20% of dogs and 10% of cats have some form of ear disease. Most of these problems are otitis externa (external ear canal disease) or otitis media (middle ear disease). Causes of otitis include ear mites, foreign bodies, bacteria, yeast, and tumors.  Many cases of ear disease are caused by another underlying disease, such as allergies, that predisposes the ear to secondary yeast or bacterial infection.  Addressing the underlying disease is essential to cure or control ear infections.

    Our pets depend on us to help them with their ear problems.  Otitis can cause intense pain, discomfort, head shaking, ear twitching, skin trauma from pruritis (itching), head tilt and imbalance.  Uncontrolled otitis seeds other organs with bacteria and can extend to the inner ear and brain.  Anyone who has had a child with an ear infection or had an ear infection understands the pain involved.

Examination: Using an otoscope or video-otoscope, we look at the ear. Some patients may require sedation if the ears are particularly painful. We carefully examine the long external canal and visualize the ear drum. An open ear drum tells us that the middle ear has been entered and otitis media is present.  An open ear drum alerts us to avoid using medications that potentially could affect hearing or balance. A narrowed ear canal complicates treatment, preventing adequate ventilation of the canal and making in harder to get local medicines in.

Cytology: We make a smear to determine if yeast or bacteria are playing a role in the ear disease.  Each condition requires a different treatments and may have different underlying causes.

Treatment: After evaluation, the appropriate treatment is performed.

Follow-up: It is important to recheck the patient to ensure the canals remain clean, are progressing and healing, and to follow-up the investigation of any underlying causes.  Please ask any questions you have and as a team we can help make your pet comfortable and pain-free.         

Cleaning: Cleaning is critical to good ear care. Q-tips should NOT be used. Hair should not be pulled, generally, since this procedure inflames the ear and invites infection. Cleaning may be directed as a home procedure. Some canals require surgical lavage. Ear canals filled with inflammatory material prevent topical medications from reaching the skin surface, impede the natural movement of wax and material out of the ear, and act as a persistent irritant to the ear drum. 

Ear mites:  Since ear mites live on the fur, all pets should be treated. In addition to the miticide, corticosteroids and antibiotics may be needed for pronounced itchiness and pain.  Ear mites can chew through the ear drum and cause a hypersensitivity to the ear canal resulting in swollen inflamed ears and otitis media. The chronic inflammation of untreated ear mites can result in benign polyps in the middle ear.

Yeast infections: Yeast infections are extremely irritating and painful. There is often an underlying cause, such as allergy, poor ventilation, or an endocrine disorder, that must be determined to prevent recurrence or minimize the severity.  Chronic long-term maintenance is often required

Bacterial infections:  While some ear infections are caused by bacteria alone, most are secondary to allergy, poor ventilation and hormonal disease.  Recurring bacterial infections will require a culture to identify the bacteria and determine the best antibiotic.  Corticosteroids may be used initially if severe inflammation is present.  Once the infection is resolved, maintenance treatment with an ear cleaner is often recommended.

Foreign Bodies:  Removal of foreign materials and treatment of accompanying bacterial or yeast infections should be curative.  If ceruminoliths (ear wax balls) are present, regular ear flushing should prevent recurrence.

Ear tumors and polyps- these conditions are corrected surgically.

Stenosis of ear canals:  Underlying causes of disease need to be evaluated. Some canals require surgery to improve ventilation and enable the delivery of topical medicine to the canal.