Pseudomonas ear inf

Re: Pseudomonas ear inf

vs0u — Mon, 19 Apr 2010 13:16:24 GMT

[quote user="robloxley"]How much did they spend 'trying everything' and then 'for bilateral TECA'?
In a number of cases of pseusdomonas OE we see, discussion of surgery at the outset would be high up on my list, maybe avoiding spending lots of time and money on difficult medical treatment of a painful condition that will often recur, and end up having a teca.[/quote]

Quite a bit - hence why I was saying I wished we'd gone for surgery a lot earlier on, rather than worrying about the dog's hearing etc. However the referral vet from AHT (who was kindly advising me on what to do via email on a weekly basis free of charge over about 6 months) was following treatment plans she had successfully used before in several dogs of the same breed, and the referral vet (a different one) that the dog ended up going to for surgery said everything had been done right with the case - so it's not as if we were just messing about. It's only in retrospect that we can know which cases will respond to treatment and which won't.

Re: Pseudomonas ear inf

Rob Loxley — Mon, 19 Apr 2010 00:14:45 GMT

[quote user="alison howell"]

bad pseudomonas infection, tried absolutely everything...

...eventually the dog was referred for bilateral TECA and was immediately so much happier in himself, playing like a puppy again.

[/quote]

How much did they spend 'trying everything' and then 'for bilateral TECA'?
In a number of cases of pseusdomonas OE we see, discussion of surgery at the outset would be high up on my list, maybe avoiding spending lots of time and money on difficult medical treatment of a painful condition that will often recur, and end up having a teca.

Re: Pseudomonas ear inf

Vikki Halliday LLB — Sun, 18 Apr 2010 21:53:23 GMT

[quote user="Evelyn Barbour-Hill"]

Speak for yourself - I wouldn't put anything but the brown stuff on my chips And of course Heinz tomato sauce (from a glass bottle)

[/quote]

Eurgh! Mayonnaise or at the very least , brown sauce please!

By strength I was quoting directly from the labels. Standard vinegars quote 5-6% acidity,. by that I am assuming 5-6% acetic acid. Pickling Vinegars, ( the kind you probably eat silverskin onions and pickled eggs from if you are into that sort of thing!), tend to be higher, up to 18%.

Re: Pseudomonas ear inf

Evelyn Barbour-Hill — Sun, 18 Apr 2010 17:09:30 GMT

[quote user="Vikki Halliday"]I usually recommend white distilled malt vinegar, same stuff you put on your chips![/quote]

Speak for yourself - I wouldn't put anything but the brown stuff on my chips And of course Heinz tomato sauce (from a glass bottle)

[quote user="Vikki Halliday"]The Supermarket own brands tend to be about the same strength, 5-6% acidity,[/quote] Not sure what you mean by that.

Re: Pseudomonas ear inf

Vikki Halliday LLB — Fri, 16 Apr 2010 08:40:42 GMT

[quote user="Martin McDowell"]Can you please clarify exactly what vinegar you used as they do vary in strength (acidity).[/quote]

I usually recommend white distilled malt vinegar, same stuff you put on your chips! The Supermarket own brands tend to be about the same strength, 5-6% acidity, but would avoid the pickling vinegars as they have a higher acidity. Would not recommend wine or cider vinegar as these are usually much stronger, and cider vinegar can burn.

Re: Pseudomonas ear inf

Martin McDowell — Thu, 15 Apr 2010 21:15:24 GMT

Hi Vikki & Vikki

Can you please clarify exactly what vinegar you used as they do vary in strength (acidity).

Martin

Re: Pseudomonas ear inf

Vikki Halliday LLB — Thu, 15 Apr 2010 16:52:09 GMT

I have used vinegar washes also with good effects, but normally at a 1:10 dilution as 50% I would imagine could be quite painful in a very inflamed ulcerated canal?

