Primary Secretory Otitis Media in Cavalier King Charles Spaniels

Purpose

The purpose of this study is to find and develop effective and more economical diagnostic tests for otitis media in the Cavalier King Charles Spaniels than the currently used CT scan, and to see if and to what extent auditory function is restored with current treatment methods.

Background

The Cavalier King Charles Spaniel (CKCS) seems to have a predisposition to a non-infectious otitis media (OM) marked by mucus accumulation in the middle ear, hence the descriptive diagnosis of "glue ear". One or both ears may be affected. This OM is unusual because of its lack of association with concomitant external ear infection and because of frequent accompanying neurological involvement. These neuropathies include:

  • ataxia
  • facial paralysis
  • nystagmus
  • head tilt
  • hearing loss/deafness

Pain around the head and neck (with vocalization and/or guarding), scratching around the ears, external ear infection, hearing loss, or any combination of the above also occur. These presentations are due to mucus build-up in the middle ear, possibly as a result of Eustachian tube dysfunction. Upon otoscopy, the ear drum is often bulging outward due to mucus accretion behind it. PSOM seems to share many features with secretory otitis media, which is one of the most common ear problems in children. In the CKCS, PSOM can be misdiagnosed as progressive hereditary deafness or as syringohydromelia, two other disorders to which CKCS are prone. Therefore, development of a specific test or tests for PSOM, easy enough to perform in the office and affordable for the owner, will promote both appropriate treatment and accurate assessment of this problem in the breed.

Study Criteria and Course of Treatment

Cavalier King Charles Spaniels presenting with any of the above signs or combination of signs are eligible for screening. Because this is a blinded study, it is imperative that results of any previous diagnostic tests performed elsewhere NOT be revealed.

DAY 1

Screening (owner pays all fees): The dog is admitted for a physical and neurological exam, including comprehensive blood work, to determine if there are any metabolic or cardiovascular conditions that might preclude or complicate anesthesia. The ears are also checked for excessive exudates in the external ear canals obscuring the ear drum. If the dog qualifies as a study subject, the owner is invited to return for a second day of more extensive testing and treatment.

DAY 2

More specific battery of tests and treatment (hospital pays fees up to $1100). Tests include: CT scan, ultrasound of the middle ear for mucus build-up, BAER tests for hearing loss, tympanometry and acoustic reflex testing for hearing loss, pneumo-otoscopy to assess tympanic membrane compliance, and myringotomy (ear drum incision) to flush and drain the middle ear (s) if PSOM is confirmed. The CT and BAER tests are repeated after flushing the middle ear.

Although this study is complete, if you suspect your dog is suffering from PSOM, please contact Dr. Lynette Cole via cole [dot] 143 [at] osu [dot] edu for a consult.