Otitis

Question 1

how is the middle ear cavity of the cat different

Answer 1

it is divided by a septum into two distinct regions

Question 2

which nerve courses near the inner ear and through the middle ear

Answer 2

facial nerve

Question 3

clinical signs of external ear diseases

Answer 3

head shaking, scratching, otic pain, otic discharge

Question 4

signs associated with middle ear disease

Answer 4

increased otic pain and head shaking, lethargy, inappetence and pain on opening the mouth

Question 5

which neurologic signs can be associated with middle ear disease

Answer 5

facial nerve paralysis, horner’s syndrome, problems with parasympathetic nerve to nose and eye

Question 6

components of horner’s syndrome

Answer 6

enopthalmus, miosis and ptosis

Question 7

what is seen with damage to the parasympathetic nerve (unilater)

Answer 7

xeromycteria: unilateral dry, hyperkeratotic nasal planum and KCS

Question 8

what are some peripheral vestibular signs that can be seen with inner ear disease

Answer 8

head tilt, horizontal or rotary nystagmus, circling, falling toward side of lesion

Question 9

what is the lower translucent part of the tympanic membrane called

Answer 9

pars tensa

Question 10

what is the dorsal pink, semi-translucent part of the tympanic membrane called (vessels)

Answer 10

pars flaccida

Question 11

what tests is otic exudate collected for

Answer 11

cytologic exam and bacterial culture

Question 12

what is otitis externa

Answer 12

an inflammatory condition with or without concurrent infection of the outer ear

Question 13

define ‘causes’ in regard to otitis externa categorization

Answer 13

factors that incite inflammation directly

Question 14

primary causes of otitis externa will

Answer 14

create disease in a normal ear

Question 15

secondary causes of otitis externa will

Answer 15

create disease in an abnormal ear

Question 16

examples of primary causes of otitis externa

Answer 16

hypersensitivity disorders (atopy, adverse food reactions);
parasites (otodectes);
immune-mediated diseases (pemphigus);
foreign bodies;
endocrine disease;
glandular disorders – sebaceous adenitis, seborrheic disorders

Question 17

secondary causes of otitis externa

Answer 17

bacteria, yeast, overcleaning, physical trauma

Question 18

define ‘factors’ in regards to categorization of otitis externa

Answer 18

features of the disease or the pet that contribute to or promote otitis externa

Question 19

define predisposing factors of otitis externa

Answer 19

factors that increase the risk of development of otitis

present BEFORE development of otitis externa

Question 20

examples of predisposing factors of otitis externa

Answer 20

conformation, lifestyle (swimming), obstructive lesions, neoplasia and polyps

Question 21

which breed may have the predisposing factor of large pendulous ears

Answer 21

cocker spaniel or springer spaniel

Question 22

which breed has the predisposing factor to otitis externa of narrow ear canals

Answer 22

shar pei

Question 23

which breed has the predisposing factor to otitis externa of excessive hair in the ear canal

Answer 23

poodle

Question 24

define perpetuating factors of otitis externa

Answer 24

factors cause the disease to continu once established

occur AFTER development of otitis externa

Question 25

examples of perpetuating factors of otitis externa

Answer 25

otitis media; | progressive pathologic changes to the ear canal

Question 26

examples of progressive pathologic changes to the ear canal with otitis

Answer 26

edema and erythema; infiltration of inflammatory cells; hyperplasia of sebaceous and ceruminous glands; permanent anatomical changes from calcification of auditory cartilage and fibrosis of dermis and subcutis

Question 27

steps in assessing a patient with otitis

Answer 27

``` history; clinical/dermatologic exam; otoscopic exam; ear canal cytologic exam; ear swabs in mineral oil; bacterial C&S; try to identify causes and factors ```

Question 28

what are you aiming to assess with an otoscopic exam

Answer 28

patency of tympanic membrane

Question 29

what do you need to have if doing an ear flush under GA

Answer 29

an inflated endotracheal cuff!

Question 30

what type of infection is Tris-EDTA useful for

Answer 30

gram-negative infections

Question 31

what type of infection can Epi-Otic be useful in

Answer 31

bacterial or malassezia

Question 32

3 types of topical therapy for otitis

Answer 32

glucocorticoids, antibiotics, antifungals

Question 33

what should be done while a patient is on topical therapy for otitis

Answer 33

monitoring cytologically and adjusting therapy

Question 34

why must we evaluate the patency of the tympanic membrane

Answer 34

no otic topical treatments are labeled for non-intact tympanic membrane

Question 35

benefits of using glucocorticoids to treat otitis

Answer 35

antipruritic, anti-inflammatory, antiproliferative and reduce otic secretions

Question 36

which topical antimicrobial has good activity against pseudomonas

Answer 36

polymixin B

Question 37

what are systemic glucocorticoids used for with otitis

Answer 37

to decrease stenosis, edema and hyperplasia

Question 38

when using systemic antimicrobial therapy, what needs to be done for otitis

Answer 38

culture and sensitivity

Question 39

what is the primary cause of otitis media in cats

Answer 39

infection ascending through the auditory tubes

Question 40

what 3 clinical signs should be asked about when considering otitis media

Answer 40

sneezing, ocular discharge and nasal discharge

Question 41

benefits of a myringotomy

Answer 41

both diagnostic (cytology and C&S) and therapeutic (ability to flush)

Question 42

where is the incision for a myringotomy made

Answer 42

through the caudoventral quadrant of the tympanic membrane

Question 43

general steps in treating otitis media

Answer 43

access to middle ear (myringotomy); cytology and bacterial culture of middle ear; flush tympanic bulla using warmed saline; reduce inflammation with corticosteroids; topical antimicrobials +/- systemic; recheck weekly, may need repeat flushes