Levi is a 7 year old NM Labrador mix. He is presented to our veterinary clinic for acute onset, bilateral otitis externa. His otitis signs started about 3 months prior to being referred to our dermatology service. Primary care attempted topical therapy, but his symptoms worsened. This initiated referral.
Meagan Painter
Angell-West Specialty Referral Hospital, Waltham, MA
November 2022
When gathering his history, it was interesting to note that the onset of his otitis signs was relatively acute; prior to age 7 he did not have a history of otitis externa. He did not have any symptoms of allergic dermatitis. He was not pruritic. He received oral flea/tick medication (Simparica) monthly. He was in good health otherwise.
Objective:
On physical examination, it was very clear that he had severe bilateral otitis externa. The pinnae were mild to moderately erythematous. There was a moderate amount of brown-black discharge at the entrance to the ear canals. Otoscopic examination revealed a marked amount of brown-black to purulent discharge extending to the level of the tympanic membrane. It was not clear if the tympanic membrane was fully intact due to the large obstructive film of discharge overlying it.
The remainder of Levi’s physical examination was within normal limits.
Cytology samples were collected from both ears revealing both yeast (2-3+) and scattered rod-shaped bacteria (0-1+).
Assessment:
Bilateral, otitis externa
PRIMARY _ open, obstructive vs. allergic vs. other
SECONDARY _ mixed infection, yeast and rod-shaped bacteria
PERPETUATING _ biofilm formation, chronic inflammatory changes, loss of epithelial migration, otitis media, and other
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