Sunday, August 14, 2011

540. Sunday Aug 14, 2011 - interesting case

Usually the vet gives an injection and ear drops and antibiotics. But no cure. The owner is unhappy as the dog keeps on scratching and the ears become smelly and red.

CASE STUDY

Ears very painful, esp. painful for the last 4 weeks. The dog just scratched her ears to death.
The Maltese just could not stop scratching her two ears. So the busy lady consulted me. The ear canals were swollen and red and so I would not be able to scope the ear canals to see what's wrong.

In this case, I suspect some foreign bodies stuck deep inside the horizontal canal.

ADVICE 1
My treatment in such cases would be 2 steps.

1. Anti-inflammatory and antibiotics to control the itchiness and infections. The owner is asked to return 5 days later for ear irrigation.

2. Ear irrigation 5 days later (Sunday today). The dog was wary of her ears being touched. So, I advised sedation. The owner wanted to know whether no sedation would be possible. How badly infected were thears? Could she just apply the ear ointment? Could she see me irrigating the ears so that she would learn how to do it?

ADVICE 2
Option: Vertical ear canal resection for long-standing ear infections (over several months and years) but most Singapore owners are not keen on this option. However, this option must be told as it is another option to monthly cleaning of the ears.

EAR IRRIGATION
1. Sedation is best. The poor dog would be avoiding and turning her head if forced to be restrained to be irrigated in the ears. In the past, I had tried to do ear irrigation without sedation (to save the owner some money) but it was very painful and stressful to the dog.

COACHING LESSON FOR MY ASSISTANT

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