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Pseudomonas Chronic Ear Infection


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Hi Everyone,

Just want to check you think I'm on the right track...

My 9.5 year old westie boy has a moderate but chronic ear infection in one ear. After trying every dog ear drops known to man, we finally did a swab and it came back as moderate pseudomonas. For the last 9 days we have been on a routine of Triz EDTA cleaner liberally twice a day then half an hour later follow with 4 drops of Otomax. We have also had a short course of anti-inflammatories, Rimadyl (which he has finished).

Tonight the vet swabbed the ear and looked at it under the microscope and found that it is better but the nasties are still there. It seems to be getting better - he seems better in himself and happier, and I may just be jumping the gun, but how long can these damn infections take to clear completely? We seem to have been trying things for months - since late January at least. I hear this bug can be very antibiotic resistant and am a bit frightened about the long term health of his ear canal and tympanic membrane.

BTW he gets a chicken neck and a fish oil capsule for breakfast (arthritis and ACL repair) and half a barf pattie and Joint Guard and a few veggies for dinner (for weight loss) - and he's snacking on the low hanging persimmons during the day! Apart from this ear infection he is a very healthy boy - pre-anaesthetic blood test prior to dental work in late January came back as normal/very good.

I'm happy to persevere with our current regime but if anyone has any other comments or advice I'd be very grateful.

Thanks

Westiemum :thumbsup::)

Edited by westiemum
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Your dog will probably have the infection for the rest of his life, it's highly unlikely that it will ever clear completely. I had a bitch that suffered from a pseudomonas infection for years and we tried every treatment option available, eventually she had to have a lateral ear resection. It wasn't 100% successful but at least it allowed the pus to drain and alleviated the pain.

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Hi Everyone

Thanks for the replies - appreciated. Althugh its ahrd to think he might always have at least a low level infection.

Yes he has had it cultured - came back as gentamicin as the preferred antibiotic, hence the Otomax.

Thansk again

Westiemum :thumbsup:

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Having a culture and sensitivity result is probably the most helpful piece of information.

With any ear infection, I always do an in-house swab to determine what is actually growing down problem ears. Anytime I find rods, I warn clients from the outset that these infections can be frustrating to treat and Pseudomonas in particular is prone to being antibiotic resistant. I recommend a culture at that first visit if I find rods.

TrizEDTA cleaner helps to weaken the cell wall of the bacteria so that it is more susceptible to the topical antibiotic treatment. Sounds like you're on track with this treatment. Close monitoring is really important, I like to recheck weekly and do regular in house swab to keep tabs on what is growing. It will take week, if not months to clear and infection and some dogs will have recurrent problems. I tend to use low dose steroids (one of the few situations I do) to reduce the inflammation in the ear canal, which opens them up and lets the treatment get to all of the ear canal. The Rimadyl is just a different drug doing the same thing. It is really important to treat until the infection clears, and then some. Unfortunately I come across a few cases where the owner has stopped treatment because the ear looked better, but the infection was never resolved - becomes very hard to treat those ones.

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Thanks very much Rappie - that all makes sense. My regular vet is away on leave (good for him poor man - he's so good he never gets a moments peace from all us demanding clients!) and the locum I'm seeing is an older woman who is thorough, handles him beautifully, knows her stuff and seems to go the extra mile - and yes she swabs the ear every time we see her and looks at it under the microscope - so I have a lot of confidence in her too - and seeing her consistently for this, rather than a series of locums seems to have helped enormously. (And I'm getting better at managing who I see on these vet visits too!) :thumbsup:

Some time ago my regular vet said the ear canal is also slightly stenotic (ex dog farm dog who had terrible ears when he came out so I'm sure this is a very long term problem in various guises) - and the stenosis isn't helping with ear aeration either. But last time I saw the locum she said the inflammation had cleared and the rods while still there had reduced. So I think as you say, we slog on diligently with the treatment in the longer term to make sure we get on top of it. And I hope she decides to stay with the practice - she's been very good. So I think you're right - I've not persisted long enough in the past and this may well have been the problem. It can be the same with kids ears - a bit of persistence sometimes works wonders - here's hoping.

Thanks again for your help.

Cheers,

Westiemum :thumbsup:

Having a culture and sensitivity result is probably the most helpful piece of information.

With any ear infection, I always do an in-house swab to determine what is actually growing down problem ears. Anytime I find rods, I warn clients from the outset that these infections can be frustrating to treat and Pseudomonas in particular is prone to being antibiotic resistant. I recommend a culture at that first visit if I find rods.

TrizEDTA cleaner helps to weaken the cell wall of the bacteria so that it is more susceptible to the topical antibiotic treatment. Sounds like you're on track with this treatment. Close monitoring is really important, I like to recheck weekly and do regular in house swab to keep tabs on what is growing. It will take week, if not months to clear and infection and some dogs will have recurrent problems. I tend to use low dose steroids (one of the few situations I do) to reduce the inflammation in the ear canal, which opens them up and lets the treatment get to all of the ear canal. The Rimadyl is just a different drug doing the same thing. It is really important to treat until the infection clears, and then some. Unfortunately I come across a few cases where the owner has stopped treatment because the ear looked better, but the infection was never resolved - becomes very hard to treat those ones.

