Ear problems are one of the most common and frustrating problems seen in pet dogs and cats. The causes of otitis externa, which is inflammation of the skin and structures of the ear, are multiple. Management of ear problems, especially if chronic, requires a close relationship with the doctor to control.
Primary causes of otitis include:
Ear mites- contagious- more common among cats than dogs. We now have a one time treatment we can apply in the clinic. Use of our topical REvolution also treats and prevents ear mite infestations.
Allergies- food, inhalant, contact
Seborrhea disorder- flakes, scales and oiliness- common in Spaniels.
Trauma- too aggressive cleaning- using Q-tips, removing too much hair.
Endocrine disease- Cushing's, hypothyroidism.
Predisposing factors allow the inflammation to continue by promoting an environment that is favorable for the primary causes to continue. Examples include:
Sturucture of the canal- long vertical canals, floppy ears (Bassetts)
Moisture in the canal- swimming, bathing, iatrogenic.
Hair in the canal- poodles and terriers.
Breed predispositions- Shar-Pei
Trauma- Q-tips, excess hair removal
Obstructive disease- polyps, cancer, thickening of the canal
Perpetuating factors sustain and aggravate the inflammation.
Occlusion (blockage) of the canal due to chronic inflammation
Changes in pH
Infections
Medications- can lead to resistance if used intermittently.
Clinical signs of ear disease may include head shaking, scratching, or rubbing the ears, discharge, pain or odor. Face rubbing, sneezing, foot licking, scooting, or generalized itchiness suggests an underlying allergy. Food allergic dogs may show only ear irritation with no other skin problems. Severe itchiness may indicate mange; scaling and crusting indicates seborrhea. Recurrent infections suggest an allergy or underlying endocrine problem.
Physical examination by the doctor involves palpating the canals to evaluate for pain or calicfication, evaluating the pet for neurologic defects (extension into inner ear), and using an otoscope to evaluate the canal and its contents. Yeast infection usually appears as a black or dark brown debris. Ear mites can often be seen with the otoscope. Bacterial infection appears yellow in color. Cytology (taking a swab and looking under the microscope) may be used to confirm what the doctor is seeing and to initiate appropriate treatment.
Treatment of otitis is directed toward controlling the active inflammatory process and then towards removing the underlying predisposing factors, and managing the primary cause. Successful long term management involves controlling all risk factors and causes. Cleaning of the ear is critical for success and involves filling the ear canal with a generous amount of cleaning solution, massaging the ear canal gently, and then removing the excess material with cotton balls. Never use Q-tips or harsh materials in the ear. We will dispense a cleaner appropriate for your dog's condition, as some cleaners are effective against yeast, seborrhea, or bacteria. Topical medications are based upon the disease process and usually include a steroid, antibiotic and anti-yeast medication. Sometimes oral medications are needed to clear the problem. Food elimination trials are required for pets with food allergies. Pets with food allergies need to be fed a novel protein diet (no chicken, beef or dairy) and matching treats, for a minimum of six weeks. It is very important to use the medications as prescribed and to return for follow-up visits to ensure success.