Dr. Woody Dudley, DVM
Does your pet scratch or shake it’s ears? Is there an odor, swelling, or redness in the ears?
Symptoms of ear infections include pain around ears, discharge in the ears, pain around the mouth, head tilt, nerve damage to the face and eye, rubbing ears, and shaking ears. Excessive shaking or scratching the ears can lead to a large swollen ear pinna or ear flap as a result of a ruptured blood vessel resulting in a blood clot called a hematoma.
Ear infections are seen frequently in dogs. The droopy ears of some dog breeds such as Cocker Spaniels and the L shape of all canine ear canals lead to poor drainage and poor air drying. Ear wax, skin oil, and debris build up in the ear. This wax build-up and humidity in the ear canals provide a great place for opportunistic microorganisms to grow, which are normally located on the skin such as yeast and bacteria.
Any health condition that facilitates ear wax predisposes your pet to ear infections. In our Central Florida location, skin allergies occur all year round. Ears are a part of the skin. Inflamed ears from allergies are susceptible to opportunistic secondary infections from Yeast but also Bacteria. Allergies often cause noticeable redness and swelling near the ear tips rather than deeper in the ear canals. Excessive hair in the ears especially in small breed dogs such as Poodles can lead to ear infections. Also, certain breeds with very small ear canals such as Shar Peis and English Bulldogs are prone to chronic, recurrent ear infections. Moisture in the ears from swimming also promotes the growth of yeast and bacteria.
Simple ear infections detected early, often respond well to 2 weeks of treatment. A full-body exam and cytology of ear debris should be done to determine the cause of the infection (Yeast versus Bacteria versus Mites) and determine the appropriate treatment. A progress exam should be done every 2 weeks until the infection is cleared to determine when treatment should be discontinued. Ear rinsing and ear hygiene at home will help prevent another infection.
Chronic ongoing ear infections, infections of several weeks or longer, require more aggressive testing and treatment. In some cases, these may have been painful and swollen for some time without being obvious. Or these may be ear infections that come back on a regular basis. These cases require a microscopic exam, and ear culture to determine the correct antibiotic. Ongoing ear infections often have resistant bacteria as the cause, so it is essential that they are recultured to make sure the infection is gone. Many of these cases also have Otitis Media, a Middle Ear Infection. Middle ear infections require oral medication in order to penetrate the deeper tissues of the middle ear. It is important to schedule an ear flush procedure as part of the treatment to remove infectious material and allow ear drops to be more effective.
Ear flushing is an important part of clearing up an ear infection fast and effectively. The ear canals need to be irrigated with a warm antiseptic solution under anesthesia. Removing the debris will allow the medication to penetrate better. While irrigating the ears under sedation the eardrums will be examined with endoscopy to determine if the eardrum is damaged or swollen. Damage to the eardrums needs special attention. In order to control pain, swelling, and prevent hematomas (blood clots) in the ear, aggressive application of injectible and oral pain mediation is recommended.
Ongoing ear infections should also be evaluated for underlying Allergies and Hypothyroidism, which if not treated, will lead to more Ear Infections.
Some cases just cannot be cleared up, which will require imaging such as X-rays. These cases frequently require surgery such as a Lateral Ear Resection to open up the ear canal or Bulla Osteotomy to drain the middle ear.
Surgery is also recommended for ear hematomas, large blood clots in the ear flap. These need to be drained and sutured to prevent excessive scarring and a deformed ear. A deformed ear could lead to more ear infections in the future.
Ear infections are painful. They should be treated as early as possible to reduce complications such as middle ear infection, hearing loss, and scarring!