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Otitis Externa (ear infections) In Dogs.Treating Otitis Externa in Dogs | Today's Veterinary Practice |
- The Challenge of Chronic Otitis in Dogs: From Diagnosis to Treatment | Today's Veterinary Practice
5 dog ear infection treatments
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When they are chronic and difficult to treat, it is usually because primary causes or perpetuating factors have not been adequately addressed. Predisposing factors alone do not cause otitis externa, but they facilitate inflammation by permitting the external ear canal microenvironment to be altered, thereby allowing pathogenic or opportunistic bacteria or yeast to become established.
It is important to eliminate as many of these factors as possible while realizing that some, such as ear conformation, cannot be changed. Perpetuating factors sustain and aggravate the inflammatory process and prevent resolution of, or worsen existing, otitis externa.
In many cases, perpetuating factors prevent the resolution of otitis externa when treatments are directed only at primary and secondary causes. These factors may be subtle at first but can develop into the most severe component of chronic ear disease.
They are not disease specific and are most commonly seen in chronic cases. Perpetuating factors are the most common reasons for surgical intervention. A detailed and complete history is essential to help investigate the underlying cause and associated factors. The ear examination allows the clinician to evaluate the amount and type of exudate in the ear canals; estimate the amount of otic inflammation; identify hyperplasia along with palpation of the horizontal and vertical ear canals , masses, and foreign bodies; and determine the status of the tympanic membrane eg, changes in structure or rupture.
These findings help in determining whether medical management or surgery total ear canal ablation with or without bulla osteotomy is the best treatment. Regular ie, handheld otoscopes should have a strong light and power source. If available, fiberoptic video-enhanced otoscopy eg, video-otoscope [ Figure 3 ] is extremely helpful in improving diagnosis and therapy because it not only allows visualization of fine details that may not be seen with regular otoscopes but also facilitates proper flushing of the ears, determination of disease extent, and discovery of indications for additional diagnostics and treatment eg, myringotomy, otitis media.
However, because of the expense to purchase and maintain this equipment, referral to a dermatologist may be necessary. Performing a complete physical examination, including a detailed dermatologic examination, can help in identifying an underlying or primary cause.
Otic cytology establishes whether an infection is present in the ears and assists with the selection of topical therapy. Cytologic samples should be collected gently from the horizontal canal. Exudate samples can be smeared onto a slide with mineral oil to look for mites. The most common type of coccoid bacteria found in the ears of dogs with otitis externa is Staphylococcus pseudintermedius , and the most common type of rod bacteria is Pseudomonas aeruginosa.
This might explain why, in some cases, sensitivity results in vitro and response to topical therapy in vivo do not always correlate. Clinicians should sample the middle ear separately if otitis media is confirmed when the tympanic membrane is intact. The types and sensitivity pattern of bacteria isolated from the middle ear may differ from those of bacteria isolated from the external canal. Dogs with chronic, recurrent, and severe otitis and those with neurologic signs eg, vestibular signs or facial nerve paralysis , para-aural swelling, or pain on opening the mouth usually require diagnostic imaging to help identify contributing problems, such as middle ear disease eg, otitis media, neoplasia and otitis interna, that cannot be identified with regular otoscopy Table 2.
Patients with an apparently normal tympanic membrane may also have otitis media. This procedure is very helpful not only as a diagnostic tool but also as part of the treatment plan. This procedure should be performed under general anesthesia so that the ear can be completely cleaned and the ear canal and tympanic membrane examined. Anesthesia also allows the placement of an endotracheal tube, which precludes the aspiration of fluids that may pass through the middle ear into the auditory tube and then into the posterior pharynx.
Ideally, computed tomography of the tympanic bulla should be performed before the flush to stage ear disease and help make the decision to perform myringotomy if otitis media is present. Several techniques to clean and flush the ears exist. Nuttall T. Successful management of otitis externa. In Practice. Chen T, Hill PB. The biology of Malassezia organisms and their ability to induce immune responses and skin disease.
Preliminary study of the stability of dexamethasone when added to commercial veterinary ear cleaners over a day period. Cerumen microbial community shifts between healthy and otitis affected dogs. Section 2: Otic preparations.
