Table 2: Treatment Summary for Acute and Chronic Pseudomonas Otitis
|
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.
Follow-up
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
outlined above.
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.
Conclusion
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.
References
1. Cole LK, Kwochka KW, Kowalski JJ, et al. Microbial flora and antimicrobial susceptibility patterns of isolated pathogens
from the horizontal ear canal and middle ear in dogs with otitis media. J Am Vet Med Assoc 1998;212:534-538.
2. Seol B, Naglic T, Madic J, et al. In vitro antimicrobial susceptibility of 183 Pseudomonas aeruginosa strains isolated from dogs to selected antipseudomonal agents. J Vet Med B Infect Dis Vet Public Health 2002;49:188-192.
3. Martin Barrasa JL, Lupiola Gomez P, Gonzalez Lama Z, et al. Antibacterial susceptibility patterns of Pseudomonas strains isolated from chronic canine otitis externa. J Vet Med B Infect Dis Vet Public Health 2000;47:191-196.
4. Colombini S, Merchant SR, Hosgood G. Microbial flora and antimicrobial susceptibility patterns from dogs with otitis media.
Vet Dermatol 2000;11:235-239.
5. Lloyd DH, Bond R, Lamport I. Antimicrobial activity in vitro and in vivo of a canine ear cleanser. Vet Rec 1998;143:111-112.
6. Cole LK, Kwochka KW, Kowalski JJ, et al. Evaluation of an ear cleanser for the treatment of infectious otitis externa in
dogs. Vet Ther 2003;4:12-23.
7. Lambert RJ, Hanlon GW, Denyer SP. The synergistic effect of EDTA/antimicrobial combinations on Pseudomonas aeruginosa. J Appl Microbiol 2004;96:244-253.
8. Lode H, Borner K, Koeppe P. Pharmacodynamics of fluoroquinolones. Clin Infect Dis 1998;27:33-39.
|
Featuring Information from:
