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Diseases of Eyelids, Claws, Anal Sacs, and Ears
... apocrine cystadenoma, ceruminous cystadenoma, 8 apocrine cysts, apocrine hidrocystomas, 8,13,16 sweat gland cysts of the skin, 5,6,11,12 melanotic ceruminous cysts, 17,18 ceruminous gland adenomas, ceruminous gland cysts, 19 ceruminous gland hyperplasia, 19,20 ceruminous cystomatosis 21,22 and epitrichial cystadenomas 15 have all been used. We have previously used the term 'cystomatosis' in abstracts. ...
... 11,20,21,30 The glands involved in cystadenomatosis are the modified sweat apocrine glands, which can be found in the skin surrounding the eyelid margins (Moll's glands), lip margins and perianal regions, but are most prevalent in and around the ears. [5][6][7]9,13,15,31 The external acoustic meatus of cats contains ceruminous and sebaceous glands, 9,11,12 with mixed epitrichial and atrichial units, 5,6,24,32 which produce the waxy cerumen emulsion that coats the ear canal surface. 12,33 Cerumen is a mixture of desquamated flattened keratinized squamous epithelial cells and the fatty secretions from sebaceous and ceruminous glands, and helps to maintain barrier function within the ear canal. ...
... 2,35 The bluish-black clinical appearance of the cystadenomatosis lesions are partially a reflection of the distended skin and partially attributed to the pigmentary contributions from hemosiderin and ceroid of the thick acellular or cell-poor fluid filling the cystic lumen. 5,12,15 Histopathologically, these cysts have been theorized to be caused by obstructed glandular ducts, 13,16 or retention cysts, based on the flattened appearance of epithelial cells with dermal fibrosis or due to compression exerted from benign adenomas process with papillary digital projections into the cystic cavities. 15 No known etiology has been identified as a potential cause for the cyst formation, but some authors have theorized that a senile change may play a role in cyst formation. ...
Objectives
This study aimed to understand epidemiological factors associated with feline cystadenomatosis, including signalment and papillomavirus PCR status. Cystadenomatosis is an uncommon condition primarily involving the ceruminous and apocrine skin and ear glands.
Methods
This was a retrospective case series. Clinical records from 2011 to 2019 from a tertiary referral hospital in Boston, MA, USA were screened for cases, and case data were re-evaluated and analyzed. The total patient pool contained 65,385 individual cats, of which 797 were referred to the dermatology service. Medical records and biopsy specimens were reviewed; the information collected included signalment, clinical signs, physical examination and diagnostic tests, comorbidities and histopathologic findings. PCR was performed on biopsy specimens to test for papillomavirus DNA.
Results
The cystadenomatosis population consisted of 57 cases (7.1% of total cases referred to the dermatology service) with 105 affected ears. Twenty-seven cases (48 ears) were confirmed via histopathology; four cats (7%) exhibited clinically cystic lesions on the periocular, periorbital and perianal regions; only one cat did not have pinnal lesions. Domestic shorthair cats were most often affected. Relative risk for cystadenomatosis was 2.24 times higher in male cats. In 48 cats (84.2%), ears were bilaterally affected. Seven cats (12.3%) had malignant neoplasia, which included: inflamed adenocarcinoma (n = 5); mast cell tumor (n = 1); or squamous cell carcinoma (n = 1). PCR testing on biopsy specimens from 24 cats revealed feline papillomavirus type 2 DNA in only four cats.
Conclusions and relevance
Cystadenomatosis was more prevalent in senior non-purebred cats, over-represented in male cats and did not appear to be associated with papillomavirus, feline infectious peritonitis, feline immunodeficiency virus/feline leukemia virus status or other identifiable illnesses. Further studies are needed to investigate the causes of cystadenomatosis.
... Los cambios crónicos favorecen la prolife ración de bacterias y levaduras, las que contri buyen a perpetuar la afección (Scott et al., 2001). Estos generan lesiones secundarias debido a la irritación crónica y a la proliferación excesiva de microorganismos (Jacobson, 2002). ...
... Los animales afectados presentan grados variables de prurito, dolor, mal olor y exudados de diferentes tipos, desde cerumi nosos, en los casos más leves, hasta purulentos, en los casos más graves, generalmente en OEs crónicas y recidivantes. El otohematoma es una complicación que puede aparecer cuando existe prurito intenso asociado (Scott et al., 2001). El desafío diagnóstico más importante consiste en tratar de identificar las causas primarias de la OE (Paterson, 2016a; Paterson & Matyskiewicz, 2018 y determinar claramente cuáles son las causas secundarias y los factores perpetuantes. ...
... Luego, se utilizan antibióticos en la mayoría de los casos inicial mente, aunque pueden ser innecesarios en el man tenimiento y el tratamiento preventivo. Neomi cina, cloranfenicol, polimixina B, ciprofloxacina y gentamicina son, con frecuencia, los antimicro bianos incluidos en los preparados tópicos comer ciales para el tratamiento de este tipo de afección en perros (Scott et al., 2001). ...
La otitis externa es una enfermedad de presentación frecuente en la práctica diaria. La comprensión de su fisiopatología es importante para su prevención, diagnóstico y tratamiento. El protocolo diagnóstico debe ser estricto, siendo fundamental el rol que cumplen en estos casos el cultivo bacteriano y el antibiograma. Pseudomonas aeruginosaes un microorganismo oportunista e invasor, que constituye en sí mismo un factor perpetuante para las otitis crónicas. Además de sus factores de virulencia y la resistencia intrínseca a múltiples fármacos, forma biopelículas de protección sobre tejidos colonizados y posee gran capacidad para adquirir genes determinantes de resistencia cromosómica y extra cromosómica durante el tratamiento. Los casos crónicos o recurrentes con aislamientos de P. aeruginosa resultan un desafío constante para el veterinario. El oído externo tiene escasa irrigación, por lo cual los antimicrobianos sistémicos no alcanzan concentraciones adecuadas, siendo la terapia tópica la primera elección. El éxito terapéutico evoluciona hacia la aplicación de pautas farmacocinéticas/farmacodinámicas, desde una concepción netamente empírica hasta una concepción cuantitativa, permitiendo describir y simular el efecto de un antibiótico sobre una población bacteriana en función del tiempo, mediante la modelización matemática de los datos experimentales, con objeto de maximizar la eficacia y minimizar fenómenos de resistencia.
... Dark granular substance is often will be present in the ear canal of a cat with ear mites, and signs of irritation and itchiness will be evident. This debris, caused by mite waste products, cerumen, dead tissue and fluid, resembles dark coffee grounds like substance (Degiorgis et al., 2001 andScott et al., 2001). The mites can also crawl to other parts of the body and cause itching. ...
... Otodectes cynotis is responsible for up to 50% of the cases of otitis externa seen in practice with an incidence higher than in dogs (Scott et al., 2001). In Egypt, previous report done by Waly and Khallaf (2013) stated that cause of ear inflammation was in 59.21% of cases due to ear mite infestation. ...
... In Egypt, previous report done by Waly and Khallaf (2013) stated that cause of ear inflammation was in 59.21% of cases due to ear mite infestation. The mite feeds on superficial debris and cerumen, irritates the ear canal and may cause hypersensitization (Powell et al., 1980) resulting in erythema, ear scratching and a dark, waxy discharge having the classic ground coffee appearance in both ear canals (Scott et al., 2001). Otoacariosis is treated by cleaning the external ear canal and removing debris and discharge, and by multiple instillation of an otic preparation, that contains an acaricide. ...
... Embora a OL possua etiologia idiopática, há suspeita que sua fisiopatologia possa estar relacionada a distúrbios autoimunes ou ocorrer como hipersensibilidade a trofoalérgenos ou a fármacos (1,3,4,5). Inúmeras raças foram descritas, porém o Pastor Alemão, parece ser predisposto (1,6,7). A idade de ocorrência é variável, tendendo a acometer cães entre um e seis anos de idade e de ambos os sexos (4,6). ...
... De acordo com a literatura, não há descrição de uma onicodistrofia similar a OL em seres humanos, embora estes apresentem várias doenças que transcorrem com onicopatias, tais como lúpus eritematoso discóide e sistêmico, dermatomiosite, eritema multiforme, psoríase e dermatite liquenóide (7). ...
... Nos cães, a OL não demonstra consenso sobre sua etiologia, porém fatores imunológicos ou auto-imunes podem estar correlacionados, já que muitos casos são responsivos à corticoterapia imunossupressora (1,6,7). ...
