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Discussion on Aural Plaques
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Member:
Chrism
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Posted on Monday, Nov 15, 2004 - 10:33 am:
My 4 yo has aural plaques mostly in one ear and that ear is rather sensitive to touch - I have to be gentle with haltering/bridling.
When my vet was out for fall shots, he suggested applying Nolvason ointment once or twice a day to each ear for 10 days. Every few days, I was lighty wash the accumulated goo out with a antibacterial hand soap.
Well, this seem to knock back the tenderness and flaking quite a bit. My vet thought the plaques would likely flare up again, but the Nolvason treatment should slow down their progression and help the horse be more comfortable.
Thought I'd pass this along.
Chris
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Moderator:
DrO
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Posted on Tuesday, Nov 16, 2004 - 6:45 am:
Hello Chris,
typical aural plaques are a chronic inflammatory response to fly bites that results in loss of pigment and a hyperkeratosis which gives the appearance of a flat shallow flaky growth but is not associated with infection.
As such I would not have expected the antibacterial treatment to be of therapeutic value but the repeated cleaning will remove the flakes and encourage the horse to be more amenable to handling. Your vet is right in that this is a chronic, usually permanant change that will return and much faster when the biting flies return. I have wondered in the past if the hyperkeratosis is protective as it makes the ear harder to bite by the small midges that cause this condition.
DrO
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Member:
Nonie
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Posted on Friday, Dec 3, 2004 - 8:52 pm:
Hi Chris!!
Molly has had aural plaques since I bought her six years ago. She won't let me TOUCH her left ear. So, always up for a new trial (you know me ;-) ) I ordered this: https://www.dermafas.com/order.shtml. I am using it whenever I go to the barn, about four times a week. Will report on our progress (I've only used it three times so far but yesterday she actually let me hold her ear and rub it on, and reach down into the ear, where I found a hard little knob like a marble--interesting....
Will keep you updated.
How is Silke?
Zoe
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Member:
Chrism
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Posted on Monday, Dec 6, 2004 - 3:41 pm:
Hi Zoe,
Silke is good (21yo!) and is very settled down. It only took how long? People laugh when I mention how rowdy she was.
The nolvason ointment treatment seems to provide the young horse (now 4 and started) some comfort - she is allowing me to clean her ear and apply. She is still a bit tender about it. I do both ears, but it is the right that bothers her and has the plaques. You would think if it was something environmental, such as gnats, both ears would be equally affected. In any case, I find marking her compliance with an oral "click" and treating with a lump of sugar makes her pretty obedient about this for me.
I think I'll keep her in an ear net next bug season and see if that helps, too.
Let us know how your product helps.
How is Molly doing? Has she mellowed any? Give us an update.
Chris
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Member:
Nonie
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Posted on Monday, Dec 6, 2004 - 5:57 pm:
Hay Chris--Silke is good (21yo!) and is very settled down. It only took how long?
Good, then there is hope for Molly. 
So far I've used the Dermafas about four or five times. It seems to be helping, definitely. Molly will now let me hold her ear and apply it. Last time I was up for the first time I felt this hard nodule inside her ear, the size of a large pea. Today as I was applying the ointment it detached--I couldn't draw it out and now of course I am terrified it went down into her ear canal but hope it just mushed up and disintegrated into her ear hair. Nothing is easy. 
I'll keep you posted.
Zoe
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Member:
Chrism
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Posted on Monday, Apr 25, 2005 - 5:18 pm:
Update:
Tried Nolvason, including 10 day "induction." - gave up on that.
Tried Dermafas, looking for alternative - gave up on that.
Tried Desitin think something with staying power would help - giving up on that.
Horse is still REALLY sensitive about her one ear and wears fly face with ears when out.
I've gotten wind that NCSU is looking into something for aural plaques - no detail.
I've also read to try a smear of athelete's foot powder.
Other ideas of stuff that is hanging about are Otomax (for dog), Coat Calm, Tea Tree Oil, MTG Shapely ....
Sigh. I have to be so very careful of her right ear.