Ames, IA: Wiley-Blackwell; — Evaluation of biofilm production by Pseudomonas aeruginosa from canine ears and the impact of biofilm on antimicrobial susceptibility in vitro. Tris-EDTA significantly enhances antibiotic efficacy against multidrug-resistant Pseudomonas aeruginosa in vitro. Glaze MB. Chapter Diseases of eyelids, claws, anal sacs and ears. Louis, MO: Elsevier; — Peer Reviewed. Treating Otitis Externa in Dogs Ear cytology is a quick way to confirm infection and the degree of inflammation for patients with suspected otitis externa.
Patrick Hensel Dr. Read Articles Written by Patrick Hensel. Read Articles Written by Nao Hensel. Identify and correct primary causes. Remove debris and discharge. Treat secondary infections topically.
Increased humidity or swimming can result in increased moisture in the ear canals and maceration of the ear canal, resulting in infection. Trauma from excessive cleaning with ear cleaners or cotton buds, or vigorous hair plucking can also predispose to infection. There are also primary factors that can directly cause inflammation of the ears otitis externa. The most common primary factors include:. Parasites — ear mites are one of the most common parasites which affect the ears, sometimes they can be seen when your vet examines the ear with an otoscope, but other times we can only identify them by looking under a microscope.
Fleas and ticks are other common parasites which can cause ear problems. Allergies — Atopy is the most common underlying disease in recurring or chronic ear infections. Atopy is a genetically predisposed condition, where inflamed, itchy skin including the skin lining the ears! Dysfunction of the skin barrier is thought to play a role in this process.
Dogs can react to many different allergens and if atopy is suspected further investigation and treatment is required. Food allergies can also commonly result in recurrent otitis externa, and a food trial is recommended. An external ear infection first shows signs of local inflammation redness, discharge.
Pets may shake their heads, scratch their ears, or rub their ears against furniture or the floor. Some pets with severe infections may cry or groan as they rub and scratch their ears. Some pets scratch so severely that their nails create wounds on the skin around their face, neck, and ears. External ear infections may progress to involve the middle and inner ear, leading to more serious signs of disease: External ear infection otitis externa Itchy or painful ears Head shaking Discharge and odor from the ears Narrowing or even closing of the canals Middle ear infection otitis media Paralysis of the nerves in the face Dry eye Hearing loss Abnormal pupil size Inner ear infection otitis interna Inability to keep balance, stand, or walk Nausea Head tilt How Is an Ear Infection Diagnosed and Treated?
During a physical examination, your veterinarian will look in the ear for the presence of inflammation, redness, discharge, growths, or other findings that may indicate an ear infection. Sometimes, a cotton swab is used to collect debris from the ear. This material can be placed on a slide and examined under a microscope to determine if the infection is due to yeast, bacteria, or mites. Your veterinarian may also collect a sample of ear debris for culture and sensitivity testing, which identifies the exact organisms present and helps your veterinarian select the best antibiotic to use.
In severe cases, or if the animal is in too much pain to permit an examination of the ears, sedation may be needed to evaluate the ears, collect samples of discharge, clean the ears, and initiate treatment. Some are administered multiple times a day and some are long-acting medications that are administered once by your veterinarian.
Many are a combination of an antifungal, corticosteroid, and antibiotic. Examples of these medications include:. Depending on which type of ear infection your dog has, oral antibiotics may be used to treat certain bacterial infections. Antibiotics used to treat bacterial ear infections in dogs include:. Oral antifungal medications and topical antifungal ointment or creams may be used to treat dog ear infections that are fungal in nature and may include:. Over-the-counter NSAIDs such as Advil ibuprofen and Aleve naproxen and products containing acetaminophen such as Tylenol should never be given to dogs, as they can cause serious health issues.
NSAIDS are not typically used in combination with corticosteroids due to risk of stomach ulcers when these two types of medications are used together.
Because corticosteroids are a common part of combination ear medications, it is important to only use canine NSAIDs after recommendations from your veterinarian.
For example, veterinarians may offer a total ear canal ablation TECA , a procedure that removes the vertical and horizontal ear canals down to the level of the middle ear.
Search for:. Home Care. Facebook Twitter Email Print. Skip To. Chronic ear infections may involve bacterial or yeast overgrowth in the external, middle, or inner ear. Chronic infection can permanently damage the ear canal and cause pain, neurologic signs, and deafness. Ear infections are usually secondary to an underlying condition that allows for an unhealthy ear environment.
Treatment is based on eliminating the bacteria or yeast with antibiotics or antifungal medication while working to resolve the underlying condition. Regular ear cleanings and resolution of the underlying condition help to prevent recurrence. What Is a Chronic Ear Infection? Ear infections are usually secondary to inflammation of the external ear canals the tube-shaped part of the ear visible under the ear flap.
