Possible to have ear infection without pain,viral cause of tinnitus desaparece,pioneer noise cancelling earbud headphones review volver - Review

Author: admin, 27.03.2015. Category: Is There A Cure For Tinnitus

The outer ear collects sound waves, which move through the ear canal to the tympanic membrane, commonly called the eardrum. The inner ear also contains three semi-circular canals that function as the body''s gyroscope, regulating balance. The Eustachian tube, an important structure in the ear, runs from the middle ear to the passages behind the nose and the upper part of the throat. In children, ear infections often recur, particularly if they first develop in early infancy.
Children who are susceptible to OME can have frequent episodes for more than half of their first 3 years of life.
Most episodes will resolve within 3 months, but 30 - 40% percent of children may have recurrent episodes.
An important 2006 study indicated that chronic OME (both with and without effusion) may be caused by biofilms, which are slimy collections of antibiotic-resistant bacteria. The inner ear also contains three semi-circular canals that function as the body's gyroscope, regulating balance. Most episodes will resolve within 3 months, but 30 - 40% of children may have recurrent episodes.
Haemophilus influenzae, the next most common culprit, is responsible for 20 - 30% of acute infections. However, other viruses, such as respiratory syncytial virus (RSV, a virus responsible for childhood respiratory infections) and influenza (flu), can be the actual causes of some ear infections.
Otitis media with effusion (OME) may occur spontaneously following an episode of acute otitis media. The primary setting for ear infections is in a child''s Eustachian tube, which runs from the middle ear to the nose and upper throat. If a cold does occur, the virus can cause the membranes along the walls of the inner passages to swell and obstruct the airways.
About 15% of AOM-causing bacteria are now believed to be resistant to the first-choice antibiotics. Genetic susceptibility to certain bacteria may result in development of persistent and recurrent acute otitis media. Abnormalities in genes that affect the defense systems (cilia and mucus production) and the anatomy of the skull and passages would also increase the risk for ear infections. Abnormalities in genes that regulate a powerful immune factor called interleukin 1 have been identified in some patients with recurrent acute otitis media who did not have any allergic disorders. Researchers are hoping that these findings may encourage primary care doctors to closely monitor children who have a family history of unusually frequent or severe upper respiratory tract infections.
The rise in ear infections has paralleled the increasing incidences of other upper and lower airway disorders such as asthma, allergies, and sinusitis.
In 2006, the American Academy of Otolaryngology -- Head and Neck Surgery Foundation (AAO-HNSF) issued their first guidelines for management of AOE. As children grow, however, the structures in their ears enlarge and their immune systems become stronger. Certain medical disorders, including Down syndrome, cleft palate, Kartagener syndrome, and immunosuppressive disorders, such as HIV, increase the risk for ear infections. Parents who smoke pose a significant risk for both otitis media with effusion (OME) and recurrent acute otitis media (AOM) in their children. Pregnant women who drink alcohol put their babies at risk for birth defects that can cause hearing loss and OME, among other problems. Several studies have found that the use of pacifiers place children at even higher risk for ear infections. If the ear infection is severe, the tympanic membrane may rupture, causing the parent to notice pus draining from the ear. Fevers and colds often make children irritable and fussy, so it is difficult to determine if acute otitis media is present as well.
Evidence strongly suggests that severe cases of recurrent acute otitis media and persistent otitis media with effusion (OME) impair hearing. However, results from a 2007 New England Journal of Medicine study strongly indicate that chronic middle ear effusion poses no danger for developmental delays. Before the introduction of antibiotics, mastoiditis (an infection in the bones located in the skull), was a serious, albeit rare, complication of otitis media.
If pain and fever persist in spite of antibiotic treatment of otitis media, the doctor should check for mastoiditis. If an infection of the mastoid air cells cannot be controlled with antibiotics, surgery may be needed.
While severe cases of recurrent acute otitis media or persistent otitis media with effusion (OME) are associated with impaired hearing for a period of time, the long-term consequences resulting from this hearing loss may not be significant in most children.
Hearing loss in children may temporarily slow down language development and reading skills.
Before the introduction of the conjugate pneumococcal vaccine, mastoiditis (an infection in the bones located in the skull), was a serious, albeit rare, complication of otitis media. The doctor first removes any ear wax (called cerumen) in order to get a clear view of the middle ear.
The doctor uses a small flashlight-like instrument called an otoscope to view the ear directly. An otoscope is a tool that shines a beam of light to help visualize and examine the condition of the ear canal and eardrum. Neither tympanometry nor reflectometry are substitutes for the pneumatic otoscope, which allows a direct view of the middle ear. AOM (fluid and infection) is often difficult to differentiate from OME (fluid without infection). Parents can also use a sonar-like device, such as the EarCheck Monitor, to determine if there is fluid in their child's middle ear. On rare occasions the doctor may need to draw fluid from the ear using a needle for identifying specific bacteria, a procedure called tympanocentesis.
Hearing tests performed by an audiologist are usually recommended for children with persistent otitis media with effusion.
By around 5 months, infants should be laughing out loud and making one-syllable sounds with both a vowel and consonant. Between 6 - 8 months, babies should be able to make word-like sounds with more than one syllable.
Usually starting around 7 months, and by 10 months, babies babble (making many word-like noises).
Around 10 months, babies can identify and use some term for a parent, such as dada, baba, or mama. If a child's progress is significantly delayed beyond these times, a parent should suspect possible hearing problems. Parents can also use a sonar-like device, such as the EarCheck Monitor, to determine if there is fluid in their child''s middle ear. By around 5 months the child should be laughing out loud and making one-syllable sounds with both a vowel and consonant.
Between 6 - 8 months, the infants should be able to make word-like sounds with more than one syllable. Usually starting around 7 months the baby babbles (makes many word-like noises) and should be doing this by 10 months.
Around 10 months, the baby is able to identify and use some term for the parent, dada, baba, or mama. If a child''s progress is significantly delayed beyond these times, a parent should suspect possible hearing problems.
