Long-term results of hydrocortisone aceponate for chronic dog ear

Abstract

ABSTRACT Background Effective management of otitis externa (OE) requires addressing all contributing factors to prevent chronicity and recurrence. Evidence on the long‐term efficacy of topical corticosteroids in preventing recurrence and secondary infections remains limited. Objectives This retrospective noncontrolled study evaluated the efficacy of hydrocortisone aceponate (HCA) in resolving non‐infectious chronic or recurrent (CR)‐OE with or without proliferative changes, and preventing recurrence of acute episodes and secondary infections. Animals A total of 63 owned dogs (115 ears) with unilateral or bilateral non‐infectious CR‐OE were included. Most ears were enrolled after resolving infectious otitis, as persistent inflammation or recurrence required further management. Materials and Methods Clinical records from two dermatology referral centres (February 2022–July 2023) were reviewed. Dogs were included if they had recurrent otitis for over a year (≥ 1 year) or chronic otitis (≥ 1 month). Otitis severity was assessed using the Otitis Index Score (OTIS3) scale, and by grading stenosis and hyperplasia severity. Enrolled patients received HCA 0.584 mg/mL at weight‐adjusted doses. A reactive phase continued until OTIS3 < 2, followed by a proactive phase with regimens adapted to otitis severity. Concurrent treatments were recorded. Results Recurrence was not observed in 79.1% of ears (mean follow‐up 202.6 days). Among 24 relapsed ears, 29.17% recurred after treatment discontinuation. Higher recurrence was associated with stopping therapy ( p < 0.001) and recent bacterial otitis ( p = 0.015). No adverse effects were noted. Conclusions and Clinical Relevance The use of HCA appears to be an effective and safe option for reactive and proactive management of non‐infectious CRC‐OE, reducing recurrences and improving patient and owner quality‐of‐life.