Otitis externa diagnosis: 11 questions to obtain a better veterinary patient history

In any veterinary dermatology case, obtaining a detailed patient history is crucial to identify the underlying cause of the disease. Here, Paul Bloom, DVM, DACVD, DABVP, offers up 11 questions to ask pet owners in order to make sure that history is as thorough as possible:

1. When did the signs first occur? This is an important question, because many pet owners will only tell you when this current episode of otitis-related signs occurred, not the very first time it occurred.

2. Has the dog ever had ear problems before this episode? Other than the problem the pet owner presents the patient for, you must ask all owners if the dog has ever had problems with excessive licking, scratching, chewing, biting or rubbing. Has the dog ever had ear problems before this episode? If so, when, with what medication and what was the response to treatment?

3. Where does the dog live? Indoors, outdoors, both? Describe the environment, especially the outdoor environment.

4. Is the dog on heartworm and flea prevention right now? If so, what product, how often is it administered and is it year round or seasonal?

5. Are there any other pets in the household? If so, what kind, and are they symptomatic? If they are cats, do they go outside?

6. Are any of the humans in the household showing “new” skin problems? If so, what kind?

7. Do they board the dog or take him to obedience school, training or a groomer? If so, when was the last time?

8. Do they know if the parents of the dog or any siblings have ear or pruritic skin problems? If so, what was done and what was the response?

9. What does the dog eat?

10. How do the ears seem today? Is today’s presentation the best, worse or average since the problem began?

11. Between the different seasons, do you notice whether the symptoms are better, worse, no different, or are you unsure?

The real-world management of otitis externa can be tricky, no doubt. But you and your veterinary team will feel better prepared to face these cases when you have as much information possible—don’t skip a thorough history-taking!