Malassezia ear infection

Re: Malassezia ear infection

Martin Atkinson — Fri, 20 Feb 2015 12:49:47 GMT

[quote user="Kate Richardson"]

Hey- you and me openly agreeing Martin! Every cloud and all that!!! And am glad Andrew has verified his technique- still not a fan but better than forceps!

[/quote]Actually I never thought that we sang from different hymn sheets most of the time Kate so I must have unwittingly (something to do with the ignorance of my arrogance perhaps) rattled your cage some time in the past.

I always was a pheasant plucker and took great satisfaction in pulling out great clumps of festering hair and wax concretions then I went to a lecture session by a dermatologist + ENT surgeon who told me about the bad things this can cause and saw the light. I don't pluck anymore and I don't find that the long term recurrence rate is any worse, the hair grows back after all, so long as I can get clients on board with sorting out the base problem which for sure 'aint just hair.

Re: Malassezia ear infection

Kate Richardson — Fri, 20 Feb 2015 11:08:51 GMT

[quote user="Anthony Todd"][a] logic, via ventilation, visualisation and access for medication,[/quote]

Haven't had any problems with any of these so far in my career that can't be solved with using a routine ear cleaner. Maybe Wiltshire dogs have less hairy ears than elsewhere. Yes I have plucked them in the past and I did find they found it painful. Why can't you just accept that I personally haven't found any benefits and I am not about to start plucking ears again just because you say its fine?!

Re: Malassezia ear infection

Anthony Todd — Fri, 20 Feb 2015 10:45:27 GMT

[quote user="Kate Richardson"]until I can be convinced it is[/quote]

[a] logic, via ventilation, visualisation and access for medication, and others have said it is beneficial.

Have you ever tried plucking an ear in a poodle? How many times?

[b] I, and others have said it is painless [even, I reckon, with forceps which grab the greasy hair and gunk better.

[c] you are doing harm; see [a] above

There ain't no risks and there are obvious benefits.

again.

Re: Malassezia ear infection

Kate Richardson — Fri, 20 Feb 2015 10:29:41 GMT

[quote user="Anthony Todd"]

[quote user="Kate Richardson"]I just feel passionately about ear plucking! If I am in the minority then so be it.[/quote]

And I'm the one with the fixed ideas??

[/quote]

I accept that I am fixed on this one at the moment, but until I can be convinced it is (a) beneficial and (b) not painful I stay where I am. But by doing so I am doing no harm which first and foremost is the most important rule of veterinary medicine. As discussed on another thread it is about risks and benefits. Even with something as simple as ear plucking. :-)

Re: Malassezia ear infection

Anthony Todd — Thu, 19 Feb 2015 23:01:47 GMT

[quote user="Kate Richardson"]I just feel passionately about ear plucking! If I am in the minority then so be it.[/quote]

And I'm the one with the fixed ideas??

Re: Malassezia ear infection

Andrew Mellor — Thu, 19 Feb 2015 18:40:42 GMT

[quote user="Kate Richardson"]

[quote user="Martin Atkinson"]

[quote user="Kate Richardson"]I agree and should also have apologised (and do) to Anthony for using the word tosh- it wasn't directed at him specifically. I just feel passionately about ear plucking! If I am in the minority then so be it.[/quote]It was tosh and we're clearly in a minority of two!

[/quote]

Hey- you and me openly agreeing Martin! Every cloud and all that!!! And am glad Andrew has verified his technique- still not a fan but better than forceps!

[/quote]

can I just add for those who do pluck and may not have tried this , use fingers , pinch a few hairs - or one of those satisfying dreadlock concretions some dogs form and hold some tension on it and often the follicle just seems to let it go, you don't need to yank the hair out just persuade it.

OMG think the pet remedy is getting to me MAN!

Re: Malassezia ear infection

Kate Richardson — Thu, 19 Feb 2015 18:28:19 GMT

[quote user="Martin Atkinson"]

[/quote]

Hey- you and me openly agreeing Martin! Every cloud and all that!!! And am glad Andrew has verified his technique- still not a fan but better than forceps!

