Peripheral vestibular disease associated with cryptococcosis in three cats.

Peripheral vestibular disease referable to otitis media/interna was the main reason for presentation in three cats with cryptococcosis. In two cats, Cryptococcus neoformans var neoformans was isolated from the tympanic bulla. In the remaining cat, otitis media/interna was considered to be secondary to occlusion of the auditory tube by a nasopharyngeal granuloma associated with a C neoformans var gattii infection. This report emphasises the importance of maintaining an index of suspicion for a fungal aetiology in cats with signs of otitis media/interna, particularly in countries with a high prevalence of cryptococcosis. The presence of C neoformans may be overlooked with potentially fatal consequences where only standard methods for bacterial isolation are used to examine samples obtained from the middle ear.     

Inner ear fluid‐attenuated inversion recovery MRI signal intensity in dogs with vestibular disease

The inner ear contains endolymph and perilymph. The second is comparable and in continuity with the cerebrospinal fluid (CSF) so it is expected to suppress in fluid‐attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) if normal. Even though inner ear FLAIR abnormalities have been extensively described in humans with inner ear disease, its diagnostic value in dogs is yet to be proven. The goal of this retrospective cohort study was to investigate the diagnostic utility of FLAIR MRI in dogs with vestibular disease. A review of medical records identified 101 dogs that had brain MRI performed because of vestibular signs. Based on the final diagnosis, patients were allocated to three groups: otitis media/interna, idiopathic vestibular disease, and central vestibular disease. Additionally, a control group (n = 73) included dogs with normal MRI and without vestibular signs. Inner ears were delineated using a region of interest, and signal intensity was measured in FLAIR and T2‐weighted images. The percentages of suppression in FLAIR were calculated and compared between affected and unaffected sides of each individual and between groups using a general linear mixed model. Correlation between suppression and CSF cell count and protein concentration was assessed. Affected inner ears in dogs with otitis media/interna had decreased suppression in FLAIR compared to the unaffected side (P < .001), and all other groups (P < .01). No significant correlation was detected between CSF results and suppression. These results show the diagnostic value of FLAIR in otitis media/interna due to lack of suppression in the affected inner ear.     

Brainstem and cranial nerve abnormalities: listeriosis, otitis media/interna, and pituitary abscess syndrome.

This article reviews three disorders associated with multiple asymmetric cranial nerve deficits in ruminants: encephalitic listeriosis,otitis media/interna, and pituitary abscess syndrome. Emphasis is placed on encephalitic listeriosis, an infectious disease of the brainstem and cranial nerves caused by Listeria monocytogenes.The epidemiology, pathophysiology, clinical manifestations, diagnosis,and treatment of encephalitic listeriosis are reviewed, and differences between cattle and small ruminants are noted. Physical and neurologic examination findings that distinguish otitis media/interna and pituitary abscess syndrome from encephalitic listeriosis are highlighted.     

A case of otitis in a domestic cat

A case of otitis media and interna in a domestic cat is described in which granulation tissue extended into the external ear canal. An unusual histological feature was the presence of mucous glands within the granulation tissue. The possible origin of these glands and a differential diagnosis of this condition is discussed.     

Otitis media‐interna and secondary meningitis associated with Corynebacterium pseudotuberculosis infection in a horse

A one‐year‐old Thoroughbred colt was evaluated because of facial nerve paralysis, ataxia and fever. Neurological evaluation found the colt to be obtunded and grade 3/5 ataxic in all 4 limbs. Right‐sided facial nerve paralysis was present and a large, deep corneal ulcer noted in the right eye. Signs of vestibular disease were also present, including circling towards the right and horizontal nystagmus. A complete blood count showed mild leucocytosis, neutrophilia and hyperfibrinogenaemia. A computed tomography (CT) examination of the skull was performed under general anaesthesia and a diagnosis of right sided otitis media‐interna was made. Culture of fluid taken from the middle ear and cerebrospinal fluid collected from the atlanto‐occipital site yielded pure growth of Corynebacterium pseudotuberculosis. Initial therapy consisted of antimicrobial treatment with cefotaxime and anti‐inflammatory treatment with flunixin meglumine. Six days after initiating treatment, the colt developed Clostridium difficile associated colitis. The colitis resolved with supportive care and the colt was discharged from the hospital receiving chloramphenicol. Eight months later, the colt continued to be mildly ataxic (grade 1/5), with a slight head tilt and facial nerve paralysis. To the authors' knowledge, this is the first reported case of otitis media‐interna due to C. pseudotuberculosis in the horse.     