Preventing influenza (the "flu'') may prove to be a more important protective measure against ear infections than preventing bacterial infections. In general, experts recommend that the flu vaccine be given to all children over 6 months with a condition that requires regular medical care. Still, the pneumococcal vaccine does not completely protect against otitis media because other types of bacteria can cause the problem. The recommended schedule of pneumococcal immunization is four doses, given at 2, 4, 6, and 12 - 15 months of age.
In one 2005 study, 223 children with non-severe AOM were randomly prescribed either watchful waiting or immediate antibiotic treatment. Another 2005 study surveyed parents and doctors on their use and perceptions of watchful waiting. In 2004, the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) released updated guidelines for the management and diagnosis of acute otitis media.
Children 6 months or older should be treated for pain within the first 24 hours with either acetaminophen or ibuprofen. An initial observation period of 48 - 72 hours is recommended for select children to determine if the infection will resolve on its own without antibiotic treatment. For children aged 6 months - 2 years, criteria for recommending an observation period are an uncertain diagnosis of AOM and a determination that the AOM is not severe. If antibiotics are needed, amoxicillin is recommended as first-line treatment (except in children who are allergic to penicillins). The American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) released updated clinical practice guidelines for OME in 2004.
OME that is persistent or recurrent (even if there is no hearing loss) and may put the child at risk for developmental delays or structural damage to the ear. Adenoidectomy plus myringotomy, with or without tube insertion, is recommended as a repeat surgical procedure. Adenoidectomy is not recommended as an initial procedure unless some other condition (chronic sinusitis, nasal obstruction, adenoiditis) is present.
Until recently, nearly every American child with an ear infection who visited a doctor received antibiotics. If there is no improvement or symptoms worsen, parents can schedule an appointment with the child's doctor to determine if antibiotics are needed.
While children with non-severe AOM who are given antibiotics may recover slightly more quickly, they often have a high number of side effects and antibiotic-resistant bacterial strains. Preventive antibiotics (antibiotic prophylaxis) may be recommended for recurrent acute otitis media. Tympanostomy (the insertion of tubes into the eardrum) is the first choice for surgical intervention. In one 2000 study, 240 children under age 2 who were diagnosed with acute otitis media were treated with watchful waiting. High fever, severe pain, or other signs of complications should warrant immediate attention by a medical professional. Parents of infants should contact their doctor immediately if they have any fever, regardless other symptoms. Depending on regional cultures, parents may have pressed a warm water bottle or warm bag of salt against the ear. Studies have reported that Otikon, an extract made of various plants, including garlic and St. Herbal remedies are not standardized or regulated, and their quality and safety are largely unknown.
The parent should be sure to instruct the child not to blow too hard or the eardrum could be harmed.
Either acetaminophen (Tylenol) or ibuprofen (Advil) is the pain-reliever of choice in children. Older children may be able to take prescription pain relievers that contain codeine if the pain is severe. Note: Aspirin and aspirin-containing products are not recommended for children or adolescents. Many non-prescription products are available that combine antihistamines, decongestants, and other ingredients, and some are advertised as cold remedies for children. Swimming can pose specific risks for children with current ear infections or previous surgery.
Children with ruptured acute otitis media (drainage from ear canal) should not go swimming until their infections are completely cured. Some doctors recommend that children with implanted ear tubes should use earplugs or cotton balls coated in petroleum jelly when swimming to prevent infection. Seek immediate medical attention for high fever, severe pain, or other signs of complications.
Most children with uncomplicated acute otitis media (AOM) will recover fully without antibiotic therapy. If your pet is unfortunate enough to have an encounter with a snake you can help by being aware of the signs and symptoms of snake bite, and getting the affected animal to the hospital as quickly as possible. The first clue that a pet has been bitten may just be a small amount of blood on the coat, face or limb with a some soft tissue swelling around a small puncture wound(s). Most snake bites in humans occur when people try to kill snakes, often after seeing them bite a pet. Calling ahead gives us critical extra time to make necessary preparations to ensure prompt and effective treatment.
When you call, listen very carefully to the announcements, and then call the emergency mobile number on the message (Mark sometimes has a night off with the after hours phone going to another vet). If your pet has stopped breathing, attempt mouth to nose resuscitation and if possible continue this during transport of your pet to the hospital.
These days the treatment of snake bite has a good success rate, and with appropriate and timely medical therapy many patients recover completely. The unfortunate animal will require constant monitoring, day and night, every one or two hours for the first 24 hours then every three hours for the next two days, with high rate intravenous infusions, blood clotting products and regular blood tests. If a snake needs removal from the property, contact WIRES to ask for theie recommended local snake handler. Hyperthyroidism in Cats: Great News!This is a very interesting disease of cats which we see in nearly any age group. Hyper-active thyroids (hyperthyroidism) make cats act like a car all revved up- ravenous appetite, hyper-active (just like my kids), under weight, often difficult to handle (again like my kids!) and may suffer from heart failure- rapid heart rate, shortness of breath, panting. By performing a simple blood test, we can diagnose affected cats and institute therapy to knock-out the thyroid hormones causing all the problems. Left un-treated, hyperthyroid cats run the major risk of high blood pressure and heart failure. The ventricles become smaller and smaller and as a result, can’t fill up with the same volume of blood. Treated cases usually see an improvement in heart function and the removal of heart drugs from the treatment regime at this stage i.e.
Blood test are performed before and 24-36 hours after starting therapy to ensure the kidneys can handle having the blood pressure dropped. Kidney DiseaseDogs and cats can suffer from either acute or chronic renal failure caused by many different types of illnesses.
Kidneys have powerful protective mechanisms in place which kick into action if problems arise. Kidneys are also responsible for sending messages to the bone marrow telling it to make more red blood cells (RBC's) to replace the old ones which are "gobbled up" by the spleen and liver when they are worn out.
As with most diseases, early detection and treatment is much more preferable especially for a vitally important organ like the kidneys.
For all our renal failure cases, we use a Doppler machine to record elevations in blood pressure and measure response to blood pressure lowering medications.
Force feeding using a stomach tube through which fluids and liquidised renal support diets can be administered. For cases with elevated Phosphorous in their body, we can use drugs called phosphate binders. For young cats in Australia with kidney failure, there is the possibility of kidney transplantation in Brisbane, but it is quite involved and the donor cat has to be taken on as a new family pet.
