Cold atmospheric plasma shows promise in canine acute otitis: full analysis

Cold atmospheric plasma is drawing fresh attention in canine dermatology after a March 2026 Veterinary Dermatology paper reported that the technology performed comparably to standard topical treatment in dogs with acute otitis externa. The open-label split-body trial enrolled 22 dogs with bilateral disease and found significant improvement in otitis scores with CAP, with no adverse effects reported during the study period. (researchgate.net)

The finding lands in a familiar clinical setting. Otitis externa is one of the most common conditions seen in small animal practice, but it can be frustrating to manage because the visible ear infection is often only part of the problem. Underlying drivers such as allergic skin disease, ear canal conformation, moisture, and chronic inflammatory change often shape recurrence risk and long-term outcomes. Recent guidance continues to stress that controlling the primary cause of otitis is just as important as treating secondary infection and inflammation. (merckvetmanual.com)

In this study, the investigators used a split-body design so each dog contributed one CAP-treated ear and one conventionally treated ear. According to the abstracted report, one group received standard topical antibiotic, antifungal, and corticosteroid treatment in one ear for 10 days while the opposite ear received CAP on days 0 and 5; a second group followed a different bilateral protocol, again comparing CAP against standard care. Across groups, otitis intensity and cytology scores improved significantly, and CAP was described as well tolerated. The paper positions CAP as a nonpharmacologic modality with antimicrobial, anti-inflammatory, and wound-healing effects that may be relevant in acute otitis cases. (researchgate.net)

This isn’t the only recent signal supporting the approach. A separate 2026 Veterinary Dermatology paper by Ralf S. Mueller and Cosima Bouassiba reported that a single cold atmospheric plasma treatment may improve outcomes in canine otitis externa with secondary infection, suggesting growing interest in CAP within otology, not just wound care or dermatology more broadly. Outside otitis, veterinary literature has also explored CAP’s antimicrobial activity in ocular pathogens and its broader potential in infection management, though review authors note that treatment standardization, dosing, and long-term effects still need more study. (pubmed.ncbi.nlm.nih.gov)

Industry and academic commentary around CAP has generally centered on its potential as an antimicrobial-sparing tool. Tufts described cold plasma as an emerging veterinary option for chronic wounds and superficial skin infections, reflecting a wider interest in technologies that may reduce reliance on antibiotics in selected cases. That interest is also shaped by the broader treatment landscape: conventional otic products remain central to care, and companies continue to invest in easier-to-administer drug options, including single-dose in-clinic therapies for canine otitis externa. (now.tufts.edu)

Why it matters: For veterinary professionals, the most important takeaway is not that CAP is ready to displace standard otic medications, but that the evidence base for non-drug adjuncts is starting to mature. In a disease category where antimicrobial exposure is common, compliance can be uneven, and recurrence is often tied to chronic underlying pathology, a well-tolerated in-clinic modality could be useful in carefully selected patients. It may be especially relevant when pet parents struggle with repeated ear medication administration, or when clinicians want to support antimicrobial stewardship while still addressing microbial overgrowth and inflammation. Still, the study’s open-label design, small sample size, and focus on acute bilateral cases limit how far the findings can be generalized. (researchgate.net)

There are also practical questions that matter before CAP can move from promising to routine. Clinics will need clarity on device availability, treatment protocols, case selection, cost, and how CAP fits alongside ear cleaning, cytology, culture in selected cases, and management of primary disease. Published work so far supports plausibility and short-term tolerability, but not yet a definitive standard of care. (researchgate.net)

What to watch: Watch for larger blinded comparative trials, protocol standardization, and more data on recurrent or chronic otitis, because those will likely determine whether CAP becomes a niche adjunct, a referral-level tool, or a broader part of first-line otitis management. (researchgate.net)