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September 2004
End Stage Otitis & WCVD5
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Table of Contents
Medical Management of End-Stage Canine Otitis Externa
Territory Managers
SPECIALS
DermaPet Vision Statement
DermaPet Mission Statement
Medical Management of End-Stage Canine Otitis Externa
HALL J, Guelph
Excerpted from WCVD5 Proceedings
Ear Flushing
Flushing the ear canal can be very effective in removing cerumen and debris
to allow topical products to reach the canal wall. Removal of bacterial toxins,
degenerative cellular debris and free fatty acids decreases the stimulation
for further inflammation. Purulent material and inflammatory debris will inactivate
some medications (e.g. polymixin B).
Flushing should never be attempted in the face of severe inflammation, as it may lead to erosion and ulceration of the ear canal. In acute ears, it is preferable to treat appropriately based on cytology then re-evaluate. Typically, the author will not recommend flushing the affected canal until satisfied that the inflammation is under control.
Ear flushing can be challenging in the end stage ear case because of the limited size of the ear canal. However, flushing debris from the ear canal can be of benefit when treating chronic Pseudomonas or Malassezia.
A warm solution of white vinegar in water (1 part of white vinegar to 3-5 parts water) makes an excellent general flush if well tolerated. This solution appears to be safe in the presence of a ruptured tympanum. Vinegar and water flushing is normally carried out every 2-3 days during the treatment protocol.
A proprietary ear flush with an acidic pH may also be useful. The author currently uses a 2% acetic acid, 2% boric acid cleanser (MALACETIC OTIC, DermaPet) when required for maintenance in dogs with chronic bacterial or Malassezia colonization. In-depth flushing under general anesthesia is not always that useful or practical in the end-stage case because of sever ear canal stenosis. A wipe impregnated with 2% acetic acid and 2% boric acid (MALACETIC WET WIPES) may be used to clean the orifice area in those individuals with severe stenosis. Burrow's solution may be used for the same purpose.
The surfactant product, Tris-EDTA, may significantly increase the sensitivity of Pseudomonas to topical gentamycin and the other aminoglycosides. The EDTA has a direct effect on the organism by chelating metal ions, thereby destabilizing the cell wall. Tromethamine (Tris) enhances the effect of the EDTA on the organism. Tris-EDTA solution is available as TrizEDTA from DermaPet in North America. The recommended protocol is to flush the canal 15 minutes prior to topical antibiotic use.
The entire article is is available on
our web site.
Last month, we wrote about a special USDA program to track and identify animals. I have just returned from a trip through Germany, the Czech Republic, Austria and Hungary, with our US born 18 month Yorkshire terrier, ROXY. Despite authorities on trains, planes and at various stations being aware of her presence, we were never asked to show any papers demonstrating her health or identity. I can say we had proper documentation with the apt and enthusiastic assistance of an about to give birth SUSAN WILLIAMSON of the Annapolis office of the USDA/APHIS. I was referred to her by the Maryland State Vet and, it turns out, she also was the expert respondent to my query on VIN.
ROXY was allowed in all places except some museums in Prague and Vienna . All restaurants allowed her inside except in Budapest. In most places, she was kindly greeted with a bowl of water. In Vienna, animal kindness was extraordinary as illustrated by her first encounter with a goat while riding on a tram. Despite banning animals in the tradeshow hall, ROXY openly greeted people at our booth, which was at the entrance to the WCVD conference. Having read about her in this newsletter, several people wanted to know if she was the same dog who fell in the airline toilet. Not one of our proudest moments.
WCVD5, Vienna
JACK WHITE and I worked the booth while BARBARA WHITE and GLORIA socialized
and checked out Vienna. SUE PATERSON did booth work greeting her UK pals in
between presenting papers, posters and attending sessions. KARIN STECHMAN identified
herself as a derm consultant for our distributor in GERMANY, ALBRECHT.
Appropriately, the first derm we saw was STEVE WAISGLASS, GARY LANDSBERG's Toronto partner. CHARLES CHEN's (Taiwan) baggage arrived well after him. The Opening reception was at the office of the government/mayor of Vienna known as the RATHAUS. Many of us pondered why, given the inhabitants, more political domiciles in the US do not adopt a similar name. MITCH and NANCY SONG and PETER joined us in our search for the entrance to the massive complex with a long steep staircase to climb to a massive room. All attendees were warmed by tasty local wine and beer..
JAN HALL, whose paper is at our web site and excerpted here, did the OTOLOGY Symposium with TIM NUTTAL(UK) and LYNETTE COLE.. TONY YU (Portland) is going to travel to GUELPH to work with Jan and raise his family. LISA ROUNDTREE, (LSU derm tech) and CLAUDIA NETT (Switzerland via LSU) visited early as did numerous large contingents of TrizEDTA seeking Swedes led by KERSTI BERGLAND whose paper on fatty acids sparing corticosteroids in atopics re-energized interest in EICOSADERM and OFA Plus EZ-C and garlic.
