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Presentation

Lucy, a 6-year-old female spayed Golden Retriever, was presented for several days’ worth of head shaking and scratching at her right ear. Lucy had been previously healthy and was current on vaccinations. She was the only dog in the home and, other than monthly parasiticides, was not currently receiving any medications. Lucy often spent a large amount of time outdoors with occasional swimming. Her owner applied a topical ear cleanser twice weekly after Lucy’s swims.

Physical Examination

Lucy’s right ear was erythematous, warm to the touch, and contained moderate ceruminous debris. A significant amount of crusting was also noted. No cranial nerve deficits or ocular changes were observed, and the remainder of Lucy’s physical examination was unremarkable. 

Diagnosis

Otoscopic examination disclosed a normal-appearing and intact tympanic membrane, moderate amount of ceruminous debris, and mild swelling of the vertical ear canal. Cytology yielded 3+ cocci and neutrophils (Figure 1).

Figure 1 Cytology results demonstrating neutrophils and intra- and extra-cellular cocci. Image courtesy of Elizabeth Layne, DVM

Management

Predisposing factors of otitis externa (eg, allergies, ear canal conformation, excessive hair and glandular secretions, excessive moisture, certain endocrinopathies) do not cause otitis but contribute to ear disease. These factors are important to address in order to prevent recurrence. 

Lucy was prescribed topical TRESADERM® (thiabendazole, dexamethasone, neomycin sulfate solution) Dermatologic Solution to treat her otitis externa. TRESADERM is a combination antibiotic (neomycin), antifungal (thiabendazole), and steroid (dexamethasone) medication that aids in the treatment of certain bacterial, mycotic, and inflammatory dermatoses and otitis externa in dogs and cats.

Outcome

Lucy was re-evaluated by her primary care veterinarian 1 week after TRESADERM therapy was initiated. Her right ear was markedly less swollen and erythematous, and her owner reported no further head shaking at home. Her owner was counseled on the potential predisposing causes of otitis externa and committed to monitoring Lucy closely for signs of recurrence.

Important Safety Information: TRESADERM is for topical use only in dogs and cats. On rare occasions, application of the product may result in erythema or discomfort in the treated area. Discomfort in the treated area can last from 24 hours to 48 hours. 

TRESADERM® is a registered trademark of Merial ©2017 Merial, Inc., Duluth, GA.

All rights reserved. TRE17CASESTUDYAD (12/17)

Merial is now part of Boehringer Ingelheim

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