Ears, teeth, and general frustration

Just got back from vet w/2 civvies and they both have ear mites. I was given Otomite to use once a week for three weeks (for Flo too, assuming she has them as well, though she didn't go to vet today), and Tresaderm to use BID for 5 days. They also gave me 3 tubes of Revolution (I normally use Frontline Plus). I asked if either of the meds might negatively impact Flo's BGs (she's diet controlled), and was told no. I seem to see contradictory information on the old board though. Doc said there would likely be an infection in addition to the ear mites, hence the Tresaderm. I'm not sure how to proceed.

The nightmare is that they've all probably had ear mites for ages. I've always used Frontline Plus, which apparently doesn't prevent ear mites, and I always figured the brown gunk I cleaned out of their ears every month or so was normal brown gunk, and that occasional scratching was normal too. I also made sure kitties ears were cleaned before going to vet, so it never got diagnosed. I feel like a terrible mom.

And now for the teeth:
The whole reason for the appt. is that my civvies are 6 1/2 and have never had dentals. I went in armed with my list of Dr. Lisa questions and recalled anesthesia meds for their pre-dental exam. Doc did basic exam, chipped tartar away and sent me home.

I'm ready to pull my hair out. Oh, and they gave me printouts from wormsandgermsblog.com talking about the evils of raw food. I also called UC Davis dentistry dept. and asked Dr. Lisa's questions, and they told me they don't give antibiotics unless there's a diagnosed heart issue (I forget the specifics, but it sounded like a major thing), and they only give fluids during the procedure, not before or after. I feel like I'm running out of options here. Have I mentioned that I'm ready to pull my hair out?!?! angry(2)_cat :twisted: :?:

 

Hi Karen

I think I"m missing some of the back story here so I'll just comment on your present problems ...

Good lord. Sounds like they are trying to kill a minnow with a bazooka. Otomite, Tresaderm AND Revolution all kill ear mites. Tresaderm contains a steroid (it soothes inflammation in the ear) and may impact your cat's BGs. Did they give you an explanation as to why they prescribed three medications for a single parasite? Are you positive they have ear mites to begin with BTW?

Frontline does kill ear mites, oddly enough. The company rep told me so, but they can't advertise it because they never applied for approval for it. Anyway I've used it twice as the sole agent in two of my rescued cats and it killed the mites. Perhaps some mites are resistant or something? Dunno but it definitely can kill Brooklyn ear mites ...

Ugh.

All of this sounds reasonable. Don't depend on the person who answers the phone to know everything .. if your cats have renal issues, they will likely start fluids before and run them afterwards as well. If your cat has serious systemic disease or is on immuno-compromising medication they will likely give antibiotics. Healthy cats don't need antibiotics for dentals, and it's fine to run fluids during anesthesia but not before for these cats. Two 6.5 year old healthy cats will do fine with no ABs and fluids for anesthesia only.

hope this helps.
Jess

 

Aaaargh, my lengthy response just vanished, then crashed my computer.

Thanks so much for your response, Jess. Here's a little more info.:

Civvies have no symptoms of tooth pain, no trouble eating, etc. I just noticed a nasty chunk of tartar on one of Ollie's back teeth, and figured it was time for a dental. Seems from the info. here that most folks tend to get dentals AFTER there's a problem, rather than as a preventive measure, which I thought was the point. At least that's the impression I got from reading posts by Dr. L, Jojo, etc. Doc today said that if I have their teeth chipped every 6 months or yearly, they should be fine, which, of course, goes completely against what Dr. L said. No mention of x-rays either.

The person I talked to at Davis was actually a veterinary dentist (not sure if that's the proper title, sorry). Sounds like same deal as you said--no extra stuff (fluids or antibiotics) if young, healthy cats. But again, that sorta goes against what Dr. L said.

As for the ear stuff, doc DX ear mites microscopically. Only one swab had visible mites, but other civvie has identical ear gunk and itching issues, so the assumption is that he just didn't get any mites in that sample. He prescribed Otomite for the mites, but said that many patients end up coming back a week or so after treatment with an infection, despite having treated the mites. Hence the Tresaderm. As for the Revolution, that was given to me by the receptionist (at no charge), and I don't think the doc had anything to do with that. Receptionist said it's good for preventing ear mites (she didn't say anything about using it as a treatment FOR ear mites), and that Frontline Plus doesn't prevent them. If you say it does, I'm happy to continue using FP. I will also cop to the fact that I've been using it about every 6 weeks, instead of monthly, and thought it was fine b/c I wasn't seeing fleas or ticks. Clearly it's not fine b/c they're getting ear mites. And is it okay to use the Rev for a month and go back to FP? I know Rev is systemic, so I'm wary....

