Cerumen forms a protective barrier, which traps debris, organisms, hair, and desquamated corneocytes. Cytology is a valuable and easy method for evaluating the presence of bacteria or yeast in the ears of animals with otitis externa (Angus 2004, Rosser 1988) and is also important for monitoring response to treatment (Rosychuk 1994, Wilcke 1988). 6 Nestlé PURINA Interpretation of Canine and Feline Cytology tivity testing. Coagulase-negative. My dog had a middle ear infection that coat $48.50 for the cytology ear swab and $35.86 for the Claro ear gel treatment. Separate swabs are used for opposite ears, as the same process is not always active in both ears at the same time. In most cases, material obtained from the deeper horizontal canal is more clinically relevant than material obtained from the superficial vertical canal. Cytology, however, is not the only test that should be performed when evaluating bacterial otitis externa. In order to maintain consistency in cytologic evaluation, each specimen should be specifically evaluated for the presence, estimated number, and morphologic characteristics of three specific features: yeast, bacteria, and leukocytes. The absence of leukocytes does not rule out the role of bacteria or yeast as pathogens. When performed routinely on each subsequent visit, cytology provides an accurate method for monitoring the patient’s response to therapy. You may also notice a yeasty smell or redness. Although we will do a comprehensive physical examination and look into your pet’s ears with an otoscope we can only ‘see so much’. For cats, fewer than four bacteria per 40× field (1.6 per 100× field) was consistent with normal conditions, and more than 15 bacteria per 40× field (6 per 100× field) was abnormal. Figure 3-1 Technique for staining a cytologic specimen from the ear. Each cytologic description should contain information regarding the morphologic characteristic of bacteria (cocci or rod), the presence or absence of Malassezia and leukocytes, whether bacteria were phagocytized by leukocytes, and a semiquantitative estimation of the relative numbers of each type of organism seen. In: Gotthelf LN, ed. Figure 3-2 Suggested medical record insert for documenting cytologic findings. Thanks for reading, Dr. Randolph. Finally the highest magnification is used, oil immersion. He may use either or both of these to choose the field he wants to evaluate more closely, based on the patient’s and/or infective cells he sees. After examining several fields with the high-dry objective, switch to the high-magnification, oil-immersion lens (100× objective, 1000× magnification) for detailed evaluation. Compared with Malassezia, Candida spp. Some dogs have naturally healthy, self-cleaning ears that require no routine maintenance but others may be prone to excess build up of dirt, wax, and debris. In general, heavy colonization of the canal by opportunistic pathogens is reflected in the number of bacteria seen per high-powered field. West Sussex: Blackwell; 2008:162-172. Ear mites can also lead to ear infections but are easily prevented with most monthly flea and tick medications. Recognition of these melanin granules as a normal finding is important; otherwise, the structures may easily be misidentified as cocci or small rods colonizing the surface of the keratinocyte. In our practice, we keep cytology results in the medical record. The type of inflammation usually can be determined, and etiologic agents sometimes can be identified. The combination of wax and dried blood create the look of coffee grounds in the ears. In several studies the temperature within the external ear canals of dogs measured between 38.2° to 38.4°C (100.7° to 101.1°F). LSTAIN. Ear cytology is performed using a separate cotton-tipped swab for each ear. Overgrowth may contribute to disease through the production of exotoxins that perpetuate inflammation; however, overgrowth does not typically warrant culture and susceptibility testing or expensive systemic therapy. If a doctor or technician is especially interested in the eosinophilic- or basophilic-staining structures he will leave the slide in the appropriate station longer. Place a coverslip directly onto the mineral oil and examine the specimen with low magnification (4× or 10× objective). Ear cytology is a test in which the veterinarian gathers a sample of the discharge in a dog's ear on a cotton swab. More often might wash the medicine out of the ears. The presence of stenosis, inflammation, and voluminous exudate makes the exercise difficult and potentially