Parvovirus- the Ebola equivalentWe all know about Ebola- one of the nastiest and most contagious viral diseases for man. Parvovirus has to be one of the nastiest and most infectious diseases of dogs causing severe suffering with a very high fatality rate despite all the best intensive care.
Surprisingly, because Parvovirus has been around for so long, some pet owners have either forgotten what it does to dogs, or they were not yet born when it first arrived on the scene in a world wide epidmiec in the 1980's. Parvovirus is a virus that attacks the lining of a dog’s stomach and intestines and literally strips it out.
If pet owners are struggling financially, vets often have to euthanise infected dogs before starting any therapy. Camden vets had 10 Parvovirus cases in just one day, not to mention how many cases they had for a whole year! In a recent national study, there were 1,200 cases reported - and that was from only a small number of vet practices taking part in the survey.
When Parvovirus first occurred in the 1980’s, people were not aware of just how tough and contagious it was.
Well, the very fact that Parvovirus managed to spread across the world in just 2 years puts a few holes in this statement.
A dog either brewing or in the recovery stage of a Parvovirus infection, sheds millions of the viruses into the environment. It does not take long for an epidemic of Parvovirus to occur if the general dog population has a low vaccination percentage. Parvovirus can affect dogs of all ages; however dogs less than one year of age are particularly susceptible. Treatment is difficult because there is no way to kill the virus once it has infected the dog. Treatment is intensive and involves hospitalisation in an isolation ward (sometimes for many days), aggressive fluid therapy, antibiotics, pain relief and anti-vomiting drugs. Despite all of these treatments, a high percentage of dogs die a few days later leaving the owner with no dog and a very large vet bill. Malignant tumour of the adrenal glands- tumours made up of the cortisone producing cells of the adrenal glands make excessive cortisone. Dogs with pituitary gland tumours can go on to live comfortably for some time until the tumour gets too big and starts to place pressure on adjacent parts of the brain.At this stage, we might see symptoms such as blindness and other hormone imbalances. Unfortunately, adrenal gland tumours are often malignant and can spread to other parts of the body. Suspected cases have blood tests done to try and find out where the excess cortisone is coming from. Until recently, most cases were treated with a drug called Lysodren which destroys the parts of the adrenal glands that make cortisone. Many cases on Trilostane can have the dose lowered after a few months, which helps with the budget. Diabetes is commonly seen in Cushing's cases, probably as a result of cortisone interfering with the action of insulin.
Before embarking on treatment, owners need to be very aware of the expensive nature of treament. In human medicine, pituitary gland tumous can be removed by specialist surgeons operating through the nose or roof of the mouth. Increased Thirst (Polydypsia)There are a large number of causes of increased thirst (polydypsia) in pets. Blood tests (biochemistry and full blood count) give an overall picture of a pet's health.
Pets and humans can donate a kidney (and therefore be down to 50% total kidney function) and still lead a healthy life with no elevation of kidney blood tests or polydypsia. If their remaining kidney becomes diseased, and loses over half of its ability to function, kidney blood test start to rise i.e. When there is 25-50% of healthy kidney function, kidney blood tests are often normal, but the urine may be dilute (low specific gravity).
Between 50-100%, the urine will still be concentrated (high specific gravity), and bloods normal. It is important to check a urine sample as it can detect kidney failure long before a blood test. These chemicals travel down a special tube from the pancreas into the first part of the small intestines (the Duodenum). Sometimes as pets get older and fatter, the pancreas gets inflamed or worn out from too much of a workload e.g. Traveling through the pancreas is the bile duct- a tube connecting the gall bladder in the liver to the duodenum.
We normally see pancreatitis in older overweight dogs or dogs being fed too many fatty meals e.g.
From the history, breed, sex, age, symptoms and clinical examination, a vet usually has a pretty good idea the pet is suffering from pancreatitis.
A special in-house blood test ( Idexx SNAP CPL) gives an accurate positive result in pancreatitis cases (blue dot on the right is the same or darker than the dot on the left- see picture).
Other blood tests may show elevated white blood cells combating inflammation and infection and elevated liver enzymes if the bile duct becomes blocked.


As mentioned above, the inflamed pancreas can block the bile duct, so jaundice is a common symptom, sometimes seen 1-2 days after the start of the condition. Cases failing to respond to therapy may require surgery to rule out pancreatic cancer or to gently flush the affected area to try and settle the inflammation. Repeated episodes of pancreatitis can destroy the ability of the pancreas to produce food digesting acids and alkalis, resulting in chronic diarrhoea.
In humans, there is an overall 20% fatality rate, usually due to a secondary infection developing in the affected areas of the abdomen.
Dogs with pancreatitis and diabetic keto-acidosis have a poor prognosis and despite the best of efforts, may die from complications. Treatment can be very costly due to the length of stay in hospital with intensive care, drugs, repeat blood tests and fluid therapy. Boxer CardiomyopathyThis condition is characterised by feinting (syncope) and sudden death in Boxer dogs. The problem is due to a run of extra heartbeats interrupting the normal flow of oxygen rich blood to the brain.
These extra heartbeats originate in damaged heart muscle in the right ventricle (ventricular premature contractions -VPC's).
A run of several or more VPC's can cause sudden death which is a common consequence of the condition. By listening to the heart for several minutes with a stethoscope, a vet may detect a skip in the normal heart rhythm although this is not a sure fire way of detecting a problem as affected dogs can go for several hours without as much as one skipped VPC. Similarly, connecting a dog to an ECG machine to record the heartbeat for a few minutes may miss a run of VPC's. Listening to the heart or recording an ECG while the dog has a syncopal episode would be ideal way to diagnose the problem, but these events tend to happen away for vet surgeries and owners can be too stressed to  think about recording the heartbeat while their unconscious dog lies at their feet. Specialist cardiologists can loan out 24hr ECG recording machines (Halters) which attach to the trunk of the body in special leather harnesses. Quite often it is astounding to see how many runs of VPC's occur while the dog is asleep. Atrial FibrillationSome dogs with dilated cardiomyopathy and left A-V valve disease get a life threatening arrhythmia called atrial fibrillation.
