# Ear Infections



## Jill in Mich (Feb 24, 2008)

I'm starting this thread to post information I received from a Skin, Allergy and Ear Specialist for anyone dealing with ear infections. Others who have information are welcome to post information here also. (Louise, you come to mind with everything you've been going through with Ellie.)

Many dogs, especially those with long ears, suffer from an ear infection at some point in their life. These are easily treated through a visit to your vet and a round of ear drops. Much of the following information is based on a dog with more serious problems but hopefully will provide some general information to everyone - hopefully you'll never need it!

Tess suffers from chronic ear infections as a result of her allergies. In this recent round, she has an infection in her left ear and her right ear is plugged (probably as a result of previous infections and treatment). Yesterday, when they did the allergy skin test, they also flushed her right ear and used a video otoscope to examine both ears. She was put under general anesthesia in case additional steps were needed.

Here's is the written information (with limited editing) I was given by Dr. Paul Bloom from the Bloom Animal Hospital in Livonia, Michigan:

*Otitis Externa *(disease of the external ear)

Otitis externa, or inflammation of the external ear, is a very common ailment in dogs, often with an infection present.

Symptoms include: an odor or discharge from the ear, scratching or shaking his/her head or ear, soreness or swelling in the ear flap. However, some dogs show very few symptoms and it will only be diagnosed by an otoscopic exam.

Initiating causes: flea allergies, atopic dermatitis (an allergic reaction that occurs when an animal inhals airborne substances (pollen, housedust) or ingets (eats) a substance to which they are sensitive), ear mites, or anatomical abnormalities (e.g. - scar tissue from previous ear infections or polyps/tumors in the ears).

Yeast or bacterial (cocci or rods) infection will complicate otitis externa, however, these germs don't start an ear problem.

_(Tess' symptoms include scratching - but it's difficult to tell the difference from her regular scratching - and they black "dirt" infection found when cleaning her ears. Yesterday's tests showed she does have some scar tissue in the right ear.)_
In order to diagnose and treat an ear problem this doctor does the following:
1) A complete history to help identify an initiating cause.
2) A complete dermatological exam, since frequently the ear is part of an overall skin problem
3) A thorough otoscopic exam. It is important that the ear canal is evaluated for swelling, discharge or ulcers. The ear drum also needs to be visualized to determine if a middle ear infection exists.
4) A cytological exam (cell examination) to identify what king, if any, of organisms (yeast or bacteria) are present. This is very important because certain bacteria (rods) are hard to treat and need long term therapy. Also, ear mites can be identified from this test.
5) An ear flush may be done to completely clear the ear canal and make certain the eardrum is intact.
6) Dr. Bloom uses a video-otoscope for diagnosing and treating these ear diseases which allows them to visualize the entire ear canal, ear drum, and occasionally the middel ear. 
7) A bacterial culture and sensitivity is performed in the infection is chronic or the eardrum is ruptured.

If medication is prescribed, it is essential to do a follow-up exam since the symptoms may disappear during the treatment but the problem (disease) may persist.

Most infections need medication for 7-14 days once the infection is resolved. An otoscopic examination is the only way to be sure the ear problem is gone. If the otitis recurs or becomes chronic, further testing or procedures may be needed. (allergy testing, elimination diets, etc.)

If the eardrum is ruptured, the middle ear will need to be flushed out and skull radiographs will be performed. These procedures are done under general anesthesia. _(They did not go into Tess' middle ear, more on that later.)_

Even though there are many causes of otitis, most cases respond quickly to treatment expecially if the initiating cause is addressed.


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## Scooter's Family (May 23, 2008)

Poor Tess! Wish I could give her a belly rub and a snuggle!


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## marb42 (Oct 19, 2008)

Poor Tess! If the allergies weren't enough.... That info will be very helpful to many. I didn't realize how serious it could be and that the eardrum could rupture. I guess it's really important to stay on top of a potential ear infection before it gets worse.
Gina


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## Jill in Mich (Feb 24, 2008)

I'm attaching a drawing of the ear. Not the best, but gives you an idea.

What happened with Tess' right ear was that infection and then medication had built up until it plugged the base of the vertical canal, at the ear drum. My regular vet was concerned that there may be an infection in the inner ear which was causing the recurring infections. She recommended I see a specialist for this, which fortunately was the same specialist dealing with Tess' allergies.

What the specialist explained he would do was to flush out the plug, then go in with a video camera. It was possible the ear drum had been punctured/ruptured _(which is what Louise is going through with Buster). _If so, he would take the camera into the inner ear to look for damage and/or infection. At that point they would also do an x-ray of the inner ear to look for bone damage.

Going into the inner ear can result in side effects (rare but possible) including:
- The dog's head tilting to the side
- The dog face looking like they've had a stroke (sagging)
This is due to damage to the auditory ossicles area. These symptoms can be temporary or permanent.

Fortunately when he flushed her ear the eardrum was intact. He could have chosen to puncture the eardrum to check the inner ear. Being conservative he chose not to. He said 99% of the time, if the eardrum doesn't have a hole in it they won't find infection in the inner ear and he didn't want to risk the potential side effects.

In Tess case, if we can get her allergies under control the ear infections should get better.

I am putting animax ointment in her left ear (because there was an infection in that ear canal) for the next two weeks. I don't have to do anything for the right ear that was flushed. He will recheck both ears in two weeks.

If the allergies clear up and the ear infections don't, he will redo the video otoscope and at that point go into the inner ear.

I asked if there was something I could do (besides getting her allergies under control) to prevent the ear infections. He said no - that they sell a lot of ear washes, etc. but he doesn't find that they really help. (I do put cotton into her ears whenever she's bathed so that water doesn't get in them.)


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