Therapeutic Management of Chronic Pseudomonas Otitis in a Dog.
A Labrador retriever dog was presented with history of persistent ear infection since last twenty days. Based on clinical laboratory and otoscopic examination, case was diagnosed as chronic otitis due to Pseudomonas aeroginosa infection. The case was successfully managed with combination of topical and systemic therapy.
Keywords: Chronic otitis; Pseudomonas aeroginosa, marbofloxacin
Otitis externa is inflammation of external ear canal. Clinically, otitis externa can be unilateral or bilateral, acute or chronic, mild to severe, non-recurrent or recurrent and amenable or resistant to routine therapy. It has been classified according to type of exudates as erythematoceruminous or suppurative with the former subgrouped as parasitic or non-parasitic. Management of chronic otitis is a quite difficult task because of complexity and multiple etiological agents and emergence of drug resistance (Kumar et al., 2002). In the present paper, otitis externa caused by Pseudomonas aeroginosa and its management in a Labrador has been discussed in detail.
History, Diagnosis and Treatment
A male Labrador retriever, aged four years was presented with history of discharge from right ear, head tilt and pet was on kept on different medication since last twenty days. Detailed clinical examination of animal revealed normal left ear but right ear had erythema, foul smelling exudate, head shaking/tilt (Fig. 1). Animal not evinced any pain on palpation of base of ear. Sample was collected from infected ear with sterile cotton swabs and was subjected to bacterial culture and antibiogram studies. On cultural examination, sample was found positive for Pseudomonas aeroginosa. In the antibiogram studies, sample was found sensitive to Marbofloxacin, Enrofloxacin, Amoxyclav and resistant to Streptopenicillin, Cefadroxil, Cephalexin and Cefazolin. On otoscopic examination ear canal was inflamed, lot of purulent material was observed and tympanic membrane was intact (Fig. 2).
The case was considered as Chronic Otitis due to Pseudomonas aeroginosa infection, pet was kept on Marbofloxacin @ 5 mg/kg b. wt. for 15 days (Tab Marbomet (a)) and Gatifloxacin ear drops (Gatiquin-P (b)) @ five drops three times daily for seven days.
Owner was advised to apply Gatifloxacin ear drop two hours after cleaning ear with the Chlorhexidine, EDTA and Propylene alcahol ear flush (Ambiflush (a)). Animal started showing gradual improvement, at the end of first week and head shaking, discharge from ear was almost stopped. The same treatment was continued for one more week, resulting in complete recovery.
Diseases of external ear are commonly encountered in dogs and are among the most frustrating in diagnostic and therapeutic point of view to practicing Veterinarians. Chronic otitis externa in dogs are often associated with bacterial infection, particularly Pseudomonas aeruginosa (Lakshmi, 2013). Treating Pseudomonas aeruginosa infection can be a considerable challenge for both clinicians and clients. Antibiotic resistance has always been a serious problem in treatment of Pseudomonas infections and new multiple resistance genes are still appearing (Degi, 2010). Miller et al. (2013) reported that other agents like Escherichia sp., Staphylococcus aureus, Klebsiella sp., Proteus sp., Haemolytic Streptococci, Staphylococcus sp. and Micrococci sp. are also known to cause chronic otitis.
Marbofloxacin and Gatifloxacin is a synthetic, broad spectrum bactericidal agent and has good activity against many gram negative bacilli and cocci. It is able to attain high concentrations within cells in many tissues and it has long elimination half life and high bioavailability after oral administration (Heinen, 2002). Of the quinolones, most strains of Pseudomonas sp were susceptible to Marbofloxacin with lower susceptibility than Enrofloxacin. Pseudomonas sp. develops resistant to Enrofloxacin very rapidly when compare to Marbofloxacin. Chlorhexidine gluconate is a broad spectrum antimicrobial drug. Acting as an antiseptic, it is an effective bactericidal agent against all categories of microbes, including bacteria, yeast and viruses and also helps to remove the debris from the ear canal (Kaplowitz and Cortell). Corticosteroids are important to use in the treatment of otitis externa to relieve the inflammation present and its concurrent discomfort (Daigle). EDTA offers a distinct advantage of lowering down the required MIC for microorganism and works well for cleaning of ear.
The authors are thankful to The Professor and Head, Department of Veterinary Microbiology, Veterinary College, Bangalore for all the support provided during the study.
Daigle, J.C. Canine otology - the one hour version. Central Texas Veterinary Speciality Hospital, Round Rock Texas-78681.
Degi, J., Cristina, R.T. and Stancu, A. (2010). Otitis externa caused by bacteria of the genus pseudomonas in dogs. Lucrari stiin3ifice medicina veterinara Xliii timisoara 143.
Heinen, E. (2002). Comparative serum pharmacokinetic of the fluoroquinolones Enrofloxacin, difloxacin, marbofloxacin and orbifloxacin in dogs after single oral administration. J. Vet. Pharmacol. Therap. 25: 1-5.
Kaplowitz, G.J. and Cortell, M.A. Peer-Reviewed Publication.
Kumar, A., Singh, K. and Sharma, A. (2002). Treatment of otitis externa in dogs associated with Malassezia pachydermatitis. Indian Vet. J. 79: 727-29.
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B. Soumya (1), G.K. Chetan Kumar (2) and P.T. Ramesh (3)
Department of Veterinary Medicine Veterinary College Karnataka Veterinary, Animal and Fisheries Sciences University (KVAFSU) Hebbal Bengaluru - 560024 (Karnataka)
(1.) Assistant Professor and Corresponding author. E-mail: email@example.com
(2.) Assistant Professor
(3.) Professor and Head
(a) - Brand of Intas Animal Health, Ahmedabad
(b) - Brand of Cipla Ltd., Mumbai
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|Title Annotation:||Short Communication|
|Author:||Soumya, B.; Kumar, G.K. Chetan; Ramesh, P.T.|
|Article Type:||Clinical report|
|Date:||Jul 1, 2016|
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