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Otitis Externa in Dogs

By: Dr. Debra Primovic

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Treatment

Treatment of otitis externa involves treatment of the primary disease process, recognition and treatment of the underlying factors that predispose the pet to infection, and treatment of the specific infectious agent.

Treatment for otitis externa may include one or more of the following:

  • Initial management includes cleaning your pet's ear. This can be accomplished by placing solutions in your pet's ear at home or by having them cleaned by your veterinarian. Moderate to severe infections may require sedation and in-hospital flushing. Flushing debris from the canal is critical prior to topical treatment. There are several types of ear cleaners.

    Ear cleansers can be detergent and ceruminolytic (products such as Epi-Otic, Oti-Clens, Routeen, Alo-Cetic) or antimicrobial (Chlorhexiderm, Malaseb). Ear cleaning should be once or twice daily until all debris is removed which is typically 3 to 7 days. Excessive cleaning should be avoided is it can cause ear problems. Cleaners can keep the ear moist and susceptible to infection.

  • Topical therapy usually consists of ear medication that you place in your pet's ear one to two times daily. The specific medicine will depend on the cause of the infection. It is extremely important to follow your veterinarian's directions on getting the medicine in your pet's ear. Improper medication and improper administration is a common cause for treatment failure. Uncomplicated ear infections respond well to topical ear medications such as Antimax, Otomax, Surolan.

  • Systemic therapy with glucocorticoids, such a prednisone, may be given to decrease pain and inflammation. These are hormones often used as inflammatory agents. It is often used for 10 to 14 days when pain and inflammation is present. Topical glucocorticoids can also be used.

  • Antibiotic therapy may be indicted with severe bacterial infections or ulceration. Antibiotics may be chosen based on cytology and/or bacterial culture. Clorhexidine (Chlorhexiderm flush), Gentamicin drops, Baytril otic are often used.

  • Antifungal therapy is indicated in cases of severe recurrent yeast infections. Drugs used may include Ketoconazole (Nizoral®), Itraconazole (Sporanox®) or Fluconazole (Diflucan®) for 2 to 4 weeks.

  • Many therapies extend for 1 to 2 weeks beyond clinical signs.

  • Regular follow-up visits to your veterinarian are important to ensure that your pet's condition does not worsen.

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