Does your dog get regular ear infections?
You’re not alone — it’s estimated up to 20% of all dogs will suffer at least 1 ear infection during their lifetime.
Some unlucky dogs are martyrs to their ears with infection after infection. But why is this, and what can you do about it?
A One-Off Ear Infection
The dog scratches his ear, keeping you awake all night. You lift his ear flap to discover an angry red ear and a smelly discharge. You hotfoot it to the vet, who examines the ear.
The vet will look for trigger factors that caused the problem, such as:
- Swimming: Water in the ear canal softens the skin, making it more vulnerable to infection.
- Anatomical factors: Hairy ear canals, excessive wax production or heavy, pendulous ears can decrease air circulation.
- A foreign body: The classic is grass stuck in the ear canal, causing pain and irritation.
- Ear mites: A common parasite that likes to set up home in the ear canal and cause intense itchiness.
- General itchiness: A dog with parasites or allergies will be itchy. Scratching the ear could damage it and set up infection.
If this is the dog’s first ear infection and there is no obvious cause (such as grass in the ear canal or a colony of ear mites), then the treatment is straightforward, consisting of:
- Using a good ear cleaner to get rid of the discharge and debris
- A topical treatment applied to the ear
Fingers crossed, the ear infection clears up and never comes back. But what if it does?
Ear Infection Flare-Up
If the infection comes back relatively quickly, the vet may need to take things to the next level and investigate. This involves any or all of the following:
Culture and Sensitivity
The ear discharge is swabbed and sent for culture and sensitivity. This tells the vet exactly which bugs are present and which is the best antibiotic at killing them. This makes for targeted treatment that stands an excellent chance of success.
Here, the vet rolls a cotton swab against the skin of the ear canal, then presses the sample onto a slide. This is then stained and examined under the microscope. This gives valuable information about the cell types (inflammatory or infectious), bacteria types (rods or cocci) or the presence of yeasts or parasites such as ear mites.
Again, this helps to target treatment.
Examine Under Sedation
The ear may be too painful to properly examine with the dog conscious. Sedation allows the vet to check the deepest part of the ear canal and give the ear a thorough clean.
Long Course of Treatment
Once the right drugs are hit upon, a long course of treatment gives the best chance of totally clearing the problem.
At the end of treatment, the vet will check if the culture is now negative and the bugs are gone.
But what if you do all this and the ear flares up again?
Regular Ear Infections
There are dogs where all the right protocols are followed and yet still get repeated infections. This is a strong indication that there’s something unusual about that ear. There has to be a deeper underlying reason that the ear is poor at fighting off infection.
One possible explanation is a food allergy. For some bizarre reason, dogs that have food allergy often present with recurrent ear infections. The answer here is a food trial and putting the dog on a hypoallergenic diet.
The theory is when the allergen that triggers the allergic reaction is removed from the diet, then the trigger for the ear infection is removed. In short, if Ms. Fluffypants goes on venison and potato chow for 3 months and her ears don’t flare up, then she could have a food allergy. It’s great news when this is diagnosed because controlling what the dog eats is close to “curing” those flare-ups.
But what if the dog goes on a dietary trial and still gets ear infections?
The Dog Still Gets Flare-Ups
By this stage, your vet may well be thinking of referring the dog to a specialist. But there’s one last throw of the dice:
- Repeat culture: Is infection present, or is this a sterile form of inflammation that isn’t linked to infection?
- Cytology: Again, this is to see if the ear is free from bacteria.
If the sore ear is sterile (no bacteria present), then the problem could well be with the dog’s over-reactive immune system. The next step is to suppress the immune system either with steroid ear drops or with medications that suppress inflammation.
Of these, the most economical is prednisolone. However, there are several much more sophisticated (but more expensive) options with fewer side effects.
By this stage, a good percentage of problem ear infections are under control. But what if they’re not?
Learn more about chronic ear infections in pets from this video:
The Final Option: Surgery
When all other options have been explored, the dog fails to respond and is in constant discomfort, then surgery is the best option.
There are various operations, of which the most common is a total canal ablation (TCA). This is literally removing the ear canal (the dog will be deaf on that side), but in so doing the cause of the inflammation and pain is removed. A nuclear option, yes, but it definitely improves quality of life for those poor dogs plagued with a constant earache.
I guess the take-home message is if your dog gets regular ear infections, work with your vet to get to the bottom of the problem. Yes, ear infections are frustrating, but they’re also surprisingly complex and can be difficult to treat, so it will take time and patience.
This pet health content was written by a veterinarian, Dr. Pippa Elliott, BVMS, MRCVS. It was last reviewed April 20, 2018.