Ear Infections (Otitis Externa) Dr. Robert Baker, DVM
Otitis externa is the most common disease entity seen in most small animal veterinary practices. It appears either as an acute or chronic inflammation of the lining of the ear canal. The ear canal in a dog consists of a vertical long portion (5 to 8 cm in length), then a 90-degree bend opening into a relatively short horizontal portion (2 cm in length). The ear canals are lined with hair follicles and wax producing glands.
Otitis externa is not always as simple to treat as it may appear; it must be appreciated that there are many predisposing factors that can make the treatment anywhere from simple to complex. Underlying factors often need to be addressed to prevent the acute form of otitis externa from developing into the chronic form.
Predisposing factors include but are not limited to:
- Anatomical factors such as breeds that have small ear canals (e.g. Chinese Shar-Peis) and breed that have floppy-ears.
- External problems such as excessive wax, dirt or moisture accumulating in the ear canals.
- Systemic problems such as underlying allergies (a common one) and immunosuppressive diseases.
- Inherited predisposition such as seborrhea in Cocker Spaniels (very common)
- Parasitic disease such as ear mites.
- Excessive hair plucking frequently will predispose dogs to develop otitis externa
If the underlying predisposing factors are not properly addressed, reoccurrence of otitis externa is often common.
The actual infections themselves can be caused by yeast (Malassezia species) and/or many different types of bacteria (some examples are Staphylococcus spp., Pseudomonas spp, and E. Coli). Cytology (ear swab smears examined under the microscope) is always appropriate and culture and sensitivities testing is sometimes warranted. Some bacteria are very resistant to common antibiotics and require special procedures to eradicate.
Treatment:
- Topical preparations containing antibiotics and antiinflammatory medications are placed into the opening of the ear canal. The ear is then pulled gently upward, which straightens the L-shaped bend of the canal. Massaging the canal in a downward direction facilitates the medication to reach the bottom.
- Topical antifungal medications may be used or combined with antibiotics to treat the common yeast infections (Malassezia spp).
- Many cases of otitis externa require some continuing preventative measures to avoid reoccurrences, particularly if the underlying causes cannot be addressed. Your veterinarian can advise you on this.
- Using medications as frequently and for as long as directed is important for successful treatment.
- In chronic cases, re-checks are mandatory to evaluate and assess treatment results.
A surgical procedure called a Zepp operation (which opens up the vertical canal to the air, thereby changing the environment in the ear canal) is sometimes necessary in chronic conditions. In some very chronic situations, the infection has progressed through a ruptured ear drum (tympanic membrane) into the middle ear and established an infection in this area in addition to the infection in the external canals. This can potentially be very difficult to treat and may require surgical intervention to remove the underlying infection (lateral bulla osteotomy).
Prevention of otitis externa is not always possible because of the many underlying factors listed above. Prompt veterinary care is essential when signs of otitis extena develop. Shaking head or ears, rubbing ears, crying in pain when ears are touched, unusual odors coming from ears and excessive amounts of brown or black waxy material building up in the canals are all signs that an ear infection may exist. Delays in treatment could result in prolonged and expensive surgical procedures.
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