Hypertonic Nasal Saline Drops for an Upper Respiratory Infection

A 10 year-old FS DSH presented for chronic sneezing and nasal discharge. The owner reported that she had been placed on antibiotics several times in the past with some improvement but no resolution of clinical signs. On physical examination, she had bilateral mucopurulent nasal discharge, moderate dental disease and referred upper respiratory noise on auscultation of her lungs. Diagnostics offered to the owner included blood work, nasal radiographs, rhinoscopy +/- biopsy and culture if indicated. A dental was also recommended. The owner elected to start with blood work, and a dental with nasal radiographs. The blood work revealed a leukocytosis. The remainder of the blood work was within normal limits, including a negative FIV/FeLV.  The nasal radiographs were performed under general anesthesia at the same time as the dental. The radiographs revealed a mild increased density of both nasal passages. Oral Zithromax® (Azithromycin), Chlorpheniramine and Cerenia® (Maropitant citrate) tablets were dispensed for a total of 3 weeks. The doses were as follows:  Chlorpheniramine 2 mg PO BID; Cerenia for 5 days initially then twice weekly; Zithromax 20 mg PO once daily. Cerenia works to reduce nasal discharge and itchiness from infection, and also works well with antihistamines as they potentiate each other. Hypertonic saline and neopolydex ophthalmic drops were also dispensed to be applied to the nasal passages twice daily for 3 weeks. DermaFlush Premixed Saline Packets were used to make the hypertonic saline nasal drops by simply adding 2 of the premixed saline packets to 1 Liter of water. The hypertonic saline was then placed in a dropper bottle and instructions were to instill several drops to both nasal passages twice daily prior to application of the neopolydex ophthalmic drops. Hypertonic saline works to help reduce edema and flush out debris. DermaFlush Saline Packets are an economic and convenient form of saline when added to water. The saline is soothing, preservative and iodine free, and may be made into an isotonic or hypertonic saline. The patient returned for a re-check after 3 weeks and her sneezing and nasal discharge had resolved. She was sent home on an L-lysine supplement and was told to call or return for a re-check if the discharge and/or sneezing...

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GlycoZoo Case Study

A 5 year-old female spayed cocker spaniel presented for a routine annual veterinary examination. On physical examination, she had grade 2/4 dental disease, a  greasy, malodorous coat with generalized scaling and was slightly overweight. The owner reported that that patient was not pruritic but did notice that she smelled badly. Skin cytology and skin scraping were performed and found to be negative. Blood work (including a thyroid level) and a urinalysis were submitted to the laboratory, and returned normal besides a slightly elevated Alkaline Phosphatase (ALKP), which was attributed to the dental disease. A DTM was also performed and negative results were obtained a few weeks later. The patient was diagnosed with a mild form of seborrhea oleosa (greasy seborrhea) and was sent home with GlycoZoo Shampoo and Spray Conditioner to be used 2-3 times a week for 3 weeks, until re-check. The owner was instructed to lather, massage, and then allow skin contact time of at least 10 minutes before rinsing the GlycoZoo Shampoo. The GlycoZoo Spray Conditioner is leave-in, dry-on and may be used after bathing (as was done in this case) or alone. Seborrhea is an inherited disorder of keratinization. Seborrhea (excessive scaling) is associated with abnormal (accelerated) epidermal turnover which gives rise to excessive scaling. Seborrhea oleosa (greasy seborrhea) is typified by greasy skin and haircoat, a malodor, and brown-yellow scales and sebum that clump to the hair and skin. Keratolytic agents, such as Glycolic Acid, may be used to treat seborrhea complex. Keratolytic agents loosen adhesion between cells in the epithelium and facilitate cell shedding (removal of excess scale). The patient returned for a dental 3 weeks later and the coat was significantly improved with decreased scaling, and no odor or greasiness appreciated. The Glycolic Acid worked to exfoliate the excess dead skin cells as a result of the seborrhea, and the drying effects of the Boric Acid helped to degrease the skin and coat. Both ingredients helped to remove the odor. A routine dental under general anesthesia was performed with no extractions and the patient was sent home with T/Edta/C Dental Wipes to maintain a good oral hygiene regimen at home. The owner was also instructed to use the GlycoZoo Shampoo and Spray Conditioner weekly for maintenance to keep the skin and coat healthy. Please submit any case studies you may have using DermaZoo or OtoPet-USA products to jessvet3@aol.com.   What is Glycolic Acid? Glycolic Acid is the current gold standard in chemical exfoliants available within the human dermatology market. It...

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The Earigator: Wound Flushing

The Earigator may be used in other ways besides flushing ears. If presented with a bite wound that needs to be flushed under pressure, the Earigator may be used along with DermaFlush(™) Premixed Saline Packets. DermaFlush is a saline crystal packet that when added to water creates a saline solution which can be used anywhere a saline flush may be beneficial, including ears, sinuses, wounds and external surgery. DermaFlush will be available in October 2013. Prior to using the  Earigator to flush a wound, clean and flush the unit and the tubing with a mild bleach solution and water. Then cut the tip off the catheter tipped end of a 10 – 12 Fr red rubber feeding tube to fit the trumpet valve nipple. Fill the Earigator flush bottle with a saline solution made with DermaFlush(™). The catheter can be used, with the fluid under pressure, to snake under the skin and into loose skin or muscle tissue and wash abscesses and fistulated areas. The saline acts as an osmotic agent helping to reduce edema and the pressure provided by the Earigator can help remove debris, such as purulent discharge that may be present in an infected wound. If you have an interesting case that you would like to submit with pictures, please contact Dr. Jessica Melman Bhatia...

