Otitis externa

RE: Otitis externa

David Bentley — Thu, 14 May 2020 14:10:33 GMT

Off license and no papers suggesting this, so only anecodotal, but Lamisil works very well. It contains Terbinafine, which is the antifungal in Osurnia and Neptra. I have used "Lamisil Once", which is a single use topical for human athletes foot, in a few cases of purley Malassezia otitis now. The first time I used it was in an elderly Peke with epitheliotrophic lymphoma that had a severe secondary Malassezia otitis (no previous history of otitis until it developed EL and wall to wall yeasts on cytology) that was completely resistant to any of the topicals containing azoles or sytemic Itraconazole. The only thing that worked was Osurnia. Not wanting to to have to continue using Osurnia long term as there was no need for either the steroid (it was already on pred) or the florfenicol, I tried an experiment with the owner's consent, to try Lamisil Once using half a tube in each ear every 2 weeks.. It worked amazingly well. If treatment was stopped the Malassezia. eventually came back. He went on to live for another year on this protocol before the EL finally took him. Although Lamisil Once comes as a gel, it is not the same gel that is used in Osurnia.

RE: Otitis externa

David Scarff — Thu, 14 May 2020 11:27:00 GMT

If there were really no other factors involved, topical Canesten 1% solution is often helpful. If there is concurrent allergic skin disease then some anti-inflammatory treatment may be required.And once the Malassezia have gone it is worth rechecking to see if bacteria have now appeared.

RE: Otitis externa

Mark Craig — Thu, 14 May 2020 10:50:02 GMT

It depends very much on the clinical presentation. Malassezia alone can be associated with severe pruritus and chronic changes in some dogs whereas in other dogs the presentation is mild. You also need to assess how much Malassezia is present. Some level is normal. If there is an overgrowth, ideally you should investigate why and aim to correct or address any predisposing factors. In severe cases, some degree of anti-inflammatory therapy, probably steroids (systemic and/or topical), will probably be necessary, at least for a while.