dangerous if the patient moves suddenly or unpredictably. The organism exhibits narrow-based budding and can form short, tubular, septate pseudohyphae. Bacterial infections typically describe cases with purulent response to bacteria, ulceration of epithelial lining, or colonization of the tympanic cavity. Veterinarians who are gentle, cautious, and quick can safely obtain a diagnostic sample from the majority of patients. Analysis of cell count, protein concentra - tion, and specific gravity will determine if the fluid is a transudate, a modified transudate, or an exudate (see thetable “Guidelines to Distinguishing Transudates and Exudates,” Part IV).Cells should be enumerated manually or by elec - Aim: Cytological examination is crucial for the diagnosis and classification of canine otitis externa. If your dog scratches enough, the insides of his ears could start bleeding. Please help me with your honest thoughts. Unlike bacterial infections, suppurative inflammation is not a common feature of Malassezia otitis5 and therefore cannot be used to determine a pathologic state. To obtain consistent samples in awake or painful patients, veterinarians should aim for the junction of the vertical and horizontal canals, where the cartilage bends at a 75-degree angle. Reported as Mean Number of Organisms per High-Dry Field (40× Objective). Cytology from ear (aural) exudate can be collected by a direct technique. Although cytology should be viewed as a screening tool, most reactions can be classified as inflammatory, hyperplastic, or neoplastic. are not common pathogens in cases of otitis externa. Dogs with bacterial ear infections may have yellow-brown debris or pus in the ears. Cytologic examination of discharge from ears should be a routine part of every ear examination. The diameter of most coccoid bacteria is typically 0.3 μm; coliform, rod bacteria are typically less than 1.5μm in length.24 In spite of this small size, and given quality equipment and practiced skill and ability, cytology can actually be more sensitive than culture for detecting bacteria.5,10 In one study of normal ear cytology, gram-positive cocci were identified in 42% of dogs by cytology but only 25% by culture. To estimate the numbers, evaluate five to 10 areas, and record the average count per high-powered field (Figure 3-2). Cytology is the examination and study of blood or tissue cells under a microscope that can be done in dogs and other animals. 30 Photos Ear . Another common finding on otic cytology is basophilic staining yeast, ranging in size from 2.0 μm × 4.0 μm up to 6.0 μm × 7.0 μm. Swab with purulent debris came from the left ear. The high-oil magnification also permits detailed evaluation of the cytoplasm of neutrophils and macrophages for phagocytized bacteria—another important indicator of that particular organism’s acting as a pathogen rather than a commensal. If you enjoy the site, please support our mission and consider a small gift to help us keep pace with its rapid growth. The diameter of most coccoid bacteria is typically 0.3 μm; coliform, rod bacteria are typically less than 1.5μm in length. 12 – 15 However, the genus actually consists of eight species, including seven distinct lipid-dependent species: M. furfur, M. sympodialis, M. globosa, M. obtusa, M. restricta, M. sloofiae, and M. equi. Cytologic samples can be collected from the lumen of … Artifacts (cytology) ... (dog, cat) 5 Photos Synovial fluid (large animal) ... 8 Photos Eye . Another common finding on otic cytology is basophilic staining yeast, ranging in size from 2.0 μm × 4.0 μm up to 6.0 μm × 7.0 μm.12 For comparison, canine red blood cells are approximately 7.0 μm in diameter; feline red blood cells are 5 μm. The result is a moist, warm ear canal that is the perfect environment for growing organisms. However, if you have lost confidence in this doctor, it might be time to seek another doctor’s advice. Ear infections are among the ten most frequent reasons for dogs to be presented to veterinarians and may affect up to 20% of dogs [1, 6]. Melanin granules do not take up stain; therefore, granules can be differentiated from purple-stained bacteria by focusing up and down through the cell until the true color of the structure is recognized. How Pet Owners May Recognize Ear Problems Early, Auburn University’s College of Veterinary Medicine. Unlike humans that have a very short ear canal, dogs have a long narrow ear canal that makes almost a 90 degree bend as it travels to the deeper parts of the ear. Your email address will not be published. More