Each time the damaged atrium contracts, it tries to sends an electrical signal to the ventricles below telling it to contract as "its their turn now". The refractory period may only be a split part of a second, and follows a normal ventricle contraction. In effect, the atria are doing their own rapid irregular heart beat and 8 times out of 10 their extra contractions cause the ventricles to contract.
As a result, we see the ventricles pumping at a much faster and irregular rate than in a dog with no atrial fibrillation.
If a dog has either A-V valve disease or dilated cardiomyopathy, the ventricles are already having a hard time.
Cardiac output is reduced in A-V valve disease and dilated cardiomyopathy, so oxygen rich blood does not reach vital organs e.g. But don't forget the heart which is the most dynamic oxygen hungry organ (next to the brain). The last thing the diseased ventricles want is atrial fibrillation causing them to contract even faster. Atrial fibrillation can very quickly cause the ventricles to fail and lead to sudden heart failure and death. On exmination, the heart rate is very rapid and irregular- often over 200 beats a minute (nearly 3-4 beats a second).
A normal ECG has one P wave (atrial contraction) followed by one QRS wave (ventricle contraction) and a normal heart rate of approx 100-140.
Atrial fibrillation shows rapid irregular spaced ventricle heartbeats (QRS waves) and no regular P waves.
When incoming sound waves strike this membrane, it vibrates like a drum, and converts the sound waves into mechanical energy. Here, hair-like structures stimulate nerves to change sound waves into electrochemical impulses that are carried to the brain, which senses these impulses as sounds. An inflammation in the middle ear is known as "otitis media." AOM is a middle ear infection caused by bacteria that traveled to middle ear from fluid build-up in the Eustachian tube. This condition occurs when fluid, called an effusion, becomes trapped behind the eardrum in one or both ears, even when there is no infection. The middle ear is a complex structure filled with air that surrounds a chain of three tiny bones.
This condition refers to persistent fluid behind the tympanic membrane without any infection present. For pain relief, over-the-counter remedies such as acetaminophen or nonsteroidal anti-inflammatory drugs (such as ibuprofen) usually help, but in severe cases opioid drugs may be prescribed.
Viruses play an important role in many ear infections, and can set the scene for a bacterial infection. Nearly a third of infants and toddlers with upper respiratory infections go on to develop acute otitis media.
Viruses can increase middle ear inflammation and interfere with antibiotics' efficacy in treating bacterial-causes ear infections.
Any medical or physical condition that reduces the ear's defense system can increase the risk for ear infections. The Eustachian tube is shorter and smaller in children than adults, and therefore more vulnerable to blockage.
If this inflammation blocks the narrow Eustachian tube, the middle ear may not drain properly. Allergens can also produce inflammation and blockage in the Eustachian tube, which creates an environment favorable to bacteria.
Rhinovirus is a common virus which causes a cold, and plays a leading role in the development of ear infections. Several studies suggest that multiple genetic factors may make a child more susceptible to acute otitis media. Interleukin-1 plays a major role in producing inflammation in tissues and cells during heightened immune activity. Any medical or physical condition that reduces the ear''s defense system can increase the risk for ear infections.
Susceptibility to OME may also be due to an abnormal or malfunctioning Eustachian tube that causes a negative pressure in the middle ear, which allows fluid to leak in through capillaries. For example, the same bacteria are often responsible for both ear infections and sinusitis. Although ear infections themselves are not contagious, the respiratory infections that precipitate them can pose a risk for children with close and frequent exposure to other children.
Some experts believe that an increase in allergies is also partially responsible for the higher number of ear infections, which is unlikely to be related to day care attendance. About two-thirds of children will have a least one attack of AOM by age 3, and a third of these children will have at least 3 episodes.
The earlier a child has a first ear infection, the more susceptible they are to recurrent episodes (for instance, 3 or more episodes within a 6-month period). OME is very common in children aged 6 months to 4 years, with about 90% of children having OME at some point. Some doctors believe that an increase in allergies is also partially responsible for the higher number of ear infections. Although ear infections themselves are not contagious, the respiratory infections that often precede them can pose a risk for children with close and frequent exposure to other children.
Several studies have found that the use of pacifiers place children at higher risk for ear infections.
Risk FactorsAcute ear infections account for 15 - 30 million visits to the doctor each year in the U.S. The earlier a child has a first ear infection, the more susceptible he or she is to recurrent episodes (for instance, 3 or more episodes within a 6-month period). OME is very common in children aged 6 months to 4 years with approximately 90% of children having OME at some point. The American Academy of Pediatrics recommends breastfeeding for at least the baby''s first 6 months.
Sucking increases production of saliva, which helps bacteria travel up the Eustachian tubes to the middle ear. However, it is difficult to determine if an infant or child who hasn't yet learned to speak has an ear infection. Some hearing loss may occur, but it is often fluctuating and hard to detect, even by observant parents. In such cases, some parents or teachers may attribute their behavior to lack of attention or even to an attention deficit disorder.
However, it is difficult to determine if an infant or child who hasn''t yet learned to speak has an ear infection.
Children with impaired hearing may appear to be distracted, inattentive, and unintelligent. Researchers evaluated children who had either prompt insertion of ear tubes to drain fluid when they were younger than age 3, or delayed insertion of tubes many months later.
Certain children with severe or recurrent otitis media may be at risk for structural damage in the ear.
Cysts in the ear called cholesteatomas are an uncommon complication of recurrent or severe ear infections. In rare cases, even after a mild infection, some children develop calcification and hardening in the middle and, occasionally, in the inner ear. This condition is difficult to treat and requires intravenous antibiotics and drainage procedures. Some studies have indicated that children with chronic OME have problems with motor development and balance. However, uncomplicated chronic middle ear effusion generally poses no danger for developmental delays in otherwise healthy children. Certain children with severe or recurrent otitis media may be at risk for structural damage in the ear, including erosion of the ear canal.
Inflammatory tissues in the ear called cholesteatomas are an uncommon complication of chronic or severe ear infections.