Clinical signs, magnetic resonance imaging features, and outcome after surgical and medical treatment of otogenic intracranial infection in 11 cats and 4 dogs

Brainstem dysfunction resulting from central extension of infection is a life-threatening complication of otitis media/interna (OMI) that has been described infrequently in dogs and cats. We review the clinical signs of disease, diagnostic findings, and results of surgical and medical treatments of brainstem disease attributable to otogenic intracranial infection in cats and dogs. Eleven cats and 4 dogs were examined because of acute, subacute, or chronic clinical signs of brain disease including central vestibular signs, altered mentation, abnormal posture/gait, cranial nerve deficits, and seizures. Results of a minimal database (CBC, serum biochemical panel, urinalysis, thoracic radiographs, and abdominal ultrasonographic images or radiographs) were within reference intervals in all animals. Magnetic resonance (MR) images of the head were acquired for all animals, and cisternal cerebrospinal fluid (CSF) from 9 of 11 cats and 3 of 4 dogs was examined. Surgical exploration and ventral bulla osteotomy were done for 12 of 15 animals, followed by 1–3 months of antibiotic therapy; the remaining animals were euthanized before treatment. In all animals, MR imaging was effective in characterizing the location and extent of the pathologic changes intracranially as well as within middle/inner ear structures. Results of CSF analysis were characteristic of bacterial infection in most of the animals with acute or subacute disease. Since long-term outcome in all treated animals was very good to excellent, it was concluded that dogs and cats with intracranial disease secondary to extension of otitis media/interna have a good-to-excellent prognosis when the condition was diagnosed and was treated by surgical exploration and appropriate antibiotic therapy.     

Facial neuropathy in dogs and cats: 95 cases (1975-1985)

The medical records of 79 dogs and 16 cats admitted to the New York State College of Veterinary Medicine between January 1975 and October 1985 with facial nerve dysfunction were reviewed. In 31 dogs and 8 cats, facial neuropathy was the only abnormal finding. In 48 dogs and 8 cats, the clinical findings most often noted in the records in addition to facial neuropathy were vestibular signs. Facial neuropathy appeared unassociated with gender or right vs left sides in both dogs and cats, or with hypothyroidism in dogs. Facial neuropathy was associated with increased age, with certain breeds in both dogs and cats, and with otitis media/interna and keratoconjunctivitis sicca in dogs. Causes of facial nerve dysfunction in dogs and cats included surgical and nonsurgical trauma, neoplasia, and otitis media/interna. Facial neuropathy was judged to be idiopathic in 74.7% of dogs and 25% of cats.     

Otitis media in five cats associated with soft palate abnormalities

The medical records of five cats that were diagnosed with otitis media and soft palate abnormalities, three of which had concurrent otitis interna, were reviewed retrospectively. The animals presented with unilateral or bilateral otitis media or otitis interna associated with soft palate hypoplasia (four cases) or unilateral soft palate cleft (one case). Otitis media was confirmed by radiography, CT or MRI. The soft palate abnormalities present were discovered on oropharyngeal examination at induction of anaesthesia. These five cases provide additional support of a link between otitis media and soft palate abnormalities in cats, as reported in humans and dogs.     

Horner's syndrome in dogs and cats: 100 cases (1975-1985)

The medical records of 74 dogs and 26 cats with Horner's syndrome (HS) that were admitted to the New York State College of Veterinary Medicine between January 1975 and October 1985 were reviewed. In dogs, but not cats, HS was associated significantly (P less than 0.01) with increasing age. Dogs with hypothyroidism (defined liberally but not rigorously), intracranial neoplasia, or thoracic neoplasia, cats with otitis media/interna (defined liberally), and dogs and cats with brachial plexus root avulsion were at greater risk for developing HS than were animals that were hit by a car. Dogs and cats with otitis externa were at less risk of developing HS than were animals that were hit by a car. The cause of HS could not be determined in 50% of dogs and 42.3% of cats. The results of topical adrenergic drug testing in dogs were inconclusive in localizing lesion site. In dogs and cats, HS appeared to be unassociated with gender, breed, or right vs left side. The important causes of HS in dogs and cats were trauma (hit by car), brachial plexus root avulsion, intracranial and thoracic neoplasia, and otitis media/interna.     

