{"id":8881,"date":"2020-10-01T00:00:08","date_gmt":"2020-10-01T07:00:08","guid":{"rendered":"https:\/\/todaysveterinarybusiness.com\/?p=8881"},"modified":"2022-06-15T17:46:32","modified_gmt":"2022-06-15T17:46:32","slug":"ear-issues-veterinary-care","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarybusiness.com\/ear-issues-veterinary-care\/","title":{"rendered":"Reality Checks"},"content":{"rendered":"

When Kathryn Primm, DVM, CVPM, called to find out why her client\u2019s dog missed a follow-up appointment after two weeks of otitis treatment, she got a response that changed her practice permanently. \u201cThe client said her dog\u2019s ears were fine, she didn\u2019t need a recheck, and we were just trying to get extra money.\u201d<\/p>\n

Needless to say, Dr. Primm, who owns Applebrook Animal Hospital in Ooltewah, Tennessee, was frustrated at being unable\u00a0to see the case through to the\u00a0end. The patient\u2019s ears had been so swollen that she had been\u00a0unable to see the eardrum, and she strongly suspected that the infection was resistant to first-line therapies.<\/p>\n

Dr. Primm decided that if she couldn\u2019t help that patient, she\u2019d help the rest. Now, every sick pet, including otitis patients, receives a courtesy recheck.<\/p>\n

\u201cI decided to put my money where my mouth is,\u201d Dr. Primm said. \u201cI think it reinforces the idea that we\u2019re not just trying to get money out of our clients; we really care if the pet is feeling better or not.\u201d<\/p>\n

Why Rechecks Are So Important<\/h3>\n

As Dr. Primm\u2019s story illustrates, otitis cases can be frustrating all around to clients, to veterinarians and even to veterinary dermatologists, said Melissa Hall, DVM, DACVD, of Animal Dermatology Clinic in Tustin, California.<\/p>\n

\u201cWhen it comes to ear infections, you have to deal with the infection itself, but then you also have to go on a quest to find the underlying trigger,\u201d Dr. Hall said. \u201cAnd unless you identify that underlying trigger, it\u2019s going to come right back again.\u201d<\/p>\n

The initial appointment is usually about getting the infection under control, addressing swelling and managing pain, Dr. Hall said. For some simple cases involving the external ear only, that\u2019s enough. But many patients need more extensive and ongoing care, which means the second appointment can be even more important because it sets the stage for the entire plan.<\/p>\n

\u201cThat recheck is a great time to say, \u2018OK, let\u2019s start talking about potential triggers. Is your dog itchy and licking at its paws? Does this ear infection seem to pop up around the same time every year? Have we had ear infections since we were a puppy?\u2019\u201d Dr. Hall said.<\/p>\n

The answers to these types of questions help Dr. Hall determine whether something like an environmental allergy or food allergy is behind the ear disease.<\/p>\n

Another common issue with otitis cases is that, as in Dr. Primm\u2019s case, the ear canal is so swollen and painful that the veterinarian can\u2019t use an otoscope to visualize the tympanic membrane. A follow-up appointment<\/a> is necessary to see if it has ruptured and whether the middle and inner ear<\/a> are affected. Also possible? The pet might not be feeling better at all.<\/p>\n

\u201cOne of the most important things I do with every ear case is, if there\u2019s debris or pus or exudate in that ear, I swab it and I do an otic cytology,\u201d Dr. Hall said. \u201cThat\u2019s even more important at the recheck. Maybe you were super focused on all that bacteria you saw the first day, and then on the recheck, you swab it and now there\u2019s a ton of yeast. The skin is still red, the ear is still swollen, the pet\u2019s still itchy and shaking its head, but now you have a whole different beast.\u201d<\/p>\n

So, the recheck is essential for many reasons:<\/p>\n