Problematic Otitis Externa in Diabetic dog

Re: Problematic Otitis Externa in Diabetic dog

Malcolm Ness — Wed, 01 Dec 2010 10:21:05 GMT

Don't discount surgery - properly executed lateral wall resections will improve ventilation and establish drainage and will usually render previously problematic ears treatable and resolve discomfort etc. That holds true even for most pseudomonas infected ears.

Salvage surgery - TECA and bulla osteotomy - remains an effective option. Ear surgery (LWR or TECA/LBO) is a little more technically demanding than many think - most failures can be put down to technical error.

Re: Problematic Otitis Externa in Diabetic dog

Heather Toft — Tue, 30 Nov 2010 23:06:51 GMT

I've always assumed the systemic absorption of steroid from topical products to be fairly negligible so have given them in diabetics and in animals getting concurrent systemic NSAIDs etc. Maybe I should be more careful, but I've never knowingly encountered problems. Sounds like the dog needs something to reduce inflammation in the ears.

Re: Problematic Otitis Externa in Diabetic dog

Michael Woodhouse — Tue, 30 Nov 2010 22:55:09 GMT

[quote user="Gillian Mostyn"]With diabetics I use ear drops with steroids in because they are likely to be the most efficaceous treatment. In fact, unless very contraindicated I use whichever meds are likely to be effective, even low dose corticosteroids if necessary. I figure the stress caused by the pain of sore ears (ouch!) is just as likely to upset the diabetes control as my treatment - no?[/quote]

With you there.

Re: Problematic Otitis Externa in Diabetic dog

Mark Hedberg — Tue, 30 Nov 2010 20:52:26 GMT

Systemic absorption of steroid from ear drops is pretty low, especially if we consider the fact that you're only putting in 5-10 drops in the ear.

If you've got chronic oe, you might want to do T4, just to rule out a concurrent hypothyroidism. Autoimmune polyglandular syndrome could be a cause of complicated diabetes management (you said you had only just gotten it stabilized?) and chronic ear issues may mean the ear canal tissue has underlying causes. TT4 is reasonably cheap to do; if you haven't had steroids in then you shouldn't be affecting the results.

Re: Problematic Otitis Externa in Diabetic dog

Christopher Saul — Tue, 30 Nov 2010 19:22:32 GMT

If you have a pseudomonas I would request an extended culture and sens to include the antipseudomonal penicillins - eg ticarcillin etc

Re: Problematic Otitis Externa in Diabetic dog

Gillian Mostyn — Tue, 30 Nov 2010 17:54:44 GMT

With diabetics I use ear drops with steroids in because they are likely to be the most efficaceous treatment. In fact, unless very contraindicated I use whichever meds are likely to be effective, even low dose corticosteroids if necessary. I figure the stress caused by the pain of sore ears (ouch!) is just as likely to upset the diabetes control as my treatment - no?

Re: Problematic Otitis Externa in Diabetic dog

Rebecca MacMillan — Tue, 30 Nov 2010 17:43:48 GMT

Are the use of topical steroids in ear drops generally an issue in diabetic animals? I presume that they are contraindicated, but how much of the drug really gets into the dogs system to cause an adverse effect? Just curious really, as I would also like to know how best to manage these problem cases!

Re: Problematic Otitis Externa in Diabetic dog

Andrew Mellor — Tue, 30 Nov 2010 16:07:01 GMT

white ( DISTILLED MALT) vinegar 1 part to 10 of water works increadibly well for that creamy yellow horrible otitis you get with pseudomonas or proteus, have lots of cases that have fasiled with conventional treatments but done really well on vinegar washes tend to get owners to syringe 0.5-1 ml twice daily and try nsaid for stenosis.

Re: Problematic Otitis Externa in Diabetic dog

Clive Ansell — Tue, 30 Nov 2010 16:01:19 GMT

I have had a similar case. A dog was booked in for surgery today, TECA/BO, but has responded so well to mediactions that I have decided to postpone surgery for now. He was seen a month ago in a rescue centre, so no history, with a terrible and chronic OE and stenosed ear canal. bacterial cultured showed a pseudomonas sensitive to Fluoroquinolones. He has had a month of daiily ear cleaning and been on Baytril and Aurizon, no systemic steroids, and the improvment is amazing.

Re: Problematic Otitis Externa in Diabetic dog

Anonymous — Tue, 30 Nov 2010 15:49:47 GMT

Good luck

Don't know if any use, but have used 'Cortivance' in dog's ears before with thought that less systemically absorbed steroid to upset diabetes.