VETTECH U 2024 / HOUSTON, TX
OTITIS: INSIDE & OUT CHANTELLE HANNA, CVT, VTS (DERMATOLOGY) ANIMAL DERMATOLOGY CLINIC-CHARLOTTE
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SATURDAY PM • SEPTEMBER 21 2:00 - 2:45 PM
INTRODUCTION Pet owners are often surprised that otitis falls under the umbrella of dermatology. Like I tell our clients, ears are just tubes of skin, after all. Otitis cases are routinely seen daily in a general practice setting. Because it’s so common, it’s important to have a firm understanding of just what otitis is and that often begins with simply knowing ear anatomy, both normal and abnormal. We need to speak the language of otitis and understand terminology to communicate with our doctors and clients. We should be comfortable with procedures used to diagnose and manage otitis such as cytology and imaging. Last, the importance of a solid knowledge base of the various treatments for otitis is a must. I’ll try to touch on all aspects of working through an otitis case with you. BASIC ANATOMY Ears consist of four main anatomical structures. From the outside in, these structures include the pinna, the external ear canal (vertical and horizontal), the middle ear, and the internal ear. For that reason, the person performing the otoscopic exam requires skill and finesse to accomplish the exam thoroughly and efficiently. The external canal is lined with sebaceous and ceruminous glands, whose secretions produce ear wax, or cerumen. Cerumen protects the ear and keeps the tympanic membrane (ear drum) moist and pliable. Middle ear anatomy consists of the bulla, auditory canal, and three ear ossicles, which differ between dogs and cats. Cats have two- chambered bullae separated by a septum. The middle ear is also home to many important nerves. The internal, or inner ear, receives the auditory signals and is responsible for maintaining balance. It is comprised of the cochlea, the vestibule, and semicircular canal.
FACTORS OF EAR DISEASE There are four factors of ear disease: Predisposing, Primary, Perpetuating, and Secondary. • Predisposing factors present risk for ear disease but don’t directly cause it, such as primary secretory otitis media (PSOM), hair, poor conformation (stenosis), and moisture. • Primary factors directly result in an inflammatory process causing otitis, such as atopy (environmental allergies), food allergy, foreign body (cotton swab, grass awn), neoplasia, external parasites (ear mites, demodex, ticks), endocrine disorders (hypothyroidism), autoimmune and immune-mediated diseases (vasculitis, erythema multiforme, pemphigus), and keratinization disorders (sebaceous adenitis, primary seborrhea, zinc responsive dermatosis). • Perpetuating factors interfere with resolution of disease and prolong it, such as otitis media, mineralization, stenosis, inappropriate treatment, topical drug reactions, and inflammatory polyps. • Secondary factors typically result from primary factors and cause disease, such as otitis externa (bacterial or yeast infections), hyperplasia, mineralization, stenosis, and topical drug reactions. It’s important to note that certain factors can certainly fit in multiple categories. Stenosis due to a breed’s conformation is a predisposing factor but can also be a perpetuating and secondary factor. WORKING UP THE OTITIS CASE As with any dermatology case, working up the patient with ear disease starts with a very thorough history. The following are some key points to consider when speaking with clients about their pet’s ear disease.
SEPTEMBER 20-22, 2024 | PROCEEDINGS | VETGIRLONTHERUN.COM
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