The ‘Ugh’s and ‘Why’s of Chronic Otitis
Managing a one-time case of otitis is bad enough. Treating difficult cases? Insert exasperated sounds here. Don’t worry, we’ve got your back.
It’s a rough situation for everyone. Chronic otitis is at it again!
How do we prevent otitis from recurring? At CVC Kansas City, James Noxon, DVM, DACVIM (SAIM), reviewed the best practices of ear treatment, focusing on Pseudomonas species infections.
- Make a proper diagnosis. This means to perform a thorough ear examination, an otoscopic examination, and key diagnostic tests. For example, according to Dr. Noxon, cytology is absolutely necessary to properly evaluate a patient with otitis.
- Remove obstructions such as wax and hair.
- Clean the ears before treating for the effectiveness of topical therapy.
- Provide good client education.
- Follow good principles of therapy-proper product, at the proper dosage, for proper frequency and proper duration.
Recurrence is usually due to failure of figuring out why the infection is there. Dr. Noxon says otitis is all about the what and the why-what is going on and why is it there. He says Pseudomonas species infections should be suspected when:
- Ears are extremely painful
- Mucopurulent discharge accumulates toward the outer part of canal
- A single populace of rods is seen on cytology, especially gram-negative rods. Gram stains are recommended, and very helpful if rods are seen on cytology.
- Tissue bleeds readily.