So in the meantime, I have no idea how much or how little to do for the mites, and I don't know if I need to schlep over an hour each way AND spend at least $1500 to get dentals done @ Davis (and spend another $100 for "pre-dental exams, which is what I thought I was getting today)?!?! Hence the frustration, and the psychotic animated cats. angry(2)_cat angry(2)_cat angry(2)_cat

 

Oh, and Flo is 18 1/2, diet controlled diabetic (OTJ for 20+ months), has a heart murmur, and has no symptoms of tooth pain/discomfort, eats fine, has occasional stinky cat breath, so I'm pretty much leaving her out of the dental equation. Davis vet seemed to agree w/me on that.

 

Just to clarify, Dr. Lisa does not advocate the use of antibiotics for dentals except for rare occasions such as I mentioned. There was a post on this recently. Somehow the "always use antibiotics" thing has gotten into the popular dental posts around here but it is not the current standard and it is not advocated by veterinary dentists (or Dr. Lisa or me FWIW )

As for the earmites, I would abandon the tresaderm for your diabetic since I do remember someone having issues with it and BGs. You can start a post to ask if you'd like. I do find it is true that cats with long-term ear mites sometimes do end up with a secondary overgrowth of some sort in the ears but you can cross that bridge if you come to it. In the meantime I'd choose one means of attacking the mites .... Since FL didn't seem to work well enough for you, I'd be sure to get rid of them some other way and then go back to FL for fleas. On a related subject, my favorite ear cleaning solution is MalAcetic. It creates a mildly acidic environment in the ears which microorganisms dislike. I have used a bit of warm water with a drop of vinegar if I dont' have any real ear cleaning solution.

I don't have a problem with Revolution. It also protects against heartworm which never hurts!

 

Thanks, Jess. I totally missed the updated Dr. L posts--I was going on her 2005 info. It did strike me as going against her anti-overuse of antibiotics mantra, but who am I to question? ;-)

And to confirm--Otomite once per week for three weeks? I have the Tresaderm just in case I need it, esp. for the civvies. Only one of Flo's ears ever seems to get gunky, and nothing like the civvies. I'll give her the Otomite too though, just in case. Any reason not to switch back and forth between Frontline Plus and Revolution? I hate to give up on Frontline Plus, esp. because I haven't been using it AS DIRECTED.

And I still don't know if I should still try for a real dental, now that their teeth have been (pseudo) cleaned?

 

My Twigie had an ear infection (yeast and bacteria). First used Otomax, which contains a steroid. It skyrocketed her BG to the 400's. Next tried Tresadern which made it go to the 500's. Ended up using Conifite for the yeast and oral antibiotics for the bacteria.

 

Dr. Lisa's latest discussion of dentals is in this thread.

 

Hiya folks. This is the thread I found Dr. Lisa's updated info. on antibiotics, etc. in: http://www.felinediabetes.com/FDMB/view ... f=3&t=4136

 

Larry--This is the info. I found about Otomite Plus, which is what I was prescribed:
Pyrethrins 0.15%
Technical piperonyl butoxide* 1.50%
N-octyl bicycloheptene dicarboximide 0.5%
Di-n-propyl isocinchomeronate 1.0%
Inert ingredients 96.85%

This is what I found for Otomax:
(GENTAMICIN SULFATE, USP; BETAMETHASONE VALERATE, USP; AND CLOTRIMAZOLE, USP OINTMENT)--it was listed as only for use in dogs, and (forgive me I didn't read everything as I'm still mostly asleep), but it said something about causing deafness. Big time yikes!!!!

It looks like they're very different things, with the latter being much more broad spectrum, steroidal and scary, and the former basically being bug spray (pesticide). Please please please correct me if I'm wrong.

 

I think your concussion is right, I do not think that Otomax is good for eat mites. It is good for yeast and bacterial ear infections.