Ear & Nose Disorders

Idiopathic Nasodigital Hyperkeratosis

Animal's Ear & Nose DisordersIdiopathic Nasodigital Hyperkeratosis is an idiopathic (unknown cause) condition that is characterized by the excessive formulation of nasal or footpad keratin. This type of nose disorder is common in older dogs. Thickened, hard, dry keratin accumulates on the top of the nose, footpads, or both. The accumulated keratin is usually most prominent on the top of the nose and at the edges of the footpads. Nasolacrimal (tear) duct blockage may present a contributing factor. Affected dogs are otherwise healthy and have no other skin signs.

• Diagnosis- Is made by ruling out other medical problems such as Zinc deficiency, distemper, pemphigus foliaceus and discoid lupus and others.

• Treatment- The intensity of treatment depends on the severity of the lesions. Tear ducts should be flushed. For mild, asymptomatic cases, no treatment may be appropriate. For moderate to severe cases, affected areas should be hydrated and a softening agent will be prescribed.

• Prognosis- Is good. Although it is incurable, this is a cosmetic disease that can usually be managed symptomatically.


Discoid Lupus

This disease is considered by many to be many to be a benign variant of systemic lupus erythematosus. It is common in dogs and rare in cats.

Nasal depigmentation, erythema (redness), scaling, erosions, ulcerations, and crusting are characteristic. Similar lesions may involve the lips, bridge of the nose, periocular skin, ear flaps, and, less commonly, distal legs or genitalia. Hyperkeratotic footpads and oral ulcers are rarely present.

• Diagnosis- Is made by biopsy.

• Treatment- Is usually symptomatic shampooing therapy to remove crusts. Avoiding sunlight exposure and using topical sunscreens. Sometimes supplemental vitamins are prescribed, as is medicated ointments.

• Prognosis- Is good, but lifelong treatment is usually necessary. Permanent scarring or depigmentation and rarely, squamous cell carcinoma are possible.


Vitiligo

Is a condition that is characterized by one or more areas of depigmented skin or hair. Lesions are usually first noted in your adulthood and often affect the nose, lips, face, buccal mucosa, and footpads. It is uncommon in dogs, with the highest incidence in Belgian Tervurens, German shepherds, Rottweilers, and Dobermans. It is rare in cats, with the highest incidence in Siamese.

• Diagnoses- Is confirmed by biopsy.

• Treatment- Is unknown.

• Prognosis- Is good. This is a cosmetic disease that does not affect the animals quality of life. The depigmentation is usually permanent, but in some animals, spontaneous repigmentation may eventually occur.


Canine Eosinophilic Furunculosis of the Face

Is an acute, usually self-limiting disease of the face. Although its exact cause is not known, a hypersensitivity reaction to insect stings or spider bites is suspected. It is uncommon to rare in dogs, with the highest incidence in inquisitive, young adult dogs with ready access to the outdoors. Blister, Erythematous (red) papules, and nodules, ulcerations, crusts, and hemorrhage may develop acutely and usually peak in severity within 24 hours. Lesions are not itchy or not very itchy but may be painful and typically involve the muzzle, bridge of the nose, and around the eyes. Occasionally, the abdomen, chest or ear flaps may be involved.

•Diagnosis- Is made by ruling out other causes, performing a cytology to look for numerous eosinophils, and sometimes biopsy.

• Treatment- Is often short term steroids with hydrotherapy to speed clinical improvement. Also secondary infections (if present) should be treated for 3-4 weeks with antibiotics.

• Prognosis- Is good.


Nasal Pyoderma

Is a facial bacterial skin infection that may occur secondary to trauma or insect bites. It is uncommon in dogs and rare in cats. Nasal pyoderm appears as papules, pustules, redness, hair loss, crusting, swelling, erosions, or ulcerative fistulae that develop over the bridge of the nose. Lesions may be painful.

• Diagnosis- Is determined by ruling out other medical condition. Performing cytology of pus with bacterial cocci or rods viewed under microscope, biopsy and or cultures.

• Treatment- Gentle warm water soaks and antibiotics for 3-4 weeks (continue 2 weeks beyond complete clinical resolution).

• Prognosis- Is good, but scarring may be a permanent.


Mycosis Fungoides (Epitheliotropic Lymphoma)

Is a malignant cancer that arises from T lymphocytes. It is uncommon in dogs and cats, with highest incidence in older animals. Among dogs, Scottish terriers and Golden Retriever are predisposed. Symptoms of the skin may include sing to multiple plaques or nodules that range from a few millimeters to several centimeters in diameter. Mucocutaneous depigmentation (skin color changes on mucous membranes like nose and anus) and ulceration or generalized erythema, alopecia (hair loss), scaling, dry skin, dandruff and pruritus (itching) may occur.