A Oniquite Lupóide (OL) é uma síndrome que afeta várias unhas e leitos ungueais, conduzindo a onicomadesia, onicodistrofia e onicalgia, sendo a presença de onicorrexis e onicosquizia variáveis. Acredita-se que sua etiologia seja idiopática, porém sua fisiopatologia pode estar correlacionada a dis-túrbios auto-imunes, farmacodérmicos ou a hipersensibilidade a trofoalérgenos. Várias raças já foram descritas como predispostas, sendo cães jovens, de meia idade e adultos mormente acometidos, sem aparente predisposição sexual. O presente estudo descreve um caso de OL isolada em uma cadela da raça Yorkshire Terrier, de 12 anos de idade, a qual apresentava um excessivo crescimento da unha do quarto dígito do membro pélvico esquerdo, onicalgia e claudicação com evolução de seis meses. Abstract Lupoid Onychitis is a syndrome that affects several nails and nail beds, leading to onychomadesis, onychodystrophy and onicalgia, and the presence of onychorrhexis and onychoschizia are variables. It is believed that the etiology is idiopathic, but its pathophysiology may be correlated with autoim-mune disorders, pharmacodermias or hypersensitivity to drugs or food allergens. Several races have been described, with young, adult and middle-aged dog´s particularly affected, with no apparent sex predisposition. This study describes a case of isolated Lupoid Onychitis in a dog Yorkshire Terrier, 12 years of age, who presented an excessive growth of the nail of the fourth digit of the left pelvic limb, pain and lameness with the evolution of six months.
... As suas dimensões variam, tendo em cães normalmente 5 a 10 cm de comprimento e 4 a 5 mm de largura (Gotthelf, 2005a), com um lúmen de 0,5 a 1 cm de diâmetro. No entanto, os cães da raça Shar-pei têm um canal auricular de menor diâmetro relativamente a outras raças caninas, especialmente o canal vertical (Scott, Muller, & Griffin, 2001). Já o canal horizontal de algumas raças (e.g., Bulldog Inglês, Pug) e de alguns indivíduos de determinadas raças (e.g., Chow Chow) pode ser mais estreito, ou pelo contrário (e.g., Basset Hound) muito longo (Rosychuk, 2005). ...
... Num ouvido normal a única comunicação do ouvido médio com o ambiente exterior é através da tuba auditiva (Scott et al, 2001), um curto canal que se estende desde a nasofaringe até à cavidade timpânica propriamente dita (Cole, 2009), cuja função é igualar a pressão em ambos os lados da membrana timpânica (Heine, 2004), prevenindo assim a sua ruptura (Tartaglia & Waugh, 2005). ...
... Muitos parasitas têm sido associados a otite externa (Scott et al., 2001), contudo o parasita ...
... In domesticated dogs otitis externa is very common and is estimated to occur in 10% -20% of dogs. The most common microorganisms isolated from the ears include the bacteria, Staphylococcus intermedius (now reclassified as Staphylococcus pseudintermedius), Pseudomonas aeruginosa, and-Proteus species, and yeasts such as Malassezia pachydermatis [2][3][4][5]. Most of the microorganisms isolated from inflamed ears are found in smaller numbers in normal ears [5][6][7][8][9]. ...
... The most common microorganisms isolated from the ears include the bacteria, Staphylococcus intermedius (now reclassified as Staphylococcus pseudintermedius), Pseudomonas aeruginosa, and-Proteus species, and yeasts such as Malassezia pachydermatis [2][3][4][5]. Most of the microorganisms isolated from inflamed ears are found in smaller numbers in normal ears [5][6][7][8][9]. In the dog, primary causes and predisposing factors, such as allergies, keratinization disorders and anatomical abnormalities, create suitable conditions for the proliferation of microorganisms [9,10]. ...
... A total of 98 ear canal samples were taken similarly to the jackals. Dogs from breeds with known anatomical features that predispose them to otitis externa were excluded from the study [5,9,11,12]. Most of the dogs were mix breeds and stray dogs. ...
... Otitis externa is a very common presenting complaint in dogs that has a complex and multifactorial aetiology. 1 The causes of otitis externa are conventionally classified as: predisposing factors that bias an individual to ear disease; primary factors that trigger the otitis; and perpetuating factors that exacerbate the disease and prevent resolution. Bacterial and yeast infections are particularly important perpetuating factors as they quickly complicate most cases of otitis in dogs. ...
... Bacterial and yeast infections are particularly important perpetuating factors as they quickly complicate most cases of otitis in dogs. 1,2 The dominant pathogens in canine otitis externa are Staphylococcus intermedius, Pseudomonas aeruginosa and Malassezia pachydermatis. 2,3 Staphylococcus intermedius and M. pachydermatis are part of the normal canine mucocutaneous flora and can be isolated from healthy ears. ...
... Pseudomonas aeruginosa is not regarded as a commensal and has not been isolated on culture or cytology from healthy ears. 1,[4][5][6] It is often difficult to eliminate as there are many multidrug resistant P. aeruginosa isolates. 2,3 Ear cleaning is frequently performed to maintain a normal otic environment, both to help treat otitis externa and to prevent recurrence in dogs prone to otitis. ...
The aim of this study was to compare the antimicrobial efficacy of ear cleaners against Staphylococcus intermedius, Pseudomonas aeruginosa and Malassezia pachydermatis. Single isolates of each organism were incubated in duplicate at 38 degrees C for 30 min with each ear cleaner diluted 1/2 to 1/256 in phosphate-buffered saline. Positive and negative controls were included. Aliquots were then incubated for 16-18 h on sheep blood agar (bacteria) or for 3 days on Sabouraud's dextrose agar (Malassezia) at 38 degrees C. The lowest dilutions exhibiting 100% antimicrobial efficacy for S. intermedius were: Cleanaural Dog 1/32; Sancerum 1/16; Otoclean 1/4; EpiOtic 1/2; MalAcetic 1/2; and Triz Plus 1/2. The results for P. aeruginosa were Sancerum and Triz Plus 1/16; Cleanaural Dog and EpiOtic 1/8; Otoclean 1/4; and MalAcetic 1/2. Results for M. pachydermatis were: Cleanaural Dog 1/32; Sancerum, Otoclean, EpiOtic and Triz Plus 1/8; and MalAcetic 1/4. Cleanaural Cat, MalAcetic HC and Triz EDTA did not display any antimicrobial activity at any dilution. Antimicrobial activity appeared to be associated with the presence of isopropyl alcohol, parachlorometaxylenol and a low pH. The results of this study may help clinicians make evidence-based decisions when selecting ear cleaners for use in individual cases.
... Bununla birlikte kulak kanalı içerisinin nemli olması, kılların yolunması sırasında kanalın irrite edilmesi, immun yetersizlik ve endokrin dengesizlikler gibi nedenler de sayılabilmektedir. [8][9][10] Sarkık kulaklara veya uzun kıllarla kaplı kulak kanallarına sahip köpeklerin hepsinin otitis olmadığını ve bunun aksine dik kulaklı bazı ırkların da (Alman kurdu) kulak problemlerine yatkın olduğunu belirtmek gerekir. Otitis eksternada etkili bir tedavi uygulayabilmek için hazırlayıcı nedenler araştırılmalı ve ortadan kaldırmak için gerekli önlemler alınmalıdır. 1 ...
... Eğer zamanında teşhis ve tedavi edilmezse bu vakalar hızla sekonder bir bakteriyel otitis eksterna gelişmesine sebep olur ve prulent bir exudat ortaya çıkar. 9 TRAVMA Dış kulak yoluna isabet eden travmalar sonucu karşılaşılan otitis eksternaya ender olarak rastlanmaktadır. Çoğu ...
Otitis externa, inflammation of the externa ear canal, is relatively easy to diagnose based on the history and physical examination findings. The pathogenesis of otitis externa has been classified into redisposing, primary, and perpetuating factors. It is critical to the management of ear disease that the clinician recognize and investigate which factors are contributing to each individual
patient's ear disease. Failure to identify of the primary and/or predisposing factors is the most common cause of chronic recurrent otitis externa. Chronic inflammation of the ear canal leads
to the development of the perpetuating factors, which may be the major reason for treatment failure, regardless of the primary cause of the ear disease. In this article, it is aimed to give information
about the causes and diagnosis of otitis externa.
... Se as recidivas forem frequentes os champôs ou a medicação oral administrada de forma pulsátil, podem ser usadas profilacticamente (Nuttall, 2003;Chen & Hill, 2005;Prélaud, 2005 (Pellerin, Bourdeau, Sebbag & Person, 1998;Scott, 2001b;Bensignor, 2003;Noli, 2003;Hauschild & Wójcik, 2007 (Duquette & Nuttall, 2004;Guardabassi et al., 2004a). ...
... Na literatura vem descrito que o S. intermedius é a bactéria patogénica mais frequentemente isolada nas otites externas dos animais de companhia (Scott, 2001b;Bensignor, 2003). Bensignor e Legeay (2000) apontam o S. intermedius, a P. aeruginosa e o P. mirabilis como os isolados mais comuns em cães com otite externa num estudo realizado em França e outros autores apontam as mesmas bactérias como estando frequentemente implicadas, mas acrescentam a E. coli e relembram que estas espécies bacterianas podem ser ocasionalmente isoladas em animais saudáveis (Hariharan, Coles, Poole, Lund & Page, 2006). ...
... It is generally recognized that many chronic changes of otitis media can be identified radiographically, but normal radiographic findings do not exclude middle ear disease. 10 As expected, CT provided superior detail in comparison to radiography and revealed MpEs in 5 ears that were radiographically normaleven very small MpEs located in the ventral TB or in the epitympanic cavity, a presentation not reported in the dog. Thus, it has to be considered that in living lions without the use of CT imaging, MpEs may remain undetected. ...
