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?
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
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Please visit http://www.speakingforspot.com 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 www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.
Tags: American College of Veterinary Dermatology, American College of Veterinary Surgeons, canine ear disease, chronic ear disease, chronic ear infections, Dr. Nancy Kay, ear disease in dogs, Nancy Kay DVM, otitis, Speaking for Spot, veterinary dermatologist, veterinary surgeon, Your Dog's Best Health