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Otitis externa: the role of the veterinary nurse
Abstract
Otitis externa is a common problem in primary care veterinary practice. While the diagnosis and treatment of disease is the responsibility of the attending veterinary surgeon, the veterinary nurse, as an integral part of the veterinary surgeon-led team, plays an important role in the investigation and management of disease. Veterinary nurses are more than capable of assessing the external ear canal both macroscopically and cytologically to help the veterinary surgeon to make a diagnosis. Client facing nurse communications can help with the administration of therapy, provide owner support during treatment to increase compliance and help with follow-up assessments.
The investigation and management of otitis externa is similar to any skin problem, and involves the collection of a history, a physical and dermatological/otic examination before undertaking diagnostic tests (Griffin, 2006; Bloom, 2009). An appreciation of the aetiology helps in that process. The aetiology and pathogenesis of otitis externa can be divided into four parts represented by the initialism PPSP. The first P represents primary causes (Table 1) that are present in every case of otitis externa. Primary causes, which are almost always skin problems, are responsible for the initiation of the inflammatory process in the ear that in turn leads to disease.
The second P in the initialism represents predisposing factors, which contribute to ear disease but do not cause inflammation. There is some overlap between some of these factors and primary causes, e.g. obstructive disease caused by neoplasia can be a perpetuating factor and a primary cause. Important predisposing factors are listed in Table 2.
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