Technicians: The great ear detectives
Paul Bloom, DVM, DACVD, DABVP
Allergy, Skin and Ear Clinic for Animals
To get to the bottom of a tough otitis presentation in a patient, it's time for technicians to perform a little sleuthing.
Ear disease: It's only a symptom (no more specific than “pruritus”), and, as Dr. Flemming Kristensen states, “A patient showing ear problems is a dermatology case until proven otherwise.” This means the challenge is not only to find the “what” that is causing the otitis but the “why” as well.
Enter the veterinary technician. These super sleuths can help in many ways to determine both the “what” and the “why." And it all begins with a detailed history.
Getting to the bottom of a patient's history is important for all dermatologic cases, and that doesn't change when it comes to ear disease. Some specific questions to ask:
Psst! Want to take it a step further? We have a form with these exact questions! Click to download. > When did Hank's symptoms first occur?
> Has Hank ever had problems with excessive licking, scratching, chewing, biting or rubbing? Has he ever had ear problems before this episode? If so, when? And what was the medication used and Hank's response to it?
> Is Hank an indoor or outdoor dog (or both)? What's the environment that he lives in like, especially the outdoor environment?
> Is Hank on heartworm and flea preventive? If so, what product? How often is it administered? Is it year-round or seasonal?
> Are there any other pets in the household? If so, what kind? Are they symptomatic? If they're cats, do they go outside?
> Are any of the people in the household showing “new” skin problems? If so, what kind?
> Do you board Hank or take him to obedience school, training or to the groomer? If so, when was his last visit to any of these places?
> Do you know if Hank's parents or any of his siblings have ear or pruritic skin problems? If so, what was done and what was the response?
> What does Hank eat?
> How do the ears seem today? Is today's presentation the best, worst or average since the problem began?
> Do you notice if his symptoms were better, worse or no different between seasons?
It's important to remember that in addition to obtaining the history, the technician include the pet's age, breed and sex in the record. And don't forget to ask for a copy of medical records from the previous veterinarian. Many times you can expedite treatment by reviewing previous treatments and tests and the patient's response. Happy sleuthing!