One of the more common complaints I hear from pet owners regards itchy, smelly ears. Dogs scratching and whining in the middle of the night make unacceptable sleeping partners. Sometimes the odor emanating from the ears precedes the sight of the dog entering the room. How do these pets get these ear infections and why do they keep coming back after treatment?
Infections of the external, or outer, ear canal are most commonly found in dogs with long, floppy ears. There is less air circulation under the ear flap, which can promote a dark, moist environment perfect for bacteria and yeast organisms to colonize. Swimming, bathing, or applying water into the ear canals can lead to infection due to the moisture that remains in the ear canal. When cleaning the ears, application of a drying agent will decrease the chances of infection.
In order to correctly diagnose the cause of the infection, the veterinarian must perform a cytology, which is a smear of the ear contents that is stained and examined under a microscope. The examination will determine whether the infection is being caused by yeast, bacteria, or both. Generally, a grading system will be given that shows the approximate number of yeast or bacteria, from 1+ to 4+. This enables the veterinarian to compare cytology at recheck to determine whether treatment is working. The veterinarian should examine the ear canal using an otoscope, in an attempt to visualize the ear drum to determine whether it has ruptured.
Generally, bacterial infections will be treated with topical antibiotics. Oral antibiotics do not reach high concentrations in the external ear canal and are typically not very effective for treatment. Oral antibiotics would be more effective for infections of the inner ear. Inner ear infections are more common when the ear drum has been ruptured, allowing bacteria to travel from the external canal to the inner ear.
Yeast infections will generally be treated with a topical anti-fungal medication. Oral anti-fungal medications would not be very effective.
Almost all topical ear preparations also contain steroids. Most infections of the external ear canal will be accompanied by significant swelling and the steroids will decrease the swelling and inflammation.
For those who desire to avoid the use of antibiotics and steroids, there are natural enzyme preparations that work well to keep infection at bay.
Treating the infection is fine, but the underlying cause must be addressed. For the most part, chronic yeasty ear infections are caused by an intolerance to a food ingredient. Bacterial infections may occur secondary to yeast infections or may occur due to moisture or drainage problems with the ear canal. The skin lining the ear canals is very thin and extremely sensitive. Improper or rough cleaning will cause pain and ulceration.
Most pets with chronic ear infections, both dogs and cats, will show great improvement when a species-appropriate diet is fed. The photo of the ear accompanying this blog is from one of my rescue Cocker Spaniels at the time of adoption; he was eating a poor quality dry kibble. It was impossible to even find the ear canal, with chronic swelling, inflammation, and infection with both bacteria and yeast. He now eats a raw rabbit diet and his ear canals are wide open and gorgeous!
Stop treating chronic ear infections. Find the underlying cause and solve the problem permanently. Your pet deserves to live a pain-free life.