Which dogs can get ear disease?
Any dog can get an ear infection
However certain breeds and types are more prone. Dogs with long ears that hang down such as spaniels, and dogs with hairy ears such as poodles and their crosses are more prone as air does not circulate in their ear canals as well as dogs with upright, clear ears.
How do dogs get ear disease?
Anything that reduces air flow past the ears or encourages debris to get stuck around the ear canal entrance, (excess wax or grass seeds) can lead to ear infections.
There is always bacteria and yeast on our skin as well as the skin of dogs and cats. (Ear canals are lined with skin.)
If there is a nice warm, moist environment that is not regularly groomed these pathogens can proliferate and cause an infection.
Any break in the natural skin barrier such as self-trauma or penetration from a grass seed can introduce infection.
Once infection starts the ears’ natural defence is to produce wax.
This then builds up further, creating less air flow and encouraging bacteria and yeast to proliferate. The bacteria and yeast you find in ear infections generally like to grow in oxygen deprived areas, so this environment is ideal for them.
What are the clinical signs of ear disease in dogs?
Dogs with chronic (long term) ear problems can show very few symptoms as they have learnt to live with the discomfort. In this case it is very important to be vigilant and report any concerns before they escalate as left untreated ear infections can get very nasty and difficult to treat.
- Generally, dogs will show the following symptoms:
- Shaking head
- Scratching in or around the ears
- Holding the head to one side
- Discharge from the ear (can be any colour)
- A foul smell around the ears
- Red or thickened skin on the ear flap
A lot of dogs with ear disease will also have skin allergic disease, so looking for other signs on the skin is important.
How is ear disease diagnosed in dogs?
An ear infection will need to be diagnosed by a vet. If in any doubt it is best to get things checked. If there is just waxy build up and no infection, ear cleaners can be prescribed to help prevent future infections.
During the consultation the vet will perform a full physical examination. This is to check for other conditions related to ear disease, such as skin disease, hormonal diseases (diabetes, hypothyroidism, Cushings disease) or any systemic illness which can suppress the immune system. The ear examination will involve an internal and an external exam. An otoscope is used to examine the inside of the ear canal. This is a long metal instrument with a light inside to allow the vet to see down the canal. There are three main parts to the ear canal which will be examined. The vertical canal is the first part heading down inside the ear. This then turns a corner to enter the horizontal canal, before ending at the tympanic membrane (ear drum). After the ear drum is the middle ear which can only be viewed via x-rays or advanced imaging such as a CT scan.
The presence of fowl smelling discharge and inflammation along the canals may be enough to diagnose an ear infection and the vet may prescribe treatment straight away. However, it is important to know what type of infection your pet has, such as bacterial (cocci or rods) or yeast (Malassezia or other), which will dictate which treatment your pet will receive.
Sometimes it may not be possible to fully examine the ears in the consultation and sedation or anaesthesia may be required. This may be because your pet is particularly sensitive around their ears or because your vet would like to perform an ear flush to remove the discharge from the ears to better assess them. It is very important that the vet is able to see the tympanic membrane before they prescribe treatment as some ear drops can have side effects if they are put into the middle ear (which is accessed when the ear drum is ruptured).
An ear flush is generally performed under general anaesthesia as the ears can be very sensitive even when your pet is sedated. It involves a tube being placed in the canal and flushing with either saline or very dilute iodine and then syringing the debris out. This is repeated several times until the ear canal is clear. During this procedure the ear is generally plucked of excess hair, as needed, which will make cleaning the ear canal going forward much easier. If there is an ongoing infection the ear flush itself is not a cure. Discharge will build up again after the procedure which is why ongoing treatment will be needed. If there is no infection or there is a foreign body to remove such as a grass seed, this procedure may be curative, however grass seeds can then lead to infections so monitoring and a re-check consultation is always recommended after ear flush procedures.
An ear swab (a sample of the discharge taken from the ear canal) can be assessed to see which type of bacteria are present which will allow your vet to choose the correct type of antibiotic. This can be done in house during or after the consultation and will help guide the vet as to which treatment option is best for your pet. It can also be sent to the lab for a culture and sensitivity which will tell us exactly which antibiotic is best to use for that particular infection. This can take 5-10days so your vet may prescribe a temporary treatment in the meantime which may need reviewing depending on the results.
