Treatment FAQ

if tresderm ear drops fails to clear feline otitis, what is the next line of treatment?

by Darrion Turner Published 2 years ago Updated 2 years ago
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Can I give my Cat Tresaderm for ear infection?

If used as prescribed, Tresaderm will get rid of susceptible organisms that can result in skin or ear infection. After using Tresaderm, you should notice your cat starting to feel better. Further, you should begin to notice your cat’s skin and ears starting to return to normal.

How is feline otitis reviewed in the workup of otitis media?

Feline otitis is reviewed by evaluating the predisposing, primary, and secondary causes. Diagnostic and treatment options are summarized. Emphasis is placed on comparing feline and canine otitis.

Can florfenicol be used to treat otitis in cats?

Although not approved for cats, florfenicol formulations (Claro-Bayer Animal Health, Osurnia-Elanco) can also be effective, Dr. DeBoer said. He uses these single-dose applications off-label for feline otitis cases for which cytology indicates cocci and treatment compliance is questionable.

What can I give my Cat for otitis externa?

Feline otitis is typically managed well with aminoglycoside/steroid combinations, such as Tresaderm (Merial) or Mometamax (Merck Animal Health). Although not approved for cats, florfenicol formulations (Claro-Bayer Animal Health, Osurnia-Elanco) can also be effective, Dr. DeBoer said.

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What is second line treatment for otitis media?

Oral cefuroxime or amoxicillin-clavulanate and intramuscular ceftriaxone are suggested second-line choices for treatment failure.

Why won't my cats ear infection go away?

Chronic otitis is basically a long-lasting ear infection that can affect any cat, causing itchy, painful ears. Quite a few things can cause the disease — parasites, allergies, growths, and more — which is progressive and can lead to rupture of the eardrum or even permanent narrowing of the ear canal.

Why does my cats ear infection keep coming back?

Cats also can be subject to chronic ear problems. Almost half of the ear infections in cats are caused by ear mites. Other causes include allergies, environmental irritants, thick hair in the ear canal or wax buildup in the ears. Polyps or growths within the ears can also be a breeding ground for bacteria.

How do you treat chronic ear infections?

If you have a chronic ear infection, your doctor will prescribe antibiotics. These may be taken orally or (rarely) given intravenously if the infection is severe. Your doctor may suggest ear drops if you have a hole (perforation) in the eardrum.

How long does it take a cat to recover from an inner ear infection?

That said, most cats with otitis interna respond well to medical management. Expect a two- to four-month course of oral antibiotics to prevent a relapse. The altered sense of balance that generally accompanies otitis interna typically improves within two to six weeks.

How long does it take for a cat ear infection to go away?

Recovery and management of ear infections in cats Most ear infections in cats can be treated with medical management in 1-2 weeks. While complications such as ruptured ear drums and middle and inner ear involvement can lead to hearing loss, most ear infection symptoms resolve with treatment.

What is the black gunk in my cat's ears?

Mites also stimulate the wax producing glands inside the ear canal. The result is a black, crusty build-up in the ears that resembles coffee grounds. This discharge is made of blood, wax, debris, and mites themselves. In some cases, this crust can thicken enough to block the ear canal.

What is the brown stuff in my cat's ears?

As with humans, it's completely normal for a small amount of earwax to form in your cat's ears. However, excessive wax buildup can occur if your kitty has allergies, a bacterial infection, systemic inflammation, ear mites, or a yeast infection. A cat's brown earwax often resembles dirt or dried blood inside the ears.

What causes ear infections in indoor cats?

Causes of Ear Infection in Cats Ear infections can develop when the skin lining in the ear canal becomes irritated, leading to inflammation. Inflammation can lead to excess wax production which in turn creates an environment where the naturally occurring bacteria and yeast grow out of control.

What if ear infection doesn't go away after antibiotics?

