Managing Your Dog’s Chronic Ear Disease

If you care for a dog with recurrent ear problems, I suspect you have experienced your fair share of frustration, impatience, and/or exasperation. This is undoubtedly true if you live with a dog who develops stinky ears and head shaking seemingly within minutes of when the ear medication runs out.

For those of you dealing with “repeat offenders” I encourage you to expand your knowledge by reading about the anatomy of the canine ear canal, the many types of ear diseases, and their predisposing causes.

And now, here is my best advice to manage your dog’s chronic ear disease. Please note that I purposefully used the verb “manage” rather than “cure”. Sometimes chronic ear disease is cured, but for most dogs long-term if not lifelong care is necessary. Patience and perseverance will be your most important allies in successfully maintaining your best friend’s comfort and preserving your own sanity.

Look for the underlying cause

Rarely does that infection in your dog’s ear represent the primary issue that is the true cause of the problem. This is why medication that treats the yeast or bacterial infection provides only a temporary fix. Transitioning a diseased ear canal back to a truly healthy state requires identification and effective treatment of the primary issue. For example, a hypoallergenic diet may be the ticket to healthy, comfortable ears for the dog with food allergies. Daily use of a drying agent may restore ear canal health to the dog with free access to a backyard swimming pool. The hypothyroid dog (producing inadequate thyroid hormone) may need thyroid supplementation to resolve his chronic ear issues.

Here’s the bottom line. Don’t just treat that ear infection over and over and over again knowing full well it’s gonna come back the minute you stop the medication (sounds a bit like the definition of insanity). Look for and treat (or eliminate) the primary issue that is disrupting the normal health of your dog’s ear canals.

Work with an expert

If you’ve been working on your dog’s ear problems with your family vet for awhile without long lasting success I strongly encourage you to get a second opinion from a veterinarian who specializes in dermatology. Board certified veterinary dermatologists receive mega-advanced training in diseases of the skin and ears, and this is all they deal with in their practice lives. Ask your family vet for a referral or pay a cyber-visit to the American College of Veterinary Dermatology to find a dermatologist within driving distance.

Trial and error

Imagine that I examine three different Labrador flavors in one day- one chocolate, one yellow and one black. They all have chronic yeast infections in their ears as a result of doing what they love most (besides eating). All three swim multiple times daily in their backyard pools. While I might initially prescribe the same medication for all three dogs to clear their infections, it would be naïve of me to think that the same long-term treatment protocol to maintain healthy ears would be work well for each dog. Use of an ear canal drying agent twice a week might be the ideal maintenance therapy for the yellow Lab. The chocolate might require daily treatment with the drying agent along with once weekly application of a yeast-fighting medication. The solution for the black Lab might involve alternating daily between the drying agent and yeast-fighting medication. There’s really no predicting in advance which long-term (maintenance) protocol will be the best choice for any given individual. The key is to methodically try various rational therapies and determine which protocol most effectively sustains happy and healthy ear canals. A caring veterinarian and your own patience and determination are imperative for success.


The normally wide-open ear canal becomes permanently narrowed in some dogs with chronic ear disease. All that inflammation produces proliferation of scar tissue that obstructs the ear canal making it difficult for ear medications to travel where they need to go. The narrowing also creates poor air circulation and any discharge that accumulates within the ear canal is difficult to remove. Some dogs are born with extremely narrowed ear canals- Shar Peis are the “poster breed” for this problem.

Narrowed, scarred ear canals render medical therapy ineffective and surgery becomes the treatment of choice. There are two surgical options. One type of surgery involves “opening up” the ear canal. The second approach ablates (removes) the ear canal. Ear canal surgery is tricky business, one potentially fraught with complications. If your dog is a surgical candidate, be sure to work with a veterinarian who specializes in surgery. Ask your family doc for a referral or visit the American College of Veterinary Surgeons to find a specialist in your community.

Surgery provides an effective way to restore comfort and markedly enhance the quality of life for dogs suffering from chronic ear disease. While it is considered a treatment of last resort (when medical therapy fails) I encourage discussion about surgery sooner rather than later. It’s important to recognize when ongoing medical therapy is simply beating one’s head against the wall (and all the while the dog is miserable). Following ear canal surgery, it’s not uncommon to hear a client say, “I wish we’d done this sooner.”

Now, let’s hear from you! How have you treated your dog’s chronic ear disease? What has worked and what hasn’t?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at,, local bookstores, and your favorite online book seller.


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8 Comments on “Managing Your Dog’s Chronic Ear Disease

  1. Maintaining clean ears is the best way to avoid persistent ear infections and fowl odors. However, many dog owners hate cleaning their dogs ears because it is so difficult. I think almost every dog owner knows how much their dog hates getting their ears cleaned. That is why my friend developed PurOtic Natural Ear Cleaner. It is the only ear cleaner with a patented silicone applicator. The soft silicone tip of the applicator makes cleaning a dogs ears quick and easy. You don’t have to hold the dog down and when the dog moves it’s head during cleaning, the soft tip bends and flexes so the solution doesn’t spill. It really is the easiest way to clean your dogs ear. I would highly recommended this product to anyone who needs to clean their dog or cats ears.