If an infection does not appear to be resolving a repeated swab may be necessary. This may show a different bacterium to be present, or the same bacteria may have developed resistance to the antibiotic being used. Antibiotic resistant strains of bacteria are just as important to identify in dogs as they are in humans and can cause similar problems with resistance to treatment. It is always best to follow your vet’s advice on how often and for how long to use antibacterial treatments including drops.
How is ear disease in dogs treated?
ALWAYS CONSULT YOUR VET BEFORE PUTTING ANYTHING IN YOUR DOG'S EAR AS THIS MAY CAUSE MORE DAMAGE.
- Ear cleaners are a fluid which is designed specifically for dogs to dissolve the wax and soothe the ear canal.
- Some ear cleaners will have an antibacterial property to prevent infection.
- Some ear cleaners are safe to use with a ruptured ear drum; however, some are not.
Medicated ear drops:
Most medicated ear drops can have side effects if used in an ear with a ruptured ear drum. Although side effects are very rare, please discuss this with your vet before application.
- Antibacterial ear drops are used to treat bacterial infection
- Anti-fungal ear drops are used to treat fungal or yeast infections
- Steroid ear drops help to reduce pain and inflammation
Most medicated ear drops have a combination of the above treatments in. Your vet will explain which ones are best for your pet.
Most ear drops are to be given twice daily, however there are other options for less frequent treatments if you and your pet struggle with ear drop administration.
Sometimes it is not always possible to use ear drops to treat ear infections. This may be due to the ears being too sensitive to touch, or because the ear drum is ruptured, or the vet suspects a deeper infection which will not be reached by ear drops. In which case the following medications may be used:
- Antibiotic tablets
- Anti-fungal tablets
- Anti-inflammatory tablets such as Prednisolone (steroids) or Apoquel may be used to reduce inflammation which will open the canal to make it easier to apply drops.
There are several surgical techniques which can be used on chronic (long term) ear problems. However, these are reserved for cases which do not respond to medical treatment. Medical treatment is always preferred if possible.
Lateral wall resection:
This surgery will remove one wall of the vertical ear canal which will open the entrance up to allow easier access for medications to be placed. It also increases air flow and drainage in the ear. The surgery alone is not a cure, but it may help make long term management of ear disease easier.
Vertical ear canal ablation:
This will remove the whole of the vertical canal and will create a new opening for the ear, closing the original opening and removing the inflamed tissue inside the vertical part of the ear canal. This is for extreme cases only.
Total ear canal ablation with bullae osteotomy:
This surgery is reserved for extreme cases of ear disease which involve the middle ear also. These cases would not be responding to medical management. This is a specialist procedure, and specialist advice is recommended before embarking on this procedure. Your vet will discuss this with you, but it may involve taking your pet elsewhere to see a specialist in a referral clinic. Your vet can arrange this for you if needed. The surgery will remove the whole of the vertical and horizontal ear canals, whilst also cutting into the bullae (middle ear).
Can ear disease in dogs be prevented?
Prevention is always much better than cure!
If we can prevent the ears from becoming infected and inflamed there is a better chance of a good outcome.
Ear cleaners on a regular basis can be helpful, but the key is to clean as often as is needed to remove the wax, but not to clean too often that the ears are left wet for long period of time.
Keeping fur trimmed and hair plucked from around the ear entrance can help reduce debris build up and increase air flow.
Long eared dogs may need protection when running through long grass to prevent grass seeds penetrating inside and checking dogs with long coats after walks to remove them.
Long eared dogs may also have their ears held up for a period during the day to help ‘air out’ the ear canals.
Clothing pegs or hair bands can be used to help with this if your dog will tolerate this.
Regular checks with your vet can pick up minor infections before they become severe.
Treating any other underlying disease as mentioned above can reduce the severity of ear disease.
What is the prognosis if my dog has ear disease?
A small number of patients will require further surgery described in the treatment options outlined above, but the majority will be treated medically and will be curative.
It is important to be mindful that bacteria can develop resistant to antibiotics through prolonged use. Therefore, it is always important to follow the Vets’ advice on how long and how frequently you should apply the medicated ear drops and antibiotic tablets.