Small Animal Ear Diseases: An Illustrated Guide PDF
Preview Small Animal Ear Diseases: An Illustrated Guide
W01375-FM 1/28/05 7:36 PM Page iv 11830 Westline Industrial Drive St. Louis, Missouri 63146 SMALL ANIMAL EAR DISEASES: AN ILLUSTRATED GUIDE, SECOND EDITION ISBN 0-7216-0137-5 Copyright ©2005 Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier’s Health Sciences Rights Department in Philadelphia, PA, USA: phone: (+1) 215 238 7869, fax: (+1) 215 238 2239, e-mail: [email protected]. You may also complete your request on-line via the Elsevier Science homepage (http://www.elsevier.com), by selecting ‘Customer Support’and then ‘Obtaining Permissions’. NOTICE Veterinary Medicine is an ever-changing field. Standard safety precautions must be followed, but as new research and clinical experience broaden our knowledge, changes in treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current product information provided by the manufacturer of each drug to be administered to verify the recommended dose, the method and duration of administration, and contraindications. It is the responsibility of the treating veterinarian, relying on experience and knowledge of the animal to determine dosages and the best treatment for the animal. Neither the publisher nor the editor assumes any liability for any injury and/or damage to animals or property arising from this publication. The Publisher Previous edition copyrighted 2000 International Standard Book Number 0-7216-0137-5 Publishing Director:Linda Duncan Acquisitions Editor:Anthony J. Winkel Developmental Editor:Shelly Dixon Publishing Services Manager:Linda McKinley Senior Project Manager:Jennifer Furey Designer:Amy Buxton Printed in China. Last digit is the print number: 9 8 7 6 5 4 3 2 1 W01375-FM 1/28/05 7:36 PM Page v Contributors John C. Angus, DVM, Diplomate ACVD Staff Dermatologist Southern Arizona Veterinary Specialists Tucson, Arizona Cytology of the Ear in Health and Disease Margo Ruth Roman-Auerhahn, BS, DVM Staff Clinician and Owner Veterinarian MASH Main St. Animal Services of Hopkinton Hopkinton, Massachusetts Anatomy of the Canine and Feline Ear Todd W. Axlund, DVM, Dipl ACVIM Assistant Professor Veterinary Clinical Sciences Auburn University Auburn, Alabama Otitis Interna and Vestibular Disease Noel Berger, DVM, MS Boston Road Animal Clinic Sutton, Massachusetts Laser Ear Surgery Paul Bloom, DVM, DACVD, DABVP Assistant Adjunct Professor Department of Dermatology Michigan State University East Lansing, Michigan Adverse Food Reactions Peter H. Eeg, B.Sc., DVM Poolesville Veterinary Clinic, LLC Poolesville, Maryland Laser Ear Surgery v W01375-FM 1/28/05 7:36 PM Page vi vi SMALL ANIMAL EAR DISEASES Louis N. Gotthelf, DVM Animal Hospital of Montgomery Montgomery, Alabama Examination of the External Ear Canal; Primary Causes of Ear Disease; Factors that Predispose the Ear to Otitis Externa; Factors that Perpetuate Otitis Externa; Failure of Epithelial Migration: Cerumenoliths; Diagnosis and Treatment of Otitis Media; Healing of the Ruptured Eardrum; Inflammatory Polyps; Ototoxicity A. Kumar, BVSc, MVSc, MS, PhD Professor, Department of Biomedical Sciences Course Director, Small and Large Animal Gross Anatomy Co-Director, Clinical Anatomy Tufts University School of Veterinary Medicine North Grafton, Massachusetts Anatomy of the Canine and Feline Ear Genevive Marignac, DVM Unite de Parasitologie-Mycologie-Dermatologie Ecole Nationale Veterinaire d’Alfort Maisons-Alfort, France Diseases that Affect the Pinna Steven A. Melman, VMD Founder Dermapet, Inc. Potomac, Maryland Simple Diagnosis and Treatment of Pruritic Otitis Sandra R. Merchant, DVM, Dipl ACVD Professor of Dermatology Department of Veterinary Clinical Sciences School of Veterinary Medicine Louisiana State University Baton Rouge, Louisiana Microbiology of the Ear of the Dog and Cat Jeffrey R. Moll, DVM Christensen Animal Hospital Wilmette, Illinois Laser Ear Surgery W01375-FM 1/28/05 7:36 PM Page vii Contributors vii Mauricio Solano, MV, DACVR Assistant Professor of Clinical Sciences Tufts University School of Veterinary Medicine Hospital for Large Animals North Grafton, Massachusetts Radiology and Diagnostic Imaging in the Ear Norma White-Weithers, MS, DVM, Diplomate ACVD Staff Dermatologist Center for Specialized Veterinary Care Westbury, New York Ceruminous Diseases of the Ear Ronald E. Whitford, DVM Chief of Staff St. Bethlehem Animal Clinic Clarksville, Tennessee Marketing Ear Service W01375-FM 1/28/05 7:36 PM Page ix Preface As a full-time veterinarian in a small animal practice, working every day on the front lines of veterinary medicine, I am always asked, “How can you find the time to write a book?” My answer is that I truly believe that one of the most important challenges of being a doctor is that we should each share the knowledge that we acquire with our colleagues. I have found that I read everything I can find in books and journals, as well as on the Internet, pertaining to dog and cat skin and ear diseases. So, writ- ing a book to share the information I have gathered about ear disease seems to be a logicalprogression. Since the introduction of the first edition of Small Animal Ear Diseases: An Illustrated Guide,the awareness of otic disease as a serious ailment has been brought to the forefront of veterinary medicine. Veterinarians worldwide have embraced the use of video otoscopic diagnostics for ear disease, and we are now more often iden- tifying treatable ear disease as a result. For example, recognizing