Product name

Ear ointment with permethrin, nystatin, triamcinolone acetonide and neomycin sulphate

Pharmacological action

Antiparasitic, antibacterial, antifungal and anti-inflammatory agent

Active ingredients

Each gram of ointment contains:

• Permethrin — 10 mg
• Nystatin — 100,000 IU
• Triamcinolone acetonide — 1 mg
• Neomycin sulphate — 3,500 IU

Indications for use

For the treatment of otitis externa caused by Otodectes cynotis and associated secondary bacterial (Staphylococcus spp.) and/or yeast infections in cats and kittens over 8 weeks of age and weighing at least 1 kg.

Dosage and administration

• Clean the external ear canal before application.
• Attach the flexible cannula to the tube of ointment. Hold it vertically for accurate dosing.
• Adult cats: instil 8 drops (≈ 0.3 ml) into each ear.
• Kittens: instil 4 drops (≈ 0.15 ml) into each ear.
• Gently massage the base of the ear after application.
• Apply once daily for 10 consecutive days.

As ear mite infestation is highly contagious, treat both ears even if only one appears affected. Reevaluate after 10 days. If retreatment is needed, consider an alternative therapy.

Contraindications

• Do not use in animals with a perforated eardrum.
• Do not use in animals known to be hypersensitive to any ingredients.
• Do not use in pregnant or lactating animals.
• Do not use in kittens younger than 8 weeks or under 1 kg in weight.
• Do not use in sick or debilitated cats.

Cautions

Do not exceed the recommended dose or frequency of administration, as this may lead to permethrin toxicity. Discontinue use if signs of toxicity occur.

Warnings

• Keep out of reach of children.
• Wash hands thoroughly after application.
• If the product gets into the eyes, rinse with plenty of water.

Adverse reactions

• Some animals may develop ear canal irritation or ulceration.
• Localized dermatophytosis (ringworm) may occur.
• Mild neurological signs (tremors, mydriasis) may be observed in kittens.
• Permethrin toxicity may occur if the ointment is licked (seizures, vomiting, loss of appetite, etc.).
• Hearing loss (temporary or permanent) may occur.

Information for pet owners

If the ears become redder or more painful, discontinue use and consult a veterinarian. Signs of toxicity include tremors, seizures, unsteady gait, mydriasis, vomiting, behavioral changes, and refusal to eat.

Overdose

• Wash the ointment off the fur with warm soapy water.
• Remove as much ointment as possible from the ears.
• Use fluid therapy to maintain hydration, electrolyte balance, and urine output.
• Monitor body temperature; use muscle relaxants or sedatives if necessary.

Safety studies

A study with 18 kittens aged 8–9 weeks (0.85–1.17 kg) receiving 1×, 2×, or 3× the dose showed good tolerance. Mild side effects such as depression, tail tremors, and mydriasis were dose-related.

Efficacy studies

A study on 24 adult cats showed a reduction in bacterial and yeast levels after treatment. A second study on 16 young cats showed no live mites and resolved clinical signs of otitis after treatment.

Storage conditions

Store between 15°C and 25°C.