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My poodle has chronic ear infections diagnosed with rod

shaped cocci and after ear...
My poodle has chronic ear infections diagnosed with rod shaped cocci and after ear flush under anesthetics, was treated with Gentamycin Otic and Batril Otic as well oral Ciprofloxacin which have not worked. she also has eye discharge and a runny nose. Her discomfort seems to be all through her face but mostly in her ears. She shakes her head and loves me to massage her ears and her entire snout and face. The vet prescribed Neomycin and Polymycin and Neopolydex Opt for her eyes but didn't cure her eyes either. I have spent $500 in the past months with no resolution. I realize her ears are primary, but I can't help thinking these symptoms are related. Please help me, I love her so much. also, I should add that she is not around water. I would appreciate your input as soon as possible. Thank you, Karen (and Izzi)
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Answered in 7 minutes by:
9/19/2013
Dr. Andy
Dr. Andy, Medical Director
Category: Dog Veterinary
Satisfied Customers: 30,100
Experience: UC Davis graduate, emphasis in dermatology, internal medicine, pain management
Verified
Welcome! My name is***** am a 2003 graduate, and currently a Medical Director of a veterinary hospital.
I am sorry to hear about this concern for Izzi.
A few things to think about.
1. The ear infection (otitis externa).
The vet mentioned rods. These are possibly psenudomonas, which is often resistance to a lot of medications. I don't know if they did this, but what the vet needed to do or ask you is a culture of the infection!
Any time rods are seen or there is a severe infection, a vet should request the extra funds from you to do a culture and sensitivity test. This test tells the vet what bacteria (often multiple) are present and which antibiotics will kill it. Often, in this case, there are only 1 or 2 that will work!
The eyes. May not be directly related, although if related, it could be because:
1. The eyes were injured from scratching at the ears
2. Possible environmental allergies, a common cause for ear problems as well.
I know you have spent a bit, but this may still be a bit more costly to get some resolution.
Also, NEVER EVER hesitate to simply go directly to a dermatologist to get on the right track.
Find a Dermatologist
--> Then select "find dermatologist"
In addition, sometimes a special ear cleaner should be used in combination with the right ear medication.
For example, TrizEDTA cleaner. It actually helps to weaken the bacteria making ear medicine more effective!
Also, the eyes should have a simple eye stain test performed to ensure there is no active ulcers on them.
Eye Stain Test for Ulcers
Another point. STarting an antihistamine might help out a bit. In fact, some benadryl can have a sedating effect which may be useful in this case.
Benadryl can be given at a dose of 1mg per pound of body weight. Keep in mind, Benadryl tablets and liquids come in different sizes. So, an approximately 25 pound dog can get a full 25mg tablet or a half of a 50mg tablet. I usually avoid the liquid Benadryl in larger dogs (you would have to give too much of it). You can give Benadryl every 8-12 hours.
Lastly, if the ears are inflamed or swollen, a steroid would be nice to help the irritation and provide some comfort.
I hope that information has been helpful.
Please remember to select Reply to Expert, if for any reason you need further clarification, have more questions, or were expecting a different type of answer. Prior to leaving a feedback rating, which I greatly appreciate, my goal is to provide you the best answer possible.
Dr. Andy
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Customer reply replied 4 years ago

Hello Dr Andy

I have the culture results that I wish to send you. I am writing this on my TV so I can't attach them. I will go to my PC to send them but I don't know this url or how to get back to this page in order to send to you. Will you please let me know; I hope to hear from you soon.

thank you and,

Best regards,

Karen

Hello Karen,
I cannot prescribe any medication but I can offer some suggestions based on the results to ask your vet about.
You can email them to***@******.***
Ask the moderator to send the information to the following question:
http://www.justanswer.com/dog-health/80acm-poodle-ear-infections-diagnosed-rod-shaped.html
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Customer reply replied 4 years ago

I just emailed the culture results to***@******.*** and asked the moderator to forward it to the address you gave me. Please let me know when you receive it (the file is a PDF file).

Thank you,

karen

Hi Karen,
Okay. It can take a few hours, so I may not get back to you until this evening, pacific time.
Dr. Andy
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Customer reply replied 4 years ago

Hi again

This evening is fine; however, there is no link that I can see on my TV screen ... any advice would be helpful.

Karen

Customer reply replied 4 years ago

Will you please email me when you respond in case I'm not by the TV?

Thank you.

Hi Karen,
I do not know if that email came through correctly, but I am not permitted to send information outside of this forum. It's for your protection, my protection, and I would also not be credited for responding to your questions if I send to your email. So, I can only send answers here. Sorry for inconvenience.
Dr. Andy
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Customer reply replied 4 years ago

Hi Andy

i want to know what the terminology means - no one has explained it to me. I can resend it if you would like in jpg file.

Thanks,

Karen

PS. Your website indicates perhaps a call can be made.

