Ear Allergies and Infections ... they usually go together
Ear infections are very common in dogs. Why?
Because of the anatomy of the ear in some breeds of dogs.
It's longer and deeper than in humans, for example. And in some breeds, covered by an ear flap that makes the inside of the ear canal warm and moist. Like an incubator.
Another reason: dogs have a lot of mast cells that can release histamine and other allergic chemicals. In other words, it's common for dogs with allergies to have itchy, irritated ears.
It all comes together; the allergies irritate the ears and in response they produce more ear wax. Because of the extra ear wax and inflammed ear canals, and because the ear canals in many dogs are extra warm and moist because of anatomy, you can understand why so many dogs keep getting ear infections over and over again.
It's pretty easy to tell when your dog has an ear infection.
They shake their head. They whine. And when you give hugs, you can smell the special odor of a yeasty, bacterial, ear infection.
And, of course, if you take a close look, you will see that the ear canal is hot, red, inflammed, and full of goo. If you touch the ear it will often hurt. Or elicit groans. I went to vet school to learn this great stuff.
In case you didn't see my smile, that was a little joke.
But here's something serious. While the most common ear problems we see are due to some combination of allergies bacteria, and yeast infection, there are some other causes too:
Possible other causes include foreign bodies in the ear canal, masses in the ear canal, drug sensitivities, food allergies (which are different from other allergies), thyroid disease, immune disorders, parasites (there are several different types besides the common ear mite), metabolic disorders including diabetes and cushings disease.
Other factors include "swimmers" ear, excessive hair growth in the ear canals, excessive hair removal from the ear canal, excessive bathing, sensitivity to harsh ear wax cleaners.
I bring this all to your attention to underscore the importance of a good exam and probably some lab work to try to narrow down all the possible causes.
Here's how we treat ear infections at our hospital
Of course, your vet may do things differently
A good history and exam: In addition to examining the whole patient, we will be particularily interested in looking for indications of skin allergies, skin infections, infections of the paws, signs of hypothryoid disease, and fleas. And of course we will closely inspect the ears and nearby lypmh nodes. We'll also be looking for a head tilt and other signs of middle and inner ear infection
As for history, we will be interested in whether this patient has had previous ear problems, what treatments were used in the past, what helped and what didn't help much, and whether the problems were seasonal. We'll be interested in the pet's diet.
We will be really interested if we or another vet has recently treated your dog's ear infection with antibiotics and it didn't work well.
Reasons for failure: There are 3 big reasons for treatment failure:
1. the failure of the owner to medicate properly is sometimes the reason treatment failed. This may be because the owner is careless and irresponsible or more likely because the dog wasn't very cooperative. Just tell us the truth.
2. we or the previous vet treated the bacterial infection with an appropriate antibiotic and the owner was diligent about doing the treatment as prescribed BUT we didn't treat the underlying allergy and/or yeast infection the pet also had successfully. This is a common problem.
3. Most ear infections are caused by staph bacteria and respond well to the antibiotics and low pH ear washes we typically use. But sometimes the bacteria is pseudomonas or Proteus and these 2 bacteria are resistant to most antibiotics. And they need ear washes with high pH. The way we discover this is with an ear culture and sensitivity which we'll discuss below
Diagnostics that may be recommended:
Microscoptic Exam of the ear discharge: just to make sure there aren't any ear mites or demodex mites hidden in the ear goo.
Ear Culture/Sensitivity: This tells us what type of bacteria is causing the infection and what antibiotics will it. Ear cultures are fairly expensive and take time to get the results back, but I highly recommend doing a culture IF we've already tried antibiotic therapy without success.
See the paragraph above about why treatment fails.
Ear Cytology: a faster and less expensive way of differentiating Staph from Pseudomonas is by staining the discharge and examining the result under the microscope. If the bacteria seen are gram negative rods instead of gram positive cocci then we have a great clue that the bacteria is not Staph.
Blood Work: The main reasons that we might want to do a routine blood panel is to rule out thyroid disease, a high white blood cell count, and to see if the immune system isn't compromised.
Treatment Options
ZymoxHC: enzymatic ear drops that really work well at removing the wax, pus, and surface inflammation in the ear canal. It kills staph bacteria and yeast well. This is a fantastic treatment that not too many vets know about.
I like this product so well that I've written an entire web page about it. click here
Panalog, Momentamax, and other topical ear drops designed to fight bacteria, yeast, and inflammation. These or similar topical ointments and drops are what most vets prescribe. And of course, they often work well or they wouldn't prescribe them. I happen to like
Zymox HC better as a first choice.