Re: Malassezia ear infection

Andrew Mellor — Thu, 19 Feb 2015 18:20:41 GMT

[quote user="Anthony Todd"]

Try plucking ears that are full of debris and hair , just for fun and to prove yourself right, even with your fingers.

[/quote]

just to add something here - I only pluck ears with my fingers , I believe you need to feel the hair and only take the loose or easily removed hair I am a real advocate for plucking but would never ( again) pluck with forceps , the few times I have it has caused the dog discomfort because it is so indiscriminate.

Re: Malassezia ear infection

Martin Atkinson — Thu, 19 Feb 2015 18:14:15 GMT

Re: Malassezia ear infection

Kate Richardson — Thu, 19 Feb 2015 18:06:34 GMT

[quote user="Arlo Guthrie"]I think it is really very, very important to have dinovets contributing their experience, both because stuff gets forgotten (or not passed down), and to challenge new ways of thinking.[/quote]

I agree and should also have apologised (and do) to Anthony for using the word tosh- it wasn't directed at him specifically. I just feel passionately about ear plucking! If I am in the minority then so be it.

Re: Malassezia ear infection

Martin Atkinson — Thu, 19 Feb 2015 17:46:16 GMT

[quote user="Bob Russell"]Those younger vets that seem unwilling to listen to the dinovets are likely to miss out on many pearls of wisdom, often learned the hard way. Similarly the dinovets that don't listen are doing their patients no favours either. There is always masses to learn.[/quote] My three and half years qualified assistant said the other day, when I was having a (admittedly rare!) moment of self doubt, that she had learned more from me than she did at university. Now I'm sure that was a highly qualified statement and I hope it doesn't mean she's becoming a dinovet prematurely but it was appreciated and is more confirmation that despite my dinovet years I try to keep myself at the cutting edge as far as possible. More than half of my documented annual CPD requirement completed already.

[quote user="Bob Russell"] I will occasionally give a poorly responding dog with pancreatitis a dose of steroids[/quote]Hopefully only on the basis of: 'don't let an animal die without the benefit of the 'roids' rather than EBM!

Re: Malassezia ear infection

Bob Russell — Thu, 19 Feb 2015 17:29:07 GMT

There is more than one way to skin a cat! Those younger vets that seem unwilling to listen to the dinovets are likely to miss out on many pearls of wisdom, often learned the hard way.

Similarly the dinovets that don't listen are doing their patients no favours either. There is always masses to learn.

Once everything veterinary can be proved by evidence based medicine then vets can be replaced by technicians, ticking computer boxes until the right answer pops out at the end.

Respecting both experience and recent learning strikes me as the best combination!

As a dinovet who feels he will never really get the hang of the job, I just keep learning. Unlike some of the youngsters practicing in the area I am happy to do core vaccines every four years when many of them are doing them annually. I will occasionally give a poorly responding dog with pancreatitis a dose of steroids (having discussed it with the owners) knowing that there is quite a good chance it will be brighter, happier and starting to mend by the next day!

Just a matter of trying to get the balance right.

Re: Malassezia ear infection

Anthony Todd — Thu, 19 Feb 2015 17:19:54 GMT

Thanks Arlo, I 'll confine myself to that thingy of the head banging the wall in future.

This is the one, wish it was bigger.

Re: Malassezia ear infection

Arlo Guthrie — Thu, 19 Feb 2015 16:51:43 GMT

[quote user="Anthony Todd"]I'll try and be better.[/quote]

A very gracious reply.

At the risk of banging on (ironically, more or less what I'm telling you not to do!), I want to repeat how important I think your contribution to this forum is. I think what you say is usually very valuable, both as an insight as to how things have been done in the past, to challenge new stuff, and because it is often thought-provoking (even if people disagree).

I don't think it is what you say that causes any problem at all. You just need to guard against posting repetition of your point!

Re: Malassezia ear infection

Anthony Todd — Thu, 19 Feb 2015 15:59:19 GMT

[quote user="David Mills"]Hate to say I told you so, but, well, I did.[/quote]

Fair enough David, Arlo, Martin and others.

