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Ear Disease (Otitis) in Dogs

overview

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What is Ear disease (Otitis)?

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Ear disease (known as Otitis) refers to inflammation of the ear canal and is estimated to affect up to 20% of the canine population. Usually only the external ear canal down to the ear drum is affected, but occasionally the middle or inner ear is involved causing more severe symptoms. Although we often think of ear disease as being an acute infection, problems are often more chronic and there is almost always an underlying cause. Failure to address this can lead to repeated episodes and long-term changes in the ear canal, exacerbating the problem even more.

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The most common primary causes of otitis are:

• Allergies
• Parasites
• Foreign bodies

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These eventually lead to infection with bacteria and/or yeast, causing a smelly discharge. Other causes such as auto-immune conditions and tumours are much less common.

Predisposing factors like floppy, hairy ears, inappropriate cleaning or high humidity make otitis more likely to occur but won't cause a problem on their own.

diagnosis

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What tests are used to diagnose Ear disease (Otitis) in dogs?

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1. General exam

   Often ear disease is a sign of a more widespread problem; examination checks for signs of allergies such as inflamed skin on the paws or groin.

2. Ear exam

   An otoscope is used to examine the ear canal and look for parasites or foreign bodies, inflammation and ulceration. Some dogs are phobic around their ears, or very sore - it may be better to examine them under sedation.

3. Cytology

   This is a simple test that involves examining a sample from the ear under the microscope to identify the presence of bacteria and yeast, and estimate severity of infection.

4. Culture

   Although cytology can identify the presence of bacteria, a sample must be sent to the lab for culture if we want to know exactly which antibiotics will be effective.

5. Imaging

   Occasionally x-rays or CT scan may be advised to assess the inner ear, usually if middle ear disease is suspected.

treatment

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How is Ear disease (Otitis) treated?

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Effective treatment often consists of multiple components and is dependent on the factors at play in your individual dog's ear.

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1. Cleaning

   Cleaning is essential to remove physical debris from the ear canal. This can often be done at home; however, some bacteria make a sticky coating called a biofilm which prevents antibiotics penetrating. This can only be removed by a thorough ear flush under anaesthetic.

2. Antibiotics

   Antibiotics can be used to treat both bacteria and yeast. Not every antibiotic will work against every bacteria so it is important to use cytology or culture to guide treatment choice. Antibiotics are usually administered as drops or a slow-release gel. Treatment should be continued until cytology tests clear; if bacteria still remain, infection will recur even if the ear looked better.

3. Steroids

   Steroids are potent anti-inflammatories used to reduce swelling and open up the ear canal, making treatment easier. Pain relief may be prescribed as well or instead of steroids.

4. Treating the primary cause

   If your vet suspects allergies are causing your pets ear problems, they may advise additional testing or treatment. Foreign bodies can be removed easily under sedation.

outlook

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What is the outlook for dogs with Ear disease (Otitis)?

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For the majority of dogs, the prognosis is very good; first-line treatment is effective though sometimes it can take several weeks for complete resolution of the problem. Pets who have underlying allergies are likely to need more extensive diagnostics and may need lifelong treatment for successful management.

A small number of ear infections are caused by a bacteria known as Pseudomonas. This bacteria is typically resistant to many antibiotics and can be extremely challenging to treat. Often, affected animals will need multiple ear flushes under anaesthesia, and may require antibiotics not licensed for veterinary use. Rarely, animals with pseudomonas may require surgical treatment.