Otitis media

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Sections available in full article Introduction, Presenting signs, Breed predisposition, Pathogenesis, Etiology, Predisposing factors, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Differential diagnosis, Treatment, Initial symptomatic treatment, Standard treatment, Monitoring, Subsequent management, Prevention, Control, Prophylaxis, Group eradication, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Kyle Braund BVSc MVSc PhD FRCVS DipACVIM
Dr Rosanna Marsella DVM DipACVD
Synonyms Middle ear disease

Introduction

  • Cause : sequel to chronic otitis externa Skin: otitis externa , ascending syndrome through the Eustachian tube.
  • Signs : vestibular syndrome Vestibulocochlear neuritides variable depending on stage and route of infection, eg:
    • Ascending otitis media shows as lethargy, inappetence, fever, slow head-shaking transient head tilt to affected side; signs of otitis externa, ie head-shaking, scratching, pain on palpation of external canal.
  • Diagnosis : signs, radiography or other imaging.
  • Treatment : antibiotics, ear flushing, bulla osteotomy if not responding.
  • Prognosis : may → otitis interna Otitis interna.

Diagnosis

Clinical signs

  • Intermittent slow head-shaking.
  • Affected ear tilted downwards.
  • Persistent purulent aural discharge.
  • Otitis interna Otitis interna.
  • Involvement of temporomandibular joint.
  • Facial paralysis.
  • Horner's syndrome Horners syndrome.

Diagnosis

Differential diagnosis


Causes of head shaking, irritation, painful external ear canal
  • Otitis externa Skin: otitis externa.
  • Aural hematoma Ear: aural hematoma drainage.
  • Aural foreign body.
  • Aural neoplasia.
Causes of head tilt
  • Otitis interna Otitis interna.
  • Idiopathic peripheral vestibular disease.
  • Congenital peripheral vestibular disease Vestibulocochlear neuritidesIntervertebral disk: type 2 herniation.
  • Central vestibular disease Old dog encephalitis.
  • Canine geriatric vestibular disease Old dog encephalitis.
  • Toxicity.
  • Cerebellar disease Cerebellum: disease.

Sequelae

Prognosis

  • Good: except animals predisposed to otitis externa Skin: otitis externa.

Expected response to treatment

  • Improvement in demeanor over 24-48 h.
  • Improvement in head-shaking/aural discharge over 1-2 weeks.

Reasons for treatment failure

  • Lack of client compliance.
  • Client inability to maintain treatments.
  • Financial constraints.
  • Resistance to antibiotics.

Sources

Publications

Refereed papers

  • Garosi L S, Dennis R, Penderis J, Lamb C R, Targett M P, Cappello R & Delauche A J (2001) Results of magnetic resonance imaging in dogs with vestibular disorders - 85 cases (1996-1999). JAVMA 218 (3), 385-391.
  • Dvir E, Kirberger R M & Terblanche A G (2000) Magnetic resonance imaging of otitis media in a dog. Vet Rad Ultra 41 (1), 46-49.
  • Allgoewer I, Lucas S & Schmitz S A (2000) Magnetic resonance imaging of the normal and diseased feline middle ear. Vet Rad Ultra 41 (5), 413-418.
  • Garosi L S, Lamb C R & Targett M P (2000) MRI findings in a dog with otitis media and suspected otitis interna. Vet Rec 146 (17), 501-502.
  • McKeever P J et al(1997) Ear disease and its management. Vet Clin North Am Small Anim Pract 27 , 1523-1536.

Other sources of information

  • Rosychuk R A W et al(2000) Diseases of the ear. In: Textbook of Veterinary Internal Medicine.5th edn. Eds: S J Ettinger & E C Feldman. Philadelphia: W B Saunders. pp 986-1002.

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