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Publication
Otite Externa Crónica em Cães: Desafios e Abordagens Terapêuticas
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Advisor(s)
Abstract(s)
A otite externa crónica é uma patologia multifatorial comum em cães, caracterizada pela inflamação
persistente do canal auditivo externo e frequentemente associada a alterações significativas na
microbiota auricular. Esta condição resulta de uma combinação de fatores predisponentes como
conformações anatómicas desfavoráveis do canal auricular, orelhas pendulares e a exposição
frequente à água sem secagem adequada, fatores primários como doenças subjacentes (e.g.,
dermatite atópica, hipotiroidismo, hipersensibilidades alimentares) e fatores perpetuantes, como a
disbiose auricular e alterações crónicas do epitélio do conduto auditivo. A disbiose, definida como o
desequilíbrio na microbiota normal do ouvido, contribui para o crescimento excessivo de agentes
patogénicos oportunistas, incluindo Staphylococcus pseudintermedius, Pseudomonas aeruginosa, e
Proteus mirabilis, frequentemente associados a multirresistência antimicrobiana.
O uso prolongado de agentes antimicrobianos convencionais é muito utilizado no tratamento das
otites, mas a emergência de estirpes resistentes representa um desafio crescente na prática clínica.
Além disso, a redução da diversidade bacteriana e o domínio de certos géneros, como Staphylococcus
e Pseudomonas, destacam a importância de estratégias terapêuticas adaptadas a cada caso.
Nos últimos anos, novas abordagens terapêuticas têm sido exploradas, incluindo a terapia fágica, o
laser CO2, a terapia fotodinâmica antimicrobiana, a fotobiomodulação, a utilização de probióticos e
fitoterapia. Estas estratégias inovadoras visam não apenas combater a resistência antimicrobiana, mas
também restaurar o equilíbrio da microbiota auricular, promovendo tratamentos mais eficazes e
sustentáveis.
Desta forma pretende-se evidenciar que estratégias como a fototerapia antimicrobiana, a
fotobiomodulação e o uso de probióticos não apenas demonstram eficácia contra estirpes
multirresistentes, mas também contribuem para a modulação imunológica e a regeneração tecidular.
Foram identificados efeitos sinérgicos entre estas abordagens e terapias convencionais, com destaque
para a redução da carga microbiana, inibição de biofilmes e melhoria clínica em casos refratários. A
personalização do tratamento, ajustada à microbiota individual, revela-se essencial para a eficácia
terapêutica a longo prazo. Estes dados reforçam a importância de integrar diagnósticos avançados e
abordagens direcionadas na prática clínica, promovendo uma medicina veterinária mais precisa.
Chronic otitis externa is a common multifactorial condition in dogs, characterized by persistent inflammation of the external ear canal and frequently associated with significant alterations in the ear microbiota. This condition results from a combination of predisposing factors such as unfavorable anatomical conformations of the ear canal, pendulous ears, and frequent exposure to water without proper drying; primary factors such as underlying diseases (e.g., atopic dermatitis, hypothyroidism, food hypersensitivities); and perpetuating factors such as dysbiosis and chronic epithelial changes in the ear canal. Dysbiosis, defined as an imbalance in the normal ear microbiota, contributes to the overgrowth of opportunistic pathogens, including Staphylococcus pseudintermedius, Pseudomonas aeruginosa, and Proteus mirabilis, often associated with multidrug-resistant profiles. The prolonged use of conventional antimicrobial agents has been widely employed in the treatment of otitis, but the emergence of resistant strains poses an increasing challenge in clinical practice. Moreover, the reduced bacterial diversity and dominance of certain genera, such as Staphylococcus and Pseudomonas, emphasize the importance of tailored therapeutic strategies. In recent years, innovative therapeutic approaches have been explored, including phage therapy, antimicrobial photodynamic therapy, photobiomodulation, and the use of probiotics and phytotherapy. These novel strategies aim not only to combat antimicrobial resistance but also to restore the balance of the ear microbiota, promoting more effective and sustainable treatments. Phototherapies and immunomodulatory approaches such as antimicrobial phototherapy, photobiomodulation, and the use of probiotics have shown promise not only against multiresistant strains but also in promoting immune modulation and tissue regeneration. Synergistic effects between these approaches and conventional therapies have been observed, with notable results in microbial load reduction, biofilm inhibition, and clinical improvement in refractory cases. Personalized treatment plans, adjusted according to the individual microbiota, appear essential for long-term therapeutic success. These findings underscore the importance of integrating advanced diagnostics and targeted therapies into routine clinical practice, fostering a more precise, sustainable, and animal-welfare– focused veterinary medicine.
Chronic otitis externa is a common multifactorial condition in dogs, characterized by persistent inflammation of the external ear canal and frequently associated with significant alterations in the ear microbiota. This condition results from a combination of predisposing factors such as unfavorable anatomical conformations of the ear canal, pendulous ears, and frequent exposure to water without proper drying; primary factors such as underlying diseases (e.g., atopic dermatitis, hypothyroidism, food hypersensitivities); and perpetuating factors such as dysbiosis and chronic epithelial changes in the ear canal. Dysbiosis, defined as an imbalance in the normal ear microbiota, contributes to the overgrowth of opportunistic pathogens, including Staphylococcus pseudintermedius, Pseudomonas aeruginosa, and Proteus mirabilis, often associated with multidrug-resistant profiles. The prolonged use of conventional antimicrobial agents has been widely employed in the treatment of otitis, but the emergence of resistant strains poses an increasing challenge in clinical practice. Moreover, the reduced bacterial diversity and dominance of certain genera, such as Staphylococcus and Pseudomonas, emphasize the importance of tailored therapeutic strategies. In recent years, innovative therapeutic approaches have been explored, including phage therapy, antimicrobial photodynamic therapy, photobiomodulation, and the use of probiotics and phytotherapy. These novel strategies aim not only to combat antimicrobial resistance but also to restore the balance of the ear microbiota, promoting more effective and sustainable treatments. Phototherapies and immunomodulatory approaches such as antimicrobial phototherapy, photobiomodulation, and the use of probiotics have shown promise not only against multiresistant strains but also in promoting immune modulation and tissue regeneration. Synergistic effects between these approaches and conventional therapies have been observed, with notable results in microbial load reduction, biofilm inhibition, and clinical improvement in refractory cases. Personalized treatment plans, adjusted according to the individual microbiota, appear essential for long-term therapeutic success. These findings underscore the importance of integrating advanced diagnostics and targeted therapies into routine clinical practice, fostering a more precise, sustainable, and animal-welfare– focused veterinary medicine.
Description
Keywords
Cão Disbiose Microbiota auricular Multirresistência antimicrobiana Otite externa crónica Patogenios oportunistas Terapias inovadoras Antimicrobial multidrug resistance Chronic otitis externa Dog Dysbiosis Ear microbiota Innovative therapies Opportunistic pathogens