Any other ideas?
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Moderator:
DrO
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Posted on Monday, Apr 25, 2005 - 9:32 pm:
Hello Christine,
I think the failure stems from the idea that the aural plaques are the problem, they are not, instead they are a visible sign of the ears sensitivity to fly bites.
If your goal is to desensitize the ear there are 2 issues:
1) The irritation by the new fly bites.
2) The learned response that we do not want the ear to be messed with because it has been painful. I don't think it remained painful over winter for instance but the avoidance remained.
You know the fly issues as well as anyone. By minimizing new fly bites you minimize the pain. However I think the big issue is the learned avoidance response. Chris I would turn to the article on Conditioned Responses to relearn your horse a new way to deal with you touching the ears.
DrO
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Member:
Chrism
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Posted on Tuesday, Apr 26, 2005 - 12:10 pm:
Dr. O -
Normally I would agree with you on the conditioning response, but I've gone through a process building to handling, treating, etc. and I've concluded that she really does not like the right ear being touched on the inside at all, any season. She will tolerate me to medicate if I am very, very gentle, have no fingernails, she is in cross ties, I croon at her and periodically mark good behavior with sugar. I can do anything I want to the left ear and the rest of her body.
Bridling can only be done by unbuckling the cheek piece and gingerly laying the crown piece over the ear ...
However, I will check out your article and see if there is any conditioned response tips I've over looked.
I really believe she isn't being ill as she is so good natured otherwise.
Thanks!!!
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Moderator:
DrO
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Posted on Wednesday, Apr 27, 2005 - 8:18 am:
If it is true that this ear is painful, the question is why. Neither the hyperkeratosis or depigmentation (the two lesions that make up a aural plaque) are inherently painful. I have seen hundreds of ears with aural plaques, none of which seemed to be causing the horse trouble. Have you had the horse heavily sedated and the ears examined deeply?
DrO
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Member:
Chrism
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Posted on Wednesday, Apr 27, 2005 - 11:15 am:
No sedated exam. Vet has looked at twice (fall and spring shots) and this has not been suggested.
I can press him. Under saddle, there is no head shaking or reactionary response to conventional riding. Nor does she worry it on her own. What kind of things might be found deep in the ear?
I can also gently touch examine her a bit more specificially to localize the reactive response area and explore the idea that it is a deeper response.
Thanks!!
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Member:
Sunny66
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Posted on Wednesday, Apr 27, 2005 - 11:32 am:
Is she just a touch swollen below the ear? I didn't notice when my guy had an ear infection. A sedated exam and a week of medicine and he was fine.
Just a thought.
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Member:
Nonie
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Posted on Wednesday, Apr 27, 2005 - 9:43 pm:
Chris, we continue to lead parallel lives. GRIN. Molly has the same issue with her left ear. For seven years now she has flinched and not let me near it. I have to be really careful with bridling her, and generally we are okay--I have done the desensitizing procedures, Dr. O, and also clicker training, and she will let me bridle her carefully and quickly, but there is obviously an ongoing pain issue. If she is handled by other people who aren't aware of the ear--haltered by new barn help, for instance--I will have trouble with her for a few days afterwards. She has aural plaques in both ears, but the left is larger. She is not painful or resistant to touch on the right ear at all.
I've just learned to live with it, and I always reassure her I know that it hurts, I'll be careful. I am a certified nutcase, I know. LOL. But she seems to understand.
I've never had her deeply sedated and examined for it--maybe next time she is having her teeth floated. If I remember.
Cheers.
Zoe
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Member:
Nonie
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Posted on Wednesday, Apr 27, 2005 - 9:49 pm:
Chris--
I just reread this whole thread and realized that my latest post to you is pretty much a word-for-word duplicate of my earlier one. 
Ahhh, middle age. Everything is new, every day.
Zoe
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Moderator:
DrO
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Posted on Thursday, Apr 28, 2005 - 7:19 am:
Actually Chris I would be surprised if you found anything because I think this is a learned response but if I thought pain was responsible it would be my next step. I agree that the lack of other symptoms support the idea that there is no pain. Some of the things found deep in the ear canal are unhealing wounds, tumors, and ticks.
