Alternative treatments or control groups were not used in this study. There are several reasons for this study design. Because
of the nature of the condition, a crossover study is impractical because the use of appropriate treatment may result in clinical
resolution.6 Untreated controls were not used because spontaneous cure was unlikely in patients that had been unsuccessfully treated with
topical or systemic therapies for at least six weeks before enrollment in the study. Additionally, Pseudomonas species are a perpetuating factor of otitis capable of maintaining an inflammatory response,6 and all patients had to be treated for humanitarian reasons. We did not determine whether twice-a-day flushing for 14 days
with another product would produce similar results, although a single flush with saline solution before the Sanova treatment
did not significantly alter culture counts. This suggests that the significantly reduced culture counts are not due to dilution
Underlying causes of ear disease were not addressed in this study because of the study's short evaluation period. We recognize
that successful management of ear disease requires diagnosis and treatment of primary and perpetuating factors.
Additional studies are needed to determine whether a more frequent treatment interval or a prolonged treatment period would
result in a higher percentage of cures, as evidenced by clinical signs and bacterial cultures. Direct comparisons to products
containing appropriate antibiotics (identified by bacterial culture and antimicrobial sensitivity testing) may help in determining
the most efficacious treatment protocol. Additionally, Sanova may be more effective when used in conjunction with antibiotics.
Developing a commercially available susceptibility test for Sanova would help to determine its proper place in the treatment
of individual cases. However, the results of this study demonstrate that this cleanser is generally helpful in treating uncomplicated
otitis externa caused by P. aeruginosa and may be especially appropriate when sensitivity data show that other antimicrobial therapy is unavailable or impractical.
Editor's note: This study was presented orally at the American Academy of Veterinary Dermatology and the American College
of Veterinary Dermatology Annual Meeting in Kansas City, Mo., in April 2004. The abstracts from this meeting have been published
in Vet Dermatol 2004;15(3):199-206.
The authors acknowledge Alcide Corporation of Redmond, Wash., for its material support in the form of providing Sanova for
this study. They also thank Chandra Cristofono, CVT, for her technical assistance.
Tim B. Strauss, DVM, DACVD
Tricia M. McKeever, MS, PhD*
Midwest Veterinary Dermatology
11850 Aberdeen St. NE
Blaine, MN 55449
Patrick J. McKeever, MS, DVM, DACVD
McKeever Dermatology Clinics
7723 Flying Cloud Drive
Eden Prairie, MN 55344
*Current address: Division of Respiratory Medicine, University of Nottingham, University Park, Nottingham, UK NG7 2RD
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