Today's Veterinary Practice

MAY-JUN 2017

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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60 DERMATOLOGY DETAILS DERMATOLOGY DETAILS The Challenge of Chronic Otitis in Dogs— From Diagnosis to Treatment Sandra Koch, DVM, MS, DACVD College of Veterinary Medicine, University of Minnesota DERMATOLOGY DETAILS Canine chronic and recurrent otitis externa can be extremely challenging to treat and require multifactorial, step-by-step strategic plans. Understanding otitis and its associated causes and contributing factors is an important initial step toward successful diagnosis and treatment. UNDERSTANDING OTITIS: CAUSE AND PATHOGENESIS Understanding the multifactorial nature of otitis and paying attention to the different causes and contributing factors, not just the infection, is critical because the infection is usually only part of the problem ( Figure 1 ). The most recently proposed classification for otitis includes primary and secondary causes and predisposing and perpetuating factors ( Table 1 ). 1–3 Primary Causes Primary disorders initiate the inflammatory process within the ear canal and alter the aural environment, allowing secondary complicating factors, such as infections, to develop. The primary cause may be very subtle and often is unrecognized by the owner or even the veterinarian until a secondary complicating factor arises. Most cases have a primary cause. In a retrospective study 3 of 100 dogs with acute (37%) and chronic-recurrent (63%) otitis externa, the most common primary cause of otitis was allergic dermatitis (43/100 dogs; Figure 2 ), followed by grass awns (12/100) and otoacariasis (7/100). No primary factor could be identified in 32 of 100 cases. Allergic and hormonal diseases can be associated with shutterstock.com/135 pixels FIGURE 1. Pathologic cycle for chronic otitis externa.

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