Malassezia otitis unresponsive to primary care: outcome in 59 dogs.

BACKGROUND: Otitis externa (OE) is a common disorder in dogs. Infection by the commensal yeast, Malassezia pachydermatis, may result in chronic disease that does not respond to standard primary care. Chronic infectious OE may be associated with otitis media (OM). HYPOTHESIS/OBJECTIVE: To report medical management, clinical outcomes and frequency of middle ear involvement, in dogs with Malassezia otitis unresponsive to primary care. ANIMALS: Fifty-nine dogs from one referral veterinary hospital from January 2007 to September 2018. METHODS AND MATERIALS: Retrospective analysis of medical records of dogs referred with chronic otitis and treated for Malassezia otitis at a referral veterinary hospital. RESULTS: Chronic Malassezia OE was treated successfully in 91% of ears, in 87% of these cases with one ear flush intervention. Median time-to-resolution was 27 days after ear flush intervention. Neither duration of otitis, presence of neutrophils in aural discharge nor administration of oral itraconazole affected clinical outcome. Malassezia OM occurred concurrently in 17% of ears. CONCLUSIONS AND CLINICAL RELEVANCE: These findings assist clinicians and carers of affected dogs in decision-making, by documenting that most cases of canine Malassezia otitis that have not resolved with standard primary care, can be treated successfully with a well-staged and intense medical treatment plan. Malassezia OM should be suspected to occur concurrently in around a fifth of affected ears.

Management of canine atopic dermatitis using the plant extract PYM00217: a randomized, double-blind, placebo-controlled clinical study.

This study evaluated PYM00217, a proprietary blend of plant extracts, in the management of canine atopic dermatitis (AD). One hundred and twenty dogs were diagnosed with perennial AD on the basis of history, clinical signs, a positive test for perennial allergens and elimination of other dermatoses. Exclusion criteria included antimicrobials within 7 days, antihistamines within 14 days, oral/topical glucocorticoids or ciclosporin within 28 days, and parenteral glucocorticoids, essential fatty acids or immunotherapy within 56 days. Flea control, shampoos and ear cleaners were permitted. Dogs with a minimum canine atopic dermatitis extent and severity index (CADESI) of 25 were randomly allocated to receive PYM00217 (100, 200 or 400 mg kg-1 day-1) or placebo for 12 weeks. The mean reductions in CADESI (intention-to-treat population) were 3.9% (placebo; n=29), 4.4% (100 mg kg-1 day-1; n=30), 23.4% (200 mg kg-1 day-1; n=29) and 8.5% (400 mg kg-1 day-1; n=29). The reduction in the 200 mg kg-1 day-1 group was significant (P<0.01). For dogs with a baseline CADESI>or=50, the mean changes were +10.6% (placebo; n=12), +0.6% (100 mg kg-1 day-1; n=14), -29.3% (200 mg kg-1 day-1; n=14) and -3.4% (400 mg kg-1 day-1; n=15). The 200 mg kg-1 day-1 dose was significantly more effective than placebo (P=0.038). No serious adverse effects were reported. Minor adverse effects seen in 10% (placebo and 100 mg kg-1 day-1), 24% (200 mg kg-1 day-1) and 42% (400 mg kg-1 day-1) of cases were mainly minor gastrointestinal disorders and only five cases required cessation of dosing. Two dogs (one in each of the 100 mg kg-1 day-1 and 200 mg kg-1 day-1 groups) refused to eat the medicated food. In conclusion, PYM00217 at 200 mg kg-1 appears to be an effective, palatable and well-tolerated treatment for canine AD.