Development and validation of an endoscopic myringotomy technique to treat otitis media and interna in a case series of three guinea pigs (Cavia porcellus)

Background: Medical treatment of clinical otitis media and interna in guinea pigs is often unsatisfactory. Total ear canal ablation and lateral bulla osteotomy are used successfully in dogs, cats, and rabbits to treat chronic, medically nonresponsive ear disease. However, in guinea pigs this surgery can cause death. This study aimed to evaluate and describe a standardized myringotomy technique to treat guinea pigs with otitis media and interna. Methods: Ear dissections and endoscopically assisted myringotomy were evaluated on guinea pig carcasses to choose the most suitable endoscope and optics. Three client-owned guinea pigs with chronic otitis media and interna had a myringotomy with bacteriological sampling and therapeutic irrigation of the tympanic cavity performed. Anesthesia for the procedures was 25 minutes, the patients were recovered and eating within 2–6 hours, and discharged on targeted antibiotic therapy within 24 hours. Videotoscopy was performed at 7- and 14-days follow-up to assess the ear canal, healing of the tympanic membrane, and to evaluate the tympanic cavity. Repeat lavaging of the tympanic cavity was performed until the tympanic membrane incision was healed. Further follow-up occurred at 21- and 154-days postmyringotomy. Results: Two out of three guinea pigs had complete resolution of clinical signs, and the other showed clinical improvement from a 90° head tilt to a 30° head tilt. Conclusions and case series relevance: Videotoscopy assisted myringotomy under general anesthesia was a quick and straightforward endosurgical technique in three guinea pigs with chronic otitis media and interna. It allowed the collection of fluid for bacteriological culture and provided symptomatic relief.     

Meningoencephalitis secondary to bacterial otitis media/interna in a dog

Central nervous system (CNS) complications of bacterial otitis media/interna are an infrequent occurrence in human patients and have rarely been reported in the veterinary literature. Early recognition of CNS involvement and the use of appropriate diagnostic tests to characterize the nature of the lesion(s) are crucial in determining the best course of treatment. In this paper, the authors describe a dog with bacterial meningoencephalitis secondary to otitis media/interna.     

Nasopharyngeal polyps in cats

Nasopharyngeal polyps are non-neoplastic, inflammatory growths that arise from the middle ear or the eustachian tube and extend into the pharynx. The exact etiology of nasopharyngeal polyps is unclear; proposed etiologies include a response to chronic upper respiratory tract infection, chronic otitis media, ascending infection from the nasopharynx, or a congenital origin. Clinical signs usually relate to obstruction of the nasopharynx, with Horner's syndrome and head tilt being consistent with otitis media and otitis interna, respectively. Diagnostic tools include digital or visual examination above the soft palate, flexible fiberoptic caudal rhinoscopy, radiography, computed tomography, and magnetic resonance imaging. Ventral bulla osteotomy combined with traction removal of the polyp is the recommended treatment, although traction only followed by prednisolone therapy can be considered in some cases, especially when there is no evidence of otitis media.     

Otitis interna (labyrinthitis) associated with Salmonella enterica arizonae in turkey poults

Otitis interna was diagnosed in five 9-to-21-day-old turkey poults with clinical signs of paralysis, opisthotonus, torticollis, blindness, and increased mortality. Gross and microscopic lesions in the poults included omphalitis, typhlitis, hepatitis, meningoencephalitis, ophthalmitis, neuritis and ganglionitis of the vestibulocochlear nerve, and otitis interna. Salmonella enterica arizonae was isolated from the brains, eyes, intestines, yolk sacs, and livers of poults. Birds with otitis interna also had meningoencephalitis. It is most likely that the S. enterica arizonae infection spread from the brain to the internal ears through the vestibulocochlear nerve. This is the first documentation of otitis interna caused by bacteria in an avian species.     

A pathologic and bacteriologic study on otitis media in swine.

A pathologic and bacteriologic study on otitis media in swine was performed on 237 swine, ranging in age from 1 day to 1 year. These 237 swine from eight selected farms were slaughtered due to unfavorable prognosis associated with clinical signs of illness. One hundred sixty-three (68.8%) of the 237 swine were found to be affected with otitis, though only a few swine showed clinical signs characteristic of the disease. One hundred fifty-one (63.7%), 53 (22.4%), and 39 (16.5%) had lesions in the middle, external, and internal ear, respectively. Of the 151 cases with otitis media, bilateral and unilateral infection accounted for 114 (75.5%) and 37 (24.5%), respectively. Only 5/53 swine with otitis externa and 6/39 swine with otitis interna failed to show otitis media. All swine with infection in the tympanic cavity had inflammatory lesions in the auditory tube. Examination of the swine grouped by age revealed that, regardless of age, incidence of otitis media was 50-70%. In swine younger than 1 month old, otitis media tended to center on the auditory tube, where a mild infiltration of neutrophils into the mucous membrane was frequent. Thereafter, otitis media increased in degree and extent with age. Forty (26.5%) of the 151 swine affected with otitis media were accompanied by a substantial amount of inflammatory exudate in the tympanic cavity and bulla. Purulent exudate was found in 20/40 (50%) swine. Severe otitis media prevailed in swine between 1 and 4 months of age, showing inspissation of a suppurative exudate in the tympanic cavity and lysis of the underlying osseous wall of the tympanic bulla with subsequent fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS)     