... In dogs, only extension from otitis externa is considered a common cause of otitis media, but in cats, upper respiratory infections are known causes of otitis media. 10 Recently, it has been estimated that 31.8% of cats presenting with signs of respiratory disease had severe disease in the ears, whereas in cats without clinical respiratory signs, this proportion was significantly lower (5.2%). Respiratory infections appear to be one major cause of otitis media in cats. ...
... Otitis externa (OE) is a common problem in dogs, estimated to occur in 10 to 20% of canine patients seen by veterinarians (Scott 2001a). The most common primary causes of OE are allergies such as atopic dermatitis and adverse food reactions. ...
... Malassezia was frequently found in chronic cases of OE (Bernard and others 1998, Cafarchia and others 2005). However, rods are more commonly associated with more chronic and severe cases of OE (Kiss and others 1997, Scott 2001a). In this study, the highest levels of rods were found in endocrinopathies suggesting a more severe otitis due to this primary cause. ...
To determine whether associations exist between pathogens, allergies, conformational abnormalities, endocrinopathies and signalment in canine otitis externa (OE).
Medical records of 149 dogs which met predetermined inclusion criteria were evaluated retrospectively. Correlations between pathogens and the presence of allergy, endocrinopathy, conformational abnormalities and signalment were evaluated statistically.
The shar-pei, German shepherd and cocker spaniel breeds were over-represented compared with the hospital's breed distribution (P<0·001). German shepherd dogs and cocker spaniels were statistically more prone to infection with rod-shaped organisms and Labrador retrievers less than other breeds (P=0·034). Almost all dogs that were older than five years when diagnosed with OE had cocci (P=0·01) and also had higher levels of rods (P=0·028). The incidence of rods was higher in endocrinopathies (P=0·004), while that of Malassezia spp. tended to be higher in allergies (P=0·098). There were no statistically significant differences among the groups for all the other parameters examined.
OE infection is usually not influenced by primary causes or predisposing factors. Endocrinopathies may be followed by a more severe otitis, however. OE may be more severe when it affects older dogs.
... O tratamento para otopatias geralmente é tópico e, em alguns casos, cirúrgico, visto que independentemente da etiologia, é indicada a limpeza do canal auditivo com ceruminolítico, antecedendo, geralmente, a aplicação de preparados polifarmacêuticos tópicos associados ou não à terapia sistêmica (SCOTT, 2001.;LUCAS et al., 2016). ...
... Otitis externa is defined as an acute or chronic inflammation of the epithelium of the external ear canal which may also involve the pinna. Otitis externa is one of the most common and multifactorial disorders accounting for up to 10-20 % of consultations in canine practice (Scott et al., 2001). In otitis, the clinical signs are head shaking, pruritus, foul-smelling discharge, pain, and reddening of the ear mucosa (Cole, 2004). ...
The objective of this study was to compare the therapeutic efficacy of three different ear cleansers in 30 dogs of various breeds suffering from otitis. Based on history and clinical signs, ear exudates were collected by aseptic cotton swab for isolation and identification of organisms. The cerumen deposition in-ear canal was cleared using one of the ear preparations, viz., ear cleanser-I (0.2 % salicylic acid and 0.3 % phenoxyethanol) ear cleanser - II (chlorhexidine, propylene glycol and tris–EDTA) or ear cleanser-III (2% para-dichlorobenzene, benzocaine 2.7%, chlorbutol 5% and turpentine oil 15 %). Systemic/local antibiotics were used as per sensitivity testing. The treatment protocol found effective in the management of ear infections included cleaning the ear debris using ceruminolytic preparations/ear wax dissolvent, viz, ear drop. Ear cleanser-III showed excellent results (100%) in ceruminous as well as bacterial otitis with subsequent instillation of ear preparations containing antibacterial drug(s) and antifungal agents compared to cleanser-II (90%) and cleanser-I (70%).
... Canine otitis externa is one of the most frequent canine infections, and is estimated to affect 10% to 20% of the dogs ( Scott et al., 2001). It commonly occurs as a secondary complication of primary factors that initiate inflammation within ears such as atopic dermatitis, cutaneous adverse reactions to food, foreign bodies, ectoparasites, metabolic diseases, keratinization abnormalities, and autoimmune diseases ( Mize and Rosser, 2004). ...
... Os sinais clínicos observados neste animal foram similares aos diagnosticados em outras espécies, com comportamento clínico típico de pacientes com processo patológico de otite bacteriana (Scott et al., 2001;Rosser Jr, 2004), neste sentido Alés (2001) e Angus & Campbell (2001), ressaltam que qualquer sintoma de otite externa ou média, tais como sacudir a cabeça, prurido, secreção no conduto auditivo externo e síndrome neurológica (ataxia, perda de equilíbrio ou outro sintoma compatível com síndrome vestibular), justificam a avaliação sistêmica do animal através do histórico, exame clínico geral, citologia, cultura e antibiograma, bem como, a biópsia, em casos recorrentes e severos (Jacobson, 2002). ...
Otitis externa is among the most prevalent diseases in dogs. If the underlying cause is not addressed, bacterial reinfection becomes frequent, necessitating antibiotic administration for an extended period of time. Prolonged treatment promotes the emergence of antibiotic-resistant bacteria and increases the risk of their transmission from animals to humans. This study aimed to analyze the antibiotic resistance pattern of the emerging pathogen Proteus mirabilis to identify bacterial virulence and antibiotic selection. Samples were collected from randomly encountered dogs with chronic otitis externa. Thirty-two strains of P. mirabilis were isolated and identified, using MALDI-TOF. The Kirby-Bauer disk diffusion method was used to assess the antibiotic susceptibility of P. mirabilis to 11 antibiotics. The isolates (n = 32) were most resistant to cefazolin (75%), trimethoprim–sulfamethoxazole (72%), chloramphenicol (72%), amoxicillin–clavulanate (63%), ampicillin (59%), cefepime (56%), ciprofloxacin (53%), aztreonam (50%), ceftazidime avibactam (50%), gentamicin (22%), and amikacin (16%). Moreover, 75% of isolates were found to be multidrug-resistant bacteria. P. mirabilis was found to have a high resistance-pattern ratio. Although the exact cause is unknown, continuous antibiotic use is thought to be a major factor. We concluded that antibiotic use must be prudent and selective to prevent antibiotic resistance.
Erythemato-ceruminous otitis externa (ECOE) is the most common type of otitis in dogs and is generally associated with bacterial and/or yeast infections. The performance of an ear cleaner was assessed over two weeks in canine ECOE, associated with a mild or moderate secondary infection, in a prospective open-label study. Forty ear canals with ECOE that did not receive any type of aural treatment and were not cleaned for 7 days were included. Pruritus (PS), 0–3 Otitis Index Score (OTIS-3) and 0–4 scale cytology (CYTO) scores were assessed on Day (D) 0, D7 and D14. Concentrations of a panel of 13 cytokines on the ear canal surface and the lipid profile of the exudate were measured on D0 and D14. From D0 to D12 or D13, the dogs’ ears were cleaned daily if the secretion score (SEC) was 3/3, every second day if the score was 2/3 and every third day if the score was 1/3. PS, OTIS-3, SEC and CYTO were significantly lower on D7 compared to baseline (−40%, −31%, −36%, −34%, respectively; p < 0.0001). The same parameters decreased further on D14 (−60%, −53%, −61%, −73%, respectively; p < 0.0001) and amounts of interleukin 8 and chemokine KC-like were also reduced compared to baseline (−45%, p < 0.01; −36%, p = 0.3, respectively). The lipid profile was also modified, with a decrease in free lipids and an increase in bound lipids.
American Cocker Spaniels (ACSs) develop aural ceruminous gland hyperplasia and ectasia more often than dogs of other breeds. Data on the cause and development of these breed characteristic histopathological changes are lacking. We performed video-otoscopic examinations and dermatological work-up on 28 ACSs, obtained aural biopsies from each dog and assessed the statistical associations between the presence of ceruminous gland hyperplasia and ectasia and disease history, clinical or microbiological findings and underlying cause of otitis externa (OE). Histological lesions of ceruminous gland hyperplasia and ectasia were observed in aural biopsies from 6/13 clinically healthy ears and 13/15 ears with OE from 19/28 examined dogs. Nine of 28 dogs had histologically normal ceruminous glands (odds ratio [OR] 6.2, 95% confidence interval [CI] 1.1–36.6). Bacterial growth in microbiological culture of aural exudate (OR 14.1, 95% CI 2.1–95.3) was associated with ceruminous glandular changes, whereas previous history of OE, cutaneous findings or underlying allergies were not. Pedigree analysis and a genome-wide association study (GWAS) were performed on 18 affected and eight unaffected dogs based on histopathological diagnosis. While the GWAS indicated a tentative, but not statistically significant, association of ceruminous gland hyperplasia and ectasia with chromosome 31, a larger cohort is needed to confirm this preliminary result. Based on our results, ceruminous gland hyperplasia and ectasia may also precede clinical signs of OE in ACSs and a genetic aetiological component is likely Further studies with larger cohorts are warranted to verify our preliminary results.