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You're welcome westiemum :vomit:

It's not uncommon to end up with a Pseudomonas infection secondary to a number of other "normal" infections. Pseudomonas likes to have a party in the first line treatments like Dermotic / Surolan and Canaural etc. After a few infections the micro-environment of the ear changes and become even more hospitable to nasties :vomit:

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Hi WestieMum,

Since he has been on antibiotics have you tried a really good probiotic capsule to restore the helath of the gut,this can go a long way to allowing the body to fully recover.

Tomas.

Hi Everyone

Thanks for the replies - appreciated. Althugh its ahrd to think he might always have at least a low level infection.

Yes he has had it cultured - came back as gentamicin as the preferred antibiotic, hence the Otomax.

Thansk again

Westiemum :vomit:

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Westie mum, I have had this problem for many months with one dog. A dermatologist ended up fixing it (fingers crossed, no more flare ups in over a month, which is GREAT for us). We have gone the drops, cleaner, antibiotics, ear flush etc., a very very resistant bug. also found that my dog's canals were so very long that it would be lucky for the drops to get all the way down. She actually didn't have drops!! she had 2 ml per ear twice a day with an extended syringe. One bottle lasted a few days. There was improvement and one ear cleared up. We are doing very very well now, it's just wonderful!! :)

Hope it all clears up very soon, and yes, persevere with it.

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  • 3 weeks later...

Bumping this back up. My Dad's Welsh Springer, George, has been diagnosed with a pseudomonas infection in his ear too.

He has had ear problems on and off since he was a pup (he is about 4 now), for one he seems to produce excessive amounts of ear wax, but they are bad again.

Just wondering if anyone had any updates on how their dogs were going - Monah? Westielover or anyone else for that matter.

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Hi Quickasyoucan,

Last Thursday morining we got the all clear from the vet - no bacteria and some residual inflammation only. So fingers crossed its gone.

Good luck with your Dad's dog.

Cheers

Westiemum

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  • 4 weeks later...

Hi Everyone,

Quick update - we've had a couple of check-ups since mid May and my last post - and we're still bug clear!!! Yay!!! :thumbsup::)

We have a bit of imflammation again but no nasties as checked under the microscope tonight!! And the pinna (or whatever its called in dogs) and ear canal are no where near as angry and red.

So we are keeping up the TrizEDTA a couple of times a week with some Dermotic drops this time (worried about over-reliance on Otomax/gentamicin and then the buggies developing resistance and not having any back-ups to treat any flare-ups so have switched to Dermotic).

Rappie you were so right - thanks very much :) - the trick to this going to be keeping up the treatment for long enough and beig really vigilent...

Cheers everyone,

Westiemum :)

Edited by westiemum
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Hi Westie mum.

I have just been through this with Misty, & i think it is reaccuring thing.

She has had it on & off for several years.

We have done all the drugs avaible, as each infection she has had has been a different strain & they are resistant to different drugs.

It is important that each infection is diagnosed & treated as they do tend to be different.

So It is really worthwhile to keep having the ear swabbed to see the effect on the rotten little bugs the treatment is having.

Our last treatment was Trizeta & Baytril which cleared it up in about 2 weeks

This time it has been Trizeta & Dermotic & Macrolone, same infection but different strain, hence different treatment.

Hope this makes sense, still asleep this morning.

editted to add, just read Rappie's post & yes that is what i was trying to say.

Edited by Silverblue
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  • 1 month later...

Hi Everyone,

Well sadly for my stoic boy the pseudomonas is back - and with a vengeance. So he had a huge flush out under GA on Monday afternoon - and although it went well apparently the putrid rubbish that came out was incredible... the tympanic membrane is ruptured (and not in good shape anyway) and apparently there's evidence that the infection has been behind the ear drum all the time which explains why the wretched thing keeps coming back. In other words this is not just chronic ear infection but serious chronic middle ear disease.

We have done a culture again, results in today and it seems we are going to have trouble finding an oral medication this time which he isn't resistant to... but the vet is doing some research tonight and we'll talk tomorrow. In the meantime his pain is well controlled except when the dermotic drops are inserted in the ear (the pain behaviours all escalate and he's miserable...)

It looks like we are heading for major surgery - removal of the ear canal, drum and the middle ear cavity. If it means that my boy will be pain free and off this constant parade of medication then I think we have got to the stage where we need to go ahead...

So... does anyone have any experience with this type of surgery? How successful was it? (I'm not worried about how I'm going to pay for it - that's what equity in the mortgage is for).

Any help or advice would be really appreciated... as he's not the only one feeling very 'flat' about the prospect of surgery... :laugh: :D

Thanks everyone,

Cheers,

Westiemum :laugh:

Edited by westiemum
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Hi I have seen one dog that had had it. He was an adult male rotti, he looked great, they actually believed he responded better because he didn't have a constant earache! Not sure how true that was though. He seemed very happy and well adjusted.

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Thanks rommimum - really appreciated - and your comments make me feel better. I was so hoping someone would say something like that - I'd love my boy to be pain and earache free.

He's much better today - adn not responding so badly to the Dermotic. Off to the vets to pick up some short-term steriods - will let you know how I get on.

Cheers

Westiemum :D

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