Treating and Managing Ear Disease in Dogs
In our Summer Issue we discussed the causes of Canine Otitis, or Ear Disease. In this issue we look in greater detail at symptoms to look out for, treatment options and management of the condition.
What Are The Symptoms?
Dogs suffering from ear disease commonly:
In more severe cases, a dog might:
Early recognition could make it easier for your vet to identify and treat the condition ... and it could save you money too!
What Treatment Is Available?
Cleaning the affected ear manually
There is no substitute for physically cleaning muck from the ear. Please note: this does NOT include the removal of hairs in the ears! Although they may contribute to ear conditions, the practice of "plucking" only increases inflammation and perpetuates the problem. Ear canals may be cleaned by a veterinarian with crocodile forceps, wire loops, syringe-bulbs and the “Auriflush" system (made by Schering-Plough). This is generally done under anaesthetic, as few dogs would tolerate this procedure while awake, and the slightest movement might drive the crocodile forceps through the eardrum, with disastrous consequences. NB: If the eardrum has not been examined, DO NOT APPLY TREATMENT!! Remember this: NO EARDRUM SEEN = NO TREATMENT APPLIED until a thorough otoscopic examination, under sedation or general anaesthesia. Why not? This brings us to the next type of cleaning:
Chemical cleaning and otic medications
ANY substance placed down the ear canal, EVEN in the presence of an intact, non-inflamed eardrum, can be toxic to the ear, causing deafness and/or balance problems temporarily or even permanently. Modern ear cleaners and ear medications for dogs contain substances to help them dissolve or reach the ear skin. In rare instances, these substances may provoke or perpetuate inflammation. Typical ear cleaners (e.g. Otoclean, Docusol, Epi-Otic and Sanserum) serve to remove wax build-up and change the pH (acidity) of the ear as some bacteria and yeasts find it hard to survive an acidic pH. Some vets also formulate mixtures containing vinegar, but these should only be use for infections known to be caused by the resistant Pseudomonas aeruginosa bacterium. This can only be determined by analysing a swab sample, prior to treatment. NB: If a smear or culture hasn't been taken, treatment is a waste of time. This is always true for serious or recurrent ear infections, and often true of many first time infections, except in the mildest of cases. The point of cleaning is to remove the muck from the ear canal, to allow visualisation of the eardrum, and to allow direct contact of the drug with all parts of the ear canal lining.
Infections of the middle and inner ear
Infections of the middle and inner ear (otitis media/interna) are best treated with systemic (Le., oral) antibiotics, and other medications (e.g. cortisone, non-steroidal antiinflammatories, anti-vertigo drugs, diuretics) as indicated. Topical ear drops down a dog's middle ear are really not the ideal treatment option.
What does ear treatment consist of?
Usually a combination of an antibiotic, antifungal, cortisone and other substances. Your veterinarian will prescribe the correct ear treatment, which can be only eardrops or a combination of eardrops and antibiotic tablets.
Does Treatment Ever Fail?
Yes, unfortunately this is the case. Two of the most important causes of treatment failure are when vets cannot do the full diagnostic procedure required, e.g. collecting swabs, doing cytology, X-rays, etc., because of the financial constraints of the owner of the dog or poor client compliance. As little as 4 in every 10 pet owners treat their pets consistently, adequately and exactly as their vets advise them. Consequently the disease recurs.
What Are The Symptoms?
Dogs suffering from ear disease commonly:
- Have a foul odour from their ears (not just a "clean dog" smell);
- Have black, pussy or waxy discharge;
- Tilt their heads to the affected side;
- Shake their heads continuously;
- Scratch at the ear flaps or side of their faces;
- Cry when the face or head is touched ("head shy"); and
- Rub their ears or faces along the ground or hard objects.
In more severe cases, a dog might:
- Develop dizziness and an inability to stand
- Have "windscreen wiper" eyeball movements
- Vomit
- Get skin infections of the side of the face - this is common in Rottweilers; and
- Develop blood-filled swellings of the ear flaps.
Early recognition could make it easier for your vet to identify and treat the condition ... and it could save you money too!
What Treatment Is Available?
