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Old 10-15-2015, 03:15 AM
minimay minimay is offline
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Default Re: Warning: Risk of Deafness from Ear Medications

Quote:
Originally Posted by jaw444 View Post
Hi. I found this forum last night as i was googling hearing loss and ear medications because this has happened to my dog. My dog is Zack, a 9 year old Cavalier King Charles spaniel.

Googling led me to this thread, which i read through. I see that the main or only medication discussed here is gentamycin, an aminoglycoside.

My dog was given EKT 2 1/2 weeks ago. It is a triple medication including antibiotic, steroid and anti fungal. It was given in the form of a thick oil apparently plunged into his ear canals.

The antibiotic in EKT is enrofloxacin. It is a flouroquinolone, not an amino glycoside. The brand name is Baytril, made by the Bayer company.

The vet was treating Zack for a respiratory condition, for about 2 weeks at that point, Zack was taking two antibiotics and prednisone. One of the antibiotics was oral Baytril. Baytril is only for animals, not for humans, according to what i've read in the past couple of days.

I was going out of town, with Zack, by plane, on 1/30. On that morning he barfed his breakfast just after i gave him his three pills with Pill Pockets. He never barfs. It was emphasized to me that if he wanted to get over his "serious" (i am now questioning this after talking to another vet) respiratory condition, he must not stop taking his antibiotics until medically advised. So, i rescheduled my flight to the next day and took him to the vet.

The vet said the respiratory condition was doing really good. I could see that. He wasn't coughing at all anymore. He said the Clavamox caused the vomiting and he took him off it, continuing the Baytril and giving him a shot for an antibiotic called Convenia which he said would last for two weeks. He took Zack into the back to do X-rays to check his progress. i heard Zack shriek while i was waiting in the exam room. (btw, after reading up on Convenia, i would not consent to it, instead asking for a daily dosing medication because a medication that stays active in the body for 2 weeks does not give you the option to stop giving the medication if there is an adverse reaction. It was mainly invented to insure that doses would not be skipped. i don't tend to miss doses so for me, i don't see a reason for it).

when he brought Zack back to me, he said he had done something to his ears, i think. It's really foggy in my memory, so much was going on, and i said "Is that why he shrieked, and he said "no, that was the shot we gave him." And so then the subject was changed from the ears as he told me about the shot, and the ears didn't come back up. i just wish he had examined the ears when he was in the exam room with me and told me what he saw and what he wanted to do.

I went out of town to my daughter's with Zack for a week and we both kept noticing there was some kind of thick goop in his ears, and i didn't know what it was so i called the vet office. They looked at the chart and said it was BKT (same as EKT but the B is for Baytril, the brand name). I told them it was causing his hair to mat inside his ears and was greasy, a week after he got it. They said i could bring him in and they would wash it off.

I noticed while i was away that Zack's hearing seemed to not be as good as before, and i thought maybe it was from flying in the plane, though we had flown other times without that happening. He could still hear me if i called him or gave him a command, 'sit,' 'stay,' 'come.' But when i would walk by if he was sleeping he wouldn't wake up, which is very unusual. He just about always would wake up and follow me around if i walked past him when he was sleeping. I am not saying his hearing was perfectly fine before. i had noticed some hearing loss in previous years, showing up mainly in his not waking to noise when he was sleeping on his left side if i called him. And i believed that the right ear was not as good as the left. But that seemed to fluctuate and showed up sometimes more than others. Maybe it's that it was getting better over time. i wonder what caused it in the first place. I just thought it was aging, though he wasn't very old, 6? Now, after what is happening from BKT, i have to wonder.

When i got back from my trip, a week later, i took him in, choosing to see a different vet because of trust issues i was having with the first one, related to communication problems. I was supposed to bring him in after 2 weeks for a follow up on the respiratory thing. I told her the history when she asked why i was there, i told her i was there for a follow up. I told her the whole kind of odd story of the respiratory thing. She was examining him and was looking in his ears. I said that he had some goop in his ears and that i thought it was an antibiotic and i was told if i brought him in, they would wash it off. She said it was BKT.

She said they would wash it off. I said that since the goop was put in his ears, his hearing was not as good. It had been getting seemingly worse in the previous week. She immediately said, about the antibiotic he was given, "That causes temporary deafness." I asked "Will his hearing come back?" and she said yes. She also said she would not have given him that medication.

