Donn W. Griffith, DVM, M.S., has battled otitis externa for 40 years, and he has developed an alternative way to engage the enemy. In fact, he doesn’t treat it as war at all.
“The conventional Western approach says to identify the organism (causing the infection) and try to kill it,” said Dr. Griffith, whose practice is Animal Medical and Emergency Hospital in Columbus, Ohio. “The only problem is that, like in war, the enemy tends to recur.”
So instead, Griffith’s Eastern-influenced goal is to restore balance.
“You can go in and try to club all the bacteria to death, but then you might not know what the original fight was about,” he said. “So you’re doomed to repeat history.
“I think one of the nicest things about alternative therapies is that they allow time to look for the cause of the problem,” Griffith continued.
For 13 years, Deborah Brown has been promoting options other than antibiotics and steroids to neutralize ear infections. So she gets excited when she hears a practitioner like Dr. Griffith commit himself to an approach that includes alternative therapies.
Brown is vice president of marketing for Pet King Brands Inc., the Westmont, Ill., maker of Zymox enzymatic products for chronic ear and skin conditions. As she prepared for this month’s North American Veterinary Conference and her company’s launch of its Advanced Formula Zymox Plus product, designed to manage the toughest otitis externa cases, she talked about how in recent years veterinarians have become more receptive to alternative treatments.
“We’re all gaining an understanding that the overuse of antibiotics is not doing the medical community or the environment any good,” Brown said. “We need to seek out alternatives that go hand in hand with traditional medicine.”
Zymox ear solution products use enzymes to treat a broad range of infections, and some practitioners also recommend their use as a preventive step, especially during allergy season.
An allergic reaction is often the underlying cause of otitis, Griffith and other veterinarians say.
Stewart Roberts, DVM, said he has used Zymox to treat ear infections for three years, with a cure rate of about 95 percent. He appreciates that such an effective, broad-spectrum product is less burdensome on staff and pet owners while also avoiding the sensitivities of patients.
In most cases these days, he’s able to avoid flushing and cleaning ears, as well as cultures, a course of antibiotics, ointments and, in the worst cases, surgery.
“I haven’t had to anesthetize (an otitis patient) in the three years since I started using Zymox,” said Dr. Roberts, a veterinarian with 29 years of experience who owns and operates Concord Parkway Animal Hospital in Concord, N.C.
It’s a big advantage not to have to clean the ears before administering a product, he added.
“We can treat the ears once and send the patient home with instructions to administer once a day for two weeks,” he said.
Unlike with antibiotic protocols, no preparation is needed with Zymox formulations, says Pamela Bosco, president of Pet King Brands. In fact, the enzymes actually work best in a dirty environment “because the byproducts of exudate and pus function as catalysts.”
Dr. Roberts noted that’s much better than a common antibiotic scenario: treat for three to four weeks with a recheck in two weeks, then a four-week recheck, and many times the patient is back in six months with a recurrence of infection.
The doctor said he’s looking forward to trying the new Zymox Plus product because it targets pseudomonas, a moisture-loving organism that can thrive in the warm, damp environment of a dog’s ears.
Such a biofilm-producing infection has been estimated at 10 to 100 times more resistant to the effects of antimicrobial agents. The pseudomonas biofilm has been shown to be very thick and difficult to remove.
Zymox Plus has four additional enzymes “formulated to destroy hard-to-penetrate biofilm and break the cycle of chronic infection,” Bosco said.
As a population of micro–organisms, biofilm can adhere to living tissue or inanimate objects such as implants or catheters. Once established, the microorganisms tend to form a dense matrix that multiplies and adapts, becoming thicker and stronger.
In such cases, more frequent ear cleanings, as called for in some conventional otitis-treatment protocols, can actually feed the problem, Griffith said.
“The No. 1 thing I tell clients is that for ear infections to occur and recur, you need warmth, moisture, darkness and organisms that cause infection,” he said. “If you’re constantly putting ear wash in, that provides the moisture.”
In seeking to prevent the organisms from thriving, Griffith often is able to identify allergic reaction as a source of inflammation and the root cause of infection. In such cases, he recommends a “very strict” 90-day hydrolyzed protein food-elimination trial “as soon as possible,” he said. “It can be the best solution for long-term success.”
Still, sometimes antibiotics are the right course of treatment, Griffith noted. Cases in which treatment with an enzymatic such as Zymox or herbal remedies don’t clear up the problem can require a more aggressive and more specific approach, including cultures and cleanings.
However, Dr. Griffith quickly added that he doesn’t like to use systemic steroids, even in aggressive treatment.
“I have an axiom—I don’t treat a pet any differently than I would treat my own body,” he said. “That leads to searching for more options so you can avoid things that become problematic. I think most veterinarians are aware of the potential side effects of steroids: voracious appetite, urinating, weight gain, possibly cataracts.
“That’s why I prefer a holistic approach,” Griffith added.
Call his a measured battle plan with a ready-made exit strategy.
“We’ve found that we can usually clear up cases without going to war,” Griffith said. “And that’s the best outcome.”
This Education Series article was underwritten by Pet King Brands of Westmont, Ill.