Hi Karen,
That is generally for other types of services.
Please try to resend to
***@******.***
make sure to inform them to give the information to Dr.Andy working on the following question:
http://www.justanswer.com/dog-health/80acm-poodle-ear-infections-diagnosed-rod-shaped.html
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Okay, got Izzi's results.
What you are really looking for is only an antibiotic that indicates the bacteria is "sensitive" to the antibiotic. Meaning, in the proper concentration, it can kill it. That is what the numbers off to the side suggestion.
Ciprofloxaxin is a good oral antibiotic in this case and should be continued.
The problem is that some of the options that say sensitivity or not readily available in ear topical form.
But, some are!
If you vet is willing, some vets and specialist will "cocktail" a ear medication for you. Essentially, make a formula with a suitable antibiotic.
Here's a suggestion to ask your vet about trying:
1. Get a bottle of TrizEDTA. A 4 ounce bottle.
2. Remove 4.8ml of the cleaner and throw away
3. Add 4.8ml of 250mg/ml Amikacin injectable. This gives the entire bottle an effective concentration of 10mg/ml.
You'll need to show them this, and they will quickly now.
How is that 10mg/ml. Well, 4 ounces is 120ml. You take away 4.8ml and replace with a total of 1200mg of drug. So, 1200mg of drug divided by 120ml equals 10mg/ml.
Usually, this solution is put into the ear twice a day and sometimes treatment can extend for several weeks.
I really like it because the ear cleaner is very watery and makes it even easier to penetrate deep into the ear canal, moreso the ear ointments.
Hope that answers helps Karen. Good Luck!
Dr. Andy
Dr. Andy
Dr. Andy, Medical Director
Category: Dog Veterinary
Satisfied Customers: 30,100
Experience: UC Davis graduate, emphasis in dermatology, internal medicine, pain management
Verified
Dr. Andy and 87 other Dog Veterinary Specialists are ready to help you
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Customer reply replied 4 years ago

Dr Andy

Thank you so much for the invaluable advice you have given me. I would like to keep you updated on Izzi's condition. Will you be available when/if I need further assistance?

I received more information from you online regarding this problem than I have received from two vets we saw in person regarding Izzi's infection. PetMD is fortunate to have you on their team. You really became involved in my case and were so quick to respond. I have never sought online help but, at my wits' end, decided to give it a try - and what a pleasant surprise I received; and it is because of your expertise, communication, involvement and care to which I give credit. I felt you were truly engaged in Izzi's issue, to which I say, thank you so much. What an asset you are to PetMD and I hope they value your significant contribution to their success. I am so happy you were the doctor online when I contacted PetMD.

Warm regards,

Izzi and Karen

You are very welcome Karen, and glad to be of assistance. I hope the information can help.
Yes, you can request me for future questions by leading the question with "Dr. Andy"
Also, by clicking my link and saving it:
http://www.justanswer.com/veterinary/expert-drandy/
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Customer reply replied 4 years ago

Hi again Dr Andy

I did not mention I have another dog, a GoldenDoodle, Abbi, age 6. No matter how I try to stop her, she has been licking Izzi's ears incessantly; she is the constant groomer. Smile She has not had ear infections previously, but she is now scratching her ears and they are pink (new for her). Is Izzi's bacteria infection contagious and might Abbi contract the infection from her licking Izzi's ears.

I notice TrisEDTA is sold as a flush, crystals, and TrisEDTA Plus so I was wondering what the differences are. Also, does it come in a form to treat skin irritations/rashes which Abbi has on her tummy. I have used Vetericyn for skin but not clearing it up.

Thank you and I look forward to hearing from you.

Best regards,

Karen

Hello Karen,
No, the ear thing would not be contracted by her licking the other dog's ears.
It should also not be contagious unless she was suffering from some type of condition causing suppression of the immune system, which is unlikely.
It is much more likely that she is also a allergy sufferer, with environmental allergies being the cause. One of the #1 complications of atopy (environmental allergies), is ear infections.
The TrisEDTA wouldn't be enough used alone. The vet would be using it to cocktail the ear medication inside of it.
The TrisEdTA Plus also has some chlorhexidene antibiotic.
Ideally, the TrisEDTA is fine, and your vet adds the medication to it.
The skin would likely require oral therapy as well, in the form of antibiotics if a skin infection is present, and definitely, some oral steroids (or an injection) to reduce inflammation.
No, the TrisEDTA is designed for ear issues.
You would have to ask the vet about doing a simple skin test called a "derm impression cytology" just to look for if there is bacteria and/or yeast on the surface of the skin. It helps to pick which topicals and oral medications to use.
Dr. Andy
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Dr. Andy
Dr. Andy
Dr. Andy, Medical Director
Category: Dog Veterinary
Satisfied Customers: 30,100
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Experience: UC Davis graduate, emphasis in dermatology, internal medicine, pain management

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