DrO
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Member:
Vickiann
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Posted on Thursday, Apr 28, 2005 - 5:11 pm:
As Dr. O suggested, an examination under sedation is a good idea. One of my horses has these aural plaques but twice has been overly sensitive for periods of time to have the left ear touched or handled. He was also holding it sideways the first time. On that occasion, examination showed he had a fungal infection. Putting too much stuff inside the ears to clean can CAUSE a fungal infection because you kill off the good bacteria along with the bad. We treated the ear with an antifungal ointment (THAT WAS FUN!)and after this treatment he became less sensitive to having that one handled when he realized it actually wasn't sore any longer. When he began acting sensitive about that ear again, a year or so later, I had him sedated and it was again examined. There was a lot of "crud" down inside both ears (but more in that one), which my Vet. gently cleaned out with small damp clothes. She did not put anything strong into the ear. Shortly after that he was good again (and has been since) and the sensitivity in that ear has been no more than the other ear.
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Member:
Chrism
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Posted on Tuesday, May 3, 2005 - 10:20 am:
Ok, so this weekend I tried my desensitizing routine.
What I learned is that the horse is very sensitive to the mid to upper inside of the ear (pinna? pointy bit). If I rub low, even down inside her ear canal a bit, she is okay as long as I don't make a move for the upper sensitive area.
This is the same area I would normally associate with aural plaques.
So, while I can have the vet out to investigate by sedating her, I'd be surprised that he'd find anything "deep". I can rub (as long as I treat at times) all around the outside ear base. Outside of the ear itself needs to be very gentle rub as she wouldn't want her ear folded or bent.
The fungus idea isn't a bad thought. I changed treatment to gently cleanse any goo out and then jut put a bit of weak betadine (less than tea colored) on a cotton ball to disinfect. Then a bit of calm coat - this is very thin liquid that doesn't build up but is soothing.
We'll see.
Using the desensitizing techniques in the stall where she can move away may be helping a bit, but she really does "steel" herself when I approach the tender area to put meds on. I do believe it is tender as she normally does just about anything for sugar lumps.
So, if this doesn't work and I have the vet out, again, I suspect we should take a scraping once she is sedated ...
Cheers.
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Member:
Vickiann
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Posted on Tuesday, May 3, 2005 - 12:57 pm:
What we humans can put in our ears after using swimming pools, etc., might be okay for horses. Years ago I gave myself a horrible case of ear fungus (it looked black inside my ears) by putting peroxide or alcohol into my ears. Then I learned to use 1/3 distilled water, 1/3 white vinegar, and 1/3 rubbing alcohol to prevent "swimmer's ear." Of course, I had to get rid of the fungus first! A fungal infection is certainly uncomfortable!
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Moderator:
DrO
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Posted on Tuesday, May 3, 2005 - 6:11 pm:
Horse steel themselves for all types of procedures: vaccinations, dewormings, some even to have their feet examined. However some horses are so relaxed for their vaccinations to indicate that even in moderately adversive situations horses can learn to relax.
DrO
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Member:
Nonie
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Posted on Saturday, May 28, 2005 - 9:29 am:
Checking in again. Chris, did you ever have your filly sedated and examined? When our vet came out to do Spring shots last week, I asked her to sedate Molly and take a look in her left ear. She found nothing. Molly is still acutely sensitive to touch in exactly the same area your filly is--the upper third, where the plaques are. I can palpate the base of her ear with no problem. So today I went to CVS and bought some benzocaine 20% cream and I am going to try "blocking" the plaque area myself to see what happens.
Will post results.
Zoe
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Member:
chrism
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Posted on Monday, Feb 4, 2008 - 6:47 pm:
Okay, so I am "reopening" this for discussion.
My horse continues to be sensitive about her right ear. I continue to bridle by unbuckling the check piece and feeding sugar. Inside of right ear continues to look ugly. She seems to be become more sensitive about it when the weather is cold and there are no bugs. She is a good girl and if I wait, will present her head, reluctantly, for bridling.