The condition is difficult to treat and requires intravenous antibiotics and drainage procedures. Very rarely, a child with acute otitis media may develop facial paralysis, which is temporary and usually relieved by antibiotics or possibly drainage surgery. An ear examination should be part of any routine physical examination in children, particularly because the problem is so common and may not cause symptoms. Examining the ear can reveal the cause of symptoms such as an earache, the ear feeling full, or hearing loss. In this case, a small probe is held to the entrance of the ear canal and forms an airtight seal. Symptoms may include fever, pulling on the ear, pain, irritability, or discharge (otorrhea) from the ear. It is important for a doctor to make this distinction as OME does not require antibiotic treatment.
EarCheck uses acoustic reflectometry technology, which bounces sound waves off the eardrum to assess mobility. Unfortunately, it is very difficult to test children under 2 years old for hearing problems. DiagnosisThe doctor should be sure to ask the parent if the child has had a recent cold, flu, or other respiratory infection.
It can be used to detect fluid and obstruction, but does not require an airtight seal at the canal. EarCheck employs acoustic reflectometry technology which bounces sound waves off the eardrum to assess mobility. Colds and flus are spread primarily when an infected person coughs or sneezes near someone else.
For example, studies report that children who are vaccinated against influenza experience 33 - 36% fewer ear infections during flu season than unvaccinated children.
Children who are susceptible to recurrent ear infections should probably be given vaccinations against influenza viruses. Newer vaccines contain very little egg protein, but an allergic reaction still may occur in people with strong allergies to eggs. Up to two-thirds of people who receive the influenza vaccine develop redness or soreness at the injection site for 1 - 2 days afterward. Antibiotics have been used to prevent bacterial infections in children with recurrent ear infections (4 or more episodes a year).
Daily diets should include foods such as fresh, dark-colored fruits and vegetables, which are rich in antioxidants and other important food chemicals that help boost the immune system. Researchers are studying the possible protective value of certain strains of lactobacilli, bacteria found in the intestines. Xylitol, a sugar alcohol produced naturally in birch, strawberries, and raspberries, has properties that fight Streptococcal pneumonia bacteria. Several studies have found that children who live with smokers have a significant risk for ear infections. According to the American Academy of Pediatrics, exclusively breastfeeding for a baby’s first 6 months helps to prevent ear and other respiratory infections.
Centers for Disease Control (CDC) recommend annual influenza vaccination for all children 6 months to 5 years of age.
Antibiotics may occasionally be recommended to prevent bacterial infections in children with recurrent ear infections (4 or more episodes a year).
According to the American Academy of Pediatrics, exclusively breast-feeding for a baby’s first 6 months helps to prevent ear and other respiratory infections. The major debates rest on the use of antibiotics, surgery, and watchful waiting in both acute otitis media (AOM) and otitis media with effusion (OME). The antibiotic group recovered more quickly, but had a high number of side effects and antibiotic-resistant bacterial strains. Results indicated that although medical guidelines recommend watchful waiting, few doctors regularly practice it. For children older than 2 years, the observation period criteria are non-severe symptoms or uncertain diagnosis.
Antibiotics and corticosteroids do not help and are not recommended for routine management of OME.
Approximately 20 - 50% of children who undergo this procedure may have OME relapse and require additional surgery.
TreatmentMany of the treatments for ear infections, particularly antibiotic use and surgical procedures, are often unnecessary in many children. Major studies now indicate that antibiotics are unnecessary in most cases of acute otitis media.
The intense and widespread use of antibiotics has led to a serious global problem of bacterial resistance to common antibiotics. Studies have found that giving parents the option of delaying antibiotic treatment helps to reduce the unnecessary use of antibiotics without causing any health problems for the children. Which children should be treated this way, as well as which antibiotics and for how long, have not been clearly determined.
It is important for parents to recognize that persistent fluid behind the eardrum after treatment for acute otitis media does not indicate failed treatment.
Adenoidectomy (removal of adenoids) plus myringotomy (removal of fluid), with or without tube insertion, is sometimes recommended as a repeat surgical procedure. Home RemediesCareful monitoring of the child''s condition (watchful waiting) along with home remedies and common over the counter cold medicines may be a viable alternative to antibiotic treatment for many children with a first episode of acute otitis media. After 4 days, only 3% of the children required treatment with antibiotics, while the infection cleared in the other 97%. Now, with current concern over antibiotic overuse, many of these remedies are again popular. John''s wort, is an effective anesthetic in treating the pain associated with ear infections. There is no evidence to indicate that these candles are safe or effective for treatment of AOM or other ear conditions. Parents should never give their child herbal remedies, including oral remedies, without approval from a doctor. A simple technique called the Valsalva''s maneuver is useful in opening the Eustachian tubes and providing occasional relief from the chronic stuffy feeling accompanying otitis media with effusion.
In one study, Auralgan provides effective short-acting pain relief and helps children endure ear discomfort until an oral pain reliever takes effect. Reports of Reye syndrome, a very serious condition, have been associated with aspirin use in children who have chicken pox or flu. Researchers have found little or no benefits for acute otitis media or for otitis media with effusion using decongestants (either oral or nasal sprays or drops), antihistamines, or combination product. Water pollutants or chemicals may exacerbate the infection, and underwater swimming causes pressure changes that can cause pain. Home RemediesCareful monitoring of the child's condition (watchful waiting) along with home remedies may be a viable alternative to antibiotic treatment for many children with a first episode of acute otitis media.
A simple technique called the Valsalva's maneuver is useful in opening the Eustachian tubes and providing occasional relief from the chronic stuffy feeling accompanying otitis media with effusion.
Auralgan provides short-acting pain relief and may help children endure ear discomfort until an oral pain reliever takes effect.
Reye syndrome, a very serious condition, is associated with aspirin use in children who have chickenpox or flu. When antibiotics are needed, a number of different classes are available for treating acute ear infections. Dogs, cats and horses are all at risk, although curious dogs are the most frequently affected. Tiger and Brown snakes are also prevalent, especially on Coolangatta Mountain and adjacent flat lands. But don't waste time trying to find it as we stock a multi-snake anti-venom that covers Black, Tiger and Brown snake bites.
If we are at home, have the after hours going to another vet, or are out on a house call, you will be using up what might be precious time - always call first!
