Ear Disease in Dogs

Ear disease is a very common presentation, possibly because ears are so visible and ear disease can cause animals a lot of irritation.

Ear disease is a complex subject and is not always quick, easy and cheap to fix. It is often a long term problem and it is important that it is treated properly from the start and that we keep regular checks on it – half treated ear disease will keep on recurring!

 

WHAT ARE THE SIGNS OF EAR DISEASE?

(Not all animals will show all or any of these signs)

  • Shaking the head
  • Scratching at the ears
  • Smell from the ears
  • Ear discharge – may be brown (wax), pus (yellow), blood (red) or mixed
  • Ear flaps being swollen, thickened, scaly etc
  • Head tilt/loss of balance
  • Loss of hearing
  • There may also be signs of skin disease elsewhere e.g. flaky coat, chewing at feet etc
  • There are many factors involved and often more than one factor can contribute, e.g.

 

WHAT CAUSES EAR DISEASE?

  • Breed e.g. Spaniels, having droopy ears, have poor air circulation in the ears and this allows a moist, warm, environment, ideal for breeding of micro organisms
  • Foreign bodies e.g. grass seeds
  • Bacterial or yeast infection
  • Hairy ears
  • Ear mites
  • Previous ear disease may cause a narrowing of the ears
  • Systemic disease, especially affecting the skin e.g. skin mites (mange), allergies, under active thyroid etc.

 

HOW IS IT DIAGNOSED?

The ear consists of 3 parts. The outer ear consists of the earflap and ear canal, and acts to funnel sounds. The middle ear, which is separated from the outer ear by the eardrum, contains bones that amplify sounds. The inner ear is involved with hearing and also contains the organs of balance. We can examine the outer ear with an otoscope – a type of torch to look down the ear. In many cases we can see down to the eardrum, but in uncooperative animals or those with very dirty or narrow ears, we may not be able to see this without sedation or anaesthesia. Radiography (x-rays) may show thickening of the outer ear and can also be used to identify inflammation, growths. etc in the middle ear. CT or MRI scans are also helpful, especially in middle ear disease, but need referral to a specialist centre. Ear swabs can be taken to identify the type(s) of bacteria and yeasts in the ear and to allow us to test which antibiotics are most likely to be effective, as the ears can harbour some very resistant bacteria. Results can take a few days. We may also need to do other tests to identify underlying causes e.g. skin scrapes, skin biopsies, blood tests etc.

 

HOW CAN IT BE TREATED?

Mild cases are usually treated with ear drops. There are several types of drops available. Ear cleaning drops are used to dissolve wax. They should be put down the ear canal, massaged in, left for 5 minutes or so, then gently cleaned with cotton wool, tissue paper etc as far as you can see. Please ask for a demonstration if you do not feel confident doing this.

 

WHAT ABOUT SURGERY?

Surgery certainly has its place in treatment of ear disease, but is usually a ‘last option’ treatment, although there are times when it can be used to prevent further deterioration. The common operations are –

  • We may also need to treat any underlying conditions that could be complicating the ear disease. Good flea control is often important. A low allergy diet may need to be considered.
  • In cases where the ear is narrow or dirty, the drops will not always penetrate all the way down the ear, in which case, we may need to use tablets, given by mouth, to ensure the drugs are effective.
  • More severe cases may need the ear to be flushed out and cleaned and any hair or foreign bodies removed, under general anaesthetic. Often these cases will still need treatment afterwards.
  • Other drops contain one or more of antibiotics, anti-yeast drugs, anti-inflammatories, local anaesthetic and are usually put into the ear after cleaning.
  • Aural haematoma (swollen ear flap). Drainage under local anaesthetic may help short term, but may recur. Lancing the haematoma and suturing the 2 layers of the ear flap together is often the best way of dealing with recurrent cases.
  • Lateral wall resection – the outside part of the first half of the ear canal is removed. A relatively simple operation with few complications, but equally not often very effective because only a small part of diseased ear is removed. We would normally advised against this procedure.
  • Vertical canal ablation – the entire first half of the ear canal is removed. Again not always successful because diseased ear tissue can be left behind.
  • Total ear canal ablation with lateral bulla osteotomy. Removal of the entire ear canal and cleaning of the middle ear. A more radical operation, but far more successful. Side effects can include bleeding, head tilt, facial palsy, draining sinus tracts etc. and may occur up to several years later. Hearing is usually unaffected.
  • Other surgery may be needed e.g. to remove tumours (especially on the tips of white cats’ ears), to remove polyps, to extract foreign bodies etc.
  • Ear disease is a very painful condition that left untreated, can cause permanent changes to the ear. Animals can even change their behaviour (become more ‘grumpy’, less tolerant of other pets etc.) when they have chronically infected ears. Unfortunately, in some cases, a complete cure is an unrealistic goal but we always aim to relieve pain and provide your pet with a long term management plan to control any discomfort.

 

SUMMARY

As we know from children, ear disease can be very uncomfortable for our pets. In many cases, dogs with ear disease can have an underlying allergy as the root cause. These cases often need to be managed long term as a complete cure is often  an unrealistic therapeutic goal.

If your dog suffers from ear disease please book a consultation with one of our vets so we can discuss the various options available.