I'll try and be better.

Re: Malassezia ear infection

David Mills — Thu, 19 Feb 2015 15:24:59 GMT

[quote user="Arlo Guthrie"]I just mean that I think you need to have a more self-disciplined forum style! That is to say, don't feel you need to argue repetitively with everyone who disagrees your point.[/quote]

Hate to say I told you so, but, well, I did.

Re: Malassezia ear infection

Anthony Todd — Thu, 19 Feb 2015 15:19:14 GMT

[quote user="Martin Atkinson"]others dismissing your 'experience' [/quote]

Fortunately my reaction to my "load of tosh" when I suggested plucking ears seems, finally, to be supported by some vets still in practice which was what I was trying to get across.

I repeat "Sometimes some just have to accept that what a dinovet says really can be valid and is Experience Based Medicine."

The final irony is that "tosh" or "nonsense" are usually condemned without even a trial or experience.

Why change something which works just because treatment has "evolved" even though the "evolution"is more complicated, takes longer ,includes a GA, and is no more effective than the old way?

Unless it is that it is more expensive, takes longer and therefore justifies the fee?

Try plucking ears that are full of debris and hair , just for fun and to prove yourself right, even with your fingers.

You may be surprised how painless and easy it can be.

[quote user="Martin Atkinson"]And as Arlo implies the gramophone needle is stuck in the same groove all too often.[/quote]

That's 'cos it worked for me, and modvets won't accept it.

Try it, if it fails say so and everyone will know, just don't condemn something on theory or prejudice.

Re: Malassezia ear infection

Martin Atkinson — Thu, 19 Feb 2015 14:32:38 GMT

[quote user="Anthony Todd"]Seriously though, and returning to your comments, it seems to me that anything, or most things I state, based on experience is dismissed [as a load of tosh] but anything based on some sort of "evidence" usually a publication is regarded as gospel.[/quote]You forget Anthony that I am also a dinovet schooled by that great Brontosaurus Clive Matthews. But I survived the asteroid because I evolved, Sadly you seem to have failed to do the same. It is not so much a case of others dismissing your 'experience' but you dismissing anything that has happened since the asteroid struck And as Arlo implies the gramophone needle is stuck in the same groove all too often.

Re: Malassezia ear infection

Andrew Mellor — Thu, 19 Feb 2015 14:20:39 GMT

I like to pluck and see no evidence of problems caused. my assistant with only 1 year less experience does not pluck, doesn't think it helps in his cases, we both follow cases closely and owners do not complain about plucking and neither do the dogs , but are always terribly shocked at the huge volume of hair removed.

Re: Malassezia ear infection

Arlo Guthrie — Thu, 19 Feb 2015 14:14:01 GMT

[quote user="Anthony Todd"]I'm sure you'll reply, and I don't blame you.....[/quote]

Ah well, hoist by my own petard!

You're preaching to the converted. I think it is really very, very important to have dinovets contributing their experience, both because stuff gets forgotten (or not passed down), and to challenge new ways of thinking.

I just mean that I think you need to have a more self-disciplined forum style! That is to say, don't feel you need to argue repetitively with everyone who disagrees your point. Just make your point and only come back and argue if there is a substantively different point you want to make, or piece of evidence you want to present.

[quote user="Anthony Todd"]Diagnostic and treatment possibilities are increasing at the same rate as fees yet the results are no better in many cases than the methods used by dinovets and, IMHO, sometimes worse and always at greater expense and over a longer time which, ultimately will damage the reputation of the profession which we all love.[/quote]

Not sure about this. I mean, it is a beguiling idea that: "Back in my day, we could do a lateral bulla osteotomy for 4 shillings, with just a bowl of dog food laced with gin and a penknife." But the truth is, whilst there will always be examples of things that were done better in the past, the general direction of travel is of improved veterinary care.

One thing I completely agree with you about is the increasing cost of care (or more accurately, the cost of the increasing range of diagnostic and treatment options), which I think is a massive threat to the profession.

