Guide To Dog Ear Infection Treatment
"Dog ear infections can be infuriatingly
difficult to treat and account for 20% of visits to the veterinarian.
They are more easily treated if caught early as an otitis externa or
outer ear problem. Look
for telltale signs such as dog's that scratch or paw at the ears and
head shaking. Skin irritation and itch may or may not be present. Other
signs include ears that cause pain to the dog when touched or
inflammation inside the ear. Dogs that continually scratch the ear can
cause a more serious problem which results in the rupturing of the
Common causes of dog ear infection are water trapped in the ear,
foreign material (grass awns), yeast, atopy (inhaled
seasonal allergy), hypersensitivity to foods, bacteria, immune mediated
or autoimmune diseases (pemphigus foliaceus) or mites (Otodectes and
on the underlying condition and should be in consultation with
a veterinarian. If caught early, ear infections in dogs can be easily
treated. Treatment options range from prescription antibiotics or
antifungal agents, ear cleansers and natural ear drops. Veterinarians
often add a glucocorticoid such as prednisone, which can help reduce
inflammation and improve the speed of healing. Do not apply any
cleanser or treatment before speaking to a veterinarian and avoid
alcohol based products, as these can be irritating."
For prevention, all dogs should have canine ear hair plucked
regular basis, particularly those breeds that are susceptible to a dog
Cocker Spaniel with Otitis (Ear Infection)
Photo Credit: Washington State University
School of Veterinary Medicine
Ear infections are one of the most common and frustrating problems
dealt with by dog owners and veterinarians. Ear
infections are usually very treatable if caught and addressed early, so
it is beneficial for dog owners to be aware of the common signs of ear
infections, as well as treatment and prevention.
A dog ear infection, otherwise known as otitis externa (inflammation of
the ear canal), or just otitis, occurs when a pathogen invades the
tissue of the external ear canal and causes an infection. The pathogen
involved can be either yeast or a bacterial organism. Otitis occurs in
any breed of dog during any season, but is more common in the spring
and summer months. Otitis is often associated with allergic conditions,
such as atopy and food allergy. Sometimes the otitis will be
accompanied by itchy or irritated skin, but many times it is not. In
fact, in many cases of food allergy chronic otitis is the only abnormal
sign the dog displays.
Dog ears are structured differently than human ears making them more
susceptible to ear infection. In humans the ear canal travels
horizontally whereas in a dog the cana moves from the outer ear
vertically downward before make a turn toward the ear drum. This turn
makes it easier to collect debris, dirt and wax, allowing bacteria to
colonize and take hold as an infection.
Types of Ear Infections
There are three main types of ear infections and each requires
different type of treatment.
- Ear mites (Otodectes
cynotis): This is the most common type of ear infection. Usually both
ears are affected. To treat it, the ears are first cleaned thoroughly.
Then a medication such as ivermectin is massaged into the ear. A second
treatment may be performed in two to four weeks, just to make sure all
the mites have been killed. It is generally recommended that all pets
in the home be treated at the same time.
You may also want to clean the rooms where you dog lives to make sure
that no mites remain and then cause reinfection. A good choice for
indoor mite removal is Benzarid. They also sell a power steam cleaner
for effective outdoor mite removal. Secondary infections in dogs with
ear mites are common and generally involve bacteria or yeasts.
Dog Ear Mites
- Bacterial or fungal/yeast ear
infections: These are usually simple, first time dog ear
infections. In this case the
tissue is normal except for being a little irritated. One or both ears
may be affected. These respond readily to treatments for dog ear
infections. The affected ear is cleaned daily. The cleanser may contain
a topical steroid to reduce inflammation and/or an antibiotic to fight
infection. Oral antibiotics may also be given, particularly if your dog
has a fever, which would indicate a bacterial infection. Avoid alcohol
based products. See your veterinarian at the first sign of an ear
infection since early detection results in a faster and better result.
Chronic, repeat ear infections
The ear tissue becomes thicker, spongier, and more productive
more wax and other discharge). These infections improve with treatment
but keep coming back. Both ears are usually affected. These are most
common in dogs with pendulous ears like cocker spaniels and basset
When there are repeat dog ear infections, it's often due to
There are mast cells concentrated in the dog's ear canals, just like
the mast cells in humans' respiratory tracts. These mast cells produce
histamines and other inflammatory chemicals in response to allergens.