Ear infections that do not clear up after trying many antibiotics may need tubes. Prevention should be tried before turning to surgery. Talk to your child's doctor about when ear tubes are needed.

What happens if antibiotics don't work for ear infection?

Ear infections often go away with time or with the help of antibiotics. However, some people may experience recurrent ear infections and fluid buildup, or have ear infections that won't heal for months. In children, these issues can lead to hearing loss, behavioral issues, and speech development delays.

Can chronic otitis media be cured?

The only treatment for chronic otitis media and cholesteatoma is a surgery called tympanoplasty with mastoidectomy. There are no medicines that will cure these diseases. The primary goal of surgery for chronic otitis media and cholesteatoma is to remove all infection and cholesteatoma.

What Happens If I Overdose My Pet on Tresaderm?

If you follow the directions provided by your vet correctly, it’s highly unlikely that an overdose will occur. However, if you suspect a Tresaderm...

What Happens If I Miss a Dose of Tresaderm?

If it’s almost time for the next scheduled dose, you can skip the missed dose and just apply the scheduled one as directed. If not, then you can ap...

Can Other Drugs Affect Tresaderm?

You need to let your veterinarian know if your pet is using any other antibiotic or corticosteroid medications that are applied either orally or to...

What Should Be Avoided While Using Tresaderm?

Tresaderm should not be applied to your pet if it’s allergic to any of its individual ingredients. If hearing loss is observed during the treatment...

How many drops of tresaderm should I use?

To treat skin disorders affecting other than the ear, the surface of the lesion should be well moistened with Tresaderm, usually 2-4 drops per square inch, twice a day. Store Tresaderm in the refrigerator. Do not freeze. Tresaderm should not be used for more than one week.

Where to use tresaderm?

Tresaderm is used topically on the skin or in the ears depending on the type of infection being treated. Keep Tresaderm in the refrigerator when not being used. ❍ Clean and dry the affected area and trim any excess hair before starting topical treatment with Tresaderm.

What is Tresaderm solution?

Each dropper of Tresaderm solution contains thiabendazole and dexamethasone neomycin sulfate. Thiabendazole is a fungicide and parasiticide that kills or inhibits fungi and parasites. Dexamethasone neomycin sulfate is a potent anti-inflammatory.

How long can you keep tresaderm in the refrigerator?

Store Tresaderm in the refrigerator. Do not freeze. Tresaderm should not be used for more than one week. Do not use Tresaderm in the eyes. Do not use Tresaderm on pregnant animals. Keep out of the reach of children or pets.

How long can you use tresaderm?

Prior to use, the affected area should be cleaned. Application and use of Tresaderm should be limited to a period of not longer than one week. Do not use Tresaderm in the eyes. Store Tresaderm in the refrigerator. Do not freeze.

What are the side effects of corticosteroids?

Side effects following the use of injected or oral corticosteroids include increased thirst and urination, vomiting, diarrhea and Cushing's syndrome following prolonged or repeated steroid therapy.

Can neomycin cause redness?

Discontinue use and contact the veterinarian if sensitivity to neomycin, which may cause redness, irritation and swelling, occur s. Continue the medication and talk to your veterinarian about any side effect that seems unusual or bothersome to the animal. What other drugs will affect Tresaderm:

Topical Antimicrobial-Corticosteroid Solution

Tresaderm - Merial is a dermatologic solution indicated for the treatment of certain bacterial mycotic, and inflammatory dermatoses and otitis externa in dogs and cats. Tresaderm is used for both acute and chronic forms of these skin disorders.

Thiabendazole-Dexamethasone-Neomycin Sulfate Solution

Neomycin is antibacterial against both gram-negative and gram-positive pathogens.

What is the workup for otitis media?

The workup for otitis media should begin with ear swab cytology. Imaging under anesthesia and culture are recommended for recurrent cases. Myringotomy is done to facilitate culture (ideally from the tympanic bulla) followed by middle ear irrigation.

What is the tympanic cavity of a dog?

