Otitis Flashcards

1
Q

Primary factors of OE

A

systemic disease

- enough for inflammation (FB, allergy, autoimmune, endocrinopathy, parasitic)

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2
Q

Parasites as primary factors of OE

A
  1. otodectes cynotis (ear mite) nonburrowing obligate parasite
    *50% of OE in cats, 10% in dogs. feed on lymph and blood (especially <1 yr animals)
  2. otobius megnini (spinous ear tick) more common in SW US/Large animal, larval infection
  3. E. alfreddugesi (chiggers) seasonal(fall) see red/orange dots around ear canal
  4. Demodex. in cats suspect FeLV, FIV, neoplasm.
  5. Scabies (scabiei - dogs) usually isnt in the ear, associated with a lot of pruritis, thick crusts
    (notoedres cati - cats) face, pinna not in ear canal as much, also severe pruritis.
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3
Q

one of most pruritic diseases

A

scabies

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4
Q

Which parasite isn’t ruled out just because you can’t see it on the scrape?

A

scabies

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5
Q

FB otitis

A

unilateral! with acute pain
(plant awns, insect, sand, dry meds)
remove and use topical abx

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6
Q

intraluminal tumor causing otitis externa

A

relatively uncommon
ulceration and necrosis
often more malignant in cats than dogs (**ceruminous gland adenocarcinoma, squamous cell carcinoma, mast cell)

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7
Q

Nasopharyngeal polyp

A
  • etiology can be congenital, bacterial or calicivirus.
  • chronic uni/bilateral otitis, mass in canal, head tilt
  • tx with surgery
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8
Q

apocrine cystomatosis

A

sitting on pinna, start small.

sx necessary because they will obstruct the canal

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9
Q

atopic dermatitis and OE

A

red and inflamed

pinna, vertical canal, entire canal when chronic. 50% have bilateral

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10
Q

____% of food allergy have OE

A

80%

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11
Q

contact allergy and otitis externa

A

usually associated with topical meds (gentamycin, propylene glycol (in lots of ear products) )

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12
Q

disorders of keratinization and OE

A

primary idiopathic seborrhea
hypothyroid
sex hormone imbalance
lipid related conditions

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13
Q

primary idiopathic seborrhea

A

(cockers!!) excessive cerumen production often progresses to calcifying OE and OM

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14
Q

endocrine disease and OE

A

(hypothyroid and sex hormone imbalance)

  • inc. mucin in dermis and hyperplasia/hyperkeratosis epidermis
  • chronic bilateral otitis +/- dermatitis, usually alopecia and scaling
  • tx with hormones/sx
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15
Q

autoimmune disease and OE

A

pemphigus

tip of pinna, generally not in the canal

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16
Q

Juvenile cellulitis and OE

A

puppy strangles!

facial lesions and purulent otitis and facial ulcers…

17
Q

secondary factors for OE

A

basically infections
- bacteria and yeasts (same ones on skin)
Bacteria: staph**, psuedomonas, proteus, e. coli, klebsiella)
Yeast: malassezia (normally in ear), candida (rare) doesn’t usually affect the ear

18
Q

perpetuating factors of EO, cause otitis to persist

A

otitis media, mineralization, hyperplasia of canal

19
Q

pathogenic changes

A

hard to differentiate, get harder/calcified (v. squishable, needs to be imaged for confirmation)

20
Q

general clinical signs of OE we see

A

painful, red, edematous, pus

21
Q

clinical signs of OE

A
  • *odor, head shaking, discharge**
  • head tilt, pain
  • (with chronicity) erythema, edema, lichenification, hyperpigmentation, excoriation, mineralization
22
Q

otitis media

A

extension of OE
(goes thru ear drum and sits there, rarely moves through eustacian tubes,)
- diagnosis difficult, can’t visualize tympanic membrane, very painful
- neurological signs - facial paralysis, horners syndrome (because of compression/inflammation)

23
Q

ear cytology

A

easy, mandatory and fundamental!!!

heat fix a swab

24
Q

video otoscopy

A

used to do a deep ear flushing, can visualize tympanic membrane
(also myringotomy artifical rupture of membrane)

25
purulent discharge and meds?
discharge will inactivate meds like gentamycin, polymyxin B
26
have to _____ if doing a deep ear flush
intubate! don't want any nasties getting in the lungs
27
do a culture and sensitivity for ___ not ___
OM not OE
28
ceruminolytics
squalene or propylene need to stay in 20 minutes and be flushed out some are irritating and potentially toxic
29
acidifying agents
dry the canal | dont use with aminoglycosides
30
common antimicrobial agents
chlorhex ketoconazole hypochlorous acid
31
most common antibiotics
aminoglycosides (neomycin, gentamycin)
32
abx
aminoglycosides fluoroquinolones(enrofloxacin) polymyxin B florfenicol (leave in a week)
33
when to use systemic abx for otitis? | and then always?
OM!! or sever OE (fluroquinolines, clyndamycin) Always use with topical tx!!
34
treat OM for minimum of
6-8 weeks
35
often have contact allergy
neomycin, gentamycin
36
otitis is not | so always?
a disease!!! | treat underlying disease