Otitis Flashcards
true or false, otitis is almost never a primary problem
truuuuu beech
_____ are almost always needed for severe cases of otisi
steroids
otic cultures only apply to
systemic therapoies
lack of improvement for an otitis case is likely not because of
“the wrong antibiotic”
if a dog comes to you with a REALLY severe otitis case and wont let you touch his ears, what do you recommend?
steroids for 1-2 weeks to open up the ear canal and to ease discomfort, consider sedation/anesthesia
when is an otic culture indicated?
in otitis media, if youre using systemic therapy, or in cases refractory to topical therapy
otitis externa has 4 cateogories of causes. list them and some examples for each
primary (directly causing inflammation): allergies, endorcine disorders, FB
secondary: infections, bacterial, yeast
predisposing: conformation/breed, hair, natural stenosis, moisture
perpetuating: bacteria, yeast, glandular hyperplasia, biofilms, stenosis, hyperkeratosis
clinical signs of external ear disease vs middle ear disease
external: head shaking, scratching, otic
pain, pinnal and otic discharge.
middle: increased pain, increased headshaking, lethargy, inappetence and pain on opening of the mouth, sometimes neurologic involvement like head tilt or horner’s
is vesitbular dz casued by otitis media or interna
interna
most common cause of otitis externa
atopic dermatitis
which breeds tend to have more ceruminous glands that predisposes them to otitis?
cockers, labs, springer spaniels
whats the only real treatment that has a chance of helping change the ear canal in regards to perpetuating causes of otitis?
steroids: topical or systemic if severe
which med is ototoxic?
chlorohexidene
ototoxicity is more of an issue in
cats
list things you can do to find out/investigate the primary cause of otitis
allergies: food trial or allergy testing
rule out parasitic
do a good exam–>look for FBs or neoplasia
CBC chem T4
signs of otitis media
Clinical signs
– Neuro abnormalities (see previous slides)
– Pain (mouth, ear, head tilt)
– Swallowing or discharge from nose during ear flushing
– *Otitis externa (often recurrent)
* Otitis media present in many cases of recurrent otitis externa
– Tympanic membrane abnormalities
* Rupture
* Bulging
* Increased opacity
* Increased vascularity
treatment for otitis media
Myringotomy if the TM is still in tact (pop it)
sample the middle ear for culture and cytology
flush the debris
can put antibiotics in there
6-8 weeks of antibiotic based on culture
true or false you should use maintenance therapy in recurrent cases of otitis
truuuuu but try to avoid antibiotics
steroids + azole for yeast and antiseptics for bacteria