  2. Going to the veterinary dermatologist finally solved the problem with Chance, our 7 year old yellow lab. After doing the skin test we found out that Chance was allergic to grass, cedar trees, and other things, but not fleas, cats, yeast, or mold. So now we have him getting allergy shots once a week along with 5 Benedryl twice a day and Epi-Otic Advanced ear flush twice a week.

  3. i agree wholeheartedly wih Dr. Nancy. My 9 year old Bouvier had two bouts of ear problems in one year. Both times my vet prescribed the usual commercial veterinary medications on the basis of a visual exam of the ear canal, but no slides were done. My frustration with those ear drops is that there is no way to know whether the prescribed “5 drops in each ear” are actually delivered since the opaque tube is deep in the ear.

    Several months later he woke me up in the wee hours, shaking his head. He was so miserable, poor guy. Though he is a cropped dog, his ear leather had swelled considerably. I got a warm towel to try to help him feel better, but also had to give him pain medication I had on hand. I decided to see a boarded derm vet instead. Ears were scoped, slides were made so we knew what needed to be treated, and she provided me with drops she compounds in house. They are delivered via a small syringe that fits into the top of the bottle, so it’s very easy to draw up the correct amount, squirt it into the ear, and know that the correct dosage was given. The swelling resolved with more hot packing and the medication cleared up the infection. Have not had a problem since.

    I was very pleased with this vet and will continue to see her for any ear problems in the future.

  4. Two of my dogs have seasonal allergies that manifest as inflamed ears. No yeast or bacterial overgrowth ever found, just irritated ears and miserable dogs. For us, 3 days of Tresaderm twice a day is a miracle cure.

  5. I rescued a Boston Terrier. The inside of her ears were swollen. She was scratching and shaking her head a lot. They gave me ear drops she was taking at the time and said she needed to take them for life. I wanted my new sweet dog to be medicine free, so after process of elimination, I discovered she was allergic to the grain in dog food. She had a touchy stomach also, so again, after trying several grain free dog foods, I found one that was healthy and grain free. She unfortunately will sneak food or treats when we visit friends houses with dogs. But, she is doing MUCH better. When I am able to keep her grain free, she has NO problems.

  6. I can’t help but speak out on this topic…

    We have had numerous retrievers – the ears are the same as the stomach!

    In other words if you feed them the right food – the ears never act up, and if they do a quick rinse with drying agent put the ears back to normal in a single dose.

    I can’t help but think back To Angie (a skinny 130#) yellow lab, the sweetest dog you’d ever meet… She had chronic stomach and ear issues and as result suffered for no need… True her ears fit so well that a lot of air never got inside..
    We learned that everything was caused by allergies to WHEAT, and GLUTEN…

    Within weeks of changing away from the science diet crap to quality grain free food like Taste of the Wild – all ear/stomach problems CEASED. Poor dog was allergic to what we gave her every day and I made her sick – that is a horrible feeling!

    I now to look at the simple causes first – unfortunately for Angie she had to suffer needless for years.

    As a vet – I encourage you to educate your readers and clients about the issues related to the dog food sold, it’s contents, encourage people to know the affects of what they feed there animals, in addition to where and how it’s made – it saves lives and makes for happier households!

    Fast forward today – Sophie an 8 year old golden retriever (tightest ear flaps I have ever seen), ear infections in 8 years ZERO, blow out in house ZERO.. We buy the best feed money can buy – free of grains and fillers (still use taste of the wild) but now there are a few others…

  7. We did the ear canal removal surgery on my rescued bloodhound. The “ear” still oozes smelly stuff all over the inside of the flap…and that causes the skin to be inflamed and to create skin that sloughs off. Not sure it was worth the three grand. Other ear will probably need to be done also….had hoped this would bring relief to my girl.
    Now I am trying to save to take her back up to UF so they can re open it up. She is on Cipro daily. :(

  8. My worst experience was my first “foster failure,” a cocker with facial nerve paralysis on one side of her face. She had a few ear infections and suddenly became “difficult” when I cleaned her ears. Eventually the infections were antibiotic-resistant and they needed specially formulated medicine. She developed odd neurological symptoms and my vet at the time said “she’s just an old dog” I went to a different vet who also said she’s just old. A few months later she was so sick with vestibular and other symptoms I had her PTS, and then necropsied. They found a middle ear infection with two bacteria, and two other bacteria in her meninges — meningitis. I still mist up even thinking about how she might have been helped if her vet had recognized the middle ear infection early on. That was in 2010 and still miss her.