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May 2005
Myringotomy Video
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Table of Contents
HIRING Territory Managers/KIM CAREY Hired for NW
Artcles Available
Lou Gotthelf's Small Animal Ear Diseases
DermaPet Vision Statement
DermaPet Mission Statement
Myringotomy Video
Lou Gotthelf, whose Small Animal Ear Diseases textbook by Elsevier is one
of their Top 5 sellers, has provided us with a video of how to do a myringotomy
which has been posted on the home page. This simple
procedure has baffled many excellent practitioners. If the theorem "see
one, do one, teach one" is correct then many will be one step closer to
teaching. Lou has provided us with the following written instructions.
"This myringotomy is being done in the left eardrum of a normal cat. A
myringotomy can be done with a 5 Fr. polypropylene catheter cut to a 45 degree
angle. The tip of the catheter is directed toward the lower portion of the eardrum
away from the malleus bone. In the left ear, this would be in the 5 o'clock
position. In the right ear, this would be at the 7 o'clock position. The catheter
is lined up and then pushed through the eardrum to make an incision in the membrane.
Fluid from the bulla can be retrieved this way or the bulla can be flushed out
through this incision. Topical medication can also be instilled into the bulla
using a catheter introduced through the myringotomy incision." Ed note:
The anatomy of and procedure for the canine ear is the same as it appears in
this feline.
AAVD/SARASOTA
Although there for only 24 hours, there is much to report. It was an informative
meeting where we enjoyed many favorable comments. KAREN MORIELLO (Wisc) won
the award for achievement for her dedication to understanding and treating dermatophytosis.
ROD ROSYCHUK (CSU) and JAN HALL (Guelph) presented excellent papers on otology
including treatment protocols which pleased YT. JILL ABRAHAM, classmate of dermapet2vmd
(Jessica) will be a derm resident at PENN. JOHN ANGUS and YT talked about the
positive feedback from the 1st DermaPet Otology Symposium at TNAVC. You may
recall LOU GOTTHELF also was on that program. SUE PATERSON (UK) will join Gotthelf
in 2006. HEATHER PEIKES (NYC) complimented Jessica on a case she referred.
Then there was night. CHARLES CHEN joined JACK WHITE, JAY MAIDEN and YT for
dinner. BAYER, led by JONATHAN WHITT, hosted a party at the G-Wiz where we learned
how spies overheard conversations from a distance using parabolic technology.
PETRA BIRIKOVIA (Slovakia) registered a flatline on a heart monitor that obviously
did not take into consideration her looks. The group moved to the VIRBAC hospitality
suite hosted by the pleasant and jovial WILL VALENTINE. Just about midnite,
after the certs returned, RICHARD and JENNY HALLIWELL, DIDIER CARLOTTI and his
companion and a couple other unnamed notables, assisted me in comparing a bottle
of DOMINUS 97 and INSIGNIA 97. The INSIGNIA was the consensus winner. Anything
that happened after that is rumor only.
PETCARE TV MMTV
Petcare TV, provider of education programming
for veterinary waiting rooms, has changed it's name to "Medical Media."
We will be attending the ACVIM meeting in BALTIMORE, June 2-4 and the SOUTHEAST
CONFERENCE in MYRTLE BEACH, June 15-18.
MedRx is offering CE
with EAR Seminars by LOU GOTTHELF. They will be in KANSAS CITY (May 22) and
SAN FRANCISCO (June 5).
For more information call 888-392-1234 to find out when one is coming near you.
Gallons. Buy 3 and Get 1 FREE.
The MalAcetic HC is Buy 8 Get 4 Free.
All shampoos are on special.
All shampoos are on special. The HypoCS (our
hypo-allergenic) which is going to be renamed DermaLyte is BUY ONE GET ONE FREE.
The rest of the Shampoo line is Buy 8 and get 4 FREE.
This is our best sale of the year so stock up on your shampoo now!
Wet Wipes (MalAcetic) are BUY 10 and GET 2 free.
EicosaDerm is now available in a 32 ounce economy size
Call your DermaPet Distributor or 800 755 4738 for ordering information
MalAcetic HC Prototol
There have been many questions on when or how to use the MalAcetic HC. Since
it is virtually 50% strength MalAcetic Otic with hydrocortisone added, logically
one would use it on inflamed, irritated, erythematous, edematous, (perhaps)
ulcerated skin first. After a few to several days on the MalAcetic HC switch
to regular strength MalAcetic.
Some experts recommend using systemic corticosteroids alone with no topicals
in severely inflamed otitis cases. This will allow the ear to "cool down"
prior to placing any topicals, almost all of which could be potentially irritating.
After this "cool down" then start the MalAcetic HC for about a week
or less followed by the regular MalAcetic Otic.
MalAcetic HC is not a replacement for MalAcetic Otic, which should remain the
veterinarian's first choice to clean an ear, treat an ear with Malassezia otitis
(see articles by Gotthelf or Bassett or Benson at the web site) or prevent ear
disease. Also remember, up until now we have not had a case of ototoxicity reported
due to MalAcetic Otic, so it is safe for cases where there is a ruptured tympanic
membrane.
