purulent discharge in an atopic dog with secondary Pseudomonas otitis.
As with Malassezia , bacterial ear infections are considered secondary problems; if bacterial infections are recurring, the patient should be thoroughly investigated for primary underlying diseases, such as allergies. Because bacterial otitis externa is treated topically, bacterial culture and sensitivity is often not necessary because susceptibility testing cannot accurately determine resistance for topically applied antimicrobials. Minimum inhibitory concentration MIC is the lowest concentration of antibiotic that prevents bacterial growth and helps guide susceptibility testing; however, correctly applied topical antibiotics usually reach MICs of up to to fold.
Despite the high MICs, before treatment is started, any debris and purulent discharge must be removed and sufficient ear medication must be applied. The recommended amount is 0. To increase client compliance with treatment, 1-mL syringes can be sent home with clients so that they can draw up the recommended amount of ear medication.
Numerous commercially available ear products contain antibiotics or disinfectants with antibacterial activity TABLE 3. Common antibiotics are aminoglycosides gentamicin, neomycin , fluoroquinolones ciprofloxacin, enrofloxacin, marbofloxacin, orbifloxacin , polymyxins colistin sulfate, polymyxin B , fusidic acid, florfenicol, and silver sulfadiazine.
Many chronic cases of bacterial otitis externa are associated with Pseudomonas organisms; typically effective antibiotics are fluoroquinolones, gentamicin, and polymyxin B. However, treatment can be complicated by development of multidrug resistance as well as the formation of biofilm.
These agents weaken the bacterial cell wall and facilitate penetration of the antibiotic into the bacteria. This action has been demonstrated in vitro for multidrug-resistant Pseudomonas. It is well tolerated and not ototoxic. Biofilm has been recognized as a major virulence factor in chronic infections. It increases antimicrobial resistance by shielding bacteria from the immune system and topical medication. Biofilm is an extracellular matrix i. Figure 2. Dark, slimy otic discharge from a dog with Pseudomonas otitis and biofilm.
Figure 3. Neutrophils and bacteria surrounded by thick purple staining filaments and lace-like material in otic discharge from dog with Pseudomonas otitis and biofilm. Removing biofilm can be challenging; it needs to be broken down physically by thorough flushing and aspiration. In addition, combination of Tris-EDTA and N-acetylcysteine topical product can help to disrupt and liquify the biofilm. Various parasites e. In higher numbers, mites are typically associated with dark-brown, granular coffee-ground exudate.
Chronic ceruminous otitis externa is sometimes caused by Demodex mites. A few topical acaricidal ear preparations containing ivermectin e.
However, because many mites and ticks commonly affect other body areas, pesticides with a more systemic or generalized effect are recommended, such as spot-on topicals e.
Although treating otitis externa can be challenging, most chronic and recurrent cases can be medically treated and successfully managed, especially when underlying causes are addressed. Under certain circumstances, a surgical intervention may be necessary, but it should be performed only after all primary causes have been identified and corrected. Because of the severity of chronic otitis and potential involvement of the middle ear, the most effective surgical procedure is total ear canal ablation combined with lateral bulla osteotomy; however, clients must be informed about the potential risks and postsurgical complications.
It is very important to clearly and thoroughly discuss with clients the requirements for successfully managing chronic otitis. Discussions should address the primary causes e. To increase client compliance, show them how to clean and treat the ears, provide detailed written instructions, and schedule follow-up calls, all of which can be done by skilled veterinary nurses.
To increase patient compliance, provide pain control and ensure that ear cleaning and treatment are gently performed. Paterson S, Matyskiewicz W. A study to evaluate the primary causes associated with Pseudomonas otitis in 60 dogs. J Small Anim Pract. Aetiology of canine otitis externa: a retrospective study of cases. Vet Dermatol. Oral cyclosporine in the treatment of end-stage ear disease: a pilot study.
Nuttall T. Successful management of otitis externa. In Practice. Chen T, Hill PB. The biology of Malassezia organisms and their ability to induce immune responses and skin disease.
Preliminary study of the stability of dexamethasone when added to commercial veterinary ear cleaners over a day period. Cerumen microbial community shifts between healthy and otitis affected dogs. Section 2: Otic preparations.
Ames, IA: Wiley-Blackwell; — Evaluation of biofilm production by Pseudomonas aeruginosa from canine ears and the impact of biofilm on antimicrobial susceptibility in vitro. Tris-EDTA significantly enhances antibiotic efficacy against multidrug-resistant Pseudomonas aeruginosa in vitro.
Glaze MB.
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