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Otitis Externa

Mike Kirkpatrick, DVM
Senior Technical Services Veterinarian

Otitis Externa is a common condition and one of the top reasons pet owners bring their pet to the veterinarian1.  In fact, up to 12% of dogs and 6% of cats are affected by otitis externa2.  Initially, acute inflammation and infection need to be addressed.  Subsequently, routine cleansing of ears and maintenance of healthy ear canals becomes important, especially in patients prone to ear problems. 

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With acute otitis externa, it is important to prescribe a topical medication that contains a safe, yet effective steroid to reduce inflammation, and antibacterial and antifungal components to target secondary infection.  In addition to topical therapy, the primary cause of the patient’s otitis externa must be identified.

Most commonly, otitis externa in dogs is triggered by allergic disease, including atopic dermatitis and food hypersensitivities3.  And while otitis externa may be the only presenting clinical condition in these canine patients, frequently there is concurrent superficial pyoderma or generalized pruritus, which necessitates additional topical or systemic therapy. 

Other underlying causes of otitis externa should also be investigated, including the presence of foreign bodies, keratinization disorders and ear mites4.  In cats, the most common primary cause of otic inflammation is Otodectes cynotis, responsible for up to 50% of cases of feline otitis externa5.  Evaluating aural exudate for the presence of ear mites is particularly important in feline patients presenting with acute otitis externa.  If mites are identified, treatment with a topical miticide is both effective and inexpensive.

Once the dog or cat is treated for otitis externa, a maintenance ear cleansing protocol can help support good ear health.  The ideal cleanser should work to emulsify and disperse wax and debris, while helping keep ear canals dry.  It should also be well tolerated and non-irritating.  The formulation of a neutral pH cleanser can minimize pet discomfort and stinging upon application, and is also less likely to interfere with concurrent ear treatments (e.g. aminoglycosides, fluoroquinolones6).   In patients prone to infection, incorporating advanced technologies that provide micro-organism anti-adhesive and anti-irritant effects can help limit microbial adherence while soothing the skin.

 

References:

1. DVM360 – May 14, 2019 – Top 3 most common pet insurance claims (https://www.dvm360.com/view/top-3-most-common-pet-insurance-claims)

2. State of Pet Health 2016 Report. Banfield Pet Hospital website. https://www.banfield.com/Banfield/media/PDF/Downloads/soph/Banfield-State-of-Pet-Health-Report-2016.pdf. Accessed March 10, 2021.

3. Zur G, Lifshitz B, Bdolah-Abram T. The association between the signalment, common causes of canine otitis externa and pathogens. J Sm Anim Prac. 2011;52:254–258.

4. Scott DW, Miller WH, Griffin CE, eds. Diseases of eyelids, claws, anal sacs, and ears. In: Muller & Kirk’s Small Animal Dermatology. 6th ed. Philadelphia, PA: Saunders Elsevier; 2001a:1185–1235.

5. Forsythe P. Feline Otitis. British Small Animal Veterinary Congress, 2013.

6. Papich M.  Current Concepts in Antimicrobial Therapy in Small Animals. WSAVA World Congress Proceedings, 2001.