MAGNETIC RESONANCE IMAGING OF OTITIS MEDIA IN A DOG

Otitis media/interna was diagnosed in a 20-month-old German shepherd with the assistance of magnetic resonance (MR) imaging. The MR images were acquired primarily to exclude a brain lesion responsible for vestibular signs. No brain lesion was detected, but obvious signs of chronic changes in the left bulla and external ear canal were confirmed. Thickening of the epithelium and soft tissue surrounding the external ear canal and a laminated appearance of high and low T2 intensities in the tympanic bulla's mucosa were present. The hypointense lines were suspected to be fibrous tissue, indicating chronic changes. This report suggests that MR imaging may serve as a useful imaging tool for otitis media and that it supplies information not obtained with radiography or computed tomography.     

Expansile, inflammatory middle ear disease causing nasopharyngeal obstruction in a cat

A 7-year-old, entire female, domestic shorthair cat presented with recurrent upper respiratory tract problems. Infectious otitis media caused expansion of the middle ear which ultimately resulted in complete obstruction of the nasopharynx. A ventral bulla osteotomy was successful in relieving the clinical signs.     

Surgical management of chronic otitis secondary to craniomandibular osteopathy in three West Highland white terriers

Three West Highland white terriers were presented for investigation of left‐sided para‐aural abscessation. CT revealed chronic otitis media with extensive osseous proliferation surrounding the horizontal and vertical ear canals contiguous with the expanded temporal bone, consistent with a unilateral variant of craniomandibular osteopathy. A left total ear canal ablation with lateral bulla osteotomy was performed in all dogs. An ultrasonic bone curette (Sonopet; Stryker) proved useful when removing the osseous proliferation in two dogs. Histopathological examination of the ear canals was consistent with craniomandibular osteopathy and the treatment led to resolution of the presenting clinical signs in all dogs. To our knowledge, this is the first report of craniomandibular osteopathy engulfing the external ear canal, presumably leading to chronic otitis media and para‐aural abscess formation. This is also the first reported use of an ultrasonic bone curette in canine otic surgery.     

Total ear canal ablation combining bulla osteotomy and curettage in dogs with chronic otitis externa and media

Ear canal ablation combining bulla osteotomy and curettage was performed on 44 dogs (n = 72 ears). Indications for the procedure included one or more of the following: chronic nonresponsive otitis externa and/or media (n = 71), tumor in the horizontal portion of the ear canal (n = 1), failed lateral ear resection (n = 11), ossified auricular cartilages secondary to chronic otitis externa (n = 22), failed previous total ear canal ablation (n = 1), and otitis interna (n = 1). In 40 dogs, the surgery was successful in alleviating all clinical signs of otitis externa and media. During the immediate postoperative period, 2 dogs died of causes unrelated to otitis. Complications related to the surgery developed in 9 of the surviving 42 dogs. Ultimately, 95% (40 of the surviving 42) of the dogs were cured by use of this procedure. Surgery successfully resolved the original problems in 97% (66 of 68) of the surgically treated ears of these dogs.     

MENINGEAL ENHANCEMENT ON MAGNETIC RESONANCE IMAGING IN 15 DOGS AND 3 CATS

A retrospective study of 15 dogs and three cats was done to characterize the appearance of meningeal enhancement on magnetic resonance (MR) images of the brain, and to correlate this appearance with its underlying cause. Two patterns of meningeal enhancement (pial and dural) were identified. Enhancement of the pia mater was evident in four dogs and one cat, while enhancement of the dura mater was seen in 11 dogs and 2 cats. A variety of causes of meningeal enhancement were identified, including bacterial and cryptococcal meningitis, plasmacytic meningitis with associated subdural fluid accumulation, granulomatous meningoencephalomyelitis, inflammation secondary to otitis interna, feline infectious peritonitis, and neoplasia. The present study confirms that pial or dural meningeal enhancement may be present on MR images of the brain of dogs or cats in association with a variety of central nervous system diseases. A larger prospective study is required to further establish the incidence of specific patterns of meningeal enhancement seen in association with specific diseases.