A common problem that we treat every day at the clinic is ear infections. Ear infections can affect both cats and dogs. Many of our patients present with painful ears that cause them to shake their heads, rub the ears on the ground, scratch at them or tilt their head to one side or another. Owners may also become aware of the infection by the odor coming from the ears or redness and swelling to the skin of the ear flaps. Infections can involve bacteria, yeast or both in one or both ears. Most infections involve the skin of the external ear canal and the ear flap (pinna). Occasionally, the middle or inner ear may be involved as well. Contrary to popular belief, floppy, hairy or oversized ears do not cause infection (it can worsen an infection, but not cause it.) Several causes for ear infection include parasites like ear mites, foreign bodies in the ear canal (bugs, excess wax, or plant material), tumors/polyps in the canal or infection secondary to swimming (swimmer’s ear). By far, the most common reason for infection of the ears is secondary to allergies. Allergies to any number of dietary and/or environmental allergens (indoor/outdoor) cause intense inflammatory reactions anywhere on the skin of patients – the ears are not excluded from this inflammatory reaction. Once the skin of the pinna (ear flap) and ear canal become inflamed, the bacteria and/or yeast that is normally on the surface of the skin can overgrow and cause infection. Medical attention is needed at this point.
When a patient comes to the clinic shaking his or her head or with smelly ears, we begin by gathering information such as recent swimming or grooming episodes, prior history of ear infections or allergies and duration of current infection. The nursing staff will get the patients temperature and a swab sample of any discharge from one or both ears. The swab samples are examined microscopically for mites, bacteria and yeast organisms. While awaiting the results of the microscopic exam, the doctor will conduct a physical exam with particular emphasis on the exam of the ears. An instrument called an otoscope is used to allow them to see deep in the canal and examine the eardrum. They look for redness, swelling, discharges, narrowing of the ear canal, and any foreign material or tumors. The eardrum is also checked for any problems or injury. After we have gathered all the information, a diagnosis can be made and treatment begins. Some treatments are straightforward like medication for ear mites or the removal of a foreign material or tumor. Dogs that suffer ear infections secondary to swimming can often be treated with a topical antibiotic. However, treating an infection secondary to allergies is a little more challenging.
Most of the time we can clear up the yeast or bacterial infection very easily with medications, but if your pet has allergies, that is not the main issue. In most patients, the allergy issue is still present and can result in another infection soon after stopping therapy. For some patients, it is a reoccurring seasonal issue during the warm weather times of the year. For others, the infections reoccur year around because the allergies are always present (indoor allergies or food allergies). While it is very important to address the infection and get it under control, we also have to work with the allergies. For some pets, we can tailor a program to manage the ears and get them through their short allergy season. For those who require constant, year-around therapy to control ear infections, it may be worth doing tests to determine the underlying allergen and see if we can eliminate it. Special, hypoallergenic diets trials can be done to eliminate food allergies. Skin testing and allergy shots can help with environmental allergies. Even with the all of that, some patients still need to have their ears under constant care to prevent major infections. Regularly cleaning them and occasionally using topical medication can sometimes manage infections. Without proper care, the ears can undergo significant changes such as hardening, thickening, and narrowing of the ear canal. These chronic, changes can be painful and make it much harder for us to treat infections. In severe cases, dogs may need to undergo surgery to have all or part of their ear canal removed.
So, if your furry friend has smelly ears, is scratching at their ears all the time or walks around with a head tilt, it could mean they have an ear infection and they should see a veterinarian. Treating the infection can get it under control, but there may also be underlying problems. It is important to have your pet checked out by the doctor, so we can help determine if it is a one-time infection or could it be the beginning of a reoccurring problem. It’s a team effort between the doctors, veterinary staff and owners to manage ear infections. With help of the entire team and sound game plan, ear infections can be resolved and managed in most cases.