# Therapeutic and Formulation Innovations in the Management of Canine Otitis Externa

## TL;DR

This paper reviews the causes, diagnosis, and treatment of ear infections in dogs, focusing on new therapies and formulation strategies to improve treatment outcomes.

## Contribution

The paper introduces novel therapeutic approaches and emphasizes formulation parameters for topical treatments in managing canine otitis externa.

## Key findings

- Current therapies for COE have limitations, prompting exploration of alternatives like bacteriophages and nanomedicines.
- Pharmaceutical formulation factors like osmotic pressure and viscosity are critical for effective topical treatments.
- Microbial genomics and microbiota management are highlighted as future directions in COE treatment.

## Abstract

Canine Otitis Externa (COE) is a challenging otological disorder in dogs which causes significant irritation and discomfort. This comprehensive review provides an extensive analysis of COE with emphasis on the fundamentals of the condition, starting with the basic anatomy of the canine external ear canal, followed by pathophysiology and diagnosis of COE. Furthermore, novel therapeutic interventions, formulation considerations, and challenges, with the perspective of future directions in the field of COE management, are described. Diagnostic models, including clinical examination, cytology, and susceptibility tests, are presented to provide an overview of the processes involved in detecting and selecting appropriate therapies for the management of COE. Moreover, this paper describes the limitations of current therapies with considerations for the selection of alternative novel treatments such as aromatherapy, acupuncture, bacteriophages, nutraceuticals, and nanomedicines. This review places particular emphasis on the pharmaceutical formulation of topical products used for COE treatment. Various factors, including osmotic pressure, safety profile, viscosity, bioadhesion, and formulation pH, must be considered when developing topical preparations. These parameters are critical in formulation development to enhance therapeutic outcomes and minimise potential side effects. Finally, potential advancements in COE management are highlighted, including the integration of microbial genomics and the significance of managing the microbiota. Overall, this review serves as a valuable resource for those interested in the future of topical treatment of COE by providing a deep understanding of diagnostic, therapeutic, and medical interventions for effective management.