Treatment

Treatment of otitis interna requires long-term oral antibiotics for most cases. A minority of cases also requires surgical drainage of the exudate in the middle ear. The choice of antibiotic is important because the clinician needs to consider both the organism causing the infection and the location of the infection.

The organism can usually be identified by culturing the contents of the middle ear. The most common isolates include Staphylococcus spp., Streptococcus spp., and Pseudomonas spp. It is important to choose an antibiotic that has good penetration into areas with poor circulation because otitis interna involves infection of both soft tissue structures and bone. The drug of choice depends on the susceptibility pattern of the organism. If this is not available, a broad-spectrum antibiotic with good penetrability, such as a cephalosporin, chloramphenicol, or potentiated sulfonamide, should be used. Ototoxic drugs such as the aminoglycosides should be avoided. If trimethoprim/sulfa is used, monitoring of tear production is essential. Long-term antibiotic therapy of from 3 to 6 weeks is usually necessary to eradicate the infection. The animal should be examined periodically during the treatment period to evaluate recovery and monitor for the side effects of long-term antibiotic treatment.

Animals with severe signs of vestibular disease may benefit from the antihistamine meclizine. This drug helps to alleviate some of the signs of vestibular disease but does not affect the underlying pathology of the disease.

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Source: Gotthelf Louis N.. Small Animal Ear Diseases: An Illustrated Guide. 2nd ed. — Saunders,2004. — 384 p.. 2004

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