Our Austrian hosts were led by REGINA WAGNER and OTTO FISCHER. HANS KOCH declared Gloria to be "under-rated" while I did the same to his companion, HEIDI. Derm guru, RICHARD HALLIWELL (and wife, JENNY) declared the next meeting was going to be in HONG KONG. PETER IHRKE and THELMA GROSS seemed to be having a good time.
GREG BURTON, DAVID ROBSON and REBECCA BASSETT (Melbourne, AU) told us of their success using the MalAcetic line and TrizEDTA; specifically, they have a study, which will show the MalAcetic Wipes doing well in treating pododermatitis. SYLVIA RYBARCZYK (Graeub, Switzerland) advised us that she was both strong and efficient as she carried samples home. We visited with LIORA WALDMAN and ILAN SKORINSKY (Israel) , ANNE EVANS, PAT MCKEEVER, TERRY GRIESHABER, DOUG DEBOER and ALEX BERROCAL (Costa Rica).. PETER HILL, Veterinary Dermatology Editor, created a poster of the world signed by derms in attendance, which I hope to see a copy of soon.
The GALA party was at the grand palace where, during our tour, when explaining a particular work of art, we were advised that the 'original' flea market used trained monkeys to remove lice from noblemans hair.
Dressed elegantly for the gala event were THIERRY OLIVRY and BARB ATLEE, DIETRICH
STEINBERG (St Louis), MINUTSUGU OGATA as well as KERSTI BERGVALL. KIM BOYANOWSKI
not only looked, but, smelled well despite a touch of our putrecine removed,
deodorized EICOSADERM during the day.
CVC, KC
PATRICK RAYBURN and COLIN FERGUSON ran the show while Jack and I did the hard job in Vienna. LINDA DEBOWES and GREG DUPONT (Seattle) put in a good word about DENTEES. I was pleased to hear JIMMY NOXON (ISU) uses the TrizEDTA in his Pseudomonas protocols.
PETER EMILY AND BOB WIGGS offer the following explanation as to why most of
the dogs having dental problems are under 20 pounds. Once bacteria gets within
1/2 mm of bone in the gingival sulcus you get active bone resorption which continues
until bone density is 1.5-2 mm thick. Continued bone loss leads to tooth mobility
and subsequent tooth loss. The loss of the bone further reduces the resistance
to the advance of bacteria. They then can be seen to have reduced bone density,
which, of course, may lead to further complications including loss of the tooth.
Further, these pets seem to live longer than their larger counterparts thus
having even more disproportional bone resorption. He further explained that
this bone resorption is from a byproduct of neutrophil metabolism, usually IL-1
and prostaglandins, which are catalytic to bone. (ed note: Conclusion: Feed
your dogs and cats DENTEES to prevent dental disease.)
Please go to our web site to see the DENTEES
detail sheet for more information. DermaPet products are sold only to and
by veterinarians.
Now is the time to join the 3,000 veterinary subscribers to PetCARE
Television Network, Inc PTNW, the educational / marketing monthly video
magazine. Look for STACEY ALLYSON (Melman) to be in an upcoming one.
We will be at the SW meeting in FT.WORTH, Sept 23-26 and the Dental Meeting,
also in FT.WORTH on Sept 30- Oct 3 followed by the Great Smokies in Ashville
and Wild West Vet Conference in RENO which are BOTH the weekend of Oct 7-10
and the ACVC in ATLANTIC CITY, Oct 12-14.
MedRx is offering CE
with EAR Seminars by LOU GOTTHELF on the road next in ATLANTA Sept 19, HOUSTON,
Oct 3 and MADISON Oct 24. Call 888-392-1234 to register or find out when one
is coming near you.
Call 888-392-1234 to register or find out when one is coming near you.
JAY MAIDEN is our TM for the SE US. Jay can be reached at 727-560-2325, jaymaiden@verizonmail.com.
COLIN FERGUSON is our Midwest rep. He can be reached at 614-539-9176, cferguso@columbus.rr.com.
JOYCE HEFLIN is our West Coast TM.
CHUCK MICHAELS (NE TM) and PATRICK RAYBURN (SW TM) continue to ride with distributor reps.
All our sales are guided by the capable JACK WHITE jag6410@aol.com or call 866-DERMAPET.
For the TM nearest you please email, look at our web
site or call us.
DenTees - . Buy one box of each size and get a free case of shampoo (except MalAcetic).
3rd Quarter Special
TrizEDTA and MalAcetic Wet Wipes. Buy 10 of the small containers and get 2 FREE. Buy 5 of the big containers and get 1 FREE.
Gallons. Buy 3 and Get 1 FREE.
EicosaDerm is now available in a 32 ounce economy size
Call your DermaPet Distributor or 800 755 4738 for ordering information.
DermaPet Vision Statement
To be recognized as the leader in developing new and innovative, all natural
yet highly effective products for the veterinary community.
DermaPet Mission Statement
To contribute to your growth and that of the veterinary industry by providing
excellent, unique, innovative all natural yet highly effective products that
embrace the pet, veterinarian, and client relationship.
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Steve Melman VMD
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