I still think it is something.
Vet still says "aural plaques."
Sooo, now I am wondering, could it be some sort of sarcoid? (i.e.verrucose).
And, how would I really determine "what" it is - is looking enough?
I have a photo if I can figure out how to post.
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Member:
nonie
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Posted on Monday, Feb 4, 2008 - 8:38 pm:
I swear we do live parallel lives, Chris! Molly still has HER ear plaques and is still senstive in the right ear. She will let me halter and bridle her as I know exactly how to avoid it, but if anyone new gets hold of her (i.e. we have new barn help), I know I am in for a week or so of retraining. And yes, my vet never found anything and still says, "aural plaques."
Did you ever get a scraping?
Do you still have Silke? Molly is doing well, on rehab for a suspensory injury right now but coming along. I have a new little one who is the devil incarnate. LOL. Arab/Saddlebred. I have lost my mind.
I'll be posting to you about her shortly over on the old Stableizer thread.
Did you know we bought land in SC, right on the border? Hope to build and move down in a couple of years.
Sorry to hijack this post so much.  Back to the aural plaque question now.
(Oh, by the way, will you be at Rolex?)
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Member:
juliem
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Posted on Monday, Feb 4, 2008 - 9:17 pm:
Here's a thought--in winter lice are much more of an irritant and my vet says they do like to hide out in the ears. They tend to make a horse very itchy, so that wouldn't seem to fit with being "ear shy" though. One of the weanlings I bought showed signs of lice so I began treatment with ivermectin, and also some powder labeled for treatment of horses. My vet had me put some in a nylon stocking (took me a while to find one!) and make a little sort of "sachet" with it and then rub inside the ears. I was surprised that the time of the year lice are more of a problem is winter.
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Moderator:
DrO
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Posted on Monday, Feb 4, 2008 - 10:08 pm:
It would take a biopsy Chris to rule out other problems but the very typical appearance of aural plaques in combination with the very common problem of ear shyness would make me slow to recommend it if unless I thought it looked atypical for AP. But until you do it, how can one know for 100%?
DrO
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Member:
chrism
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Posted on Tuesday, Feb 5, 2008 - 4:26 pm:
I agree that a biopsy would tell us for sure.
Here is a photo - does it look like normal aural plaques (if there is such a thing):
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Member:
chrism
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Posted on Tuesday, Feb 5, 2008 - 4:41 pm:
Hi Julie -
Lice. Ick. I hope not. But she is wormed regularly. She doesn't particularly have itchy ears. I like the nylon sock idea - you should post it under "tips!"
Hey Zoe -
I still have Silke (coming 25 in July!) - she is currently leased to a vet student who is a perfect match. They get along well and she just laughs at Silke's antics. Silks seems sound as a dollar and doesn't look or act her age if you give her time to warm up.
I didn't know you were heading south some day. It has been dry, so you may want to bring your own water.
I've not done the scraping. My vet of 20 years is very conservative in all things so just says "aural plaques" when I ask during spring and fall shots. I normally can ignore it, but I think it seems worse to her some times and that is when I starting thinking about it again.
I had a massage client with a suspensory injury referred to me. It healed up in about half the time the vet expected. I did a full body massage weekly with some light TTEAM strokes on the injured leg for about 8 weeks. I found other areas there were tender, likely from compensation from the injury.
Dr. O -
You are right. Biopsy is only way to know. I got on this idea of sarcoid because of some study at (I think) U Minn. re using a sarcoid treatment on aural plaques. So it got me wondering.
A swipe of aloe gel or mineral oil seems to sooth her.
Thanks all.
Chris
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Moderator:
DrO
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Posted on Wednesday, Feb 6, 2008 - 6:24 am:
Not a normal aural plaque, but it does look like a unusually large aural plaque. Then again many nodular sarcoids would look just like that.
Clinically the is the way they feel: sarcoids would be nodular and hard and do not scrape off. Aural plaques would be a waxy-flaky (hyperkeratotic) build up that when scrapped away reveals a pink slightly elevated slightly irritated hairless skin.
