Effect of empirical versus definitive antimicrobial selection on postoperative complications in dogs and cats undergoing total ear canal ablation with lateral bulla osteotomy: 120 cases (2009-2019)

J Am Vet Med Assoc. 2022 Mar 24;260(8):899-910. doi: 10.2460/javma.21.10.0462.

Abstract

Objective: To evaluate dogs and cats undergoing total ear canal ablation with lateral bulla osteotomy (TECA-LBO), document antimicrobial choices, and determine relationships associated with infection-related and neurologic postoperative complications.

Animals: 107 client-owned dogs and 13 client-owned cats that underwent TECA-LBO.

Procedures: A retrospective analysis of medicals records of dogs and cats with TECA-LBO from 2 veterinary hospitals with postoperative data for at least 6 months was performed. All information associated with the TECA-LBO surgery including follow-up was recorded. Logistic regression analyses were performed and corrected using a false discovery rate to identify significance between antimicrobial administration and other perioperative variables and the outcomes of short- and long-term neurologic and infection-related complications, need for revision surgery, and euthanasia due to recurrence of infection-related signs.

Results: Intraoperative cultures were performed in 111 animals, and 95 (85.5%) had bacterial growth, with Staphylococcus spp most commonly isolated. Revision surgeries due to infection-related signs occurred in 13 of 120 (10.8%) patients. If intraoperative bacterial cultures were positive and antimicrobials were administered within 1 month of surgery, patients were 85.8% less likely to exhibit infection-related complications, whereas patients not administered antimicrobials were 10.3 times as likely to require a revision surgery. Longer durations of postoperative antimicrobial administration were associated with revision surgery and euthanasia due to infection-related signs.

Clinical relevance: Administration of systemic antimicrobials within the first postoperative month may be necessary to prevent complications when intraoperative cultures exhibit bacterial growth and plays a role in the successful outcome of TECA-LBO.

MeSH terms

  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Blister / etiology
  • Blister / veterinary
  • Cat Diseases* / etiology
  • Cat Diseases* / surgery
  • Cats
  • Dog Diseases* / etiology
  • Dogs
  • Ear Canal / surgery
  • Osteotomy / adverse effects
  • Osteotomy / veterinary
  • Postoperative Complications / etiology
  • Postoperative Complications / veterinary
  • Retrospective Studies

Substances

  • Anti-Bacterial Agents