Re: Pseudomonas ear inf

Vikki Moran — Thu, 15 Apr 2010 10:45:19 GMT

another old school remedy here - but the last one of these i had (and for these people surgery wasn't an option) i treated with 50% white vinegar once daily. worked a treat! after 3 weeks the dogs ears were swabbed and came back clear. he has since had weekly cleans with vinegar solution and has been fantastic ever since.

sometimes the old simple remedies do work pretty well.

Re: Pseudomonas ear inf

vs0u — Tue, 13 Apr 2010 22:17:18 GMT

I had a bad pseudomonas infection in a 5 y.o italian spinone, managed it with advice from someone at the AHT, tried absolutely everything including hypoallergenic diet, triz edta, topical enrofloxacin then ticarcillin, repeated flushing under GA. Nothing got it under control and the poor dog was in pain all the time. The owner was a really nice lady who kept coming back through it all and doing everything as advised.

Eventually the dog was referred for bilateral TECA and was immediately so much happier in himself, playing like a puppy again. The owner thought his hearing had actually improved. I really wished we had done it much earlier as the problem had been going on about 18 months by then.

Re: Pseudomonas ear inf

Martin McDowell — Tue, 13 Apr 2010 21:09:51 GMT

Just finished the course with a Newfoundland dog with a quite a resistant strain of Pseudomonas aeruginosa. After no improvement trying daily injections of tobramycin and orla preds I followed advice on this forum and got in contact with the vet at Dermapet UK. Made the topical TrizEDTA cocktail with marbofloxacin and dexamethasone (used the TrizEDTA crystals and added the meds and topped up with water. The once ran out of it at the end of week and I had to switch to Aurizon (marbofloxacin, clotrimazole, dexamethasone) that we had in stock. Had to add in oral ketokonazole and metronidazole as I ended up with a secondary Malassezia and anaerobe infection. It cleared up in about 10 days. The swab came back negative and the dog improved a lot. Just hope I don't see a reflare.

Re: Pseudomonas ear inf

Martin McDowell — Thu, 18 Mar 2010 10:45:59 GMT

Would this Triz-EDTA coctail be OK for ruptured TM?

Re: Pseudomonas ear inf

Evelyn Barbour-Hill — Sat, 12 Dec 2009 22:37:12 GMT

Strongly suggests continuing otitis media. Examine under GA.

Re: Pseudomonas ear inf

caroline thibodeau — Sat, 12 Dec 2009 22:25:03 GMT

What is the recipe for the Zibs? Still dealing with the pseudomonas in the Beardie. I have stopped all topical now as he seems to do better with nothing. There is still pain in the ear though and he does rub it - cries when the ear is cleaned. He has no discharge now, no smell and the ear has no external inflammation. I'm wondering if we should do another culture to see what the situation is - the ear looks absolutely normal now, but he still shakes his head, carries it on one side and does seem to have pain.

Re: Pseudomonas ear inf

Andy Wignall — Sat, 12 Dec 2009 16:00:58 GMT

Have you tried Zibs - a mixture of methylated spirits and zinc oxide? old school, I know, and I think it works by basically dessicating everything in the ear. It is very well tolerated, dirt cheap and without resistance issues I reckon. We use it on all pseudomonas infections which don't respond to abs.

Andy

Re: Pseudomonas ear inf

Rajat — Wed, 09 Dec 2009 17:02:49 GMT

Hi Dexter

Interesting and challenging case! I haven't had one this resistant before but have heard of large animal baytril 10% strength for some persistent pesky pseudomonas..never had to use it myself but may be worth a go...let us know how it goes and interested to hear how the silver sulfadazine works if you do use it...

best of luck

Raj

Re: Pseudomonas ear inf

Evelyn Barbour-Hill — Tue, 08 Dec 2009 00:01:40 GMT

Yes. My opinion is that - in general - ear cleansing is something you do under GA with a suitable catheter or Spreull needle using sterile saline, and you suck as well as blow.

Re: Pseudomonas ear inf

Fabian Kaelin — Mon, 07 Dec 2009 23:42:01 GMT

Evelyn, I guess you're right, unless you flush it out (with suction by syringe)?

