Acute otitis externa: the successful first-opinion ear consultation

Acute otitis externa is defined as disease that has been present for up to one week (Bensignor and Forsythe 2012) and is a common presentation in small animal practice (Hill and others 2006). Otitis externa is a complex disease involving primary and secondary causes of inflammation and predisposing and perpetuating factors. It frequently recurs, despite apparently successful initial therapy. Repeated episodes of otitis externa along with failure to address the various causes and factors, may lead to progressively more severe disease and potentially irreversible chronic pathological changes within the ear canal. A careful, considered approach in a case of acute otitis externa is the first step to prevent such chronic disease. In this article, Peter Forsythe outlines an approach to acute otitis externa that should be practical within the confines of a 10 to 15 minute first-opinion consultation. Cases of chronic disease require more in depth investigation beyond the scope of the typical first-opinion consultation and additional time has to be set aside for these more complex cases or consideration given to referral to a dermatology specialist.