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This Concept Map, created with IHMC CmapTools, has information related to: tx of otitis, Follow-up treatments for otitis externa and otitis media involve repeat examinations of the ear discharge and control of any underlying diseases. You may be asked to routinely cleanse the dog's ear to prevent a recurrence. With the proper therapy, most cases of otitis externa will resolve within three to four weeks, whereas otitis media takes a considerably longer amount of time to treat it, and up up to six weeks to be resolved not resolved? If these conditions persist over long periods of time, and are not treated, they may lead to deafness, facial nerve paralysis, otitis interna, and (rarely) meningoencephalitis, treatment of otitis specific dx BACTERIAL OTITIS EXTERNA, treatment of otitis Flushing the Ears -Cerumenolytics emulsify ear wax for easy removal. -Ear flushes aid in removing pus, mucus and serum from the ears. -Drying agents decrease moisture in the ears and dessicate the surface keratinocytes. -Moist ears – use combination cleansing/drying, • -Potent topical corticosteroids needed initially to relieve inflammation, edema, and pain • -Systemic corticosteroids used for the first 2 weeks - Prednisone • -Lower potency hydrocortisone for maintenance - 40 mg of dexamethasone To a 4 ounce bottle of a TrizEDTA or MalAcetic Malacetic Otic (DermaPet) Acetic acid Good degreaser Removes FFA pH 4.9 prevents yeast growth Boric acid Dessicates keratinocytes Inhibits adhesin molecules Use daily for 10-14 days then twice weekly., scroll to tx and prognosis (merck) a nice article has good approach, Most commonly used medications will resolve non-complicated gram positive otitis externa Chronic otitis externa may need systemic antibiotics (and definitely otitis media)- C & S ?? However - much higher concentrations achieved with topicals in the outer ear vs. levels that can be achieved in area with systemic antibiotics consider First line antibacterial agents: neomycin, chloramphenicol Second line antibacterial agents: gentamicin, polymyxin B, polymyxin E, enrofloxacin, silver sulfadiazine, ticarcillin Chronic ear: Pseudomonas – use above plus Tris EDTA 6 ml of injectable Baytril 100 mg/ml in 4 ounce bottle of TrizEDTA, treatment of otitis CLIENT EDUCATION -imp! -Instruction on cleaning/medicating -Stress importance of re-examination -Early recognition of problem: prompt veterinary attention, • Resolution often takes up to 3-4 weeks (for the treatment of mites) 2-4 month course of systemic • antibiotics to prevent relapse • (resolution often takes six or more weeks) • Antifungals • Corticosteroids (anti-inflammatory dosage) • Consider flushing ear (s) under general anesthesia • Recheck in 10-14 days • Vestibular signs (head tilt, nystagmus etc), often improve within 2-6 weeks • Owner should be warned that the head tilt and any facial nerve damage or Horner’s Syndrome may remain surgical Surgical treatment (save for unresponsive or relapsing infection) Treatment for chronic otitis externa with end stage obstruction: Total ear canal ablation Bullae osteotomy, treatment of otitis otitis externa scroll to tx and management (merck), treatment of otitis specific dx Otitis externa, Malassezia Otitis Externa tx • -Potent topical corticosteroids needed initially to relieve inflammation, edema, and pain • -Systemic corticosteroids used for the first 2 weeks - Prednisone • -Lower potency hydrocortisone for maintenance - 40 mg of dexamethasone To a 4 ounce bottle of a TrizEDTA or MalAcetic, has good approach consider ear wicks in tx, treatment of otitis specific dx Malassezia Otitis Externa, treatment of otitis otitis interna scroll to tx and prognosis (merck), A treatment plan be formulated that is tailored specifically to the patient after the skin and ears are evaluated, the cytology is done, and the ear canal is cleansed. treatment of otitis, treatment of otitis CLIENT EDUCATION -imp! Follow-up treatments for otitis externa and otitis media involve repeat examinations of the ear discharge and control of any underlying diseases. You may be asked to routinely cleanse the dog's ear to prevent a recurrence. With the proper therapy, most cases of otitis externa will resolve within three to four weeks, whereas otitis media takes a considerably longer amount of time to treat it, and up up to six weeks to be resolved, scroll to tx and management (merck) a nice article has good approach, -Cerumenolytics emulsify ear wax for easy removal. -Ear flushes aid in removing pus, mucus and serum from the ears. -Drying agents decrease moisture in the ears and dessicate the surface keratinocytes. -Moist ears – use combination cleansing/drying consider Soupy ears – twice daily (less if very inflamed) Waxy ears – few times weekly, Otitis externa tx • Resolution often takes up to 3-4 weeks (for the treatment of mites) 2-4 month course of systemic • antibiotics to prevent relapse • (resolution often takes six or more weeks) • Antifungals • Corticosteroids (anti-inflammatory dosage) • Consider flushing ear (s) under general anesthesia • Recheck in 10-14 days • Vestibular signs (head tilt, nystagmus etc), often improve within 2-6 weeks • Owner should be warned that the head tilt and any facial nerve damage or Horner’s Syndrome may remain, BACTERIAL OTITIS EXTERNA tx Most commonly used medications will resolve non-complicated gram positive otitis externa Chronic otitis externa may need systemic antibiotics (and definitely otitis media)- C & S ?? However - much higher concentrations achieved with topicals in the outer ear vs. levels that can be achieved in area with systemic antibiotics