Objective:
To characterize the clinical features, treatment, and outcome of aural hematomas in horses.
Animals:
7 horses with 1 or 2 aural hematomas (8 ears in total) treated at a veterinary teaching hospital in 2008 through 2019.
Procedures:
Data retrieved from medical records included signalment, pertinent historical information, clinical signs, diagnostic procedures (including dermatologic assessment), and treatments. Case outcome was determined from documentation in the medical record or via telephone communication with owners or referring veterinarians.
Results:
3 horses were presented after recurrence of aural hematoma following treatment by the referring veterinarian. Four horses had a history of allergic skin disease prior to aural hematoma development. Most (6/7) horses were unilaterally affected. Diagnostic assessments included otoscopic evaluation (3 horses), ultrasonography (3 horses), cytologic examination of ear canal swab samples (3 horses), and histologic examination of a pinnal biopsy specimen (1 horse). Of the 8 pinnae, 2 were treated by nonsurgical needle drainage (1 with concurrent corticosteroid injection) and the remaining 6 underwent surgical incision and placement of compressive sutures. Follow-up information was available for 6 horses, and all affected pinnae were fibrotic with 4 horses having permanent drooping of the pinna. One horse developed a hematoma in the contralateral pinna 1 year after hospital discharge.
Conclusions and clinical relevance:
Equine aural hematoma is a rare condition. The main principle of treatment is drainage, and treatment options commonly used in small animal practice can be successfully applied in horses. Permanent changes in the cosmetic appearance of the pinna are likely to develop owing to secondary fibrosis.
Myringotomy is a well-accepted method for diagnosing and treating otitis media in dogs having an intact tympanic membrane. In a recent study, the contamination rate of middle ear aspirates from the external ear canal via myringotomy was 67%. To evaluate the iatrogenic contamination rate of the middle ear aspirates by material from the ear canal, using a novel technique: Vertical access to the tympanic membrane from beneath the patient. Thirty-six ears from 20 canine Fresh cadavers with a CT scan negative for otitis externa and otitis media were video-otoscopically flushed with the ear upside. The instillation of the fluorescent dye into the ear canal and immediate retrieval were performed. With the patient positioned on a custom-made fenestrated table plate, a modified video-otoscopically guided myringotomy approaching the tympanum vertically from underneath, was performed. Contamination rates were assessed by the visual detection of fluorescent dye within the aspirated fluid, either by yellow staining solely, or a positive fluorescence test. Cytology and microbial cultivation were accomplished.
Middle ear sample contamination by the material from the ear canal was identified in 2 of 36 (5.55%) ears. Neither a change in colour nor fluorescence was detected in 34 of 36 (94.44%) middle ear samples. Sixteen of 36 (44.44%) external ear canal samples and 4 of 36 (11.11%) middle ear aspirates had positive bacterial culture. This novel technique is a promising method for middle ear material collection in patients with concurrent otitis externa.
The Malassezia genus is represented by several lipophilic yeasts, normally present on the skin of many warm-blooded vertebrates, including humans. The aim of this study was to investigate the occurrence of Malassezia yeasts in dogs with skin lesions (dermatitis, interdigital dermatitis and inflammation of anal sacs) and otitis externa. The presence of Malassezia spp. was investigated in a group of 300 dogs exhibiting clinical manifestations. The isolates of Malassezia were identified by using phenotypic (biochemical-physiological and morphological characteristics) and genotypic methods (PCR, RFLP-AluI, BanI and MspA1I) which allowed their precise identification. Malassezia yeasts were isolated from 84 specimens obtained from 76 positive dogs. M. pachydermatis was the most frequently isolated species (79 isolates) in this study. M. furfur was identified in four dogs and M. nana in one dog. The prevalence of isolated Malassezia spp. was 25.3 % in dogs with skin lesions; from which 36.0 % were dogs suffering from otitis externa, 24.5 % from dogs having dermatitis, 16.4 % from dogs with interdigital dermatitis and 14.3 % from dogs having inflammation of the anal sacs. A higher prevalence of Malassezia spp. was observed in animals with pendulous ears in comparison with dogs having erect ears.
Deafness in dogs and cats is infrequently observed, diagnosed or researched. Disorders of auditory function can occur in various forms with different degrees of severity. Disorders are defined by five criteria: the determinism, the time of occurrence in the life of the animal, the severity, and the level of anatomo-functional of the auditory system affected. The causes of deafness are variable. The two main causes of deafness are congenital abnormalities, usually inherited, and old age (presbyacusia). Other causes include vascular, inflammatory and/or infectious, toxic or traumatic, metabolic, idiopathic and neoplasm. The etiological diagnosis is often difficult to establish. Currently there is no treatment for this condition in veterinary medicine.
Chronic ear disease represents a difficult and challenging syndrome that most small animal practitioners face. The management of these cases often requires a multifaceted and persistent approach for successful resolution and longer-term control. The goal of this case-based discussion is to help lead practitioners in a logical and systematic approach that will hopefully aid in more successful management of these chronic and often frustrating cases.
To evaluate the effectiveness of an otic suspension containing polymyxin B, miconazole, and prednisolone (Surolan® otic suspension) in the treatment of canine otitis externa, clinical cases were recruited from veterinary practices at four geographic sites in the United States and Canada, and randomly assigned to either the test product or a positive control product containing gentamicin, clotrimazole, and betamethasone. Before and after treatment, cases were scored on four clinical parameters pain/ discomfort, erythema, swelling, and exu-dates. Ear swabs were taken for bacterial and yeast culture and susceptibility testing. The vast majority of all otitis externa cases in this study exhibited clinical improvement of the inflammatory signs in the ear, with 97% of cases given the test product and 95% of the cases treated with the positive control product improving clinically. Non-inferiority of the test product compared to the positive control product in the treatment of canine otitis externa was shown for each of the four clinical parameters and for the total clinical score. The most frequently cultured pathogenic organisms were Gram-positives, with 56% of dogs harboring isolates identified as Staphylococcus spp, 17% Streptococcus spp, 44% infections with the yeast M. pachydermatis and 12.5% cases infected with the Gram-negative Pseudomonas spp. Susceptibility testing demonstrated a high susceptibility of all these microorganisms to the active constituents of the test product. Results show that the combination of polymyxin, miconazole, and prednisolone is a good choice for first line treatment of otitis externa in dogs.
BACKGROUND: Fungal agents are considered as one of the most prevalent organisms in external otitis. OBJECTIVES: The aim of this study was to compare the fungal flora of external ear canal and concave surface of auricle in healthy Persian and Domestic Short Hair (DSH) cats. METHODS: Samples were collected from 120 healthy cats (60 Persians and 60 DSH) with swab and cellophane tape. RESULTS: Out of 103 (85.8%) organisms isolated from cats, 83 (80.6%) were identified as molds. infection with Dermatophytes were detected in 3 (5%) samples. Yeasts were also present in 20 (19.4%) cats. Based on the results of this study there wasn't any significant difference in fungal flora of the ear canal between Persian and DSH cats. CONCLUSIONS: Ear canal and pinna in most of healthy cats harbor fungal filamentous and yeast organisms that maybe pathogenic in suitable conditions. Furthermore dermatophyte organisms in apparently healthy cats can be transmitted to their owners.
Fifty-four dogs with otitis externa were enrolled in the study for the Evaluation of efficacy of a Hydrocortisone aceponate - Gentamicin - Miconazole otic combination (Easotic®, Virbac, Carros, France). Otitis externa patients were treated by Easotic® once daily for 5 days and 2 days off treatment and evaluated on 7th day. If otitis extema persisted, additional Easotic® treatment was administered once daily for 5 days and rested 2 days and reevaluated on 14lh day. For the evaluation of efficacy of Easotic®, eight clinical signs were scored on a severity scale and infectious agents from ear sample were also graded using semi-quantitative scale at each visit. Sum of clinical scores and cytological scores was defined as Global Clinical Score. When Easotic® was applied once daily for 5 days, global clinical score was reduced 76.0%. When Easotic® was administered for 10 days, during first 5 days administration, 46.6% reduction of global clinical score was detected. During additional 5 days administration, 82.2% reduction of global clinical score was observed compared with Day 0. Any relevant adverse effect was not reported during the study in all cases. Thus, Easotic® treatment once daily for 5 days and 10 days appears to be effective and safe treatment for canine otitis extema.
Morphological studies comparing normal and diseased ear canals use primarily subjective scoring. The aim of this study was to compare normal and severely affected ears in dogs with objective measurements using ImageJ software. Ear canals were harvested from cadavers with normal ears and from dogs that underwent total ear canal ablation for unresolved otitis. Histopathology samples from ear canals were evaluated by semi-quantitative scoring and also by using ImageJ-software for histomorphometric measurements. The normal ears were compared to the severely affected ears using the 2 methods. The 2 methods were significantly (P < 0.0001) correlated for epidermal hyperplasia, ceruminous gland dilation, and hyperplasia and tissue inflammation, which were significantly greater in the severely affected ears (P < 0.0001). This study demonstrated that there is a very high correlation between the 2 methods for the most markedly affected components of otitis externa and that ImageJ software can be efficiently used to measure and evaluate ear canal histomorphometry. © 2015, Canadian Veterinary Medical Association. All rights reserved.
