Recurrent yeast otitis externa is common in dogs and can be difficult to treat. These patients are thus often referred to a veterinary dermatologist.
This retrospective case series looked at treatment outcomes of 59 dogs with recurrent or persistent Malassezia pachydermatis otitis externa that were referred to dermatology specialists. Chronic M pachydermatis otitis externa was successfully treated in 91% of affected ears. Most of these cases (87%) received a single anesthetized ear flush, after which topical antifungal ear drops were applied. Median time to resolution was 27 days. Duration of otitis externa was not found to affect the length of time required for resolution.
To reverse pathologic changes to the ear canal and to facilitate treatment, 46 of the dogs were given oral corticosteroids (ie, prednisolone or methylprednisolone) prior to ear flushing. Oral antifungals did not affect odds of treatment success. It was estimated that at least 50% of the study patients showed evidence of allergy, although the authors noted this is likely an underestimation because use of corticosteroids may have masked clinical signs.