But treating snake bite is always arduous for the affected pet, as well as for the vet and the nurses. Consequently, it can be expensive, although it may be covered by pet health insurance if you have it.
With the rapid heart rate, the heart muscles get thicker and thicker- its a bit like a weight lifter doing extra work. Less blood in means less blood out of the heart, and reduced blood supply to the body and its vital organs eg kidneys, liver, heart.
In some cats, the high blood pressure from hyperthyroidism is keeping their poorly functioning kidneys going. Should your remaining kidney lose up to 50% of its ability to concentrate urine, you can still appear normal although you may be drinking a bit more and making dilute urine.
A Senior Pet Health Check urine examination looks at the concentrating ability of the kidneys to detect early reduction in kidney function. In other words, the pet makes more urine than normal because the kidneys can't re-absorb the water out of the urine like they did when healthy. We would rather diagnose renal failure before clinical signs or blood tests indicate its presence. It is very accurate at detecting early kidney problems long before blood tests start to indicate a problem.
It can survive up to 18 months in soil or concrete and needs strong disinfectants to kill it. International travellers and infected or recovering dogs being flown to other countries would infect healthy dogs upon their arrival- either by direct contact with another dog or with their clothing, bedding and foot wear.
It is vital all puppies and adult dogs are vaccinated against parvovirus and your vet will advise on the appropriate vaccination schedule.
Referral to a specialist may be an option if the tumour is in just one adrenal galnd and not adhered to any vital structures e.g.
They must be fully committed and prepared to put up with regular blood tests and expensive drug bills. Besides the expected increase in thirst with hot days, exercise or change to a drier food,  any pet showing polydypsia over 2-3 days should be examined by a vet. The pancreas is a special organ that makes many different chemicals such as insulin, acids and alkalis which help digest and process foods.
Repeating these tests during the dog's stay in hospital gives the vet an good idea on how the dog is going. Diabetes and all of its associated complications (keto-acidosis) can be a life threatening presenting sign.


It is unlike the traditional form of cardiomyopathy we see in large dog breeds (most of the time). By the time they do have a feel of the heartbeat or pulse, the rhythm may be back to normal as it may have just been a run of several VPC's taking up less than 1-2 seconds of time.
A computer runs through the 24hrs of recording in seconds and prints out a report highlighting all the abnormal heartbeats.
The damaged area fires off its own electrical current causing the atrium to contract very rapidly (sometimes as much as 200-300 times a minute). Not every electrical impulse gets through to the ventricle as a number of these extra charges arrive at the ventricle when it is in a "none-responsive" state (refractory period).
Once it has passed, the extra electrical signals from the damaged atrium above can trigger off a ventricle contraction. Any reduction in output means less oxygen for the heart muscles, so they can't pump as well as they would like. There is often evidence of left sided heart failure - coughing, weakness, pale gums, weak thready rapid pulse. These bones vibrate to the rhythm of the eardrum and pass the sound waves on to the inner ear. The researchers suggest that ear tube insertion is the best treatment for children with chronic OME.
It is called suppurative chronic otitis when there is persistent inflammation in the middle ear or mastoids, or chronic rupture of the eardrum with drainage. Rhinovirus is a common virus that causes a cold and plays a leading role in the development of ear infections. Children with shorter than normal and relatively horizontal Eustachian tubes are at particular risk for initial and recurrent infections.
CausesAcute otitis media (middle ear infection) is usually due to a combination of factors that increase susceptibility to infections by specific organisms in the middle ear. Abnormalities in interleukin production may possibly result in a persistent inflammatory response. Problems in the Eustachian tube can be due to viral infections, second-hand smoke, injury, birth defects (such as cleft palate), or genetic diseases that affect the defense systems, such as Kartagener''s syndrome.
In one study, 38% of children with ear infections also had sinusitis, and other studies have reported that nearly half of children with OME have concurrent sinusitis. Some experts believe that the increase in ear and other infections may be due to the higher attendance of very small children, including infants, in day care centers beginning in the 1970s. Studies indicate that 40 - 50% of children over 3 years old who have chronic otitis media also have allergic rhinitis (hay fever). For pain relief, over-the-counter remedies such as acetaminophen or nonsteroidal anti-inflammatory drugs (such as ibuprofen) usually suffice, but in severe cases opioid drugs may be prescribed. Some research suggests that the increase in ear and other infections may be due to the increasing attendance of very small children, including infants, in day care centers.
The American Academy of Pediatrics recommends breastfeeding for at least the baby's first 6 months. Eardrum abnormalities increased the more the child weighed, which might explain the association.
The only sign to a parent that the condition exists may be when a child complains of "plugged up" hearing. Children with even mild hearing loss may miss spoken words and have trouble making sense out of a conversation or a lesson in school.
Some have even been inaccurately diagnosed as having attention deficit hyperactivity disorder. When the children were tested at ages 9 – 11, the researchers found no differences in speech and language, auditory processing, attention, behavior, social skills, and academic achievement. PrognosisDoctors should carefully evaluate ear infections in infants fewer than 3 months old, and consider more serious infections, such as meningitis.
As the majority of chronic ear effusion cases eventually clear up on their own, many doctors recommend against placement of tympanostomy tubes for most children. Facial paralysis may also occur for patients with chronic otitis media and a cholesteatoma (tissue in the middle ear). Infection in the outer ear, however, can be confirmed by tugging the outer ear, which will produce pain. A doctor should always check for this first when a small child indicates pain or problems in the ear. While the air pressure is varied, a sound with a fixed tone is directed at the eardrum and its energy is measured. In patients with OME, an air bubble may be visible and the eardrum is often cloudy and very immobile.
When fluid is present behind the middle ear (a symptom of AOM and OME), the eardrum will not be as mobile.
