Non-blinded treatment of aural -hematoma with oral prednisolone as a monotherapy in privately-owned dogs.

INTRODUCTION: Aural hematoma is the most common injury of the pinna in dogs. Treatment options are various. More recently, medical therapy has been more commonly pursued than surgical options. Therefore, our hypothesis was that monotherapy with oral prednisolone for one month is sufficient to successfully treat dogs diagnosed with aural hematoma. In this open prospective experimental study without control group, clinicians treated 24 privately-owned dogs suffering from aural hematoma with oral prednisolone at 1 mg / kg / day for 14 days, followed by 0,5 mg / kg / day for another 14 days. In case of strong side effects, the dose reduction was already initiated after 7 days of treatment. The success was assessed subjectively after 14 days by the owner and after 28 days by a clinician or specialist. In addition, before and after treatment the thickness of the swelling was measured. In 21 of 24 dogs, oral prednisolone treatment for 28 days lead to a subjective clinical improvement of at least 80 %. The ear thickness was reduced by at least 50 %. This study showed that treating dogs suffering from aural hematoma for four weeks with oral prednisolone used as a monotherapy leads to promising results and could be considered as an economical, non-invasive and safe treatment alternative for aural hematoma in dogs.

INTRODUCTION: L'hématome auriculaire est la lésion la plus fréquente du pavillon de l'oreille chez le chien. Les options de traitement sont diverses. Depuis un certain temps, la thérapie médicale a été plus souvent proposée que les options chirurgicales. Par conséquent, notre hypothèse était qu'une monothérapie avec de la prednisolone orale pendant un mois est suffisante pour traiter avec succès les chiens souffrant d'un hématome auriculaire. Dans cette étude expérimentale prospective ouverte sans groupe de contrôle, les cliniciens ont traité 24 chiens privés souffrant d'un hématome auriculaire avec de la prednisolone orale à raison de 1 mg / kg / jour pendant 14 jours, suivie de 0,5 mg / kg / jour pendant 14 autres jours. En cas de forts effets secondaires, la réduction de la dose était déjà amorcée après 7 jours de traitement. Le succès du traitement a été évalué subjectivement après 14 jours par le propriétaire et après 28 jours par un clinicien ou un spécialiste. En outre, l'épaisseur de l'enflure a été mesurée avant et après le traitement. Chez 21 des 24 chiens, le traitement oral à la prednisolone pendant 28 jours a entraîné une amélioration clinique subjective d'au moins 80 %. L'épaisseur de l'oreille a été réduite d'au moins 50 %. Cette étude a montré que le traitement des chiens souffrant d'un hématome auriculaire pendant quatre semaines avec de la prednisolone orale utilisée en monothérapie conduit à des résultats prometteurs et pourrait être considéré comme une alternative de traitement économique, non invasive et sûre pour l'hématome auriculaire chez les chiens.

Epistaxis in anticoagulated patients: Fewer hospital admissions and shorter hospital stays on rivaroxaban compared to phenprocoumon.

OBJECTIVES: Treatment of epistaxis in patients on anticoagulants is challenging and associated with higher admission rates and longer hospital stays compared with patients without anticoagulation. However, there is little information about epistaxis in patients taking new direct oral anticoagulants such as rivaroxaban compared with patients on traditional vitamin K antagonists such as phenprocoumon. DESIGN: Retrospective cohort study. SETTING: The study was conducted at the emergency department of the University Hospital Inselspital, Bern, Switzerland. PARTICIPANTS: All admissions to the emergency department of the University Hospital Inselspital, Bern, Switzerland from 1st July 2012 to 30th June 2016 with non-traumatic epistaxis on anticoagulant therapy with phenprocoumon or rivaroxaban were included. MAIN OUTCOME MEASURES: We compared clinical outcome parameters (admission rates, length of hospital stay and mortality) for both anticoagulant groups. RESULTS: We included 440 patients with epistaxis, 123 (28%) on rivaroxaban and 317 (72%) on phenprocoumon. Fewer hospital admissions and shorter hospital stays were found in patients under rivaroxaban (12 (10.4%) vs 57 (18.0%) patients, P=.033; 0.7±2.2 vs 1.5±3.7 days, P=.011) compared with phenprocoumon. Anterior epistaxis was more common in the rivaroxaban group in contrast to posterior epistaxis in patients on phenprocoumon (74 (60.2%) vs 139 (43.8%) patients, P=.002; 7 (5.7%) vs 39 (12.3%) patients, P=.042). CONCLUSIONS: Our data suggests that epistaxis on direct oral anticoagulation with rivaroxaban is associated with shorter hospital stays and fewer hospital admissions than epistaxis on vitamin K antagonist phenprocoumon.