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Case Study: Tooth Fracture

A 5 year-old female mix breed dog presented for left facial swelling. On oral examination, the upper left 4th premolar was found to have a fractured crown with an exposed pulp cavity and gingival swelling surrounding the tooth. The patient was placed on Clindamycin for 2 days duration pending blood work, which was normal despite a neutrophilia. A fractured tooth with obviously exposed pulp, a discolored tooth, facial swelling, and a draining tract are all indications of endodontic disease. A root canal or extraction must be performed on a fractured or worn tooth with pulp exposure. The owners declined referral to a dentist and elected for extraction of the tooth. The patient was placed under general anesthesia for a dental cleaning and extraction of the upper left 4th premolar. The veterinarian used the OtoPet-USA Video Otoscope full image lens to take a picture of the broken tooth after the  pulp was removed and prior to extraction. This picture was printed for the veterinarian’s records and for the client. The patient was sent home on Clindamycin for a total of 2 weeks, as well as Rimadyl and Tramadol to control pain and inflammation. If you have an interesting case that you would like to submit with pictures, please contact Dr. Jessica Melman Bhatia...

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Image of a Ruptured Tympanic Membrane

It is important to visualize and clean the ear canals in order to effectively manage cases of chronic otitis. The OtoPet-USA Video Vetscope may be used for visualization in conjunction with the OtoPet-USA Earigator, which may be used to lavage, suction and remove debris from the ear canals. Excessive debris must be cleaned out for several reasons when managing cases of otitis. Debris can block the penetration of topical agents to the affected tissue requiring treatment, and large deposits may prevent medication from reaching the deeper parts of the ear canal. Larger clumps of debris that remain in the ear canal may sequester organisms as well. Debris can also protect microbes that are attached to keratinocytes, and therefore, covered with a protective lipid layer. These organisms may survive therapy and then infect the ear again.  Retained debris may also contain pro-inflammatory substances, such as microbial byproducts and toxins. Additionally, purulent discharge may interfere with the effectiveness of some antibiotics. Finally, it is often necessary to clean the ear of debris simply to be able to properly to visualize the tympanum. Below is a case study demonstrating the use of the Video VetScope and Earigator to visualize and clean an ear with chronic otitis. A middle-aged dog presented with a unilateral chronic otitis for several months duration. He had a normal examination besides pain, erythema and purulent discharge from the affected ear. He was placed under general anesthesia, which was required to completely assess the ear canal and for a through otic flushing. An endotracheal tube was placed and the patient was positioned in lateral recumbency. Initially, it was difficult to assess the tympanic membrane as there was discharge obstructing the view. With visualization using the Video VetScope, samples of the discharge were taken for cytology and culture and sensitivity prior to flushing the ear canal. Rods were visualized on cytology. Using the Earigator, the ear canal was then copiously flushed with a warmed saline to remove the discharge. Alligator forceps inserted through the Video VetScope probe may be used to remove any excess debris if needed as well. Finally, the ear was evaluated again with the Video VetScope to assess the tympanic membrane, which was found to be ruptured. An image of the ruptured tympanic membrane was captured and can be seen here. The patient was sent home on oral Zenequin® pending the culture and sensitivity results, a tapering dose of steroids and a topical mixture of tris-EDTA, Dexamethasone SP and Baytril®. The culture and sensitivity revealed Pseudomonas, which was sensitive to Zenequin®. The...

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Case Study: Tick Infestation in Ear Canal Diagnosis and Treatment

A 5 year-old female mixed breed dog from Arizona was presented for head shaking and discomfort for several days duration. A physical examination was performed and within normal limits. Next, an otoscopic examination was performed in the exam room using the OtoPet-USA Video Vetscope. The Video Vestcope probe was inserted into both ear canals. The image here of the left ear canal was visualized and captured using the video monitor. The owner was able to see the ticks within the left ear canal on the monitor, and the dog was taken into the procedure room for removal of the ticks. This was a case of Otobius megnini infestation. Otobius megnini, the spinous ear tick, is a soft-bodied tick found in the Southwest United States. The parasitic larvae and nymphs feed within the ear causing a significant inflammatory reaction in the ear canal. Treatment includes removal of the tick, appropriate tick control measures and management of the associated otitis. The two soft-bodied tick nymphs identified as Otobius megnini were removed from the ear canal using alligator forceps placed through the OtoPet-USA Video Vetscope probe while visualizing the procedure on the monitor. The patient was then placed on Frontline for tick control, and a topical otic steroid to treat the secondary inflammation associated with the infestation. An image of another patient in Texas with an Otobius megnini tick within the ear is on the left. If you have an interesting case that you would like to submit with pictures, please contact Dr. Jessica Melman Bhatia at...

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