I. Popularity
II. Reaction to treatment
III. Gross anatomy
a. Pendulous
i. Aerate and examine ears
b. Heavily haired
i. Keep hair trimmed as short as possible
IV. Microscopic Anatomy
a. Significantly more ceruminous glands
i. Use ceruminolytic and drying agents regularly
b. High density compound hair follicles
i. Grooming
II. No powders
III. Use anti-inflammatories after pulling hair
V. Atopy
a. Treat systemically
b. Use acidifying/drying agents on a regular basis
c. Use topical steroids
VI. Seborrhea and Hypothyroidism
a. Treat underlying disease
b. Vitamin A: 600 to 800 IU/kg/day
c. Levothyroxine
d. Ceruminolytic agents
e. Topical steroids
VII. Malassezia
a. Cockers produce more cerumen with higher fatty acid content
b. Malassezia attach to corneocytes via lipid
c. Therefore Cockers have higher yeast carriage in the ear and it may be easier for the yeast to cause disease.
d. Treatment
i. Ceruminolytic agents
II. Topical steroids
III. Drying/acidifying agents
IV. Topical antifungals
1. Ketoconazole (T8 Keto Flush®), Clotrimazole, Miconazole (Conofite®, Malaseb® flush)
v. Systemic antifungals
1. Ketoconazole (5-10 mg/kg daily)
2. Itraconazole (5 mg/kg daily or 2 days a week)
3. Fluconazole (5 mg/kg daily)
VIII. Exuberant Reaction to Inflammation
a. In most studies, Cockers far outnumber any other breed that needs surgical removal of the ears.
b. Cockers have a different type of tissue reaction to otic inflammation.
i. Most dogs breeds have slowly progressive fibrotic changes
II. Cockers have rapidly progressive, severe ceruminous gland hyperplasia
c. Must treat aggressively
i. Prednisone
1. 2.2 mg/kg divided BID for at least 3 to 14 days then decreasing over time.
II. Topical steroids
1. Fluocinolone (Synotic®)