Because MalAcetic contains both acetic and boric acids which each and combined
have other significant antimicrobial effects (see Benson's article), we also
place them in topicals such as shampoo, spray-on leave-on conditioners and wet
wipes where they can help fight Staphylococcus as well as Malassezia.
Below is a repeat from an earlier newsletter which supports use of the MalAcetic
HC logic.
The notes from DermaPet's 1st Annual OTOLOGY SYMPOSIUM at TNAVC are posted at
our web site (with permission from
TNAVC). Below are excerpts from this presentation from LOU GOTTHELF.
Corticosteroids have a definite place in the treatment of otitis externa. .....1% hydrocortisone (MALACETIC HC, DermaPet) may be used in the ear to act as a preventative for inflammation in atopic dogs that may have recurrent otitis. Corticosteroids do not remove hyperplastic epithelium or glands, so if there is no response to high dose corticosteroids after 7-10 days, the stenosis is probably the result of increased tissue growth rather than inflammation. ...
For otitis externa complicated by Malassezia, the author prefers the use of an acetic acid/boric acid solution (MALACETIC OTIC). The cleansing effect and desquamating effect of the acetic acid/boric acid solution essentially removes fatty acid substrates necessary for the metabolism and reproduction of Malassezia. Malassezia produces a chemotactic factor for neutrophils that is hydrophilic and protein in nature. The presence of this factor may help explain why only a few Malassezia organisms can cause such profound erythema and pruritus. The cleansing effect of the acetic acid/boric acid solution destroys this acid-labile chemoattractant and may account for the reduction in inflammation. Boric acid, which is hygroscopic (drying out the humid ear canal) removes moisture necessary for this hydrophilic chemoattractant and may prevent attachment of Malassezia yeasts to the epithelium by inactivating adhesin molecules that allow Malassezia to stick to keratinocytes. MAL ACETIC OTIC is used daily for 7-10 days by filling the ear canal to overflowing, massaging the base of the ear, and allowing the solution to remain in the ear canal for 5 minutes. The loosened debris is wiped off of the pinnal surface with a dry cotton ball. This procedure is repeated once daily. When the ear canal is clean, the cotton ball will remain fairly white when the solution is wiped away. At that time, treatment is reduced to once weekly.
HIRING Territory Managers/KIM CAREY Hired for NW
KIM CAREY, our newest TM will be responsible for the NW from Santa Cruz north. Kim can be reached at k_carey59@hotmail.com or 916-276-3539. JOYCE HEFLIN who handles the Far West S CA, AZ, NV. We will hire two more reps for 2005; if interested and you live near Chicago or New York City then contact either JACK WHITE or our corporate office. 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. The "old work-horse" CHUCK MICHAELS (NE TM) and PATRICK RAYBURN (SW TM) ducks2003@cox.net continue to ride with distributor reps. All our sales are guided by the capable JACK WHITE jag6410@aol.com or call 866-DERMAPE. For the TM nearest you please email, look at our web site or call us.
Coming soon will be our KlearWax, a potent, in hospital otic cleanser, MalAcetic
HC Shampoo, MalAcetic HC Conditioner and MalAcetic HC Wet Wipes. The Conditioner
is a leave-on, dry-on product. Both products retain their antimicrobial efficacy
(See New Treatment of Malassezia Otitis, Gotthelf, Vet Forum, 7/97; Efficacy
of an Acetic Acid/Boric Acid Ear Cleaning Solution for Treatment and Prophylaxis
of Malassezia sp. Otitis Externa Aust Vet Pract 34[2]:79-82 Jun'04 http://www.dermapet.com/articles/efficacy.pdf
and Susceptibility of Selected Otitis Externa Pathogens to Individual and Mixtures
of Acetic and Boric Acids, Benson CE, Proc 14th AAVD/ACVD meeting, 1998)
I invite you to read all of the above articles at our web
site. In particular, note that MalAcetic is 87% and 88% effective against
Malassezia and, at .5% MalAcetic is effective against Staphylococcus while at
1% is effective against Pseudomonas. Note: that the 2% strength provided by
our MalAcetic Otic and the rest of the MalAcetic line is what you have been
relying upon. Now, for those sensitive, inflamed, pruritic or erythematous cases,
you can use a gentler product with hydrocortisone.
Lou Gotthelf's Small Animal Ear Diseases
Lou Gotthelf's Small Animal Ear Diseases 2nd Ed is out. There is a chapter by YT as well as many others. At $59.95 this is a great deal considering all the color photos and the fact that ears represent up to 20% of your business.
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
http://www.dermapet.com
dermapet@aol.com
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| Steven Melman VMD DermaPet Animal Dermatology and Behavior Clinics Potomac, MD 20854 |
dermapet@aol.com http://www.dermapet.com 800-755-4738 fax 301-365-0191 |
8909 Iverleigh Court 
Potomac, Maryland
20854
301-983-8387 800-755-4738 Fax 301-365-0191
E-mail dermapet@aol.com