The next day, i was talking to neighbors who came to my front door. Zack ran out the door. He will run when he gets out, he doesn't just hang around, he takes off, he loves the feeling of freedom, and it used to be a major problem, but then he learned to respond to the Come command, so, i followed him, he was going fast, half way down the street, which is what he does. Usually if i yell "Zack, Come!," he stops in his tracks and turns around and comes running back, just as fast and happy as when going the other direction. this made me feel really good. But on that day, a couple of days ago, when i commanded him to come, he didn't hear me, he just kept going. That is not like him, he always comes. Always. He likes to come. He was trained with treats (by a pro, i had failed so i paid someone and it was worth every penny). So i watched him getting farther and farther away, and then he turned a corner and went out of sight, my neighbor ran after him. i'm recovering from major abdominal surgery so i wasn't able to do much. My neighbor said he caught up with Zack when he stopped to pee on something.

I am really mad about him being given this medication, without discussing it with me first, without telling me the risks and letting me have a role in the decision, i don't even know that there was anything wrong with his ears. The vet who saw him three days ago said his ears looked great. i told her that as far as i know, there wasn't anything wrong with his ears in the first place. At least, no one examined him in front of me and said "He has inflammation in his ears. We treat that with EKT. i need to tell you there are some risks but they are very rare." And then tell me about the ototoxicity and let me decide. Even if i didn't know about ototoxicity, if he hadn't told me, and maybe he doesn't know, i still would've said "He is already on 3 or 4 other antibiotics for the respiratory thing, is there anything urgent about the ear thing because i haven't noticed any ear symptoms," and i don't think he would've said it was urgent. Even if he had, i already had some trust issues related to the several interactions i had with him about the respiratory thing, and i am sure i would've said "First i want him to finish his treatment for the respiratory thing and then i will come back and see about the ears." because i don't like mixing a lot of potentially toxic medications and then not being able to know what is causing what, and how the meds interact, etc. But i never knew he was being given that medication, i wasn't told there was anything wrong with his ears, and it was just given to him and now he has major hearing loss. He's not totally deaf but if he's sleeping just a few feet away from me, if i call him, loudly, he doesn't hear me. His hearing is not functional if i can't call him when he is doing something he needs to stop, like running down the street, he could've run out into a busy street if he had turned the other way when he turned the corner.

So, i've been researching the medication he had and deafness caused by medications, and i found this page.

I wanted to share my experience so that others will know that there are other antibiotics, not aminoglycosides, that are toxic to the hearing nerve.

In reading about this, i was looking for some medical or scientific information about ototoxicity with this medication, and whether the hearing loss is temporary and what the prognosis is, and if it's temporary, how long? But i couldn't find anything like that, and there is very little on it. I wouldn't have a clue if that second vet hadn't said "it causes temporary deafness." I have found several sources on the web where hearing loss is mentioned as a side effect, just briefly, in blurbs about side effects on websites that sell it.

http://www.svpmeds.net/ekt.html

I was reading about flouroquinolones in general, including treatment of humans, to see if it there's info on ototoxicity. What i found is that it's considered to not be ototoxic in humans by the medical establishment, these are drugs like Cipro and Levaquin. They are touted as a safe alternative to gentamycin which they report has caused hearing damage. So now, they say, these quinolines can be used in ear drops. Also, mainly what i've read about gentamycin is it's usually said to be associated with perforated ear drum, but i am really doubtful about that. Would people know if their dog had a perforated ear drum? Anyway, there are websites discussing serious side effects of quinolines, which include tinnitus and hearing loss. I didn't find any that were scientific, it was people sharing experiences like here.

anyway, i am going to include a link i found on PubMed which is a site with lots of medical articles. i found one titled Ototoxicity in Dogs and Cats. It's old, 1993, but there were a couple of things i wanted to share.

One is that there was someone who posted on this thread who said she had read some place that taking aspirin might help restore the hearing and she tried it and it did seem to help. I was hopeful about that, i haven't had a chance to study it yet, but in this short abstract of the article i'll include a link to, they say that the toxicity seemed to be made worse when salicylic acid was given to the animal. I think Aspirin is salicylic acid, or that is a main component of it. I don't know what this means but the abstract says "...The administration of salicylates and loop diuretics may potentiate the action of ototoxins, especially aminoglycoside antibiotics, probably by increasing the levels of these toxins in the endolymphatic fluid…" I don't know what it means.

The other thing i wanted to share about it is that it says there is a possible treatment of the hearing loss if detected early. It says "...Early detection is especially important because early changes can sometimes be reversible. Cavinton (apovincaminic acid) and fosfomycin represent examples of experimental agents being evaluated in laboratory animals for application as potential treatments to limit the ototoxicity associated with various drugs…"

i need to keep studying this and maybe get Zack in to see a specialist if i can find one, someone who would know about treatment to reverse it. My daughter was doing a lot of googol research and she said one person reported their dog's hearing got better after 5 months.

http://www.ncbi.nlm.nih.gov/pubmed/8456203


Hi, i know its been a while since you wrote this but I'm wondering if you found a solution or your dog improved? in recent days i have found myself in the same situation after having used Otomax drops for over 2 weeks! di you get your dogs ears flushed?
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