15. Oh no my middle ear... and its chronic...

What is the drug that can cause ototoxicity?

Aminoglycosides

What are the TWO things that leas AG to causing ototoxicity?

- damage to hair cells in cochlea

- damage to cranial VIII

What can damage to the hair cells in the cochlea and CN VIII lead to?

deafness

When you are palpating the ears what are you feeling for?

stenosis or fibrosis of the ear canal

What neurologic exam is an elective stimulation that tells you if the dogs has the ability to hear or not?

brain auditory evoked response test (BAER)

What dog breed has to get the BAER test done at birth because they notoriously birth deaf puppies?

dalmatians

What are the FOUR clinical signs of Horner's Syndrome?

- Miosis (small pupil)

- Elevation of the 3rd eyelid

_ Enopthalmia (sunken globe)

- Ptosis (droopy upper lid)

What are the TWO things you should do to start?

- ear swab cytology

- otoscopic exam

What is more common to see in the ears on a gram stain??

G- rods

You have Sissy, a 9 y/o DSH, present to you for an ear infection. On the physical exam, you see this. What's happening?

polyp

When doing an otoscopic exam, what is a good marker to tell you to stop because the ear drum should be right behind them?

hairs of the cochlea

T/F In the derm world, we LOVE steroids so you can give them to calm down the inflammation

True

What is it called when there is a diseased ear that is rarely infected but rather has mucus and snot in the ear?

primary secretory otitis media

What dog breed is predisposed to PSOM for whatever reason?

Cavalier King Charles Spaniel

What drug should you consider if the ear is stenotic and why?

oral pred beucase if you can get in the ear then you cant put meds in there so you need something to decrease the inflammation

When should the owner bring the dog back after starting the pred? Why?

14 days to see if the swelling has decrease and then you can make the decision if the dog needs to go to surgery or not

What are the TWO potent synotic topical steroids that cane be given?

-flucinolone

- DMSO

What are the TWO concerns with DMSO?

- carcinogenic

- wear rubber gloves

T/F It is okay to wear rubber or latex gloves when applying DMSO treatment to your dog

False, it can spread through the latex

What is a poor prognostic indicator for medical management of otitis media?

inability to open the ear canal enough to get otoscopy in there (post 14 days of pred)

What are the FOUR indications for Myringotomy?

- middle ear involement with intact TM

- allows for appropriate culture of middle ear

- allows for cytologic sampling if neoplasia is present

- allows for removing debris from PSOM of CKCS

If youre smart and knew what Myringotomy is good for you. I do not know so this is for me :)

a surgical procedure where a doctor makes a tiny cut in the eardrum to drain trapped fluid and relieve pressure in the middle ear

What are the TWO things that the systemic antibiotic treatment for otitis media is based on?

- culture and susceptibility

- MIC

T/F Systemic antibiotic treatment for otitis media should last no more than 2 weeks due to antibiotic resistance

False it can last greater than a month

What topical therapy needs 10 mins of contact time, has a pH of 0 and is bacteriacidal?

Tris EDTA BID cleaning

Does Dr. Kennis or Whit recommend packing the ears?

no, so thats all imma say

What drugs can you give if the dogs ears are painful?

- GABA

- Steroids

T/F Carprofen is not helpful when ears are painful

True

When should you quit with the medical management?

- when the ears mineralize

- if you cant revert pathology

- if they are too painful

- if the client is too frustrated

What diagnostic could be helpful to determine prognosis?

CT

What are FOUR indications for Ear Surgery?

- calcified ear

- neoplasia

- stenosis

- proliferative

What is the curative surgical option for otitis media/ chronic canine otitis?

TECA/ Bulla Osteotomy

What is a TECA/ Bulla Osteotomy simply?

vertical canal ablation

What are some possible complication to ear surgery?

- nerve damage (horner's)

- hearing deficits

- inability to blink

- head tilt

- chronic infection

- draining tracts