Ask The Vet: Ear Infections

The Problem: Reoccurring ear infections (yeast) in droopy ear (spaniel) dogs: What are ways to prevent them from reoccurring and what are some of the best broad spectrum treatments? - Jennifer Strock

The Solution:

Ear infections and skin infections are two of the most common problems we see in veterinary medicine; especially in the Low Country. Our hot and humid environment is only one of the contributing factors. Other factors are the breed of dog, the conformation of the ear canal, whether the ear pinna (flap) stands upright or flops down, and if there are underlying allergies to fleas, pollen, food, etc. Breeds that have ears that do not stand up (“floppy ears”) can be more susceptible to problems. Their ear canal cannot dry out or breathe well and something as simple as moisture getting trapped down in the canal can lead to infection.

Some breeds and dogs with allergies will excessively produce cerumen (ear wax) into the canal which combined with moisture and a lack of breathability of the canal will predispose a dog to infection. Cerumen, moisture, and heat make for a perfect environment for the growth of Malassezia; a type of yeast. This leads to ear infections (otitis) which are characterized by a moist black discharge and a sour odor. Many times an ear infection can start with only yeast but due to the resulting itchiness, self-trauma from scratching introduces bacteria from the environment. Bacterial otitis can be more serious than yeast otitis. It can lead to ulceration of the ear canal, pain, and necrosis of the ear drum due to bacterial toxins.

One of the first things that need to be determined is what type of infection is present. Your veterinarian can perform a simple test to determine which organism is present (ear cytology). They will take a sample of the discharge and place it on a slide. After staining the slide it will be analyzed under the microscope. If an infection has been chronic or long standing a sample from behind the ear drum may need to be obtained and sent out to a lab for culture and sensitivity.

Prevention or limiting of infections is a matter of determining underlying factors and what type of infection your pet usually gets. If the infection is due to increased moisture from swimming or bathing (which usually leads to yeast otitis) a drying and acidifying agent should be used routinely. This dries the ear out, acidifies the canal, and slows down yeast growth. If your pet has underlying allergies which cannot be successfully controlled then an anti-inflammatory, anti-bacterial, and/or anti-fungal cleanser will be more helpful. Your veterinarian will guide you as to how often these cleanser need to be used. In either case, once an active infection is present it should be aggressively treated with a product chosen based on the type of infection diagnosed by your veterinarian.

Treatment may be topical drops, ointments, or a “cocktail” mix of specific ingredients chosen by your veterinarian for the particular infection. A newer form of treatment is a medicated ear plug which can be placed in the ear canal. This is particularly helpful in dogs that will not tolerate their ears being medicated or for owners that cannot medicate the ears routinely.

After the active infection is resolved (may take two to six weeks) then a maintenance protocol is chosen to help prevent further infection. This usually involves routine cleaning anywhere from one to three times weekly. Initially, the goal is to clean or treat the ears the fewest number of times necessary to prevent or control infections.

Once infections have been chronic and long standing, permanent changes to the ear canal result. At this point the only recourse may be surgery to remove a portion of the ear canal. This permanently prevents any infection but leads to significant hearing loss in that ear.

If you notice your dog is starting to have frequent infections please talk with your veterinarian about what the most likely underlying cause is (keeping in mind there could be multiple contributing factors). This way he/she can come up with an appropriate protocol for your dog.

by Dr. Cynthia P. Smith, DVM

Dr. Cynthia P. Smith graduated magna cum laude from the College of Charleston in 1977 and was the first woman to be accepted into University of Georgia’s veterinary school program from the College of Charleston. She graduated with honors from UGA in 1981. Soon after, she began working at the newly formed Greater Charleston Veterinary Emergency Clinic, the first of its kind in Charleston. After 2 years she left to open her own practice, Olde Towne Veterinary Clinic. Dr. Smith’s special interests lie in dermatology, internal medicine, and dentistry. She lives on Wadmalaw Island with her husband Wayne & two dogs: Foster & Andy.

Olde Towne Veterinary Clinic is a full service veterinary clinic offering regular medical exams, checkups, labs, surgeries, radiology, medicinal diets, natural supplements, and specialty care for pets, including geriatric medicine for aging pets. We help our clients develop ideal health and wellness programs that fit your pet’s needs and your budget.