Page 1439 - Cote clinical veterinary advisor dogs and cats 4th

Otodectic Mange 731

chronic, resulting in an irritable patient and of otitis externa only. Complete resolution of SUGGESTED READING
an unhappy owner. ear problems is unlikely unless predisposing, Diseases of the eyelids, claws, anal sacs, and ears. In
VetBooks.ir PEARLS & CONSIDERATIONS Technician Tips AUTHOR: Lynette K. Cole, DVM, MS, DACVD Diseases and Disorders
primary, and perpetuating factors are identified.
Miller WH, et al, editors: Muller & Kirks Small
animal dermatology, ed 7, St. Louis, Mosby, 2013.
Comments
ears at the first visit as well as at each recheck
Dogs with atopic dermatitis or cutaneous Otic cytology should be performed for both EDITOR: Manon Paradis, DMV, MVSc, DACVD
adverse food reaction may present with signs to monitor response to therapy.

Otodectic Mange Client Education
Sheet

BASIC INFORMATION • Ear mites can be visualized by otoscopic exam Acute General Treatment
(p. 1144), appearing as moving white specks. Spot-on acaricidal products with systemic
Definition effects:
Contagious, primarily aural mite infestation Etiology and Pathophysiology • Selamectin (Revolution/Stronghold; apply in
caused by Otodectes cynotis These psoroptic, non–host-specific, nonburrow- interscapular region) in dogs as young as 6
ing mites cause a hypersensitivity reaction by weeks of age and cats as young as 8 weeks
Synonyms feeding on epidermal debris and tissue fluids of age. Two doses are administered 30 days
Otodectic acariasis, otoacariasis, ear mite of ear canal lining. apart for optimal control. Kills ear mites as
infestation early as 10-12 hours after administration
with increasing effect over time.
Epidemiology DIAGNOSIS • Moxidectin (Advantage Multi/Advocate;
SPECIES, AGE, SEX Diagnostic Overview apply in scapular region) in cats as young
• Very common in cats; common in dogs Diagnosis established through historical and as 8 weeks of age. Two doses are admin-
• More common in puppies and kittens but physical exam findings and visualization of mites istered 28 days apart for optimal control;
may occur at any age and/or eggs on direct otoscopic or microscopic also labeled for dogs for this use in some
exam. If mites/eggs cannot be found, a positive countries
RISK FACTORS response to treatment can be used for presump- Topical (otic) acaricidal product:
Contact with stray animals; shelter, boarding, tive diagnosis. • Thiabendazole (Tresaderm) applied in affected
or grooming facility ears q 12h for up to 7 days. Off-label use:
Differential Diagnosis 10 days minimum
CONTAGION AND ZOONOSIS • Hypersensitivities (atopic dermatitis, flea- Topical (otic) products labeled for use in
• Very contagious bite allergy, food allergy, contact allergic cats
• Transmission by direct contact and fomites dermatitis, adverse drug reaction) • Ivermectin (Acarexx) applied in affected
• Very low zoonotic risk • Ectoparasites (Sarcoptes, cheyletiellosis, fleas, ears in cats as young as 4 weeks of age;
lice) kills ear mites as early as 10-12 hours after
GEOGRAPHY AND SEASONALITY • Otodemodicosis administration with increasing effect over
Worldwide, not seasonal • Bacterial and fungal otitis externa time
• Neoplasia, polyps • Milbemycin oxime (MilbeMite) applied in
Clinical Presentation affected ears in cats as young as 4 weeks of
HISTORY, CHIEF COMPLAINT Initial Database age
• Aural/periaural pruritus evidenced by head Microscopic exam of ear swab samples placed • Permethrin (Oridermyl) applied once daily
shaking and ear scratching in mineral oil is the most effective method for for 10 consecutive days in affected ears in
• Asymptomatic carriage occurs. identifying ear mites and eggs. If the skin is cats as young as 8 weeks of age; also contains
involved, collect a minimum of three broad, neomycin, nystatin, and triamcinolone for
PHYSICAL EXAM FINDINGS superficial skin scrapings (p. 1091). Crusts and the treatment of associated inflammation,
• Otitis externa characterized by erythema and papules are the best areas to scrape, but mites secondary bacterial/yeast infections
dark brown, ceruminous otic exudate (“coffee may be hard to find. • Any of the above topical otic treatments
grounds”) should be used in conjunction with an
• Erosions, ulcers, crusts found on inner pinna TREATMENT appropriate whole-body (or systemic)
and entrance of the ear canal acaricide to eliminate ectopic mites.
• Occasional ectopic infestations evidenced by Treatment Overview Off-label acaricidal treatments:
alopecia, erythema, papules, and crusts of Clean ear canal with a ceruminolytic ear cleaner, • Ivermectin (Ivomec, 200-400 mcg/kg PO or
periaural region, head, neck, feet, and tail and then apply topical (inside ear canal) or SQ) q 1-2 weeks for up to 4 treatments or
when mites escape from ears systemic acaricidal products. Animals that diluted 1 : 9 in propylene glycol and apply
• Cats may occasionally present with one or a do not tolerate or resent topical therapy can a few drops in each ear once daily for 21
combination of cutaneous patterns: erosive be treated systemically. Treatment with an days or apply 0.05 mL (500 mcg)/EAR once
and crusting dermatosis of the head and acaricidal-only spot-on agent does not resolve each week for 5 weeks
neck, miliary dermatitis, symmetric alopecia, the secondary bacterial and fungal infections, • Moxidectin (Cydectin, 200 mcg/kg PO or
or eosinophilic granuloma complex. nor does it directly resolve inflammation. Using SQ) for 2 treatments 10 days apart
• Positive ear-pedal reflex is possible, particu- a treatment that combines acaricidal, antibiotic, • Fipronil (Frontline Spot-on) 2 drops applied
larly in cats: animal scratches with ipsilateral antifungal, and antiinflammatory agents results in affected ears once or twice (1 month
hindlimb when ear canal is swabbed. in faster relief of symptoms. apart)
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