otitis media in our patients and properly treating it has helped to relieve the misery and suffering that accompanies this painful disease. The body of knowledge about ear disease is ever increasing. The number of published papers on the diagnosis and treatment of external and middle ear diseases has grown. Today, almost every small animal seminar or conference now includes lectures on ear disease and provides hands-on laboratory sessions using video otoscopy. New treatment modalities are being used in ear disease, and that has increased therapeutic options. Treating the tympanic bulla with infused topical medication is one example. Newly improvised intra-otic surgical procedures using the CO laser and the diode laser, as well as radiofrequency surgery through the 2 video otoscope, have decreased the number of lateral ear canal resections and ear canal ablations. Many questions remain unanswered, but there are currently many ongoing stud- ies that are attempting to answer the questions of why the ears become infected and what therapeutic options are the best for treatment. Exciting new drug classes and nutritional products may prove to be valuable in the prevention and treatment of ear diseases. In this second edition, I have added new, useful information to the body of knowl- edge. Obviously, some of the information has not changed since the first edition, but based on the feedback that I received from readers, many of these topics have been expanded to give an in-depth review. The new chapters are enlightening. One of my goals in the second edition was to bring a better discussion of otic cytology and a photographic manual of ear cytology to the practitioner. In addition, the chapter on diagnostic imaging is superior to anything I have ever seen relating to diagnosing ear disease. Many new photos in the second edition illustrate the vast number of ear condi- tions that are being commonly identified in dogs and cats by veterinarians. I have received many photos of interesting cases from practitioners and I have included several in this volume where appropriate. ix W01375-FM 1/28/05 7:36 PM Page x x SMALL ANIMAL EAR DISEASES My hope is that by presenting an expanded review of ear disease in dogs and cats, veterinarians can improve patient care. I would also hope that it poses some diag- nostic and therapeutic problems that stimulate more research interest. Louis N. Gotthelf Montgomery, Alabama W01375-FM 1/28/05 7:36 PM Page xi Acknowledgments It is important to recognize that I would not have the time to devote to the study of ear disease and to the preparation of a book manuscript if it were not for the support of my family, my staff at the Animal Hospital of Montgomery, and the clients who have the confidence in my abilities to allow me to treat their beloved companions. But I would be remiss if I did not acknowledge the warm reception and construc- tive feedback that I have received as encouragement from my veterinarian colleagues all over the world. The letters and phone calls I receive thanking me for providing a book that helps them understand the mechanisms of ear disease and the logical approach to ear treatments have helped motivate me to write the second edition. Part of the reason for this second edition is that, through colleague comments and ques- tions, I found that there is a thirst for new, useful information that needs to be quenched. I would also like to again thank Ron Buck and Rodney Glass from MedRx, Inc. who have supported me since 1996. Their commitment to veterinary continuing education allows me to do 25 ear disease lectures and wet labs each year for veteri- narians and technicians all over the United States and elsewhere. Their foresight in adapting their video otoscopic equipment to the needs of our profession makes it possible for me to show pictures of diseases of the ear in this book. I have come to realize that writing the manuscript is the easy part of writing a book. Actually putting it all together into a meaningful end product is the hard part; from the language editing to the page layout, printing, marketing, and distribution, many people whom I do not even know had a part. So a big “thanks” to all of the people at Elsevier who worked as a team to get it into the final form. xi W01375-01 8/27/04 6:51 PM Page 1 1 Anatomy of the Canine and Feline Ear A. Kumar, DVM, PhD Margo Ruth Roman-Auerhahn, DVM W01375-01 8/27/04 6:51 PM Page 2 2 SMALL ANIMAL EAR DISEASES The basic anatomical components of the dog and cat ear are as follows: • Auricle, or pinna • Auditory canal, or external auditory meatus • Middle ear • Internal ear Structure of the External Ear The external ear is composed of three elastic cartilages: annular, scutiform, and auric- ular (Figure 1-1). The annular and auricular cartilages form the external ear canal, and the auricular cartilage expands to form the pinna. The scutiform cartilage lies Apex Scapha Lateral border of helix Medial border of helix Foramen for blood vessel Lateral incisure Anthelix Antitragohelicine incisure Spine of helix (distal crus of helix) Styloid process Lateral process of antitragus Lateral crus of helix Medial process of antitragus Pretragic incisure Medial crus of helix Intertragic incisure Tragus Auricular cartilage Annular cartilage Scutiform cartilage Figure 1-1 Cartilages of the right external ear. (From Evans HE, ed: Miller’s Anatomy of the dog, ed 3, Philadelphia, 1993, WB Saunders.)
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