Re: Pseudomonas ear inf

Evelyn Barbour-Hill — Mon, 07 Dec 2009 23:32:14 GMT

Just pondering this subject. Suppose we consider physics rather than chemistry or pharmacology. Is it not quite likely that when the tympanum is ruptured an "ear cleanser" will break up the debris and sluice the muck into the bulla rather than out of the ear?

Re: Pseudomonas ear inf

Fabian Kaelin — Mon, 07 Dec 2009 23:25:33 GMT

saying that most cases seem to respond well to Aurizon, so seem to be good first line treatment.

Re: Pseudomonas ear inf

Fabian Kaelin — Mon, 07 Dec 2009 23:20:40 GMT

had a couple cases where pseudomonas were resistant to mabofloxacil and only sensitive to polymyxin

Re: Pseudomonas ear inf

Edward Jones — Mon, 07 Dec 2009 16:31:00 GMT

What kind of success have people been having with Aurizon in these cases?

Previously I have used Triz-EDTA with additional Marbocyl injectable (+/- dexamethasone) to be used as a wash, with some good success but now I'm using Aurizon as a first choice (due to the cascade).

I've recently had a case that didn't respond at all to an inital course of Aurizon and the C&S has shown it to be resistant to marbofloxacin - I wonder if simply using an increased concentration of topical Marbocyl would do the trick?

Has anyone found any benefit to using systemic Marbocyl?

A note about the inevitable rupture of the typmpanic membrane in a severe otitis externa - are there any products that are licensed for use when the membrane has ruptured?

Re: Pseudomonas ear inf

Dexter Smith — Mon, 14 Sep 2009 12:06:01 GMT

Hi Caroline

Hmm, looks like this one is heading for a Bulla Osteotomy!

You could try using Ear Wicks (Dermapet) into the middle ear soaked in Baytril. I think what happens alot of the time is after a few days treatment, the TM re-forms, and the infection retreats into the Bulla, only to emerge later. These ear wicks keep the access open.

Have you checked for hypothyroidism etc as David suggested to me in the previous posts?

Dex

Re: Pseudomonas ear inf

caroline thibodeau — Sat, 12 Sep 2009 21:57:14 GMT

Bearded Collie with diagnosed pseudomonas in one ear - on ciproflox with baytril topical. I`m flushing with Triz-EDTA and there is green slimy discharge, cleaning it up with the Tri-E every day and keeping ear clean. Doesn`t seem to be improving. Was on pred (5mg. 2x day) for the first 10 days. Has now been on cipro for about 7-8 wks with not much noticeable improvement. Do you think if we mixed the baytril and dex into the Tri-E it might help? Is it ok that the ear stays very wet? The dog seems to feel better when no topicals are used and the ear dries up a little, but the infection does not clear up. What would you suggest and what amount of baytril do you use with the Triz-Ed? Thanks for any help.

Re: Pseudomonas ear inf

Dexter Smith — Mon, 15 Dec 2008 09:54:07 GMT

Hi David

Long time no see!

You could well have a point. The ease with which this infection seemed to spread to a perfectly good ear was a bit disconcerting. It doesn't look like a hypothyroid dog - typical bouncy springer, not overweight etc, but it certainly could have some other immunological problem that might be the underlying cause. Will check it's T4 & cortisol state before I go any further with it, but how can you assess any other cause of immunological incompetance? I suppose you can't in GP, may need a referral then!

Merry Xmas

Dex

Re: Pseudomonas ear inf

David Scarff — Sun, 14 Dec 2008 19:50:38 GMT

Hi Dexter

Have you ruled out any specific cause of immunosuppression in this dog? I did a study for Bayer some years ago where we looked at reisitance patterns in pyoderma, comparing my referral dermatology caseload with a first opinion clinic. We had four cases of Pseudomonas infection, all of which refused to respond to any treatment tried until we controlled the underlying hypothyroidism. Just a thought!

Best wishes

David Scarff