When these chemicals are released in the ears, they stimulate the
production of excess ear wax and other secretions.
The waxy, gooey ears provide an ideal place for skin bacteria to grow.
They also attract yeast spores. To treat these infections, it is
necessary to deal with the underlying allergies, the bacterial
infection, and the yeast infection.
Predisposing and Perpetuating Factors
Certain breeds are predisposed to
developing dog ear infections, but any breed can be affected due to
related problems. Eliminating these factors do not mean that a dog will
never have another ear
- Breeds with Excessive Hair that has been plucked (iatrogenic
trauma): Poodles English sheepdog, Airedale
- Anatomical Factors such as breeds with pendulous ears: Cocker
spaniel, Labrador Retriever
- Narrow ear canals or folded ears: Shar-pei
- Moisture in the ears from swimming or high humidity environment
- Under treatment due to a lower dose of medications than is needed
when treated or the length of treatment is too short
- Presence of bacteria or Malassezia pachydermatis (yeast)
- Infection that progresses to the middle ear (Otitis media)
Otitis Externa (Dog Ear Infection) In a Chocolate
Dogs with pendulous ears are more
susceptible to Ear Infection.
Scratching and head tilting are two of the symptoms.
Photo Credit: Washington State University,
School of Veterinary Medicine
It is usually fairly easy to tell when a pet is experiencing the
of an external dog ear infection. The classic signs of otitis are
head-shaking, face rubbing on furniture, shaking or tilting the head,
pawing or scratching at the ears, and reddened/inflamed
ears with discharge or abnormal debris present in the canal. Dogs with
chronic or more advanced cases may be lethargic and avoid play in
addition to acting as in pain when the ears are touched. If an ear
infection spreads to the middle ear, a dog can have vertigo like
symptoms and appear dizzy or off-balance.
Dog Ear Infection in 3 year old
Spaniel, Ear wax exudate is present, swollen and inflamed ear canal
Source: Joel Mills
severe cases of otitis, a very pungent odor may also be present and the
dog’s ears may be very painful to the point where it will not allow or
will cry out with handling of the head or ears.
- Inhalant Allergy: Redness on ears and ear canal (may be only
- Contact Allergy: Suspect problems with topical medications if dog
ear infection gets worse after treatment
In order to prevent a dog ear infection from becoming severe, it is
important for owners to recognize and act on the signs of early ear
infections. If a dog is shaking his head or scratching his ears more
than normal, this should not be ignored. Lift the dog’s ear pinna and
look into the ear canal. If you see reddened or inflamed ear tissue or
abnormal discharge within the ear canal, you should seek veterinary
care right away. It is best to avoid over-the-counter ear cleaners and
medications until after you have spoken to the veterinarian. Many of
these cleaners contain alcohol, which can be irritating and painful to
an already irritated ear. Furthermore, putting agents into the ear
before the veterinary examination can hinder the vet’s ability to
properly diagnose the type of infection.
Ear Discharge and Causes of Ear Infection in Dogs
The color and consistency of any dog ear discharge can indicate the
cause of a canine ear infection. Vets will commonly test the discharge
in order to reach a diagnosis.
Exudates/Discharge, Symptoms and Related Causes of Ear
Infection in Dogs
Dog Ear Infection Symptoms
Probable Cause of Dog Ear Infection
|Dark Brown to Black and Waxy
ear yeast infection
|Dark Brown to Black and dry to powdery
|Pale Yellow, Cheesy
|Pseudomonas (bacterial canine ear infection)
|White, creamy to Cheesy
|Dog Ear Itch (puritic)
|Yeast, Mites, Bacteria
|Yellow/tan purulent (pus)
|Ulcerative (inflamed red
lesions or skin)
Veterinarian Examining Ear Canal Using An Otoscope
A veterinarian will start of taking a detailed health history. Tell
veterinarian when the ear problems started and if the patient was
treated for an ear or skin disorder. When an ear problem started
the first time can help the veterinarian narrow down possible causes.
Exudates/Discharge, Symptoms and Related Causes of Ear
Infection in Dogs
Probable Cause of Dog Ear Problem
|6 months to 5 years
|Atopic dermatitis (atopy) -
particularly if a seasonal issue, food reaction such as allergy
|7 years or older
|Food allergy, less likely to be
Once a history is taken, the veterinarian will examine the ears
starting with the pinnae or outer ear. Unless the infection is
severe enough to cause pain that prevents thorough examination, the vet
will likely use an instrument called an otoscope to visualize the ear
structures. If a dog is in pain the patient may require sedation.