Ear Washes: It's important to keep ear canals open and clean. There are many brands and lots of vets will add antibiotics and steroids to ear washes. Another role of ear washes is to prevent bacteria growth by changing the acidity of the ear. For most ear infections we want to make the ear canal more acidic. For ears infected with pseudomonas we want to make the ear more basic.
Note: we have to be careful with topical treatments if the ear drum is ruptured
Antibiotics: topical ear treatments are adequate for superficial ear infections, but if the infection is deep into the tissue, then systemic antibiotics will be needed. Short term treatment for 10 days if often enough, but sometimes tough ear infections require long term treatment for 3-8 weeks.
Steroids: Steroids are cheap and super effective at reducing the pain and inflammation of a hot, allergic ear. But steroids have many potential bad side effects to include suppressing the patients immune system. So your vet may not recommend steroid therapy. I recommend prednisone use in most cases for 3-10 days in hopes of greatly reducing the inflammation and discomfort of painful ears without risking the problems of long term use.
Antifungal systemic drugs: I use these potentially dangerous drugs in tough cases.
Antihistamines: Benadryl, chlorpheniramine, and hydroxyzine are all inexpensive and very safe and somewhat helpful with controlling the allergic inflammation and irritation so common in ear problems.
Atopica: Atopica is an expensive but excellent medication that reduces allergic inflammation almost as well as steroids without the risk of steroid side effects.
Hypoallergenic Diets: Sometimes food allergies are the main underlying problem making the ear canal so sensitive and irritated. The best way to find out is a diet trial. This is complicated though, because if you do the diet trial at the same time as other treatments, it's hard to know whether the diet change made a significant difference or whether it was the antibiotics, the antihistamines, the steroids and so forth. Click here for more info
Pain Management: Yes
Omega Fatty Acids: OFA's help control allergies and help heal connective tissue. They help
Anesthesia: Some ear cases are so bad and so painful that we recommend light anesthesia to allow us to clean out and flush the ear canal, and really get a close look at the inside of the ear
Rechecks: Ear problems can be tough to control. It may take multiple visits and treatment approaches to get success. We may solve your dog's ear infection, but we may never fully control your pets underlying allergies. So expect the possibility of multiple treatment attempts. Especially if you chose to try a less expensive, less aggressive treatment at first.
On This Page:
The most common ear problem we see in dogs are painful, odorous ear infections caused by a combination of allergies, bacteria, and yeast. You have to treat all 3 to solve the problem.
More about Ear Problems on other pages:
On Other Pages on topics not about ears:
malaria, yellow fever, encephalitis, plague, heartworms, Rift Valley Fever, Lymes Disease, Rocky Mountain Spotted Fever, Tick Paralysis, Monkey Pox, etc
I spent a lot of time emphasizing that most dogs with ear infections don't just have simple infections. They usually also have underlying allergy issues and overlying yeast infections. You have to treat all 3 problems to get great, long lasting results.
And yet, I haven't discussed the control of allergies much on this page.
Treating ear allergies is the same as treating skin allergies, so please go to my pages about skin allergies to pursue this topic. Thanks.
I’ve written this web site mostly to share my love of my profession … taking care of the medical and behavioral problems of pets.
But I have three other desires:
To help animal lovers make sense out of the details and confusion of veterinary care
To encourage pet owners to be more responsible in the care of their pets
And I was really hoping to somehow raise money to keep our No Kill Pet Shelter running.
Our shelter is staffed 100% by volunteers and has been successful at finding homes for 200-300 pets a year that would otherwise be euthanized.
We take pets that are often filthy, full of parasites, suffering from diarrhea or colds or injuries.
We clean them up, test and treat for heartworms, intestinal parasites, and leukemia.
Our pets are socialized, vaccinated, spayed or castrated, and treated with love and compassion until we can place them in a suitable home.
Please help us.
Here’s How:
1.
BiLo Grocery Stores generously donate 1% of all purchases to charities that they have approved.
We are on this approved list of 501c, tax deductible charities.
If you’ll print out the bar code below and take it to BiLo to scan; every time you use your BiLo Bonus Card, 1% of your purchase will be donated to our No Kill shelter.
This will help us a lot and not cost you a cent.
2.People from our community donate all sorts of craft items and home made pet clothes that we sell at our shelter.
And we also store a huge amount of garage sale items that people donate to us for our annual fund raising sale.
We are now selling these items on Ebay to raise money.
3.And finally, for those of you who are especially kind, we can now accept straight forward donations in a secure fashion using a credit card through PayPal.
If you’re willing to help by donating any amount, simply click on the Donate Button below.
Thank you so much. Your help is much appreciated and your donations will be used wisely, effectively, and with compassion.