DrO
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Member:
chrism
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Posted on Wednesday, Feb 6, 2008 - 8:57 am:
Based on feel, it does seem like aural plaque. It will flake off, sometimes with flakes and sometimes with little round waxy balls.
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Member:
chrism
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Posted on Wednesday, Feb 6, 2008 - 10:16 pm:
BTW, this was the scoop on the study:
DOES YOUR HORSE HAVE AURAL PLAQUES? The Veterinary Medical Center at the U of M is evaluating the
efficacy of Aldara (imiquimod) on equine aural plaques, which are caused by a virus. This is a
topical medication that has recently shown to have very good efficacy in the treatment of sarcoids
and has excellent anti-viral effects. If you are interested in participating in the trial, please contact
Dr. Erin Malone at 612-625-6700 or malon001@umn.edu, for details about the study protocol.
The medication can be applied by the owners at home after an initial examination performed at the
U of M. The duration of the study will be 4 months, and the medication will be provided for free.
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Moderator:
DrO
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Posted on Thursday, Feb 7, 2008 - 8:10 am:
In the past two years there has been some work that suggests that the etiology of aural plaques is more like sarcoids and involving a papilloma virus but they have not been able to conclusively show this. The problem I have with this idea is the clinical appearance of the aural plaques I see: fairly normal appearing skin that has lost its pigment and has become hyperkeratotic. There are no tumors evident. Of course two similar looking diseases is possible and what they are studing is different than what I am seeing. I do diagnose sarcoids commonly in the ear but they are usually pigmented.
Here is the latest work I can find that is based on this viral hypothesis, but continues to not be able to find the virus:
Can J Vet Res. 2007 Jan;71(1):28-33.
Evaluation of equine papillomas, aural plaques, and sarcoids for the presence of Equine papillomavirus DNA and Papillomavirus antigen.
Postey RC, Appleyard GD, Kidney BA.
Department of Veterinary Pathology, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B4.
Immunohistochemical (IHC) testing and electron microscopy have implicated Papillomavirus (PV) as the etiologic agent for equine papillomas and aural plaques, but Equine papillomavirus (EPV) DNA has yet to be demonstrated in these lesions by polymerase chain reaction (PCR). The purpose of this study was to evaluate formalin-fixed, paraffin-embedded tissues from naturally occurring cases of equine papillomas, aural plaques, and sarcoids for the presence of EPV DNA by means of PCR and for the presence of PV antigen by means of IHC testing. We used EPV-specific primers that amplified a region of 384 base pairs (bp) spanning the E4 and L2 genes of the EPV genome and consensus PV primers that amplified a 102-bp region of the L1 gene. Group-specific PV structural antigens were detected with the use of a streptavidin-biotin-alkaline phosphatase IHC stain. With IHC testing, 23 of 38 papillomas, 4 of 9 aural plaques, and 0 of 10 sarcoids were positive for PV antigen; EPV DNA was found in 20 of the 38 papillomas and 1 of the 10 sarcoids but 0 of the 9 aural plaques. The consensus primers did not amplify novel PV DNA in any of the tissues. Nucleotide sequencing of viral DNA from 7 papillomas amplified with EPV-specific primers revealed DNA fragments that were 96% to 99% identical to known EPV sequences. Some samples had nucleotide substitutions in common, which suggests infection with related strains. Together, EPV DNA or PV antigen (or both) was demonstrated in 26 (68%) of the 38 equine papillomas. Although aural plaques contained PV antigen, they were negative for EPV DNA; therefore, we hypothesize that aural plaques contain a PV distinct from EPV.
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Member:
millie
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Posted on Saturday, Jan 10, 2009 - 9:25 pm:
Does anyone have new ideas on relief for aural plaques? My 5 yr old is more head shy in the last month from the aural plaques that he has in both ears. Someone at our barn suggested rubbing baby oil in his ears, if I can even get near them. Any success stories?