In dogs, the tympanic cavity-the air-filled chamber of the middle ear-is a single compartment containing an incomplete septum. In cats, this septum is almost complete and divides the cavity into two distinct compartments; this “wall” can impede drainage and lead to occlusion.

What is the middle ground between dogs and cats?

The middle ground: otitis media. The pathogenesis of middle ear infections-otitis media-differs between dogs and cats. In dogs, it generally results from “descending” bacteria associated with otitis externa. While this route can also occur in cats, feline middle ear infections are more often secondary to “ascending” inflammatory/infectious disease ...

Is otitis media bilateral or unilateral?

Overt neurologic signs can also present, such as Horner's syndrome, head tilt, nystagmus, ataxia and obtundation. Feline otitis media may be unilateral or bilateral, and is sometimes secondary to recurrent otitis externa.

Is external ear infection eternal?

External is not eternal. The presence of foreign bodies and polyps should be ruled out with otoscopy, followed by thorough ear cleaning to remove ceruminous debris. Dr. DeBoer urged caution in ear flushing when the tympanic membrane is ruptured.

Is otic pathology a disease in cats?

In fact, according to Douglas DeBoer, DVM, DACVD, professor of dermatology at the University of Wisconsin School of Veterinary Medicine, aside from ear mites ( Otodectes cynotis ), otic pathology is rarely blamed for clinical signs of disease in cats. As he explained at the 2019 Atlantic Coast Veterinary Conference, however, ...

Can ventral bulla be a total ear canal ablation?

When medical management fails, surgery by ventral bulla osteotomy or, less commonly and particularly indicated with neoplasia, total ear canal ablation may be necessary. But, Dr. DeBoer, emphasized, “Medical management can work. You don't have to immediately send these guys to surgery.”.

What causes a cat to be deaf?

Among all acquired feline ear conditions, the most commonly diagnosed by far is otitis externa, an infection of the outer ear canal that can lead to an overproduction of earwax, progressive tissue damage, and, if untreated, permanent deafness in an afflicted cat. The most common cause of otitis externa and its frequently adverse consequences is ...

What is the smell of mites in an animal's ear?

The mites are also detectable by the unpleasant mess they make inside an infected animal’s ear canal—a thick, dark, foul-smelling accumulation of wax and debris in which they thrive. Another organism that can precipitate otitis externa, Dr. Miller points out, is a one-celled fungus, or yeast, known as Malassezia.

What is the best way to see if your eardrum is damaged?

For this, the veterinarian is likely to use an otoscope, an instrument that provides a magnified view of the ear’s inner depths. This device will reveal the extent to which an ear canal is swollen or blocked and whether the ear drum is intact or damaged.

Can cats hear deaf?

Due to a variety of congenital or acquired conditions, however, a lot can go wrong with a cat’s ears, with deafness among the potential consequences. Among all acquired feline ear conditions, the most commonly diagnosed by far is otitis externa, an infection of the outer ear canal that can lead to an overproduction of earwax, progressive tissue damage, and, if untreated, permanent deafness in an afflicted cat.

Can cats have otitis externa?

Otitis externa is most commonly diagnosed in certain breeds—Himalayans, for example—that are more susceptible than other breeds to skin ailments.

Can otitis externa cause hearing loss?

If otitis externa is not appropriately treated, the infection can migrate to the middle ear, where it is termed otitis media, and to the inner ear ( otitis interna ). In the most severe cases, the inner ear can be irreparably damaged, resulting in partial or total loss of hearing.

How much Tresaderm is in a dropper bottle?

Tresaderm is available as a dermatologic solution in a 7.5 ml and 15ml dropper bottle for use in the ear (s) or to apply topically to the skin. Each ml of solution contains 40mg thiabendazole, 1mg dexamethasone, and neomycin sulfate equivalent to 3.2mg of neomycin. Prior to use the affected area should be cleaned.

What is tresaderm used for?