Inflammation of the canals leads to the reproduction of normal bacteria and yeast that live in the ear to the point where the body is unable to control their numbers called overgrowth.
Other bacteria can also take advantage of the inflammation and unhealthy environment inside the ear to establish infection. The overgrowth of these organisms causes more inflammation.
Inflammation of the ear canal causes swelling, making the tube narrower than usual. Inflammation also causes an increase in the production of wax. The ears become very itchy and painful. Severe ear infections can lead to eardrum rupture and middle and inner ear infections. Deep infections can lead to deafness and neurologic signs. Certain disorders or diseases may be the primary reason ear infections develop. These conditions include: Allergies environmental and food Ear mites Foreign bodies Skin disorders like seborrhea Thyroid disease in dogs Tumors or polyps in the ear Ear infections may recur because of the inability to control the original infection or treat the underlying cause.
Chronic changes lead to future infections, and scar tissue and permanent narrowing of the ear canals can make future infections difficult to treat. What Are the Signs of an Ear Infection?
An external ear infection first shows signs of local inflammation redness, discharge. Pets may shake their heads, scratch their ears, or rub their ears against furniture or the floor. Some pets with severe infections may cry or groan as they rub and scratch their ears. Some pets scratch so severely that their nails create wounds on the skin around their face, neck, and ears.
External ear infections may progress to involve the middle and inner ear, leading to more serious signs of disease: External ear infection otitis externa Itchy or painful ears Head shaking Discharge and odor from the ears Narrowing or even closing of the canals Middle ear infection otitis media Paralysis of the nerves in the face Dry eye Hearing loss Abnormal pupil size Inner ear infection otitis interna Inability to keep balance, stand, or walk Nausea Head tilt How Is an Ear Infection Diagnosed and Treated?
During a physical examination, your veterinarian will look in the ear for the presence of inflammation, redness, discharge, growths, or other findings that may indicate an ear infection.
Sometimes, a cotton swab is used to collect debris from the ear. This material can be placed on a slide and examined under a microscope to determine if the infection is due to yeast, bacteria, or mites. Your veterinarian may also collect a sample of ear debris for culture and sensitivity testing, which identifies the exact organisms present and helps your veterinarian select the best antibiotic to use.
In severe cases, or if the animal is in too much pain to permit an examination of the ears, sedation may be needed to evaluate the ears, collect samples of discharge, clean the ears, and initiate treatment.
With the pet sedated, the ears can be gently flushed to remove debris and facilitate better examination of the ear. Radiographs X-rays and other diagnostic tests can be performed while the pet is sedated to determine if the middle or inner ear are also involved. Once the infection has been identified, most animals with chronic ear infections can be treated at home.
Ear mites are relatively easy to treat with medication placed directly into the ear or applied topically between the shoulder blades.
Most yeast and bacterial infections can be treated with regular cleanings and topical or oral medication. When inflammation is severe, a steroid may be needed to give comfort to your pet and decrease the swelling around the ear canals.
If there are underlying problems such as thyroid disease or seborrhea, these must also be addressed to clear the infection and reduce the chances of recurrence. If the ear canals have been permanently narrowed or damage is otherwise severe, surgery may be recommended to allow for drainage and application of medication.
In other cases, more extensive surgery may be recommended to prevent the pet from being in chronic pain due to a permanently deformed, infected ear. Once an infection has been cleared, maintaining a healthy ear environment with regular cleaning helps prevent recurrence. Underlying diseases such as allergies and skin disorders must be identified and resolved in order to help avoid future infections.
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Prednisone does not treat infections. Prednisone reduces the inflammation response and may alleviate the symptoms. But it also suppresses the immune response of. localhost › care › chronic-ear-infecti. When inflammation is severe, a steroid may be needed to give comfort to your pet and decrease the swelling around the ear canals. If there are. Oral anti-inflammatory dosages of prednisone or prednisolone ( to 1 mg/kg q24h) can be used initially and then tapered to the minimum alternate-day dosage. Depending on the severity of the inflammation and stenosis, oral glucocorticoids may be needed to reduce ear canal inflammation. Prednisolone (1 to 2 mg/kg q12h. Suppurative otitis with erythema and purulent discharge in an atopic dog with secondary Pseudomonas otitis. Ames, IA: Wiley-Blackwell; —Ear infections are a common problem in dogs. Ear infections are not always obvious when looking at the outside of the ears. Dogs will usually scratch at their ears or shake their heads when they have an infection, and you may detect a smell, or see excess wax or discharge in the ear canal.
