Obstructive ear disease and conformation abnormalities are best dealt, when practical, with surgical removal or correction, respectively. Treatment errors such as ineffective treatments or a hypersensitivity-type reaction are easily monitored by periodic rechecks of the patient once a therapy is selected. Ear canal maceration caused by excessive moisture is best treated with one of the cleansing/drying solutions mentioned above. Some predisposing causes of otitis externa are relatively easy to determine and remedy. Cleansing/drying solutions are usually instilled into the ear once or twice daily, preceding any treatment solution also prescribed. The author prefers a product containing salicylic acid, lactic acid, and propylene glycol (Epi-otic ®, Allerderm/Virbac). A number of these substances have antimicrobial properties as well. Most of these products contain various types of acids (lactic, malic, benzoic, salicylic, acetic, etc.) often with a cerumenolytic agent or alcohol added. In cases where either the owner declines anesthesia, the animal is not a good candidate for anesthesia due to concurrent health problems, or where the degree of canal occlusion and exudate are not severe, a reasonable cleaning program may be obtained on an outpatient basis utilizing products which have both cleansing and drying properties. The use of an ear curette is particularly helpful in removing wax. After the cleaning procedure has been performed, an otic examination is indicated to ensure that all remaining wax and debris are removed. This solution should then be removed via suction, with either a suction pump or a 12-ml syringe and propylene tomcat catheter. The ear is subsequently flushed using a rubber ear bulb syringe and either a mild disinfectant solution (dilute chlorhexidine works well) or just saline solution. The author prefers a product containing dioctyl sodium sulfosuccinate, urea peroxide, and lidocaine hydrochloride (Clearx ® Ear Cleansing Solution, DVM) although I limit its use to anesthetized patients because occasionally irritation occurs.
Instilling the ear with a ceruminolytic agent greatly helps the cleaning process. Such a patient must be intubated to prevent aspiration of flushing fluids that can drain through the eustachian tube. Excessive hair at the base of the medial pinna should also be clipped away.Īrguably, the best results of ear cleaning are obtained with the patient under general anesthesia. This is best done by grasping the hair with a forceps and twisting the hairs out by twirling the forceps (rather than plucking, which is more painful). Hair should be removed from the ear canal. Wax, oil, and other debris may be irritating, prevent medicaments from contact with the ear canal wall, produce a favorable environment for microorganisms to proliferate, and may inactivate certain antibiotics. Medical treatment of the ear with otitis externa may be divided into three stages: ear cleaning with management of predisposing causes, treatment of perpetuating causes, and identification and treatment of primary causes.Ĭleaning the ear is important for a variety of reasons. Books & VINcyclopedia of Diseases (Formerly Associate).VINcyclopedia of Diseases (Formerly Associate).Education Articles Supporting the health of your horses, livestock and pets.Education Supporting the health of your horses, livestock and pets.
Eastern, Western & Venezuelan Combinations.You can mail us the original written prescription.Your veterinarian can contact us by fax/phone.Let us contact your veterinarian for prescription authorization.Please note that this item requires a veterinarian's prescription. Gentamicin, betamethasone, and clotrimazole. Therapy with Otomax ointment should continue for 7 consecutive days.
Massage external ear canal carefully after instillation to ensure appropriate distribution of medication. The recommended dosage of Otomax for dogs weighing less than 30 lbs is 4 drops instilled twice daily into the ear canal for dogs weighing 30 lbs or more, instill 8 drops twice daily into the ear canal. The external ear canal should be thoroughly cleaned and dried before treatment. Each gram of Otomax contains gentamicin sulfate, USP equivalent to 3 mg gentamicin base betamethasone valerate, USP equivalent to 1 mg betamethasone and 10 mg clotrimazole, USP in a mineral oil-based system containing a plasticized hydrocarbon gel. Otomax contains gentamicin, betamethasone, and clotrimazole. Otomax Ointment for Dogs is used for the treatment of acute and chronic otitis externa (ear infection) in dogs associated with yeast and/or susceptible bacteria.