• Diagnosis- Biopsy, affected animals should also be screened for internal metastasis (xray chest/internal organs).

• Treatment- Certain chemo drugs may be used for this disease. Oral supplementation with safflower oil (which contains high levels of linoleic acid) may improve clinical signs in some animals.

• Prognosis- Regardless of treatment, the prognosis is poor, with most animals surviving less than 1 year after diagnosis.


Otitis Externa (External Ear Infection)

Is an acute or chronic inflammatory disease of the external ear canal. Causes of this type ear infection are numerous. Food Allergy, Atopy, ear mites, Hypothyroidism, Excessive ear cleaning, trauma from cleaning, over treatment, under treatment, cancer plus many more are examples of potential causes or exasperating conditions. Itchy ears or pain is a common symptom of Otitis externa. Head rubbing, ear scratching, head shaking, aural hematomas, and a head tilt, with the affected ear tilted down, may be noted. A discharge that may be smelly is often present ear wax accumulates.

• Diagnosis- Based on history and clinical findings, Otoscopic examination (or videoscopy) to assess degree of inflammation, ulceration, stenosis, and other changes. Ear swabs for cytology are routinely preformed and occasionally cultures may be required.

• Treatment- Ear wax and debris must be cleared away from the ear canal by a veterinarian and the primary causes of the Otitis should be identified and corrected, if possible. Topical antibiotics or antifungals (depending on the type of infection present) for usually a week or two are often required with systemic (oral) medications for 3-4 weeks. Without proper diagnosis of the cause, treatments will not be completely successful.


Otitis Media

Severe or Chronic Otitis (infection) leading into the medial (middle) ear.

• Diagnosis/Treatment- In-hospital deep ear cleaning/flushing (using our videocopy machine) should be preformed to remove accumulated ear wax, pus and debris from the vertical and horizontal ear canals (under anesthesia). Oral steroids are often used if the ear is painful and the canal swollen and closing/closed off. These ears need long treatments of antibiotics/antifungals and again determining the cause is of most importance to help prevent re-peat infections.


Pseudomonas

Is a bacterial infection that is often associated with a really bad odour and very painful ears. This type of infections needs to be treated aggressively for at least 4 weeks and beyond until complete clinical symptoms are gone. All underlying/primary diseases should/need to be identified and addressed.

• Diagnosis/Treatment- A cytology and culture are commonly preformed to diagnosis this problem. Cultures help the veterinarian determine what antibiotics will kill the offending bacteria, some infections develop resistance to certain drugs and cultures are our only hope of picking the proper medication. Often with this type of infection multiple ear medications are used topically and orally to combat the problem.


Aural Hematoma

(swelling of the ear flap, “ballooning”) is caused by the traumatic rupture of vessels and capillaries within the ear flap. As the animal shakes its head severely, the centrifugal action and flopping of the ear flaps cause the vessels to rupture. The blood then pools in the space between the skin and cartilage, thereby creating a hematoma.

• Diagnosis- Visually and sometimes fine needle aspirate of the hematoma revealing blood.

• Treatment- Rule out underlying causes of excessive shaking (most often Otitis Externa) Treat infections to decrease the head shaking. Depending on the severity and stage of hematoma steroids may be prescribed for the swelling but most often veterinarians choose surgery to drain it then the ear, then it is sutured in many places to keep the tissue layers adhered as it heals.

• Prognosis- Is good, but recurrence is common, especially if the primary cause of the head shaking (usually ear infections) is not controlled.

Vancouver:

1316 West 4th Avenue
Vancouver, BC V6H 4A3 Canada
(604) 558-3376

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Richmond:

140 - 8040 Garden City Rd.
Richmond, BC V6Y 2N9 Canada
(604) 270-6163

Vancouver Office Hours

Monday:

8:30 am-5:00 PM

Tuesday:

8:30 am-5:00 PM

Wednesday:

9:00 am-4:00 pm

Thursday:

8:30 am-5:00 PM

Friday:

8:30 am-5:00 PM

Saturday:

Closed

Sunday:

Closed

Richmond Office Hours

Monday:

8:00 am-5:30 pm

Tuesday:

8:00 am-5:30 pm

Wednesday:

8:00 am-5:30 pm

Thursday:

8:00 am-5:30 pm

Friday:

8:00 am-5:30 pm

Saturday:

By Appointment Only

Sunday:

Closed

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