Our dermatologist was consulted and she agreed that this dog was suffering from severe Malassezia dermatitis and otitis. This is caused by either cutaneous disease (such as atopic dermatitis, food allergy, neoplasia, parasites, sebaceous adenitis or other) or it can be secondary to systemic disease (endocrinopathy, metabolic disease,etc.). Our dermatologist recommended a novel protein diet trial for 6-8 weeks. Evaluation and treatment for ectoparasites. For management of the yeast overgrowth, an all-over body clip to allow the treatment to penetrate the skin was recommended, 3 times weekly washes with malasseb, chlorhexidine mousse for the days in between and for the ears: a cleaner, a cerumenolytic and antiseptic. Systemic azoles would be likely needed for the Malassezia, but the liver function needed to be evaluated first. For the extreme pruritus, anti-inflammatory doses of prednisone could be given if systemic disease were excluded, this would also reduce the inflammation and attachment sites for Malassezia and other organisms.
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