specifically in everyday use cytology is used to study cells placed on a microscope slide from a body source. The most common type of coccoid bacteria found in the ears of dogs with otitis externa is Because organisms from the middle ear may be coated in mucus, which prevents adequate uptake of stain, cytology from the middle ear should always be accompanied by a sample for culture and sensitivity obtained at the same time. In patients with bilateral disease, clinically relevant differences in bacteria and yeast are common when comparing the two sides. If desired, the slide can be permanently preserved by placing a drop of slide-mounting medium onto the stained material, applying a coverslip, then allowing the glue to set. Cytology can also help us find cancerous cells growing in the ear … Each cytologic description should contain information regarding the morphologic characteristic of bacteria (cocci or rod), the presence or absence of. No written results just verbal? The ear flap funnels sound into the ear canal. Once in position, the swab is extended beyond the cone and pressure is applied laterally against the epithelium, collecting the exudates; the swab is then pulled back into the cone and removed from the canal. Many approaches to data collection have been utilised in the study of otitis externa. 11 Photos Facebook. Veterinarians should not assume that the same organism contaminates both sites. Every dog needs regular bathing and having clean ears is an important part of this grooming routine. If the material from an ear is particularly moist, the slide might be air-dried, hair-dryer dried or placed atop a source of gentle heat. 9 Photos Female reproductive tract . The finding of bacteria within neutrophils (phagocytosis) strongly supports a diagnosis of infection with a significant bacterium. Cats. A study by Tater et al10 evaluated otic cytology from 50 normal dogs and 52 normal cats; it found a range of 0 to 2.6 yeast per high-dry field in dogs and 0 to 3.3 per high-dry field in cats. Dogs with long and hanging ears like Bloodhound or Basset Hound are more likely to be affected by ear infections. To estimate the numbers, evaluate five to 10 areas, and record the average count per high-powered field (Figure 3-2). This process is often called ear cytology and it is an important diagnostic tool. The most common rod-shaped pathogens associated with otitis externa are Pseudomonas spp. This is comparable to what is observed in dogs ear pinna shape does not influence ear meatus temperature [16]. As in the dog there was no difference between erected and pendulous pinnae in this study [7]. Staining should reveal micro-organisms as perpetuating factors of otitis externa. Today we are only concerned with cytology of canine and feline ears. Precise breakpoints for maximum acceptable number of yeast vary from patient to patient. Learn vocabulary, terms, and more with flashcards, games, and other study tools. These organisms are often associated with signs of otitis externa (eg, head shaking, scratching at the ears, erythema, ceruminous gland hyperplasia, waxy otic exudate). E, Rinse slide by placing unstained side of slide under gentle water stream; this permits laminar flow of water to remove excess stain. Make sure you have the following equipment: Cotton tipped applicator/swab, clean glass slides Diff-Quik stain, oil, cover slips, pencil, microscope. Should my vet have documentation of the results of the ear cytology test they claim to have performed? In one study, Malassezia was recovered from 65.8% of external ear canals and 34.2% of middle ears of dogs with chronic otitis.8 Yeast can be found mixed with bacteria; however, in the study by Cole et al,8 23.7% of dogs had otitis media associated with Malassezia infection alone. Eighty-three dogs with clinical signs of otitis externa and with ear cytology revealing microbial organisms were studied. The outer ear consists of the ear flap (also called the pinna) which can be upright (a prick ear) or floppy. The actual percentage of normal patients with cytologic or culture evidence of bacteria may vary significantly based on geographic location and humidity. Cytology and histopathology of the ear in health and disease. The authors also demonstrated that ear conformation did not result in differences in normal yeast numbers when comparing dogs with pendulous pinna with dogs with erect ear carriage. In more arid regions, only gram-positive cocci are commonly observed in normal patients. 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