OTITIS EXTERNA

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Causative Agent(s)

Bacteria: Staphylococcus spp, Pseudomonas spp, Proteus spp, Enterococcus spp. Streptococcus

spp, and Corynebacterium spp Fungi: Malassezia spp

Other Causes: Parasites, allergy, hormonal imbalance.

Clinical Presentation and Epidemiology

Signs can include head shaking, pain with ear manipulation, malodour, erythema, erosion, exudate, ulceration, swelling, and ceruminous gland inflammation. Young animals may be more commonly affected. Breed dispositions for otitis reflect those for skin disease (Allergies in Retrievers and Terriers). It can be seen in rabbits in which it is usually due to the mite (Psoroptes cuniculi).

Diagnostic Considerations

Diagnosis is based on obtaining detailed history, clinical signs, physical and otoscopic evaluation of ear canal, impression cytology of the ear canal, microbial culture, and sensitivity test.

Swab sample should be taken for MCS and ear canal sample for cytology.

Management and Treatment

Management depends on the specific causative organism. The inciting cause must be investigated and addressed to prevent recurrence. Treatment may require topical therapy including ear cleaning, otic (ear canal) flushing, systemic antimicrobial, and anti-inflammatory therapy.

The duration of treatment may vary from 2-4weeks to several months, depending on the causative agent.

Topical Antibiotics can be used solely for treatment for Otitis externa. Systemic antibiotics, anti-pruritic anti-inflammatory agents can also be used if condition is severe, but it is imperative that MCS must be compulsorily done.

First line of Antibiotics (Pending MCS result)

Enrofloxacin 5mg/kg PO q24hrs in cats; 5-20mg/kg POq24hr)

Second line antibiotics:

*Ciprofloxacin (20-50mg/kg PO, IV q12hr in dogs)

*Levofloxacin (20mg/kg PO, IV q24hr in dogs)

If fungal infection is the primary cause, Ketoconazole, Itraconazole, may be drug of choice.

Adjunct/supportive therapy to antibiotic usage:

Topical Therapy: Topical agents include cleaning and drying agents. Ozone instillation therapy.