Zeus: A dermatology case report
Name: Zeus | Age: 4 Years Old | Breed: German Shepherd
History: ‘Zeus’ a 4 year old male neutered German shepherd dog presented for evaluation of recurrent bilateral otitis externa since a young dog. Initially topical ear medications were effective but more recently the owner reported persistent infection in one ear despite treatment.
Diagnostics: Cytology revealed numerous Malassezia organisms. The external ear canal and the tympanic membrane were not visible due to ceruminous debris exudate obstructing the external ear canal. Video otoendoscopy and ear cleaning were indicated.
Diagnosis:
Bilateral Malassezia otitis externa
Failure of self cleaning
Video otoendoscopy: Otoendoscopy allows for complete visualisation of the vertical and horizontal ear canal and tympanic membrane and facilitates cleaning. The integrity of the tympanic membrane can be determined, which allows for selection of appropriate topical treatments. Any abnormal structures within the ear such as a cyst, polyp, cholesteatoma etc. can be identified. Cleaning the normal ear revealed a ceruminolith adherent to the tympanic membrane. Cleaning the affected ear revealed a large amount of impacted exudate consisting of medication, ceruminous debris and infective exudate indicating a failure of self cleaning. Repeated flushing was required to dislodge the ceruminolith and clean the ears.
Follow up: topical anti Malassezia medications are indicated for the treatment of this clean ear externa. Ongoing maintenance consisting of a combination of regular ear cleaning and topical corticosteroids will be implemented before we begin an allergy investigation. Proactive therapy using topical steroids reduces inflammation within the ear canal to prevent relapsing infection in those dogs who are prone to otitis.