Otitis Externa with no microbial cause

RE: Otitis Externa with no microbial cause

Stephen Shaw — Wed, 13 May 2020 15:43:04 GMT

Have you ruled out localised demodicosis?

RE: Otitis Externa with no microbial cause

Anthony Dennison — Sun, 10 May 2020 09:45:52 GMT

Many thanks for both the replies - I will speak to the owner and switch to cortavance long term.

RE: Otitis Externa with no microbial cause

David Bentley — Sat, 09 May 2020 14:07:02 GMT

Most likely allergic cause. As is young and could be either Atopy or food allergy, I would do a food trial before considering control using long term topical steroids (prefer Cortavance). Apoquel is fairly useless at controlling atopic otitis . If Atopic , provided the ears are the only part of the skin affected (10% atopics only have it in their ears) then long term Cortavance twice weekly is a perfectly acceptable way of controlling the otitis. I would have the dog in for regular checks initially to be sure it is being kept under control and no secondary infections . There is no risks using Cortavance long term twice weekly and unless the problem is definitely seasonal it’s best to keep using it every week as you never know when a flare could occur and this regime has be proven to significantly reduce the frequency of flares with atopic otitis. (and dermatitis). If other parts of body become affected I would consider allergy testing and immunotherapy. Apoquel/Cytopoint doesn’t help much with otitis.. Recicort is much more likely to induce comedomes than Cortavance as the hydrocortisone aceponate in Cortavance is metabolised in the skin and less likely to build up in the skin than Triamcinolone

RE: Otitis Externa with no microbial cause

Rosario Cerundolo — Sat, 09 May 2020 13:49:20 GMT

Hi,
it sounds an unusual clinical presentation and it could still be an allergy which is flaring up this time of the year. It is unusual to see comedones on the inner pinnae. If topical steroids are enough to "control" the problem I would go for that rather than use a systemic medication. Perhaps topical Cortacare/Cortavance daily or every other day on the inner pinane may be enough..