Treatment and Prognosis of Ear Infections in Dogs
Goals of Treating Canine Ear Infection
When an owner suspects that her dog has something wrong with its ears, she should take it to a veterinarian as soon as she can. Ear disorders are extremely common in companion dogs, and they can progressively become very serious and irreversibly damaging if left untreated. The goals of treating ear irritation, inflammation and infection are to relieve the dog’s discomfort, reduce inflammation of the ear canal and associated structures, eliminate any primary or secondary infections or other predisposing factors, prevent or delay the development of irreversible pathologic changes to the ear and restore a good quality of life to the affected animal.
Before actual treatment begins, it is essential to clean and dry the ear canals. Dirty ears cannot be properly evaluated, even with sedation or general anesthesia, and a thorough look through an otoscope is probably the most important step in making a diagnosis and planning an effective treatment plan. It is extremely important to know whether the dog’s eardrums are ruptured or intact before any treatment begins. It is also critical to identify whether any ulcerations, erosions or other sores are present. An otoscopic examination under sedation or anesthesia is crucial to helping the veterinarian make these determinations.
Depending on the cause of the dog’s discomfort, initial treatment may be a course of topical or systemic corticosteroids, antibiotics and/or antifungal medications. This first-line therapy is designed to reduce inflammation and help reduce overgrowth of infectious microorganisms. Antibiotics are commonly prescribed - usually topically but also orally - to treat secondary bacterial infections. Antifungal drugs are available to address fungal and yeast ear infections. Many veterinarians recommend that owners flush their dogs’ ears regularly even during treatment to remove any waxy build-up and impacted debris. This can be done a number of ways, which the attending veterinarian is in the best position to discuss with the dog’s owner. One common method is to flush the ears with a body-temperature solution of one part white vinegar diluted in three parts lukewarm water. Commercial ear-flushing preparations are also available. Again, owners should consult with their veterinarian before attempting in-home treatment of ear problems.
If the dog’s ears have become obstructed by inflammation, irritation and associated tissue mineralization and overgrowth (hyperplasia), surgery may be the only realistic treatment option. Several surgical techniques are available to address severe ear disorders. These include a bulla osteotomy and a total ear canal ablation (TECA). If the dog’s horizontal external ear canal is intact and functional, another option may be a lateral ear resection, which can promote drainage and reestablish air circulation and hearing. A veterinarian can discuss these surgical options in greater detail.
Dogs with disorders of their outer ears usually have a very good prognosis, if the problem is diagnosed and treated promptly. Once the middle and inner ear are affected, the prognosis becomes more guarded, and the dog may develop permanent hearing loss. Complete resolution of ear disorders is unlikely unless the reasons for the dog’s condition are identified and corrected. Owners should recognize that dogs with significant hearing loss should not be allowed to roam freely off-leash.