Ear mites are a common problem in animals and frequently seen in companion animal practice. Otodectes cynotis is the best known ear mite, but is not the only one. Mites from the demodecidae and sarcoptidae family can also be found in the ear canal. Clinical signs of ear mites include excessive scratching of the ear, head shaking and dark brown crumbly wax. Transmission can occur by direct contact and also via fomites. Successful treatment of ear mites requires mechanical cleaning of the ear canal, topical and systemic treatment, and also cleaning of all the material that has been in contact with the mites, for example grooming tools, bedding materials and transport cages.
Mucoperiosteal exostoses (MpEs) of the tympanic bulla (TB), also referred as middle-ear otoliths, have been occasionally described in dogs and cats in association with clinical signs of otitis media or as an incidental finding, but they have not been recorded in other species. In this report, we describe the radiographic, gross, and histopathologic features of MpEs in 8 African lions (Panthera leo). All animals (5 males and 3 females) were adults that had been kept in captivity and had their skeletons conserved as part of an anatomic academic collection. A radiographic study revealed mineralized structures in the TB consistent with MpEs in 7 of the 16 examined TB; a computed tomography study identified MpEs in 12 of the 16 TB. Six TB from 4 lions were sectioned, and several MpEs were demineralized for histopathologic analysis. Grossly, MpEs appeared variable in number and shape. Some were globular structures that were loosely attached to the mucosal surface of the TB; others were isolated to coalescent bone spicules extending from the mucoperiosteum. Position was also variable, but MpEs frequently developed in the hypotympanum, especially on the ventromedial aspect of the TB wall. Microscopically, MpEs were composed of osteonal bone growing from the periosteum and not by dystrophic calcification of necrotic tissue debris, as is hypothesized in dogs.
Feline otitis externa is a dermatological disorder that has not been evaluated much in stray cats. One hundred and eighty-seven stray cats were randomly selected during a trap-neuter-release programme to investigate the prevalence of otitis externa in stray cat colonies in northern Italy. Swabs for cytological examination were obtained from the external ear canal of each cat. A direct otoscopic assessment of the external ear canal was made in 86/187 cats. Cytological evidence of otitis externa was present in 55.1% of cats. The influence on otitis of age, gender, habitat and season of sampling were tested, but no risk factors were found. Otodectes cynotis (as a sole agent or in combination) was the primary cause of otitis in 53.3% of cats. Cocci and rods, either alone or in combination with other agents, were perpetuating factors in 71.8% and 29.1% of cats, respectively. Pregnancy status was a risk factor for otitis caused by coccal infections. Malassezia species, alone or in combination, was the perpetuating factor in 50.5% of cats with otitis. Urban habitat and winter season were risk factors for otitis associated with Malassezia species. Demodex cati was identified as an incidental finding in two cats. There was good agreement between otoscopy and cytology with regard to the diagnosis of otitis externa. The results of this study show a high prevalence of otitis externa in stray colony cats and provide information on causal factors for feline otitis externa.
EAR disease is common in small animal practice. Otitis can be associated with many conditions and is often frustrating to manage. Failure to address the underlying factors or select the appropriate medical therapy is likely to result in chronic changes that become irreversible with time and may require surgery. This article reviews the investigation and medical treatment of otitis and discusses when surgery is indicated
To investigate the in vitro efficacy of commercially available topical otic preparations ("ear cleaners") against Pseudomonas spp. isolated from canine ear infections.
Between January and May 2011, 50 isolates that were morphologically and phenotypically confirmed as Pseudomonas spp. were isolated from 48 dogs that had been identified with clinical signs of otitis externa and media at a referral dermatology clinic in the north west of the UK. The in vitro efficacy of eight different topical preparations against these isolates was investigated using an in-agar inhibition test.
Of the eight preparations tested, three showed consistently good in vitro activity against Pseudomonas spp., while a further three were consistently ineffective. For the remaining two -preparations, in vitro efficacy was variable and inconsistent.
Topical treatment with ear cleaners is considered to be a valuable adjunct in the treatment of canine otitis that involves multi-antimicrobial-resistant organisms such as Pseudomonas spp. Where treatment with antimicrobials is not an option, the use of these preparations, as a sole form of therapy, may be effective in some cases. As a comparison with other similar studies looking at the activity of ear cleaners against bacterial isolates from otitis, this study uses isolates from 50 ears from 48 dogs providing a significant number of isolates for analysis.
Granulomatous sebaceous adenitis (GSA) is uncommon in dogs; however, certain breed predilections exist. In this report, three cases of GSA in unrelated vizslas have been described. All cases initially presented with episodes of otitis externa followed by severe inner pinnal lesions. In one case, multifocal coalescing inner pinnal ulceration appeared 4 wk prior to the occurrence of the skin lesions. The other two cases presented with simultaneous pinnal and skin lesions following episodes of bilateral otitis. The pinnae were diffusely erythematous and had multiple coalescing erosions and ulcers. The body lesions consisted of multifocal alopecia, papules, and fine scales. Biopsies of the skin and pinnae confirmed GSA. Two dogs responded to treatment with synthetic retinoids and cyclosporin A, respectively. One dog was not treated, and the owners preferred euthanasia when the ear lesions recurred and did not respond to glucocorticoids. To the best of the authors' knowledge, GSA with multifocal coalescing ulcerative pinnal lesions has not previously been reported.
This study assessed the in vitro and in vivo activity of an ear solution containing a third-generation chelating agent (Tricide (R)) as an antimicrobial potentiator for miconazole in chronic Malassezia otitis. Thirty-one ears from 20 dogs were enrolled in the study. Fungal culture, minimum inhibitory concentration (MIC), and minimum fungicidal concentration (MFC) testing of miconazole with and without Tricide (R) were performed on all ears. In a randomized, controlled, and blinded treatment trial the ears were treated either with 0.9% saline solution containing 0.01% miconazole, 0.03% dexamethasone and 540 mu g/mL Tricide (R) or the same solution without Tricide (R). Cytologic and auroscopic examinations were conducted on day 0, 14 and 28 and evaluated for number of yeast organisms, degree of erythema, hyperplasia and amount of discharge. The in vitro data was compared with Wilcoxon signed-rank test. The cytologic and auroscopic scores were compared between the visits and treatment groups at day 0, 14 and 28 using a Wilcoxon-Mann-Whitney test and repeated measures analysis. MIC and MFC were significantly (P < 0.0001) reduced when miconazole was combined with the chelating agent versus miconazole alone. The cytologic scores were significantly lower on days 14 (P = 0.0156) and 28 (P = 0.0280) for the group treated with Tricide (R). The auroscopic scores decreased significantly by the end of the trial compared to day 0, but the difference between the two groups was not significant. This study suggests that Tricide (R) enhances in vitro activity and in vivo efficacy against Malassezia sp. in dogs with yeast otitis.
The Clinical and Laboratory Standards Institute published in 2008 new interpretive criteria for the identification of methicillin resistance in staphylococci isolated from animals. The sensitivity of the 2008 interpretive criteria for mecA gene-positive Staphylococcus pseudintermedius, compared with the previous criteria of 2004, was investigated. Thirty clinical isolates of methicillin-resistant S. pseudintermedius from dogs were used. The presence of the mecA gene was determined by polymerase chain reaction. The minimum inhibitory concentration for oxacillin was determined by broth microdilution. The 2008 breakpoint of >or=4 microg/ml for methicillin resistance resulted in a diagnostic sensitivity of 73.3% (22/30). The 2004 breakpoint guideline of >or=0.5 microg/ml resulted in a diagnostic sensitivity of 97% (29/30). For oxacillin disk diffusion, the 2008 interpretive criterion of <or=10 mm for methicillin resistance resulted in a sensitivity of 70% (21/30). If intermediate isolates (11 or 12 mm) were considered resistant, the sensitivity was 93% (28/30). If intermediate isolates (11 or 12 mm) were considered resistant, the sensitivity was 93% (28/30). Application of the 2004 interpretive criterion of <or=17 mm resulted in a diagnostic sensitivity of 100% (30/30). For cefoxitin disk diffusion, the interpretive criterion of <or=21 mm for methicillin resistance (as used for Staphylococcus aureus) resulted in a diagnostic sensitivity of 6.7% (2/30). The interpretive criterion of <or=24 mm (as used for coagulase-negative staphylococci) resulted in a diagnostic sensitivity of 43.3% (13/30). With the use of 2008 interpretive criteria, all 3 tests produced what we consider to be an unacceptable level of false negative results. Our findings also suggest that cefoxitin disk diffusion is an inappropriate screening test for methicillin resistance of canine S. pseudintermedius.