It will also be determined if the eardrum or tympanic membrane is
ruptured, or if any infection or problem spread to the other side of
the membrane. In cases of chronic infection the membrane can thicken.
Since the ear is associated with several nerves that can affect other
parts of the body such as the face, a middle ear infection (otitis
media) can cause some facial paralysis and deafness.
The veterinarian will collect samples of any ear debris for
testing. Lab tests will quantify the amount of yeast and bacteria
that are present in order to confirm a dog ear infection diagnosis.
Even small amounts of bacteria or yeast can cause a
reaction in the ears and may be all that is needed to justify
chronic or severe infections are caused by several different types of
bacteria, the most severe being Pseudomonas. If the vet notices a
significant amount of bacteria, a sample will be sent to the lab for
identification. Based on the type of
infection present, the vet will prescribe an ear medication that
contains an antifungal, antibiotic, steroid, or all three. The vet may
also prescribe an ear flush or cleaning agent in cases where a lot of
physical debris is present.
The vet will also take swabs of the ear canals and look at
the material under a microscope to identify the pathogen or pathogens
involved in the infection. Most first-time infections or mild
infections are caused by a species of yeast called Malassezia or by a
If a dog does not respond to dog ear infection treatment, it could mean
resistant bacterian such as Staphylococcus could be the cause.
Suspected middle ear problems can be diagnosed with the help of a CT
scan. If other problems are detected, such as a tumor then surgery may
Dog Ear Infection Treatment
Any dog ear infection treatment approach starts with a cleaning.
Cleaning should often
be used along with prescription treatment.
Do not use a product with alcohol as this could be irritating.
Instead consider an ear cleaner similar to Dermapet
Ear Cleaner since
it is PH balanced and combined with boric acid to improve
effectiveness. Cleaners are formulated to liquefy and soften any
wax. Bacteria in the debris can also trigger inflammation, so
cleaning by itself can bring some inflammatory relief. Note that not
all dogs respond well to home ear cleaning, and may require cleanings
in the veterinarians office.
Otitis in Cocker Spaniel Ear
Swelling and Pain
If the ears are swollen or in pain, the use of glucocorticoids for
up to two weeks can help to reduce any inflammation. Pain is addressed
with acetaminophen or Tramadol. NSAIDs cannot be used if a steroid is
Topical medications are the treatment of choice for otitis externa
(outer ear infections). Products are formulated with an antibacterial
or antifungal agent plus glucocorticoids. Mineral oil based products
are good at covering the ear surface and in keeping the ear clean.
The specific medication selected will be based on the type of bacteria
or fungus causing the problem. For example Neomycin or Gentamicin are
used for gram-positive bacteria, but only Gentamicin tends to be used
for gram negative bacteria (although both can be used for both, in the
case of gram-negative, Gramtemicin can be the better choice).
Anti-fungal medications such as Nystatin is used for yeast
In most cases, a dog should improve in 3 days after treatment, with
any infection being resolved in 2 weeks. A return visit will be needed
to confirm that the infection has been fully eliminated.
If the veterinarian believes that the infection as spread to the
middle ear, than an oral medication is warranted. This can also include
an antifungal or antibiotic for bacteria.
Allergies and Dog Ears
Treating allergies can be tricky, but it is an important part of
chronic treatments for dog ear infections. Many dogs are allergic to
fleas, so if your dog has fleas, getting those under control may solve
the allergy problem. Otherwise, you'll need to look at possible food
allergies. Hill's Prescription Diet d/d makes several food choices for
dogs with allergies. Try feeding your dog one of these. Of course, work
closely with your vet to treat your dog's allergies as well.
Recognizing the early signs of an ear infection in your dog will allow
you to get prompt care and prevent the infection from progressing to a
more severe infection. Be sure to avoid over-the-counter ear
medications and cleaners unless recommended by your vet, and follow
your vet’s instructions for home care and follow-up visits. If your dog
suffers from frequent ear infections, consider using a homeopathic
formulated to improve ear health such as Ear
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Brochures and References:
Brochures on canine ear problems:
For additional reading on Canine
Examining and Medicating Dog Ears
Washington State University School of Veterinary Medicine
Ears The Basics
Craig E Griffin
Animal dermatology clinic
San Diego, Ca