A few cases of acute Pseudomonas otitis are also associated with significant swelling, edema, and inflammation. In these cases, I recommend dispensing 1 to
2 mg/kg of prednisone once daily for three to seven days. Table 2 provides guidelines for treating Pseudomonas otitis in dogs.
Table 2: Treatment Summary for Acute and Chronic Pseudomonas Otitis
Treatment for acute otitis is likely to be successful within one to three weeks. In chronic otitis cases, treatment duration
is typically at least four weeks and may last as long as three months or more. If systemic corticosteroid therapy, general
anesthesia, imaging, deep ear flushing, and aggressive topical and systemic therapy are necessary, the costs and the risk
of side effects increase.
In some cases, despite the best efforts of veterinarians and dog owners, a few patients with Pseudomonas otitis don't respond to medical therapy. At this point, the best option is a total ear canal ablation and bulla osteotomy.
Thankfully, this is rarely necessary if veterinarians pursue an aggressive diagnostic and therapeutic approach like the one
Finally, and most important, preventing a recurrence of otitis depends on the determination and control of the primary and
underlying causes of ear disease. In my practice, the primary cause of otitis is allergic, such as atopic dermatitis or adverse
food reactions. Less common causes include parasites, endocrine disorders, keratinization disorders, and neoplasia.
P. aeruginosa is one of the most common bacteria isolated from cases of infectious otitis. Although many cases of acute infection respond
to empirical topical treatment, dogs with chronic Pseudomonas otitis present an important challenge to clinicians. In these cases, successful outcomes depend on aggressive ear cleaning
with topical otic and systemic antibiotic therapy. If responses to initial empirical therapy are incomplete or unsatisfactory,
clinicians should immediately institute a bold diagnostic and therapeutic plan to effectively resolve the infection.
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