Dexamethasone 0.1% in propylene glycol vehicle has been shown to cause adrenal suppression and increased liver enzyme concentrations in normal dogs. The objectives of this study were to determine if these effects are concentration or vehicle dependent and to evaluate a dexamethasone 0.01% solution. Twenty-one privately owned normal dogs were included in this double-blinded study. Chemistry panels and adrenocorticotropin hormone (ACTH) stimulation tests were performed on day 0 and 15. Dogs were randomly assigned treatment with dexamethasone 0.01% in saline, 0.1% in saline, or 0.1% in a commercial preparation (Tresaderm: Merial, Duluth, GA, USA) in each ear twice daily for 2 weeks. Nineteen dogs completed the study. After 2 weeks of treatment, all dogs receiving dexamethasone 0.01% in saline had normal ACTH stimulation tests and liver enzyme values. In contrast, four of seven dogs (57.14%) receiving dexamethasone 0.1% in saline experienced adrenal suppression, and four of six dogs (66.67%) receiving Tresaderm experienced adrenal suppression with three of those dogs (50%) experiencing marked adrenal suppression. No dogs receiving dexamethasone 0.1% in saline had increased liver enzyme concentration, while one of six dogs (16.67%) experienced a slight elevation in alkaline phosphatase. In conclusion, it appears that adrenal suppression caused by otic dexamethasone is concentration and perhaps vehicle dependent. Veterinarians who formulate dexamethasone 0.1% otic solutions should be cognizant of potential adrenal suppression similar to that seen with Tresaderm although not to the same degree. Dexamethasone at 0.01% did not cause adrenal suppression or liver enzyme alterations after 2 weeks of treatment.
The diagnostic workup for canine claw disease consists of a good history and complete clinical examination which may provide clues for a possible underlying disorder. In dogs with claw disease but no other clinical or historical signs, further recommended diagnostic procedures include cytological evaluation of impression smears or discharge from the claw fold, bacterial culture and sensitivity testing, biopsy of the claw matrix, and an elimination diet for 6 to 8 weeks. If no underlying disease can be identified, trial treatment with essential fatty acid supplementation, vitamin E, or a combination of doxycycline hydrochloride and niacinamide may be useful. In some patients, onychectomy of all claws may be considered.
Acute and chronic otitis externa and otitis media are common disorders in dogs and cats. In combination with other diagnostic and therapeutic procedures, the video-otoscope is a useful and effective tool in the management of clinical cases. The enhanced illumination and magnification provide the practitioner with more detailed information for diagnosis and prognosis, and the configuration of the working channel facilitates sampling, improves efficacy of cleaning procedures, and decreases risks of iatrogenic injury to structures of the middle and inner ear. Photographic documentation of clinical cases enhances the medical record, communication with colleagues, and client education. Although video-otoscopy facilitates diagnosis and therapy, it does not replace other important diagnostic tests such as evaluation for atopy, adverse food reactions, and immune-compromising disease. Failure to identify the underlying primary cause usually results in treatment failure regardless of the technology employed.
The efficacy of a novel avermectin, selamectin (Stronghold, Pfizer), was evaluated against naturally acquired aural infestations of Otodectes cynotis. Selamectin was administered topically in a single spot to the skin of each animal's back at the base of the neck in front of the scapulae at a minimum dosage of 6mgkg(-1). Thirty cats of a cattery of 120 animals with an endemic infestation were treated on days 0 and 30. Including untreated control cats was therefore not possible because of animal welfare consideration. Clinical examination and visualization of mites by otoscopic examination of the external ear canal and microscopic examination of aural debris/exudate were performed twice weekly from days 0 to 30. On day 0 (and day 28 if the ears canals were erythematous), a swab was taken from each canal and sent to bacteriology and mycology units for detection and identification of bacteria (Staphylococcus mainly) and yeast (Malassezia pachydermatis only). Selamectin was safe, parasites were killed before day 3 and eliminated before day 17. Selamectin was 100% effective against natural aural infestations, even if erythema (26-33% of cats) and scratch reflex (23-40% of cats) persisted for 2 weeks after the cats tested negative for mites.
Ear cleaning helps maintain the normal otic environment and is important in the treatment of otitis. Over cleaning, however, may trigger otitis through maceration of the epidermal lining. Simple manual cleaning is useful for routine cleansing but doesn't remove tightly adherent debris. Bulb syringes are more vigorous but may damage the ear in inexperienced hands. Devices using mains water pressure or dental machines are also available. Thorough cleaning of the ear canals and middle ear cavity can only be achieved by retrograde flushing using specially adapted catheters, feeding tubes or video otoscopes under anaesthesia. Myringotomy, inspection and cleaning of the middle should be performed if the tympanic membrane appears abnormal. There are a wide variety of cleaning fluids available. Ceruminolytics soften and dissolve cerumen to facilitate cleaning. Surfactants emulsify debris, breaking it up and keeping it in solution. Astringents dry the ear canal surface, preventing maceration. Maintaining a low pH and incorporating antimicrobial agents can inhibit microbial proliferation and glucocorticoids can be used to reduce inflammation. Adverse effects and contraindications following ear cleaning can include maceration, contact reactions, otitis media, ear canal avulsion, vestibular syndrome, Horner's syndrome, facial nerve paralysis and deafness. Care should be exercised in selecting cleaning fluids if the tympanic membranes are ruptured.
In conclusion, there are a wide variety of dermatologic diseases that can affect the ear pinnae. Most of these disorders are manifestations of a generalized dermatosis. Therefore, when pinnal lesions are present, a thorough diagnostic workup is indicated.
Dogs with long-standing, chronic, recurrent otitis externa often represent one of the most frustrating types of problems in daily clinical practice. The important aspect of this discussion is that the clinician may be presented with a patient in which the primary chief complaint is otitis externa but a wide variety of disease processes may be causing the problem, including various combinations of the primary, predisposing, and perpetuating causes as discussed previously. The use of a thorough history and general and dermatologic physical examinations often leads the clinician to establish a systematic approach to identify the specific underlying problems. Until this is accomplished, the recurrent nature of the otitis externa will remain as a persistent problem.
Isolated reports have alluded to the potential ototoxicity of the antiseptic flushing agent chlorhexidine. To determine the effect of chlorhexidine acetate (0.2%) upon vestibular and cochlear function, this solution was placed twice daily for 21 days in the external ear canals of dogs with intact tympanic membranes and dogs with myringotomies (surgically ruptured tympanic membranes). Vestibular func tion was assessed by daily neurologic examination, while auditory function was assessed by recording brainstem auditory evoked potentials (BAEP) at twice-weekly or daily intervals. Peak I of the BAEP represents cochlear activation and is reduced or eliminated with cochlear damage. None of the dogs in either group in the study developed signs of vestibular damage. No significant changes (P :s 0.05) in the latency or amplitude ofpeak I of the BAEP were seen; therefore, the use of 0.2% chlorhexidine acetate appears to be safe when instilled into the external ear canals of normal dogs for a period of 3 weeks. Further, we observed no signs of ototoxiCity in dogs with surgically perforated tympanic membranes.
Canine otitis externa and media are frequently complicated by the presence of Pseudomonas infection. This article reviews the Pseudomonas bacterium as well as the antibacterial agents that are indicated for treating ear infections, particularly infections with Pseudomonas species. Topical therapy may include gentamicin, ticarcillin, enrofloxacin, polymixin B, or silver sulfadiazine. Systemic therapy is important in helping to resolve chronic infections; the use of fluoroquinolones, particularly, is discussed. Medical management may also require a middle-ear irrigation procedure to remove necrotic debris and enhance the response to topical and systemic therapy. Regular rechecks are also an important part of the successful management of chronic ear disease, particularly with a severe Pseudomonas infection after irrigation or in cases of otitis externa with bacterial infections treated with systemic antibacterial agents. In all chronic cases, the underlying cause (e.g., allergic skin disease [particularly atopy], hyperthyroidism, and keratinization disorders) of the ear disease should be considered because this will influence the likehood of relapse. The aim of thorough medical management is to avoid, when possible, recourse to surgical intervention.
The frustrations inherent in treating chronic otitis in dogs are an everyday challenge for practitioners. The key to successful management of this disease is early intervention, identifying a cause of the condition, and employing specific and appropriate therapy. Failure to identify and treat a primary or predisposing condition is the most common cause of chronic recurrent otitis. This article reviews the pathogenesis of chronic otitis, provides a systematic diagnostic and therapeutic plan, and emphasizes the role of client education in the successful management this condition.
Idiosyncratic cutaneous adverse drug reactions are rarely reported in the cat. The most common offending drugs appear to be the penicillins, cephalosporins, and sulfonamides. Due to the ability of drug reactions to mimic so many other dermatoses, the diagnosis can be difficult. A detailed history, exclusion of other possible causes of the dermatosis, and dechallenge are critical.