Cleaning the affected ear manually
There is no substitute for physically cleaning muck from the ear. Please note: this does NOT include the removal of hairs in the ears! Although they may contribute to ear conditions, the practice of "plucking" only increases inflammation and perpetuates the problem. Ear canals may be cleaned by a veterinarian with crocodile forceps, wire loops, syringe-bulbs and the “Auriflush" system (made by Schering-Plough). This is generally done under anaesthetic, as few dogs would tolerate this procedure while awake, and the slightest movement might drive the crocodile forceps through the eardrum, with disastrous consequences. NB: If the eardrum has not been examined, DO NOT APPLY TREATMENT!! Remember this: NO EARDRUM SEEN = NO TREATMENT APPLIED until a thorough otoscopic examination, under sedation or general anaesthesia. Why not? This brings us to the next type of cleaning:
Chemical cleaning and otic medications
ANY substance placed down the ear canal, EVEN in the presence of an intact, non-inflamed eardrum, can be toxic to the ear, causing deafness and/or balance problems temporarily or even permanently. Modern ear cleaners and ear medications for dogs contain substances to help them dissolve or reach the ear skin. In rare instances, these substances may provoke or perpetuate inflammation. Typical ear cleaners (e.g. Otoclean, Docusol, Epi-Otic and Sanserum) serve to remove wax build-up and change the pH (acidity) of the ear as some bacteria and yeasts find it hard to survive an acidic pH. Some vets also formulate mixtures containing vinegar, but these should only be use for infections known to be caused by the resistant Pseudomonas aeruginosa bacterium. This can only be determined by analysing a swab sample, prior to treatment. NB: If a smear or culture hasn't been taken, treatment is a waste of time. This is always true for serious or recurrent ear infections, and often true of many first time infections, except in the mildest of cases. The point of cleaning is to remove the muck from the ear canal, to allow visualisation of the eardrum, and to allow direct contact of the drug with all parts of the ear canal lining.
Infections of the middle and inner ear
Infections of the middle and inner ear (otitis media/interna) are best treated with systemic (Le., oral) antibiotics, and other medications (e.g. cortisone, non-steroidal antiinflammatories, anti-vertigo drugs, diuretics) as indicated. Topical ear drops down a dog's middle ear are really not the ideal treatment option.
What does ear treatment consist of?
Usually a combination of an antibiotic, antifungal, cortisone and other substances. Your veterinarian will prescribe the correct ear treatment, which can be only eardrops or a combination of eardrops and antibiotic tablets.
Does Treatment Ever Fail?
Yes, unfortunately this is the case. Two of the most important causes of treatment failure are when vets cannot do the full diagnostic procedure required, e.g. collecting swabs, doing cytology, X-rays, etc., because of the financial constraints of the owner of the dog or poor client compliance. As little as 4 in every 10 pet owners treat their pets consistently, adequately and exactly as their vets advise them. Consequently the disease recurs.
Tips for long-term control of ear conditions:
Sniff your dog's ear canals twice weekly. More often than that, you may not pick up a difference; less often, it's too late. A dog's ear should smell "doggy"; not yeasty or purulent. For chronic otitis sufferers: try to identify and avoid the triggers, e.g. swimming. For chronic otitis sufferers: after a bout has been controlled, and with your vet's permission, use a gentle, ear-cleansing product, like Epi-Otic, twice a week. If you see signs of early otitis, increase the treatment frequency to twice daily and if there's no improvement or it gets worse within 48 hours, SEE THE VET! Control fleas with an effective product recommended by your veterinarian.
Sniff your dog's ear canals twice weekly. More often than that, you may not pick up a difference; less often, it's too late. A dog's ear should smell "doggy"; not yeasty or purulent. For chronic otitis sufferers: try to identify and avoid the triggers, e.g. swimming. For chronic otitis sufferers: after a bout has been controlled, and with your vet's permission, use a gentle, ear-cleansing product, like Epi-Otic, twice a week. If you see signs of early otitis, increase the treatment frequency to twice daily and if there's no improvement or it gets worse within 48 hours, SEE THE VET! Control fleas with an effective product recommended by your veterinarian.
Remember: treatment of severe otitis is expensive and not always easily successful, so if your dog has to have an anaesthetic, an ear cleaning procedure, cultures taken or medication administered, do it only ONCE, PROPERLY, and you may not have an earful again!
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