Most isolates of Staphylococcus spp. in the horizontal ear canal or middle ear are susceptible to a variety of topical antibiotic preparations. Follow the general guidelines listed above for diagnosis, management and treatment.

Topical application of Baytril Otic has been effective against a broad range of otic bacteria and yeast. Topical antifungals include nystatin, thiabendazole, clotrimazole, miconazole (Conofite Lotion, Schering-Plough), and ketaconazole (Nizoral, Janssen). Many compounded mixtures are being used, especially for cases where there is primary allergy with secondary yeast otitis. Typical combinations contain 1% clotrimazole solution or miconazole lotion mixed 1:1 with dexamethasone (2 mg/mL) q 12 h. For resistant cases, ketaconazole (300 mg) mixed with a vehicle such as Bur-Otic (Allerderm/Virbac) q 12 h has been effective. If systemic treatment is necessary, the treatment of choice for yeast otitis is ketaconazole at 5-10 mg/kg q 24 h or itraconazole (Sporanox, Janssen) at 5 mg/kg q 24 h. Both drugs achieve high and sustained levels in sebaceous secretions, and so intermediate dosing may suffice.
References: McKeever, Torres. Vet Clin N Am Sm An Prac 27:1523-1536, 1997; Foster, DeBoer. Compend 20:909-919, 1998; White. Compend 21: 716-728, 1999; Colombini et al. Vet Dermatol 11:235-239, 2000; Barrasa et al. J Vet Med 47: 191-196, 2000; Scott, Miller, Griffin. Sm An Dermatol, 6th ed., 2001; Kwochka. Proc ACVIM, 2002; Shell, Foil. Can Assoc on Line, VIN, 2003. (Contributed by Drs. Linda Shell and Carol Foil)

This inhibitor of steroid synthesis (Vetoryl, Arnolds Veterinary Products, Ltd, UK) has been used with success in the treatment of pituitary-dependent CushingÕs disease in dogs. There is a single case report and anecdotal evidence of successful treatment in cats. As the drug is not licensed in the US, it requires a written prescription and new drug waiver from the US FDA, to obtain approval limited to a 90 day supply. For more information, go to www.arnolds.co.uk.
Reference: Skully et al. J Sm An Pract 2003: 44(6); 269-272.

Due to increasing prevalence of leptospirosis infections in dogs attributable to Leptospira interrogans serovars bratislava and autumnalis, AntechÕs leptospirosis panel (T16510) has been updated to include these serovars. This Panel T16510 now includes antibody titers to the following Leptospira serovars: Icterohemorrhagiae, Canicola, Pomona, Hardjo, Grippotyphosa, Bratislava, and Autumnalis.