The morphological, cultural and biochemical characteristics of 80 M. pachydermatis strains isolated from cases of canine otitis externa were studied. Microscopically, the strains could be subdivided into two phenotypes. All M. pachydermatis strains grew well on Sabouraud glucose, yeast morphology and modified malt extract agar, but formed two distinct colony types. All strains were characterized by no fermentation. Assimilation of glucose, mannitol (42 strains), sorbitol (40 strains) and peptone was observed, but no ethanol assimilation. Urease and catalase tests were positive, while indole and acetoin production was not detected. All strains showed proteinase, caseinase, lecithinase and peroxidase positivity but to varying extents. Esterase activity was observed for all Malassezia strains when using Tween 20, 40 and 60, whereas Tween 80 was hydrolysed by only 42 strains. No coagulase or haemagglutinating activities were detected. When compared for satellite phenomenon and vitamin requirements, some Malassezia strains could not grow in the absence of nicotinic acid but grew well in the presence of staphylococci. In susceptibility tests, all strains showed the highest susceptibility to ketoconazole. On the basis of the biochemical differences, M. pachydermatis seems to be a heterogeneous species and can be divided into two groups.
This paper describes five dogs with symmetrical onychomadesis and onychodystrophy. Two of the dogs were diagnosed by histopathologic examination as having symmetrical lupoid onychodystrophy. The dogs have been successfully treated with omega-3 and omega-6 fatty acids for 30–52 months.
Budding yeasts were present in the majority of cases of otitis externa examined. A reddish-brown, dry, waxy discharge was the typical exudate. A successful treatment of yeast-infected ears was multiple otic lavages using a combination of an aqueous solution of poloxamer-iodine and application of an antifungal-antibiotic-corticosteroids ointment.
From January, 1973, to December, 1975, the most prevalent microorganisms isolated from ear swab specimens taken from 323 dogs with otitis externa were Staphylococcus aureus, Pseudomonas aeruginosa, and Proteus spp. Comparison of the antibiograms of these isolants to those reported from England in 1961 and from the United States in 1970 suggested emergence of a greater proportion of bacterial strains with resistance to antibacterial agents commonly used to treat otitis externa of dogs.
Enrofloxacin was administered orally to 6 healthy dogs at dosages of approximately 2.75, 5.5, and 11 mg/kg of body weight, every 12 hours for 4 days, with a 4-week interval between dosage regimens. Serum and tissue cage fluid (TCF) concentrations of enrofloxacin were measured after the first and seventh treatments. The mean peak serum concentration occurred between 1 and 2.5 hours after dosing. Peak serum concentrations increased with increases in dosage. For each dosage regimen, there was an accumulation of enrofloxacin between the first and seventh treatment, as demonstrated by a significant (P = 0.001) increase in peak serum concentrations. The serum elimination half-life increased from 3.39 hours for the 2.75 mg/kg dosage to 4.94 hours for the 11 mg/kg dosage. Enrofloxacin accumulated slowly into TCF, with peak concentrations being approximately 58% of those of serum. The time of peak TCF concentrations occurred between 3.8 hours and 5.9 hours after drug administration, depending on the dosage and whether it was after single or multiple administrations. Compared with serum concentrations (area under the curve TCF/area under the curve serum), the percentage of enrofloxacin penetration into TCF was 85% at a dosage of 2.75 mg/kg, 83% at a dosage of 5.5 mg/kg, and 88% at a dosage of 11 mg/kg. All 3 dosage regimens of enrofloxacin induced continuous serum and TCF concentrations greater than the minimal concentration required to inhibit 90% (MIC90) of the aerobic and facultative anaerobic clinical isolates tested, except Pseudomonas aeruginosa.(ABSTRACT TRUNCATED AT 250 WORDS)
The bacterial and fungal flora of 1118 ears of dogs with otitis externa and 100 ears of healthy control dogs were studied in order to isolate the causative agents. The yeast Malassezia pachydermatis (56%) was by far the most common organism in otitic dogs followed by the bacteria Staphylococcus intermedius (23%), Pseudomonas aeruginosa (12%), Proteus spp. (6%) and Streptococcus canis (5%). A statistical analysis of observed results showed that the incidence of these organisms is significant in otitic dogs. Many strains of S.intermedius, P.aeruginosa and Proteus spp. are resistant to antimicrobial agents commonly used to treat otitis externa. Therefore an antimicrobial susceptibility testing was performed using "Cobas Bact" for these bacterias. Furthermore, 80 strains of M.pachydermatis were submitted to identification-kits (API 20 CAUX, API STAPH, Cobas Micro). The observed results showed that an identification with these tests was not possible.
During a study of inflammatory middle ear disease in the dog cholesteatoma was found to accompany otitis media in seven of the 62 ears examined (11 per cent). The clinical, radiological and pathological findings in these animals imply that cholesteatoma in the dog is an aggressive lesion which must be differentiated from uncomplicated otitis media.
Abnormalities of the lipid and mucin components of the preocular tear film may result from diseases of the eyelid margins and conjunctiva. Chronic keratoconjunctivitis with epithelial edema and superficial corneal neovascularization, with or without ulceration, characterizes qualitative tear diseases. Tear components other than lipid and mucin that carry probable clinical significance include tear proteins, all-trans retinal, cholesterol, glucose, and electrolytes. Although less common than quantitative or aqueous deficiencies, qualitative abnormalities are recognized as primary or secondary causes of ocular surface disease in companion animals.
The synthetic retinoids, isotretinoin (Accutane) and etretinate (Tegison) are vitamin A analogs. They affect epithelial differentiation and thus have potential for therapy for disorders of epithelial maturation such as keratinization defects of cutaneous neoplasia. The pharmacology, indications for use, clinical experience, potential toxicities, and recommended monitoring of these drugs are discussed.
Microscopic anatomy of the horizontal part of the external ear canal was evaluated in 24 dogs. Sixteen dogs were from breeds known to have a predisposition to otitis externa. The remaining 8 dogs were from breeds that do not have a predisposition to otitis externa. Dogs were separated into groups according to predisposition to otitis externa: group 1-predisposed dogs without otic inflammation, group 2-predisposed dogs with otic inflammation, and group 3-nonpredisposed dogs without otic inflammation. Qualitative microscopic evaluation of distribution of hair follicles revealed hair within proximal, middle, and distal regions of the horizontal ear canal in all breeds. The degree of keratinization was directly proportional to the presence of otic inflammation and was excessive in group-2 dogs. Quality of sebaceous glands within the horizontal ear canal was similar among dogs with and without otitis externa, whereas the quantity of apocrine tubular glands was significantly increased (P less than 0.05) in dogs with otitis. Quantity of apocrine tubular glands was also greater in group-1 dogs than in group-3 dogs. Thickness of the soft tissue in the external ear canal increased in direct proportion to the progression of disease and was greatest in the proximal region of the affected ear canal. Soft tissue located caudally between nonopposing ends of the annular cartilage, within the proximal region of the horizontal ear canal, contained few glands and hair follicles in dogs without otitis externa. In dogs with otitis externa, this region was infiltrated by distended apocrine tubular glands.
If the tympanic membrane or attic skin is wounded with a fine needle dipped in ink, ink particles are introduced into the epidermis and underlying tissue. These particles are subsequently taken up by cells in the epidermis and dermis. In this experiment the distribution of ink within the skin of ear canal was studied in nineteen guinea-pigs, one to ten days after wounding. Examination of the intact canal reveals that ink becomes distributed along a precise line from the wound to the point of desquamation. On sectioned tissue, the ink in this line is found to be mainly intracellular, initially in the epidermis, and subsequently in the upper dermis. When considered with other evidence, these results indicate that migration probably occurs in the deeper layers of the epidermis, and that it stops at the junction of the deep and superficial parts of the ear canal.
Commercial otic preparations that contained dexamethasone or triamcinolone acetate were applied twice daily to both ears of 2 groups of dogs (n = 8). Marked adrenocortical suppression, reflected by low serum cortisol concentrations, was observed in all dogs. Results of ACTH response tests were blunted after 7 days of treatment. Twenty-one days after treatment, serum cortisol concentrations still were suppressed in all dogs, compared with pretreatment control concentrations. Fourteen days after cessation of otic treatment, 5 of 8 dogs still had inadequate release of cortisol in response to ACTH.
Three techniques for the assessment of the integrity of the canine tympanic membrane were evaluated experimentally. Tympanometry, an objective technique, was shown to be very accurate for the evaluation of the integrity of the ear drum. Otoscopic examination by experienced personnel was shown to be moderately accurate under controlled conditions when the external ear canal was not inflammed. However, under field conditions when otitis externa was present, visual inspection of the tympanic membrane was seldom possible even after lavage of the ear. Palpation of the tympanic membrane with a blunt probe was shown to be very inaccurate and led to rupture of the tympanic membrane in a high proportion of cases. These results imply that two widely used techniques for the examination of the canine tympanic membrane are unsatisfactory. Furthermore, they suggest that previous reports of the prevalence of ear drum perforations in dogs may need reappraisal. Tympanometry is a non-invasive, objective and practical technique for the assessment of ear drum integrity which is worthy of further evaluation.
Otitis externa is an important disease of dogs and, to a lesser degree, cats. The yeast Malassezia canis is the most common organism demonstrated in ear infections. Coagulase-positive staphylococci are the most common bacteria isolated, often occurring with M. canis. Pseudomonas aeruginosa and Proteus are gram-negative bacteria that are frequently encountered. Other bacteria, such as beta-hemolytic streptococci, enterococci, Escherichia coli, and Corynebacterium are also important. Malassezia canis, coagulase-positive staphylococci, and Pseudomonas aeruginosa commonly occur as monoinfections, whereas other bacteria are typically associated with mixed infections. Smears may provide rapid diagnosis on which to base empiric treatment. Cultures should be considered in recurrent or refractory cases, especially those involving gram-negative bacteria. In practices that are not equipped to perform culture and susceptibility tests, it is advisable to seek the advice of a microbiology laboratory.
