Ear problems in dogs — common challenge
Integrative Pet Vet
Ear problems are reported to be the second most common reason for taking a dog to a veterinarian. These veterinary visits cover a broad range of ear problems that include issues with the earflap (pinna), ear canal, middle ear and inner ear. Of all the ear problems, inflammation of the ear canal (otits externa) is seen most frequently.
Dogs with otitis externa will generally have some combination of head shaking, ear scratching, redness, pain, discharge or odor. Since there are numerous causes of otitis and because of the complex nature of ear disease in dogs, otitis is often challenging to treat.
It is well known that dog hearing is more acute than that of humans. They can hear about four times the distance of humans and hear high-pitched sounds. Dogs have 18 muscles that allow them to move their ears in the direction of the sound. The dog pinna comes in many sizes and shapes; some ears are erect, others are folded and hang down. Unlike humans, the dog ear canal is a very long 2 inches with a vertical portion then a horizontal portion.
It is the size, shape and length of the dog ear canal, along with the type of pinna, that can predispose dogs to otitis, can make diagnosis difficult and can make management challenging. Otitis generally starts with inflammation. Inflammation left untreated can lead to bacterial or yeast infections. With chronic otitis, the lining of the ear canal can undergo changes that are often permanent. These changes can make the otitis worse, more difficult to treat and contribute to future problems.
Issues related to otitis can be divided into groups in an effort to better understand the problem. These groups are predisposing factors, primary causes, secondary causes and perpetuating factors. Predisposing factors for otitis include a narrow ear canal, hair in the canals, pendulous pinnae, excessive cerumen production and debilitated health.
Primary causes that stimulate inflammation include allergies to food ingredients, environmental allergens (inhaled and contact), parasites, foreign bodies, thyroid dysfunction and autoimmune disease. Secondary causes include bacterial and yeast infections. They contribute to ear problems only in the abnormal ears or in combination with other issues.
Finally, perpetuating factors can prevent resolution of the otitis and are a major reason for poor response to therapy. Perpetuating factors include microscopic changes in the lining of the ear canal caused by chronic inflammation. These changes reduce the ability of the ear canal to maintain a healthy ear environment. Over time, ongoing otitis and the chronic inflammation can lead to narrowing of the ear canal and even calcification of the canal cartilage.
Treatment and management of otitis includes identification and management of the primary cause, treating secondary causes like bacterial and yeast infections and addressing perpetuating factors. How each of these factors is dealt with depends on the primary cause and severity. Once a diagnosis is made, treatment may be as simple as removing the foreign body (i.e. grass awn) or more complex if the primary cause is an issue like allergies. The ear canal should be cleaned. Use an appropriate ear cleaning solution. Never push Q-tips into the ear canal. Sometimes cleaning requires sedation or anesthesia. For bacterial infections, antibiotics placed into the ear canal may be sufficient. However, some severe situations require the use of oral antibiotics. A number of herbal and enzyme ear products are now available that may offer some therapy advantages for bacterial and yeast infections. Control of any ongoing inflammation is important.
It is noteworthy that allergies to food ingredients and/or environmental allergens like pollen are the most common predisposing factor for otitis. It is estimated that 83 percent of dogs with allergies have otitis. In some dogs the only indication of allergies is the otitis. For the dogs with allergies, avoidance of allergens is important. Food changes may be critical. Avoiding environmental triggers and/or desensitization guided by allergy testing may be necessary. Numerous nutritional supplements and herbal remedies have been advocated for managing allergy problems. While results have been variable, some products can contribute to improved management of otitis.
For dogs with poor thyroid function (hypothyroidism), thyroid therapy should be initiated. Dogs that are susceptible to otitis after swimming should avoid getting water in the ears or use a “swimmer’s solution” regularly.
Acupuncture and laser therapy provide benefits for making management of otitis easier when used in conjunction with other therapies that address the primary cause.
If you have concerns about your dog’s ears, contact your veterinarian for a consultation.
Ron Carsten, DVM, PhD, CVA, CCRT was one of the first veterinarians in Colorado to use the integrative approach, has lectured widely to veterinarians, and has been a pioneer in the therapeutic use of food concentrates to manage clinical problems. In addition to his Doctor of Veterinary Medicine, he holds a Ph.D. in cell and molecular biology and is a certified veterinary acupuncturist and certified canine rehabilitation therapist. He practices integrative veterinary medicine in Glenwood Springs.
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