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Moderator:
DrO
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Posted on Monday, Jan 12, 2009 - 7:23 am:
Hello Catharine,
I have good results with relieving the inflammatory component of aural plaques using the recommendations in the article associated with this discussion.
DrO
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Member:
millie
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Posted on Monday, Jan 12, 2009 - 9:10 am:
Dr O,
Thank you. Are you talking about the Panalog ointment?
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Member:
nonie
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Posted on Thursday, Feb 19, 2009 - 2:00 pm:
This is a post destined never to die! LOL. I originally posted here concerning my older mare's aural plaques; my young one is turned out with her and now--guess what!! The little one has developed aural plaques in one ear as well--and is sensitive to the touch there. Time to revisit the whole issue! I am off to read your article more thoroughly, Dr. O, but in the meantime, is there indication that the plaques are somehow contagious, horse to horse. I doubt very much they rub their ears together, but then nothing would surprise me with these two.
Chris, did Silke have them as well? Can't remember. Any chance she passed them on to your young one?
We are still planning our move south, though the economy has pushed it back a year or two....
Zoe
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Member:
chrism
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Posted on Thursday, Feb 19, 2009 - 5:28 pm:
Hey Zoe,
Silke doesn't have any aural plaques and she likes you to rub her ears.
Shadow has the one nasty one that nothing seems to faze. We bridle her by undoing the check piece or bit, depending on what is rigged. She will wear a fly mask with ears and halter must be put on by unbuckling crown piece. No amount of desensitization gets her "over" it. The plaque is indeed tender. But she allows me to check her ear and put fly repellent around it. I reward "presentation" of ear for bridling and checking with a verbal click/treat.
Silke had the midge allergy. But she is at a friend's farm with few biting midges, so she is fine there.
South is on sale in this economy ...
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Member:
vickiann
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Posted on Thursday, Feb 19, 2009 - 9:45 pm:
Zoe, One of mine has the aural plaques and no one else has ever caught them.
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Member:
chrism
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Posted on Sunday, Aug 8, 2010 - 11:47 pm:
I decided to resurrect this topic ...
In recent months we submitted scrapings from the mare with the aural plaques mainly in one ear for analysis and it is indeed equine papilloma.
I applied a topical for human canker sores for a couple of months and it seemed somewhat helpful to soothing the horse's ear and she would cautiously allow me to apply. However, it was pretty pricey and the improvement not dramatic.
So, after bumbling around on the People's Pharmacy web site, I decided to try applying a paste of turmeric (the ground spice you find in the grocery) and TAO (triple antibiotic ointment). While the horse is still somewhat protective of her ear, she is much easier to handle, bridle (still by unbuckling the cheekpiece), haltering by using the crown buckle and putting on her fly mask with ears and her ear net. The flakiness is smooth and she lets me gently clean her ear, etc.
I have been doing this about 2+ months, 2-3 times a week. I don't think it is desensitization as I've been handling her and trying different stuff on her ears for years.
Other people who handle her have commented and noticed the difference in her acceptance of fly mask w/ears and halter without me asking.
I thought I'd pass this on.
Per the People's Pharmacy web site, turmeric is a common topical used for wounds in India and a number of people use it successfully for warts.
Just thought I'd pass this on. I will update if I notice any significant changes/improvements.
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Member:
nonie
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Posted on Monday, Aug 9, 2010 - 8:09 am:
Chris, this is so interesting. I will try this with Molly!
It's so good to see you here again. This is your baby horse you're talking about, right. The one that's now--how can this be?--10?? Do you still have Silke? Molly is hanging in there, and I have a spunky little Arab/Saddlebred I'm having great fun with.
We are moving to SC in a couple of years! Maybe we'll FINALLY get to hang out in person somewhere.
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Member:
chrism
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Posted on Monday, Aug 9, 2010 - 4:33 pm:
Silke is still with us - 27 going on umm 4? I ride her lightly about once a week, depending on how she tells me she is feeling.
And the young one is indeed 10. She is so much better behaved, so that is good for me.
Maybe we'll have to plan a get together after you head south ...
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