If you notice any of these signs, it is important to take your dog in to see your vet. Unfortunately ear infections are a recurring problem for some dogs. The following information is intended to give you an understanding of why ear infections occur, and the best way to treat them. There are a number of factors that can predispose a dog to ear infections. These factors alter the environment in the ear canal, making it more likely to become infected. Common predisposing factors in dogs include:.
The conformation of the ear canals, such as narrowed ear canals, the presence of hair, or an abundance of secretory glands. Certain breeds are more prone to ear problems due to their conformation. Moisture can predispose dogs to ear infections. Increased humidity or swimming can result in increased moisture in the ear canals and maceration of the ear canal, resulting in infection.
Trauma from excessive cleaning with ear cleaners or cotton buds, or vigorous hair plucking can also predispose to infection. There are also primary factors that can directly cause inflammation of the ears otitis externa. The most common primary factors include:. Parasites — ear mites are one of the most common parasites which affect the ears, sometimes they can be seen when your vet examines the ear with an otoscope, but other times we can only identify them by looking under a microscope.
Fleas and ticks are other common parasites which can cause ear problems. Allergies — Atopy is the most common underlying disease in recurring or chronic ear infections. Atopy is a genetically predisposed condition, where inflamed, itchy skin including the skin lining the ears! Dysfunction of the skin barrier is thought to play a role in this process. Dogs can react to many different allergens and if atopy is suspected further investigation and treatment is required.
Food allergies can also commonly result in recurrent otitis externa, and a food trial is recommended. Discharge and odour may be noticeable to people. Bacteria and yeast infections must be treated medically. Ear infections can be a frustrating, recurring problem, and it is important to treat them properly from the start.
To do this we need to know what sort of infection is in the ear, to do proper home care regularly, and to have recheck appointments to ensure that infections have resolved before stopping treatment. In recurrent cases preventative measures are then put in place to help prevent recurrence.
This will help us determine the most appropriate ear drop for your dog. In some cases rod infections we can need to send a sample away to be cultured to determine which treatment to use, as resistance to multiple antibiotics is common with these infections. It is also very important to thoroughly clean the ear canals, as discharge in the ears will prevent medication from working effectively. In the majority of cases an ear cleaner can be used at home.
However, as ear infections can be very painful, a general anaesthetic may be necessary to properly assess and clean the ear canals, and this can be an important part of the treatment process. Different sized dogs have very different sized ear canals and your vet will advise you on the volume of ear drop required. A course of corticosteroid tablets prednisolone is often required to help reduce the inflammation.
In severe cases we will also need to use oral antibiotics for a minimum of weeks. We need to look into the ear canals with an otoscope to assess the degree of inflammation and discharge in the canal, and we need to repeat the cytology looking at the discharge under a microscope to assess whether the infection is resolving.
It is very important to treat the ears until we do not see any bacteria or yeast on cytology and usually for 1 week after this. For mild cases that respond quickly to treatment days of treatment may be required, in more severe cases at least weeks of treatment is needed. If we do not treat the ears for long enough, we are likely to get recurrence of the problem, and future treatment can be more difficult. Middle ear infection otitis media - If the infection reaches the middle ear, affected animals may have a head tilt, a lack of balance, and unusual back-and-forth eye movements called nystagmus.
These symptoms are called vestibular signs and can indicate a complication of middle ear infection. Aggressive treatment is required in these cases. In this specialist surgical procedure, the entire ear canal is removed and healthy tissue is allowed to grow in. These procedures are last resorts after severe infection has made effective medical treatment impossible.
What factors predispose dogs to ear infections? Common predisposing factors in dogs include: 1. What primary factors can cause ear problems? The most common primary factors include: 1. Foreign bodies — eg. Grass seeds, dirt, sand, hair can induce irritation. What factors perpetuate ear problems? Treatment of ear infections Ear infections can be a frustrating, recurring problem, and it is important to treat them properly from the start.
Helping prevent recurrence 1 Address underlying causes such as allergies 2 If the ear infection is likely to have occurred due to moisture in the ear canals we may recommend a drying agent be used times a week to help prevent recurrence.
Complications of Ear Infection Middle ear infection otitis media - If the infection reaches the middle ear, affected animals may have a head tilt, a lack of balance, and unusual back-and-forth eye movements called nystagmus.
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