Literature concerning the ototoxicity of the antiseptic combination chlorhexidine/cetrimide (Savlon) is reviewed. The ototoxic effects are illustrated by the results of our own experiments in guinea pigs. The impetus for this article was the observation of vestibular dysfunction in 15 clinical cases (12 dogs and 3 cats), in 8 of which it was confirmed that the ear canal had been rinsed with this drug combination in the presence of a ruptured tympanic membrane.
A retrospective study of 8975 dogs seen at 15 university veterinary medical teaching hospitals in North America (1975 to 1978) found that dogs with pendulous ears and heavy ear canal hair had significantly (P less than 0.01) more otitis externa than dogs with other ear types. Dogs with erect ears, regardless of the amount of ear canal hair, had less risk (P less than 0.01) of the disease than mongrel dogs. Direct evidence is available for the first time showing that monthly variations in ambient temperature, rainfall and relative humidity explain, to a large extent, the monthly variations in the hospital prevalence of canine otitis externa in different geographic regions.
A survey of factors which predispose the canine ear to otitis externa is presented. In resected ear specimens of 106 dogs, otitis externa without tumour was found on 58 occasions. In 46 dogs tumours were diagnosed in 15 cases with an otitis externa. In two dogs an inflammatory polyp was found. In the resected ear specimens of 48 cats, otitis externa was diagnosed 27 times, in 6 cases combined with an inflammatory polyp. In 21 cases neoplasia was present. The otitis externa was mainly a chronic proliferative inflammation characterised by hyperkeratinization, hyperplasia of the sebaceous and ceruminous glands, fibrosis and infiltration with plasma cells, lymphocytes and macrophages, often containing ceroid pigment.
Chlorhexidine gluconate is a derivative of chlorhexidine and is a popular disinfectant with a strong bactericidal action that is widely used for preoperative sterilization in ear surgery. The purpose of this investigation is to ascertain the potential ototoxicity of this agent. After topically applying chlorhexidine gluconate solutions to the middle ear cavities of 12 cats, we observed the excised cochleas using both scanning and transmission electron microscope studies. Either 0.05% or 2% chlorhexidine gluconate solutions were infused into the right ear of the test animal through one of two tubes chronically installed in the tympanic bullae. The left ears were utilized as controls and were infused with sterilized physiological saline. The solutions were administered once every other day for three separate infusions. Nine animals were decapitated 7 days after the third application, while the other three animals were sacrificed at 4 weeks. In the 2% chlorhexidine group, we found that hair cells in the organ of Corti had degenerated and had lost their hair bundles over a wide range. This pathology was more marked in the lower cochlear turns. In the animals sacrificed at 4 weeks, the injuries present seemed to have progressed. Even at a clinical concentration of 0.05%, chlorhexidine caused intracellular degeneration but with little surface damage. Our findings would suggest a cause of hearing loss when chlorhexidine is used clinically in the ear.
In the external auditory meatus of the ox, two types of secretory cells were encountered in the apocrine glands. These were (a) cells with a clear cytoplasm, and (b) cells with vacuolated cytoplasm. Cells with clear cytoplasm secreted by budding off apical cytoplasm, while cells with vacuolated cytoplasm secreted by rupture of their luminal border. The apocrine glands secreted phospholipids, protein-bound lipids, acid mucopolysaccharides, glycogen and diastase resistant P.A.S. positive carbohydrates. Alkaline and acid phosphatases were also found in the secretions. The sebaceous glands secreted large amounts of neutral lipids.
The incidence, breed incidence and age incidence of distichiasis are reported in a series of fifty–eight dogs. The detailed findings of eyelid examination conducted by operating microscope are recorded. The technique of epilation by electrolysis is discussed and certain details of the procedure described. The features described in these cases emphasise the difficulties that are encountered in the successful treatment of distichiasis in the dog and give a reasonable explanation for some of these problems.Résumé. On rapporte l'incidence, l'incidence de race et l'incidence d'ǎge de distichiase dans une série de cinquante-huit chiens. On enregistre les découvertes détaillées d'un examen de la paupière au microscope à opérations opthalmologiques. On discute de la technique d'épilation par électrolyse et on décrit certains détails du procédé. Les particularités décrites dans ces cas soulignent les difficultés que l'on rencontre dans le traitement réussi de la distichiase chez le chien et donnent une explication raisonnable pour certains de ces problèmes.Zusammenfassung. Der Vorfall, Zuchtvorfall und Altersvorfall von Distichiasis wird in einer Gruppe von 58 Hunden Berichtet. Die in Einzelheit gehehden Befunde von Augenlid Untersuch-ung durch Augenoperationsmikroskop augefùhrt, wurden berichtet. Die Technik von Epilation durch Electrolyse wird diskutiert und gewisse Einzelheiten des Vorgehens sind beschrieben. Die Unterscheidungsmerkmale in diesen beschriebenen Fàllen betonen die Schwierigkeiten auf die man stǒsst in der erfolgreichen Behandlung von Distichiasis in Hunden und geben eine ziemliche Erklǎrung fur einige von diesen Problemen.
We studied 126 cases of otitis externa among the population of a British forces base in Cyprus during one season. The causes of infection, the infective agents involved and the treatment of the observed cases in general practice are discussed. The patients were treated with either antibiotic/steroid ear drops (;Otosporin') or with aluminium acetate ear drops. We found no significant difference between the two.
Otodectes cynotis infestations were induced in barrier-reared mite-free cats. By monitoring the infested cats, sequence of humoral and cellular immune reactions to the mites was determined. Delayed hypersensitivity was not demonstrated in vivo, using intradermal skin tests. Reaginic (immunoglobulin E) antibodies, as detected by 72-hour passive cutaneous anaphylaxic reactions, were the earliest form of immune expression. Precipitating antibodies developed later in the course of the experimental infestation. Hematologic indices, including eosinophil counts, were not affected by established infestations. Antibodies prepared against feline whole blood, lymph, epithelium, and RBC indicated that these regularly occurred in extracts prepared from whole mites. It was concluded, therefore, that the feeding mode of mites required that they ingest feline tissue fluids. This mode is the interface by which the host becomes exposed to, and immunized against, mite antigens.
A two-year-old, female Lhasa apso presented with an acute onset of fever, anorexia, lethargy, prescapular and mandibular lymphadenopathy, otitis externa, and a dermatitis involving the perioral and auricular skin. Histopathological examination of affected skin and a mandibular lymph node was diagnostic for juvenile cellulitis. Extensive hematological, serological, urine, skin, and fecal testing together with special staining, immunofluorescence, and electron microscopic examination of skin and lymph node biopsies failed to reveal an underlying etiology. After 15 weeks the condition resolved completely. This represents the first adult case of a dermatosis fitting the clinical, histological, and clinicopathological description ascribed to juvenile cellulitis.
A unique, symmetrical onychodystrophy is described in 18 dogs. A rather sudden onset of onychomadesis is followed by chronic onychodystrophy affecting all claws. Pain and lameness are recognized in half of the patients, but the dogs are healthy otherwise. Histopathologically, this disorder is characterized by hydropic and lichenoid interface dermatitis. Nine dogs were treated with a commercial, fatty-acid supplement and had good-to-excellent responses. Due to the clinicopathological characteristics of this disorder, the authors propose the name "symmetrical lupoid onychodystrophy."
Ventral tympanic bulla osteotomy was performed in 13 normal dogs to evaluate healing and retention of brain stem auditory evoked potentials (BSAEP). Healing was evaluated by gross and microscopic examination of the middle ears after 1 (n = 2), 4 (n = 8), 5 (n = 1), and 6 (n = 1) weeks. One dog was eliminated from the study. Brain stem auditory evoked potentials were measured using an air-conducted sound stimulus before and after surgery and before killing. Nine of 12 dogs re-formed the tympanic bulla by formation of fibrous connective tissue lined with cuboidal epithelium in the osteotomy site. Four of the nine dogs had a reduced tympanic bulla volume (estimated 20% to 40% volume reduction) caused by soft tissue ingrowth through the osteotomy. Nine of 12 dogs had proliferation of subperiosteal new bone from the inner surface of the tympanic bulla that varied in severity. Three of these nine dogs had nearly complete obliteration of the tympanic cavity by proliferating subperiosteal new bone. Eight dogs had nodules of granulation tissue containing new bone and mineralization diffusely distributed on the surfaces of the middle ear. The measured BSAEP sensitivity before killing was equivalent to preoperative levels in 11 dogs. The remaining dog had no change in auditory sensitivity after surgery but had a markedly reduced BSAEP detection threshold before killing. This appeared to be attributable to mechanical impingement on the ossicles and tympanic membrane by proliferating bone within the tympanic cavity.(ABSTRACT TRUNCATED AT 250 WORDS)