Ear margin inflammation in a Cocker Spaniel

RE: Ear margin inflammation in a Cocker Spaniel

Judith Joyce — Wed, 04 Nov 2020 11:22:52 GMT

Thank you David, its good to share experiences with you and David B, etc. who, like me, have been dealing with stubborn cases like this one for more years than I care to remember and share the frustrations. Not one of my favourites - those big, floppy ears turn into oozing pendulums,

RE: Ear margin inflammation in a Cocker Spaniel

David Scarff — Wed, 04 Nov 2020 11:11:41 GMT

Judith, what an excellent summary!

RE: Ear margin inflammation in a Cocker Spaniel

Judith Joyce — Wed, 04 Nov 2020 10:16:57 GMT

As the condition has been going on for a few years, I don't think its too surprising that the histopath describes chronic changes and the primary condition is likely to be obscured, and you may now be dealing with stubborn secondary changes, rather than the primary condition. I would favour going back to the start with a diagnostic investigation, covering all bases, while treating the secondary change. I wouldn't repeat the biopsies unless you have to, as I think you will likely just get secondary change and will risk more ear margin bleeding, Spaniels are a nightmare for responding to everything with scaling and crusting which obscures the clinical picture and underlying condition. As well, as the environmental change in moving to New Zealand, is it worth ruling out possible other changes associated with the move? Parasitic condition ( I have seen similar with lice), dietary change (?? Vitamin A, zinc, etc), Agree I've seen similar with hypothyroidism, though not so severe. Agree that it is easier to make it worse with topical treatments. I've had to hospitalise cases like this because they are decorating the client's house every time they shake their head. Gentle soaks (e.g. Sebolytic and rinse if it doesn't result in bleeding) and topical emollients 1-2 x weekly, I would combine with oral prednisolone (maybe starting the prednisolone first, to monitor progress and stop if there isn't a rapid improvement) If not contraindicated for other reasons, having ruled out demodicosis and dermatophytosis. I try and avoid taking the clippers/scissors to these, if possible without comprising the treatment, to avoid making the bleeding worse. Good luck, nightmare to treat, especially when longstanding and inherited from someone else.

RE: Ear margin inflammation in a Cocker Spaniel

David Scarff — Wed, 04 Nov 2020 09:39:35 GMT

I do split tablets, although we don't know if this has a significant effect on the pharmacological action. I believe the drug itself does not last long whilst in the blood.

RE: Ear margin inflammation in a Cocker Spaniel

David Scarff — Wed, 04 Nov 2020 09:37:43 GMT

Propentofylline is licensed, so perhaps should be tried first - over many cases I have had more success with Trental, including those where I have tried Propentofylline first

RE: Ear margin inflammation in a Cocker Spaniel

Sarah Keir — Wed, 04 Nov 2020 09:32:03 GMT

The case I manage is on the Vitofyllin brand of propentofylline and these are 50mg tablets - the 10kg dog is on one BID.

RE: Ear margin inflammation in a Cocker Spaniel

Holly Lee — Tue, 03 Nov 2020 23:10:06 GMT

Thanks everyone for your responses.

I have no experience with Pentoxifylline, looking at the formulary I'm looking at a dose of 15mg/kg q8-12h. Is this what people typically use. It looks like the only available tablets to me are Trental 400mg modified release - are people splitting these to get accurate dosing?

Sounds worthwhile to do some thyroid testing even if there's an outside chance of involvement.

Thanks, Holly

RE: Ear margin inflammation in a Cocker Spaniel

Joyce Whitehead — Tue, 03 Nov 2020 13:59:28 GMT

We had a case similar to this in a Doberman which we referred to a dermatologist as it didn’t respond to anything we tried. Eventually put on thyroid supplementation by the derm vet, after sampling. He wasn’t an obvious hypothyroid on bloods but it definitely improved with the meds, and became much less sore and less inclined to bleed. So worth checking thyroid function I think.

RE: Ear margin inflammation in a Cocker Spaniel

David Scarff — Tue, 03 Nov 2020 11:50:36 GMT

Hi Holly, if there is tissue loss assoociated with the lesions then vasculitis is quite likely, although this may be concurrent with 'ear margin seborrhoea' whatever that truly is! My problem with potent topical steroids is their ability to thin the skin of the ear margin which can be counter productive. I've had most success with pentoxyfilline (Trental), although response is not rapid (need to trial treatment for at least four weeks).

RE: Ear margin inflammation in a Cocker Spaniel

Sarah Keir — Tue, 03 Nov 2020 10:25:52 GMT

idiopathic immune mediated vasculitis?

RE: Ear margin inflammation in a Cocker Spaniel

David Bentley — Mon, 02 Nov 2020 09:13:37 GMT

I would consider GA and hydrating all the crusts and removing them and clipping any hair that is still growing on the ear margins, followed up with a steroid/antibiotic cream/gel e.g. Fuciderm gel, on the lesions for a few days prior to continuing anti seborrhoeic shampooing. If it is a primary keratinisation disorder (likely in this breed) that is getting so hyperkeratotic that it is causing fissures, then regular shampooing with a salicylic acid containing antiseborrheic shampoo such as Sebolytic may have to continue indefinitely to prevent it from getting as bad as it has been.

If the pathologist is wrong and there is some vasculitis, then a trial of Pentoxyfylline may be worth trying?

RE: Ear margin inflammation in a Cocker Spaniel

Gillian Mostyn — Mon, 02 Nov 2020 08:20:17 GMT

I'd also be trialling corticosteroids....