Dr. Hilary Quinn: Ear Infections Common Ailment for Dogs and Cats - Noozhawk

As a veterinary general practitioner, I see and treat a little bit of everything.

Dog with tummy problems? We've got you covered. Kitty needs dental work? No problem — let's get that scheduled. Puppy needs her shots? Done and done.

But what do I see more than anything else? Skin and ear disease. In fact, Embrace pet insurance ranks skin infections (dermatitis) as the top insurance claim, and ear infections (otitis) not far behind as the third most common claim. My own experience in practice certainly supports this.

Ear infections are distressing for both pets and owners alike. Your dog (and less frequently, your cat) may up be all hours of the day and night, shaking his head, loudly scratching and digging at the ear, or even crying when his ear is touched.

This is a painful condition that almost always requires veterinary attention.

What are the signs of an ear infection?

The inside of the ear may be red, swollen, and malodorous. There is usually discharge, which can be dark and sticky (as is often the case with a yeast infection), or more yellow/golden to even pus-like (as is often the case with bacterial ear infections). 

Sometime the pinna, the flap of the ear, will be hot to the touch, or even thickened.  The ear may be itchy, or it can be very painful. Sometimes dogs will tilt their head, or hold the infected ear lower.

What causes an ear infection?

It is important to note that ear infections in dogs and cats are almost always external ear infections. This means that they involve the outer ear canal and the ear drum (much like swimmer's ear in humans).

Middle or inner ear infections, such as those acquired by children after getting sick, are much less common in our pets.

There are numerous predisposing factors that can lead to an ear infection. Perhaps the most important factor is allergies — either food or environmental.

Allergies affect the skin barrier, and that skin extends into the ear canal itself. Bacteria and yeast that normally live on the surface of the skin — without causing any problem — can opportunistically colonize the skin and ears and reproduce. This leads to an infection, and all the secondary symptoms noted above.

Another common cause are ears that are persistently wet or moist. Labradors that swim in their backyard pools every day, or dogs that are groomed regularly and get water in their ears, might develop an infection due to the excess moisture.

Ear canal anatomy can also lead to infections. Dogs with pendulous and thickened ears, like Cocker spaniels, have a higher than normal incidence of ear infections. Some dogs, like bulldogs, have very narrow ear canals, which can increase the chance of an infection.

Polyps or growths in the ear can also trap moisture or narrow the canal. And lastly, foreign material such as foxtails can lodge in the ear canal and lead to an infection.

How is an ear infection treated?

Ear cleaning can be an important part of treatment, especially for yeast infections that lead to heavy waxy buildup, which needs to be eliminated. Use veterinary-formulated ear cleaners only — I do not recommend alcohol, hydrogen peroxide, or witch hazel to clean ears, as these are harmful to the ear canal.

Your veterinarian will perform an ear cytology — that is, looking at a swab of the ear discharge under the microscope. This will confirm whether the infection is yeast or bacterial, and therefore informs us about what medication to choose for treatment.

Topical medications ("ear drops") will be prescribed that will eliminate the infectious organisms. These will need to be administered once to twice daily, usually for a week or two.

For those dogs who do not tolerate home ear drop administration, your vet may be able to instill a long-acting ear medication in the hospital. This gel or lanolin-based product will be in effect for 2-4 weeks after application.

Oral antibiotics are not recommended as first-line treatment for external ear infections.  They are usually used only in cases of middle or inner ear infections, or in cases of severe antibiotic resistance where topical drops are not effective.

In some cases, your veterinarian may prescribe steroids or similar medications (such as Apoquel) to treat the itching and swelling. This can not only help your dog feel better more quickly, but also allow the topical medications to work better.

Note: Ear infections are not contagious from one dog to another (unless it is a rare case of ear mites, which is typically only seen in puppies and kittens), so don't be concerned that you need to keep your pup home while he is being treated.

How can I prevent an ear infection?

If your dog or cat is prone to ear infections, the best thing you can do is work with your veterinarian to determine the underlying cause. If your vet suspects allergies, consider an elimination-diet trial, or allergy testing to determine if there are environmental allergies.

Keep your dog's ears clean and dry. Regular ear cleaning can keep mild ear infections at bay, in those dogs who are prone to otitis.

Do not use Q-tips or anything small to probe into the ear canal itself, as the eardrum is fragile and easily ruptured. Instead, instill the ear cleaner into the canal, gently rub the outside base of the ear, and let your dog shake out the fluid.

Take a cotton ball or soft wipe and carefully wipe out the crevasses of the inside ear.   

Examine your pet's ears regularly to look for any changes that might indicate an early infection. Sometimes a good ear cleaning or treatment with an over-the-counter anti-microbial such as Zymox can help head off a mild infection.

But if there is persistent pain, discharge, and signs of inflammation, don't wait to schedule an appointment with your veterinarian. Ear infections left to fester for long periods can lead to aural hematomas, irreversible changes in the ear canal, and hearing loss.

Next time your pup asks for an ear scratch, do him a favor and flip over his ear and take a good look in there.

Is it clean, free of debris and odor? Yes? Good!

Sometimes a good old-fashioned ear massage is just what the doctor ordered.

Dr. Hilary Quinn is a small animal veterinarian in Santa Barbara. She owns and operates Wilder Animal Hospital, and shares her own home with three humans (her husband and two kids) as well as two rowdy dogs, a very calm kitty, two fish, and six chickens. Contact her at news@noozhawk.com.