A powerful tool for addressing inflammation early in dogs with otitis externa

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Sponsored by Virbac

Otitis externa is one of the most common conditions clinicians encounter, particularly in dogs with allergic skin disease. This painful and persistent inflammation of the outer ear canal not only causes significant discomfort for the dog but also creates stress and frustration for owners who are seeking quick relief for their pets. This inflammation leads to symptoms such as intense pruritus, swelling, discharge, odor, and pain.

In an interview with dvm360®, Joya Griffin, DVM, DACVD, shared, “Many of the dogs I see with otitis are in a great deal of discomfort, and this can lead to changes in their behavior, including irritability and avoidance of handling.” The ear canal becomes red, swollen, and warm to the touch, making even basic handling—like applying medications or cleaning—challenging for both the dog and the owner. Griffin added, “It’s heartbreaking for owners to see their dogs in pain, scratching at their ears or avoiding being touched. They expect us, as veterinarians, to provide relief quickly.”

Evaluating options for rapid relief

Griffin conducted a post-approval study in collaboration with Virbac that aimed to evaluate otitis externa at days 0, 2, 7, and 28. This study compared a leading competitor with Easotic® (hydrocortisone aceponate, miconazole nitrate, gentamicin sulfate) Otic Suspension for Dogs. These products are indicated for the treatment of otitis externa in dogs associated with susceptible strains of yeast (Malassezia pachydermatis) and bacteria (Staphylococcus pseudintermedius), and Easotic® Otic Suspension only requires one dose per day for just 5 days. The results of the study were presented at the 2024 World Congress of Veterinary Dermatology.

Traditional studies of otitis treatments often evaluate outcomes after weeks of treatment, but this time frame often fails to meet the expectations of pet owners, who are seeking more immediate improvement in their dog’s condition. The study by Griffin and her team looked to elucidate how rapidly these 2 treatments could alleviate signs. The study included 86 client-owned canines diagnosed with acute otitis externa. These dogs were randomly assigned to receive either Easotic® Otic Suspension for Dogs or a leading competitor (containing florfenicol, terbinafine, and mometasone furoate). Both treatments are designed to combat the microbial and inflammatory aspects of the disease.

Clinical signs over time

Treatment with both products showed improvement by day 28, but the real differentiator was the speed at which they began to provide relief for some signs of otitis externa. “By day 2, we were already seeing notable differences,” Griffin explained. “While both products ultimately reduced symptoms by the end of the study, Easotic® Otic Suspension for Dogs provided fast relief, particularly in terms of discharge, stenosis, and odor reduction.”

At day 7, 90% of the dogs treated with Easotic® Otic Suspension for Dogs demonstrated a good or excellent response to treatment, with all signs of otitis externa resolved, compared with 71% of those treated with the competitor’s product. This difference was pronounced when looking at the reduction in discharge, stenosis, and odor—3 of the most bothersome signs for both dogs and their owners. “By day 2, Easotic® Otic Suspension for Dogs had already reduced ear discharge,” Griffin added. “The dogs treated with Easotic® Otic Suspension for Dogs showed improvements in stenosis and ear odor, which are often indicators of how comfortable the dog is feeling.”

Hydrocortisone aceponate

A key factor contributing to rapid relief with Easotic® Otic Suspension for Dogs is its inclusion of hydrocortisone aceponate, a highly potent lipophilic steroid that penetrates the epidermis rapidly, providing targeted relief without serious systemic effects. “The ability to quickly treat inflammation in the ear is crucial,” Griffin said. “Hydrocortisone aceponate is particularly effective because it is converted to hydrocortisone, a weak steroid, once it reaches the bloodstream, but it works locally to reduce inflammation where it’s needed most—in the ear.”

Inflammation is a driving force behind the pain and discomfort associated with otitis externa. As the inflammation worsens, the dog’s ear canal may become stenotic, trapping moisture and debris and creating an environment for further microbial growth. Rapidly reducing inflammation can prevent this cycle from worsening, allowing the dog’s ear to heal more quickly.

Other study takeaways

Significant improvements were observed as early as day 2 in some cases. For example, the reduction in ear discharge in the Easotic® Otic Suspension for Dogs group, compared with the other treatment, had a P value of .005 at day 2 and .001 at day 7. Other significant differences, such as reduced stenosis, ear odor, and ear dirtiness, were also noted at these early time points.

In a separate survey of pet owners, 93% reported that Easotic® otic suspension was easy to administer to their dogs.

Treatment adherence

When dogs experience improvement in their symptoms, owners may be more likely to follow through with the entire course of treatment, ensuring that the infection and inflammation are fully resolved. “It’s not just about treating the infection,” Griffin pointed out. “It’s about controlling the inflammation early so that the dog feels better sooner. This improves adherence, reduces the likelihood of not completing treatment, and, most importantly, provides comfort to the dog.”

Conclusion

Griffin’s study points to inflammation treatment as a key factor in achieving rapid relief for dogs suffering from otitis externa. Results from this study show potential in Easotic® Otic Suspension for Dogs as a treatment that delivers fast, reliable relief, improving not only the clinical outcome for the dog but also the overall experience for pet owners. “Inflammation is at the core of otitis externa, and treating it with a powerful anti-inflammatory is key to a successful outcome,” Griffin concluded.

IMPORTANT SAFETY INFORMATION

EASOTIC® (hydrocortisone aceponate, miconazole nitrate, gentamicin sulfate) Otic Suspension for Dogs: For otic (ear) use in dogs only. Humans with known or suspected hypersensitivity to hydrocortisone, aminoglycoside antibiotics, or azole antifungals should not handle this product. Contraindicated in dogs with known or suspected hypersensitivity to corticosteroids, imidazole antifungals, or aminoglycoside antibiotics. Do not use in dogs with known tympanic membrane (eardrum) perforation. The safe use of EASOTIC Otic Suspension in dogs used for breeding purposes has not been evaluated. Do not administer orally.

For full prescribing information, contact Virbac at 1-800-338-3659 or visit http://vet-us.virbac.com.

References

1. von Simson C, Poincelot L, Jasmin P, Griffin J. Comparison of the efficacy of a gentamicin, miconazole, and hydrocortisone aceponate formulation and a florfenicol, terbinafine, and mometasone furoate formulation in the treatment of canine otitis externa with a focus on onset of action. Presented at: 10th World Congress of Veterinary Dermatology; July 25-29, 2024; Boston, MA. Session P-36.
2. Take5 Survey. Virbac.