This is most often performed by an ear, nose, and throat (ENT) specialist, and usually only in severe or recurrent cases. If the child complains of pain or has other symptoms of otitis media, such as redness and inflammation, the doctor should rule out any other causes. Infection in the outer ear, however, can be confirmed by wiggling the ears, which will produce pain. More than one study has reported that people with low stress who also have an active social life have fewer colds than people who have high stress levels or those who have low stress and few social connections. The latest childhood immunization guidelines (released in 2007) recommend that all children ages 6 months – 5 years receive an annual flu vaccine. In fact, in 2003 the American Academy of Pediatrics (AAP) and the CDC encourages vaccination in all children, including healthy children, between 6 months and 2 years of age. One such drug, oseltamivir (Tamiflu), is approved for use in children age 1 year and older. Studies suggest, however, that overall they only prevent 1 episode a year, and are not generally recommended for prevention, except for specific situations. Studies have reported that children who chew gum or swallow a syrup containing xylitol experience fewer ear infections. Also, infants are held during breastfeeding in a position that allows the Eustachian tubes to function well.
Preventing influenza (the "flu') may be a more important protective measure against ear infections than preventing bacterial infections.
Also, infants are held during breast-feeding in a position that allows the Eustachian tubes to function well.
Most cases of acute otitis media do not require antibiotics, and the overuse of antibiotic prescriptions has increased the problem of antibiotic-resistant bacteria. Parents were equally satisfied with either treatment approach, and two-thirds of children in the watchful waiting group recovered without needing antibiotics. Parents who had a higher educational level, more knowledge about antibiotics, and greater involvement in medical decisions were more likely to be satisfied with a watchful waiting recommendation. Severe AOM symptoms include moderate to severe pain and a fever of at least 102.2A° Fahrenheit (39A° Celsius).
Between 80 - 90% of all children with uncomplicated ear infections recover within a week without antibiotics. Current guidelines released by the American Academy of Pediatrics and the American Academy of Family Physicians recommend an initial observation period of 48 - 72 hours for select children. Unfortunately, surveys indicate that although medical guidelines recommend watchful waiting, few doctors regularly practice it.
Antibiotics, decongestants, antihistamines and corticosteroids do not help and are not recommended for routine management of OME. Ear tube insertion may be recommended when fluid builds up behind your child's eardrum and does not go away after 4 months or longer.
The American College of Chest Physicians recommends against the use of nonprescription cough and cold medicines in children age 14 years and younger. But it’s always better to keep your pets out of likely snake habitat and avoid the risk. This thickening happens at the expense of the chamber (ventricle) sizes, and is called Hypertrophic Cardiomyopathy (HCM).
Dialysis is performed in people with renal failure to filter out the waste products that the kidney normally places in the urine. When we run blood tests on renal failure cases, we see elevated levels of urea (Blood Urea Nitrogen- BUN), Creatinine and Phosphate. More urine going out of the body automatically triggers a chemical release in the brain which makes the pet thirsty.
If the kidneys are not working properly, chemicals are released which elevate the blood pressure in an attempt to improve the flow of blood through the kidney and remove waste products that are building up in the body. Because RBC's are responsible for carrying oxygen around the whole body, the pet is quite weak and easily fatigued.
Treatment involves intensive care, fluid therapy, pain relief, blood transfusions and no guarantee of success. In a very old patient, no treatment may be a more preferable propositon especially if the owners are on a budget. When making the appointment, try to bring along a fresh urine sample as a lot of information can be found by examining it.
In other words, we don't normally see elevated kidney tests in chronic renal failure until there is only 25% of healthy tissue left.
The kidneys aren't doing their job of "recycling water" by sucking water out of the urine before it goes to the bladder to be voided. This small amount of inflammation results in leakage of acids and alkalis both inside and adjacent to the pancreas. Some older dogs can develop pancreatic cancer which looks just the same as normal pancreatitis. Dogs must go onto an IV drip to correct dehydration and reverse shock and damage to the kidneys. This is important to provide fluid and nutrition to the cells lining the stomach and intestines. It is vital that repeat episodes are avoided as too much damage to the pancreas can result in lack of insulin (diabetes) or the inability to digest and absorb foods (pancreatic exocrine insufficiency). Boxer cardiomyopathy is also known as "Boxer arrhythmogenic right ventricular cardiomyopathy".
However, other studies indicate that watchful waiting is the best approach, as many cases of chronic OME eventually clear up on their own. CausesAcute otitis media (middle ear infection) is usually due to a combination of factors that increase susceptibility to bacterial and viral infections in the middle ear. An additional defense system in the airways, such as mucus, prevents the harmful bacteria from spreading and infecting deeper passages, such as those in the ear. The defense systems described above become inefficient, and the fluid becomes a breeding ground for bacteria and subsequent infection.
But other viruses, such as respiratory syncytial virus (RSV, a virus responsible for childhood respiratory infections) and influenza (flu), may be the actual causes of some ear infections.
Inborn structural abnormalities, such as cleft palate, or genetic conditions, such as Kartagener''s syndrome in which the cilia (hair-like structures) in the ear are immobile and cause fluid build up, also increase the risk. Data indicate that nearly a third of infants and toddlers with upper respiratory infections go on to develop acute otitis media.
Research presented at a 2006 pediatric medicine meeting suggested that it may be wise to keep very young children (under 1 year old) out of day care to avoid exposure to the upper respiratory infections that can lead to ear infections.
The researchers also suggested that parents may be confusing their children''s fussiness due to the ear infection with hunger and, therefore, overfeeding them. Some parents believe that tugging on the ear indicates an infection, but this gesture is more likely to indicate pain from teething.
Other symptoms can include loud talking, not responding to verbal commands, and turning up the television or radio. PrognosisEar infections in infants less than 3 months old may indicate more serious infections, such as meningitis.
As the majority of chronic ear effusion cases eventually clear up on their own, many experts now recommend against surgical intervention for most children.
Pressing the bulb and observing the action of the air against the eardrum allows the doctor to gauge the eardrum's movement. This device can detect fluid in the middle air and also obstruction in the Eustachian tube.
A scarred, thick, or opaque eardrum may make it difficult for the doctor to distinguish between acute otitis media and OME.
In most cases, tympanocentesis is not necessary in order to obtain an accurate enough diagnosis for effective treatment. Pressing the bulb and observing the action of the air against the eardrum allows the doctor to gauge the eardrum''s movement.
Antibodies to the influenza virus generally develop within 2 weeks of vaccination, and immunity peaks within 4 - 6 weeks, then gradually wanes.
