Canesten in yeast infection!

RE: Canesten in yeast infection!

Yantha Smyth — Sun, 22 Mar 2020 14:56:07 GMT

I cannot recall what cod it was but have made notes that clotrimazole alone safe if TM ruptured. I also recently used this, and read the SPC for humans and the product is licensed for otitis external and otitis media, if that helps.

RE: Canesten in yeast infection!

Anthony Todd — Sun, 22 Mar 2020 13:37:30 GMT

[quote userid="8858" url="~/001/veterinary-clinical/small-animal/dermatology/f/discussions/28971/canesten-in-yeast-infection/220627"]all/most of the licensed products also contain a steroid,[/quote]

I have always treated virtually any otitis with a prep containing a steroid, and often just a steroid alone, and often the potent human preps.

I wondered, but usually assumed, that the increased sebum in, say allergic otitis [or mites, where they need to go]] was the trigger for a massive rise in malassezia rather than the malassezia per se.

Can you produce an otitis externa by instilling just a culture of malassezia?

RE: Canesten in yeast infection!

Beats — Sun, 22 Mar 2020 13:13:32 GMT

[quote userid="9440" url="~/001/veterinary-clinical/small-animal/dermatology/f/discussions/28971/canesten-in-yeast-infection/220633"]Is it considered as following the cascade if you use it as a first line product to treat a dog with a yeast infection in the ear ?[/quote]

I think that would best be described as 'controversial' [defining controversial as something where some people think one thing and others think the opposite]..

I think an argument can be made both ways.

I don't think there is a universally-agreed answer to that question.

Equally, if your question was "is it considered appropriate professional behaviour for a vet to use first line a product containing useful systemic antimicrobials of critical importance in human healthcare to treat a dog with a yeast-only infection in the ear" or "is it considered as defensible to use first line a product to treat a dog with a yeast infection in the ear with a product clearly stating do not use in the presence of a ruptured tympanic membrane if you either believe there to be a ruptured tympanic membrane or have not confirmed the tympanic membrane to be intact", I would also describe this as 'controversial'.

RE: Canesten in yeast infection!

janine redman — Sun, 22 Mar 2020 13:01:34 GMT

Is it considered as following the cascade if you use it as a first line product to treat a dog with a yeast infection in the ear ?

RE: Canesten in yeast infection!

Beats — Sun, 22 Mar 2020 12:38:20 GMT

"Clotrimazole alone (Canesten®, unlicensed in animals), appears to be safe in the middle ear, so could be considered in cases with a ruptured tympanic membrane. " from the Liverpool crew [

Malassezia in dogs and cats: Part 1

Vanessa Schmidt BSc BVSc CertVD MRCVS

Tim Nuttall BSc BVSc PhD CertVD BCiol M***IBiol MRCVS, SENIOR LECTURER IN VETERINARY DERMATOLOGY

First published: 30 September 2010

https://doi.org/10.1111/j.2044-3862.2008.tb00273.x

I guess depends what the complaint is. If it is lack of effect, then if there were no steroids used that might be the reason. if the complaint is that signs of vestibular problems has developed, then I guess that could happen with pretty much any product used. If it was messy and got all over the expensive sofa and ruined it [i have no idea if this might happen] after following the vets advice, then maybe not a great idea in future without advice to mitigate this?

RE: Canesten in yeast infection!

Andreas Ege — Sun, 22 Mar 2020 12:27:18 GMT

[quote userid="9440" url="~/001/veterinary-clinical/small-animal/dermatology/f/discussions/28971/canesten-in-yeast-infection"]One of my new colleagues is using canesten , human clotrimazole, as a first line treatment for dogs with confirmed ear infections due to Malassezia. [/quote]

When I started working we very frequently used canesten (human clotrimazole) to treat dermatophytosis in exotics (guinea pigs, rabbits, and I think, in a couple of cats). Worked really well and we didn't observe any adverse reactions. Never used it in ears, though.

Besides, I might be wrong here, but I remember having read at least a couple of articles about otitis externa saying if it is "only" yeast overgrowth it doesn't need antifungal treatment, as long as one gets on top of the underlying skin problems. I certainly have seen a few dogs in one practice where the otitis seemed to have cleared up using only predni (wasn't me initiating the treatment, am not brave enough to do if not already established in a practice ;-) ).

RE: Canesten in yeast infection!

Richard Carter — Sun, 22 Mar 2020 12:10:03 GMT

[quote userid="9515" url="~/001/veterinary-clinical/small-animal/dermatology/f/discussions/28971/canesten-in-yeast-infection/220628"]I sometimes use Cortavance [/quote]

Virbac has a recipe of cortavance into epi-otic that works really well as well as using cortavance syringed by drops undiluted directly into ears for those chronic ot.ext cases where nothing works anymore on the stenosis

RE: Canesten in yeast infection!

Sarah Keir — Sun, 22 Mar 2020 11:08:58 GMT

I don't think the unlicensed product is 'safer' but contains less ingredients that might cause issues, especially as some of the antibiotics are particularly ototoxic (esp gentamycin). Actually steroids are very helpful in these cases - I sometimes use Cortavance to keep those long term ones under control (think spaniels or basset hounds).

RE: Canesten in yeast infection!

Jill Butterworth — Sun, 22 Mar 2020 11:00:12 GMT

Unless I'm missing something too, all/most of the licensed products also contain a steroid, so maybe they want to avoid that?

RE: Canesten in yeast infection!

Gillian Mostyn — Sun, 22 Mar 2020 10:41:30 GMT

But if the licensed products are deemed unsafe with a ruptured TM, what makes using unlicensed clotrimazole any safer? Or am I missing something?

RE: Canesten in yeast infection!

janine redman — Sun, 22 Mar 2020 10:24:45 GMT

I have no problem with using a clotrimazole only product but had a complaint about it from a client and need to be as certain of my facts as possible before discussing it next week

RE: Canesten in yeast infection!

Sarah Keir — Sun, 22 Mar 2020 08:52:33 GMT

Do we know if clotrimazole is safe if the tympanic membrane is ruptured?

In reality we often don't know if the TM is ruptured and I did some CPD in the past year that even with inspection under GA, we missed that most the TM are ruptured in canine otitis externa! So in reality, I and I am sure most of my colleagues are putting in ear drops in dogs ears every day with ruptured TM. How often do we see a problem? I have never knowingly seen a problem except in cats.

To the original poster, I have started using this in select cases over the past year as I aim to modernise how ear problems are dealt with. Good success so far.

RE: Canesten in yeast infection!

Beats — Sun, 22 Mar 2020 08:28:50 GMT

[quote userid="9440" url="~/001/veterinary-clinical/small-animal/dermatology/f/discussions/28971/canesten-in-yeast-infection/220619"]but there are products which have a license for treating otitis external caused by malassezia [/quote]

these products may also contain antibacterials of critical importance in human healthcare - are such products therefore appropriate to prescribe in the absence of bacterial infection?

perhaps see what your colleague's results are like before imposing your own approach - it may yet turn out that their idea is better than yours? I would keep an open mind and see what their results are like, perhaps even ask them a bit more about their approach and try it out for yourself!

RE: Canesten in yeast infection!

janine redman — Sat, 21 Mar 2020 23:33:38 GMT

but there are products which have a license for treating otitis external caused by malassezia

RE: Canesten in yeast infection!

Evelyn Barbour-Hill — Sat, 21 Mar 2020 22:10:46 GMT

To the best of my belief (could be wrong) there is no licensed veterinary product whose only active ingredient is clotrimazole.