Ear wicks and pseudomonas

RE: Ear wicks and pseudomonas

Beats — Tue, 27 Dec 2022 10:41:58 GMT

[quote userid="2145" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30522/ear-wicks-and-pseudomonas"]Will not allow owner to apply topical treatment. Takes two nurses and a muzzle to allow us to exam or clean or apply treatment to an ear. [/quote]

This is a TECA-LBO for me. I personally hate the surgery, and regret it during the procedure, but as yet never afterwards.

I would say the exception may be an older patient near the end of its life or something, but I generally find that a week after surgery you and the owner look at each other and both think "why did we not do this 5 years ago".

That said, there are patients where i can see I have advised TECA-LBO before and they have not done so (I advise them that there of all risks and that is pretty off-putting, but would prefer this than get a para-aural abscess sometime and hadn't warned that it might occur and be worse to deal with than original otitis) and years later they are still doing all right or things have settled down.

In answer to your question, I didn't find ear wicks either last time I looked.

RE: Ear wicks and pseudomonas

Alistair Graham-Evans — Sat, 24 Dec 2022 03:44:41 GMT

[quote userid="3169" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30522/ear-wicks-and-pseudomonas/240315#240315"]TECA a valid option, but LWR remains a valid choice and cheap and much lower risk - don't think I've ever seen a dog not improve.[/quote]

On the other hand my experience is that these won’t clear especially with that temperament preventing intense topical treatment and if the infection has got to the middle ear.

These dogs suffer painfully, and radical surgery is actually the cheapest option in the long term - no need to clear infection prior either. Respectfully I don’t think LWR is going to guarantee a cure. These dogs can have a personality change after surgery because they are comfortable within a day or two of surgery.

I have done a few when the owners have run out of money at the dermatology referral centre and I don’t understand why the dermatologist specialist is often seem so reluctant to opt for surgery. Obviously there were still funds but ongoing expenses with no end in sight was depressing for them and my surgery looked cheap compared to what they had paid already!

Do you want to back me up here Alasdair? Your video is excellent for a procedure that is tricky to catch on camera! I have done many of these and never regretted any.

RE: Ear wicks and pseudomonas

Michael Woodhouse — Fri, 23 Dec 2022 23:41:36 GMT

[quote userid="2145" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30522/ear-wicks-and-pseudomonas"]failing that can you suggest how to treat a beagle with Proteus and Pseudomonas.[/quote]

What dose of prednisolone is the dog getting?

Controversial, but I don't really believe pseudomonas to be an antimicrobial resistance issue, but an environmental issue.

Open up stenotic canals, pain relief, flush under GA.

Lot of steroids, throw in some extra analgesia (Pardale, gabapentin)

TECA a valid option, but LWR remains a valid choice and cheap and much lower risk - don't think I've ever seen a dog not improve.

RE: Ear wicks and pseudomonas

Alistair Graham-Evans — Fri, 23 Dec 2022 22:26:34 GMT

If untreatable consider radical resection and bulla osteotomy