These symptoms are not influenza itself but an immune response to the virus proteins in the vaccine. Studies report significant reduction in symptoms and in the incidence of ear infections with this drug. It is included in the Recommended Childhood Immunization Schedule and is also specifically approved for preventing otitis media. In one study, milk containing the strain lactobacilli GG reduced respiratory infections in children who attended day care by 10 - 20%. In addition, a 2006 study suggested that breastfeeding can help protect even those children who are genetically susceptible to ear infections.
For example, studies report that children who are vaccinated against influenza experience a third fewer ear infections during flu season than unvaccinated children. It is included in the Recommended Childhood Immunization Schedule and is specifically approved for preventing otitis media.
Therefore, watchful waiting has become the preferred strategy for managing acute otitis media. In a 2006 study of children with otitis media who were treated in emergency rooms, researchers found that giving parents the option of delaying antibiotic treatment helped to reduce the unnecessary use of antibiotics without causing any health problems for the children. For one, the condition resolves without treatment in nearly all children, especially those whose OME followed an acute ear infection. In fact, a 2006 study suggested that antihistamines and decongestants may cause more harm than good by provoking side effects such as stomach upset and drowsiness. Likewise, receiving antibiotics for an acute ear infection does not seem to prevent children from having fluid behind the ears after the infection is cleared up. Pain relief can initially be given with acetaminophen (Tylenol), ibuprofen (Advil), or topical benzocaine drops.
Between 20 - 50% of children who undergo this procedure may have OME relapse and need additional surgery). Other antibiotics are available for children who are allergic to penicillin or who do not respond within 2 - 3 days.
If they are inactive (hypo-thyroidism), pets are lazy, over weight, have skin problems and greasy coats. In fact, many dogs only survive 2-3 days with this intensive care before dying, leaving pet owners with huge vet bills and no dog. It did not take long before surrounding parks and streets were covered in millions of viruses.
This means a dog may appear healthy, but can be excreting virus particles in its faeces and so become a source of infection to other dogs while the disease is brewing in its intestines. As a result, bile "backs up" in the liver and can cause a yellow staining of the blood, skin and gums (jaundice). Dehydration and shock quickly follow, making the dog thirsty, however each time it drinks, more leakage of the acids and alkalis occurs.
If they are very rapid, the ventricle does not have time to fill up to the top befoire it is "told" to contract.
Otitis externa can also be precipitated by overly aggressively scratching or cleaning ears or when an object gets stuck in the ears. The primary setting for middle ear infections is in a child's Eustachian tube, which runs from the middle ear to the nose and upper throat.
Genetic conditions, such as Kartagener's syndrome in which the cilia (hair-like structures) in the ear are immobile and cause fluid build up, also increase the risk. AOE can also be precipitated by overly aggressively scratching or cleaning ears or when an object gets stuck in the ears.
However, a causal relationship between allergies and ear infections has not been definitively established. But a reassuring 2002 study reported that only 4% of infants with an ear infection had a bacterial infection. Results indicate the likelihood of the presence of fluid and may help patients decide whether they need to contact their child's doctor. Results indicate the likelihood of the presence of fluid and may help patients decide whether they need to contact their child''s doctor. In another study, when the antiviral drug, zanamivir (Relenza), was administered in the nasal passages of adults with influenza, middle ear abnormalities were reduced by more than half, to 32%.
An important 2003 study indicated that these vaccinations could result in 1.7 million fewer office visits, 24% fewer procedures for tube implants, and significantly fewer antibiotic prescriptions. Another antiviral drug, zanamivir (Relenza), is available for children older than age 7 years .
At present, there is no compelling evidence to indicate that allergy treatment can assist with OME management nor has a causal relationship between allergies and OME been established. Antihistamines and decongestants may cause more harm than good by provoking side effects such as stomach upset and drowsiness.
But most children do not have long-term damage to their hearing or their ability to speak even when the fluid remains for many months. The brain realises it is losing more "water" than it should be from the body, so it activates the "thirst centre" in the brain which makes the pet look for water. Acute secondary kidney failure can occur due to the large amount of fluid loss causing thickening of the blood and decreased blood flow to vital organs.
The Eustachian tube is shorter and narrower in children than adults, and therefore more vulnerable to blockage. Children with Down syndrome or Fetal Alcohol Syndrome may also be at increased risk due to anatomical abnormalities.
Viruses can increase middle ear inflammation and interfere with antibiotics’ efficacy in treating bacterial-causes ear infections.
However, it is not recommended that children be treated with antibiotics based on the findings using this device. Waterless hand cleaners that contain an alcohol-based gel are also effective for every day use and may even kill cold viruses. FluMist is made from a live but weakened influenza virus; flu shots use inactivated (not live) viruses.
This drug is available for children older than 7 years for treatment of influenza, but no research has determined it value for preventing or treating otitis media in children.
They hope that this investigational vaccine may eventually help prevent middle ear infection caused by these organisms. Waterless hand cleaners that contain an alcohol-based gel are also effective for everyday use and may even kill cold viruses. In general, regions and institutions with the highest rate of resistance are those in which antibiotics are the most heavily prescribed. Recent research suggests that for children ages 5 years and younger, vaccination with the live virus FluMist may provide better protection against influenza than inactivated virus flu shots.
Children younger than 2 years old, and children younger than age 5 who have asthma or recurrent wheezing, should not receive FluMist. Even if OME lasts for longer than 3 months, the condition may resolve on its own and intervention may not be necessary.
Even if OME lasts for longer than 3 months, the condition generally resolves on its own without any long term effects on language or development and intervention may not be necessary.
More damage to the pancreas means more leakage and it does not take long for massive inflammation and tissue destruction to occur. In such cases, alcohol-based rinses are needed.) Antibacterial soaps add little protection, particularly against viruses. The doctor will re-evaluate the child at periodic intervals to determine if there is risk for hearing loss.
In fact, one study suggests that common liquid dish washing soaps are up to 100 times more effective than antibacterial soaps in killing respiratory syncytial virus (RSV), which is known to cause pneumonia and has been associated with ear infections. Wiping surfaces with a solution that contains 1 part bleach to 10 parts water is very effective in killing viruses.



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