Tresaderm is used in pets to treat certain acute or chronic bacterial, fungal and inflammatory skin disorders, as well as otitis externa (ear inflammation). Tresaderm requires a prescription from your veterinarian. Tresaderm requires refrigeration and must be kept at refrigerator temperatures at all times.

How many drops of tresaderm should I take a day?

To treat skin disorders affecting other than the ear, the surface of the lesion should be well moistened with Tresaderm, usually 2-4 drops per square inch, twice a day. Store Tresaderm in the refrigerator.

What causes otitis externa in cats?

The etiopathogenesis of otitis externa in the cat can generally be divided into various factors. Primary factors are those that are noted to cause inflammation in ears. The most common primary factors are ear mites ( Otodectes cynotis ), with the next most commonly encountered being hypersensitivities (atopy, food sensitivity). Other primary factors tend to be much less common and include foreign bodies, other ectoparasites ( Demodex, ticks), keratinization/lipid disorders (idiopathic ceruminous otitis), autoimmune diseases (e.g., pemphigus foliaceus) and masses (aural polyps, ceruminous cysts, neoplasia).

Why is otitis media more common in dogs than dogs?

This is seen more commonly than in dogs likely because of the greater incidence of posterior pharyngeal inflammatory disorders seen in cats (often viral in origin). The tympanum is usually intact in such cases.

What is the most common cause of aural hematoma in cats?

Secondary bacterial infections most commonly involve Staphylococcus pseudintermedius. In the author's practice, atopic otitis externa is the most common cause of aural hematoma seen in the cat.

What is the best ear cleaner for otitis externa?

Safer ear cleansers include dilute white vinegar and water (1:2 or 1:3 dilution); TrizEDTA or Mal-A-Ket (Dechra), Cerumene (Vetoquinol) and Duoxo Micellar Ear solution (Sogeval). Atopic otitis externa can often be successfully managed with adequate control of the underlying allergy.

How do you know if a cat has a polyp?

Polyps are inflammatory lesions of unknown etiology that are most commonly noted in young cats (variably reported with a mean age of about 1 year; range of 2.5 months to 18 years). 2,3 Although most are unilateral, polyps can be bilateral. Most polyps appear to grow from the epithelial lining of the epitympanic cavity/tympanic cavity, then extend either through the tympanum in to the horizontal canal or down through the auditory canal in to the posterior pharynx. Although uncommon, it is possible to have polyps grow in both directions (about 10% of cases 4 ). Clinical signs associated with aural polyps include signs of otitis externa (head shaking, scratching ears, otic exudate), and/or otitis media (Horner's syndrome, head tilt, nystagmus, ataxia).

What are the factors that contribute to otitis externa?

Predisposing factors are those that make the ear more prone to the development of otitis externa. Examples include immunocompromising infections (e.g. , FIV) and masses in the ear. Perpetuating factors are those that are capable of perpetuating the otitis even if the primary factor has been removed/resolved.

How often should I flush my dog's ears?

Ear cleansers are often not started until 2–4 days after anti-inflammatory medications are started to facilitate greater tolerance to the flushing procedure.

How long should antibiotics be used for otitis media?

In patients withotitis media/interna, it is not uncommon to sustainuninterrupted antibiotic therapy for 6 to 12 weeks. Because it is difficult for antibiotics to reach targetorganisms within the middle ear, use doses at thehigher end of the reference range.

Is pain management important for otitis externa?

Absolutely! The role of pain management in thetreatment of otitis externa/media/interna is extremelyundervalued and underutilized. Otitis media/interna,just like cases of osteomyelitis, can be extremelypainful. Since our patients are typically stoic, theirlevels of pain can easily be underestimated.

Is topical therapy a multimodal approach?

There is indeed a role for topical therapy. Usually,the clinician’s best chance for resolution is to create atreatment plan that utilizes a multimodal approachthat combines topical therapy and systemic therapywith pain management.

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