Re: Malassezia ear infection

Anthony Todd — Thu, 19 Feb 2015 13:17:50 GMT

[quote user="Arlo Guthrie"]Equally, Anthony, I think you need to try and adopt a slightly less, um, persistent approach! [/quote]

Arlo, what a load of tosh!

I'm sure you'll reply, and I don't blame you.....

Seriously though, and returning to your comments, it seems to me that anything, or most things I state, based on experience is dismissed [as a load of tosh] but anything based on some sort of "evidence" usually a publication is regarded as gospel.

I cite the paper published on aural haematomata and my experience with the same condition.....

Remember the "toxic" thyroxin gospel truth which turned out, on reading the actual paper, to be because three people were ALL dosing the dog!!

[quote user="Arlo Guthrie"]make your point and then leave it.[/quote]

Difficult to leave it when something you've done umpteen times which is effective cheap easy and has other advantages is dismissed without what I think are valid reasons and sometimes even as "tosh" or "nonsense".

I mean a GA to pluck ears, come on!

The profession gets so much bashing over fees which are increasing [and so is the bashing] and all I'm trying to get across is that I, and other dinovets, had the same clinical cases presented to us, probably in much greater numbers ,and [as far as we were concerned] "cured" them quicker and easier, as far as I can see, than some of the suggestions here.

Diagnostic and treatment possibilities are increasing at the same rate as fees yet the results are no better in many cases than the methods used by dinovets and, IMHO, sometimes worse and always at greater expense and over a longer time which, ultimately will damage the reputation of the profession which we all love.

Re: Malassezia ear infection

Kate Richardson — Thu, 19 Feb 2015 12:47:38 GMT

Apologies Arlo

Re: Malassezia ear infection

Arlo Guthrie — Thu, 19 Feb 2015 12:46:20 GMT

Kate and Anthony, order please! Oooorder.

To be fair, Kate, your first post to Anthony did read somewhat dismissively:

[quote user="Kate Richardson"]I'm sorry but what a load of tosh. [/quote]

I'm not altogether surprised Anthony reacted with a touch of sarcasm!

Equally, Anthony, I think you need to try and adopt a slightly less, um, persistent approach! By which I mean, make your point and then leave it. Don't just come back and argue just because someone disagrees with you - only if you have something substantive to add to the discussion.

eg. This doesn't really add anything useful to the discussion, and seems more as if intended to wind Kate up!

[quote user="Anthony Todd"]Two for, one against so far, so we still don't know which is "tosh". [/quote]

Re: Malassezia ear infection

Anthony Todd — Thu, 19 Feb 2015 12:08:16 GMT

Just out of general interest I found the following from a talk I gave around 1980.

I listed a load of consults and ops over the same period and these are the results.

Be interesting to see how times have changed.

These were just rough classifications but I doubt if "ears" would be up that high now?

Category, Cats & Dogs

Surgery incl. Teeth 21.40%

Vaccination 16.90%

Dermatology 10.40%

General Medicine 9.03%

Respiratory 8.40%

Ears 7.20%

Neutering 6.10%

Gastro-intestinal 5.50%

Cat bite sepsis 5.20%

Ocular 4.90%

Trauma 2.90%

"Advice" 1.40%

Skeletal 1.40%

Neurological 1.10%

of Surgical

Neutering 28.50%

Teeth 35.00%

Tumour 25.70%

Miscellaneous 10.80%

Of Dermatology

Fleas 48%

Allergic Dermatitis 15%

Acute Pyo. Traumatic 6%

Pyoderma 12%

Pedal Dermatitis 7%

Seborrhoea 4%

Alopecia 3%

Scabies 3%

Fungus 2%

"lick dermatitis" 2%

Demodex 1%

Arlo! It formatted lovely before I hit SEND!

Re: Malassezia ear infection

Anthony Todd — Thu, 19 Feb 2015 11:22:33 GMT

[quote user="John Flynn"]My take on ear plucking:[/quote]

Two for, one against so far, so we still don't know which is "tosh".

Does sounds like a GA mightn't be necessary. a

John seems to say the same as me, but puts it better.