how do you manage cytology for ear swabs

RE: how do you manage cytology for ear swabs

Dinu Catilina — Mon, 03 Mar 2025 13:39:53 GMT

I also stopped doing ear cytology. I used to try and do it for every case but it's almost always the same result and it's always the same approach after getting the result. Find the cause, treat the inflammation, use steroids and you may not even need antibiotics.

One of my dogs has recurent otitis, she has dust mites allergies and is on Apoquel. All I use is topical corticoids and it heals as quickly as if I used antib/antifunal/steroids products.

RE: how do you manage cytology for ear swabs

Judith Joyce — Sat, 22 Feb 2025 09:49:41 GMT

Once daily usually

RE: how do you manage cytology for ear swabs

Elizabeth — Sat, 22 Feb 2025 07:16:09 GMT

If you're just using preds and ear cleaner, how often do you get them to clean the ears?

RE: how do you manage cytology for ear swabs

Judith Joyce — Mon, 17 Feb 2025 11:29:47 GMT

I agree with David and Beats about the use of Epiotic (occasionally Malacetic) and oral prednisone and the secondary bacterial (including Pseudomonas) and fungal contaminants/overgrowths/infections associated with inflammatory ear disease. Also with the inconvenience to the client of waiting for cytology results and repeat trips for drugs. As they say you can get a long way with a history and clinical examination, including visual assessment of the cerumen and ear canal and smell.

We only stock one polypharmacy ear drop (inc. antibiotics) It does for all the acute single onset ears pretty much regardless of cause (except ear mites and foreign bodies). Rapid relief for a very painful condition, especially what I call acute moist dermatitis of the ear, which is so painful you don't get a good look down.

But I do find cytology useful for finding ear mites and assessing chronic ears. The underlying inflammatory disease is aggravated by the bugs, so I find knowing a bit about the devil I'm dealing with useful. Clients find it hard to differentiate between recurrent and chronic and the secondary changes to the ear canal and ceruminal glands do make for a permanent battle ground, so I do use cytology in anything vaguely recurrent/chronic, certainly if it needs sedation or GA to assess.

I take a bit longer to look at cytology and feel the pressure too much to do mine in a consult, so I do them at the end of the session and report by phone.

I'm not brave enough to hold up treatment while I do it though, which sometimes means changing tack at re-examaination but, if the client is primed to the idea of first aid, followed a follow up to discuss longterm issues, that doesn't usually cause problems.

It is a bit at odds with the some of the pharmaceutical companies interpretation of antibiotic stewardship maybe, but I hardly ever chop and change polypharmaceuticals with antimicrobials, and incredibly rarely, if ever, do a repeat prescription for an antibiotic containing polypharmaceutical, which I think mitigates the initial antibiotic use.

RE: how do you manage cytology for ear swabs

David Mills — Mon, 17 Feb 2025 09:01:56 GMT

Why do people bother with ear cytology? I've asked a number of people this and there is no convincing answer.

To check for bacteria? Almost always present.

To check for malssezia? So what? They're secondary and not an indication for an anti-fungal.

To check for rods? It doesn't change antibiotic (if we should be even using one) selection anyway! Let's not forget C/S correlates poorly with clinical effect. A study on cytology compared to C/S was only around 60% correlation I believe.

As Beats says the vast majority of ears can be solved with steroids (systemic or topical) and cleaning given that most ears are inflammatory. Ear cytology seems to be at best superfluous and at worst a poor test which may add pointless expense.

RE: how do you manage cytology for ear swabs

Beats — Sun, 16 Feb 2025 21:36:04 GMT

there is also the option of using a steroid solution and a separate anti-yeast solution (where required beyond simply a cleaner and steroid) in the ear.

It doesn't all have to be in the same bottle (but adding some colvasone to a bottle of otodine if you are not precious about the excessive use of chlorhexidine would achieve the objective in a single bottle)

do we really want to start over-using using useful systemic antifungals (don't come along that often) down the ear canals of dogs? Do we think that is necessary?

Some pred tablets and a bottle of epiotic will cure a large number of ear problems without resorting to the use of useful systemic anti-bacterial or anti-fungal drugs.

Some topical, effective and non-irritating steroid then used routinely, say a couple of times a week, will stop the majority of cases recurring, with regular cleaning in selected cases also.

RE: how do you manage cytology for ear swabs

Rob Loxley — Sun, 16 Feb 2025 10:01:07 GMT

[quote userid="7232" url="~/f/clinical-questions/31135/how-do-you-manage-cytology-for-ear-swabs/246570#246570"]

Mostly cocci/malassezia but until a licenced monotherapy for malassezia is available I wonder what is I’m going to change.

The BOVA product Zoe listed is interesting - if licensed

[/quote]

If you don't need the antibiotic of a licensed polytherapy you are surely justified in using the cascade. The bova product is rather expensive however!

RE: how do you manage cytology for ear swabs

Mark Holmes — Sun, 16 Feb 2025 09:59:01 GMT

I do it but tbh I could probably predict 75% of the results on the appearance/smell

Very occasionally I will get a purely inflammatory ear.

Mostly cocci/malassezia but until a licenced monotherapy for malassezia is available I wonder what is I’m going to change.

The BOVA product Zoe listed is interesting - if licensed. It’s completely impractical confidently assessing a tympanic ear drum in a dog with or so I guess it will in go along with the other drops.

RE: how do you manage cytology for ear swabs

zoe north — Fri, 14 Feb 2025 19:12:18 GMT

Yes, I am prescribing a lot less antibiotics than I used to with this method but it is case led. My clients are usually ok when I explain if they need to come back, I would recheck the ears anyway at a suitable interval. Obviously, there are some who are not so tolerant but that's usually the dogs who actually need a proper work up and have not had it in the past - "vet hoppers"

RE: how do you manage cytology for ear swabs

ian bates — Fri, 14 Feb 2025 15:43:40 GMT

Hi Zoe - so you make the client come back if you find reason to prescribe antibiotic? Do clients readily accept that?

RE: how do you manage cytology for ear swabs

zoe north — Fri, 14 Feb 2025 13:06:19 GMT

Bova make an Ear Spray with Terbinafine and Mometasone 15ml but care with ruptured tymp membranes (advice from BOVA)

I'v been using otodine with added steroid for quite a few ears with success lately, but I clean the ear in consult to demo how to clean and so we start with a clean ear.

I do try to manage owners expectations to advise that ear disease is not often an isolated or inciting issue and may take some time and thought to resolve without creating super resistance.

I do charge for microscopy/cytology, and do at end of consulting session.

RE: how do you manage cytology for ear swabs

Allison Gleadhill — Fri, 14 Feb 2025 12:21:02 GMT

Take it in consult nip upstairs to stain it & look at it, takes @3 minutes don’t charge anything for it other than consult fee. Find it really useful to chose drops , also as o sees I have to do something to choose medication I think they are less likely to start just putting something their auntie had left over in the ear.