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Ear Infections (Otitis Externa) Is your pet possibly suffering from an ear infection? Ear infections (also know as Otitis Externa) are one of the most commonly diagnosed disorders among canines, affecting 10 to 20 percent of all dogs. In cats, ear infections are much less common and affects only between 2 to 10 percent of the population and are typically the result of an ear mite infestation. Dogs are predisposed to ear infections because of the basic structure of a dog’s ear canal. They have a vertical and a horizontal passage that forms almost an “L-‐shaped” design which can trap debris. This debris will need to work its way upward rather than straight out. Also, the shape of the ear canal does not allow for proper air flow. Without proper air flow, the ears can remain moist and damp, making it the perfect environment for bacteria. When there is an irritation in the canal, the ear will begin to make an over-‐production of ear wax. An infection results when an accumulation of ear wax, skin oil and debris begin to feed the bacteria and fungi that live in the normal ear canal. This moisture from the wax promotes bacterial growth and infection. Soon pus will begin to form in the ear. You may begin to notice an odor or there may be discharge from the ear. In dogs with dropped or long floppy ears such as Spaniels or Labradors, this problem is exaggerated by further restriction of airflow in the ear canal making them particularly susceptible to ear infections. Their dark, warm, moist ear canals are a haven for these organisms! Ear infections can be a result of foreign bodies such as grass awns, foxtails, seeds and other plant matter, ear mites, narrow ear canals or an abundant amount of hair growth deep in the ear canal which is especially common in Poodles and Schnauzers. Another common cause for ear infections are dogs that have allergies or an allergic skin disease that can affect the ears. In some cases, a tumor or polyp in the ear canal may also be a cause for infection. Cats are normally very resistant to ear infections. If a cat develops an infection there is usually an underlying cause such as ear mites, an unusual shape of the ear canal or a disease affecting the cat’s immune system. Ear mites are highly contagious from pet to pet and generally an infestation can be found in kittens and outdoor cats. Although, indoor adult cats may suffer from this after direct contact from another infested animal entering the household. Cats affected with ear mites will usually have a black discharge and will shake their heads and scratch their ears attempting to remove the debris and fluid from the ear canal. Ear mites will create an environment within the cat’s ear canal that can promote the development of a secondary infection with bacteria or yeast. If left untreated, severe ear infections can occur and can lead to deafness. Signs of an Ear Infection ! Excessive scratching, rubbing against the floor, or pawing at the ear ! Shaking or tilting of the head to the side ! Foul odor ! Redness or swelling of the inner ear flap and canal ! Discharge from the ear (Either yellow and pasty, but often black and chunky) ! Ears painful to the touch ! Demonstrates irritable behavior Complications from Ear Infections If an ear infection is left untreated, the infection can reach your pet’s middle ear. This can cause vestibular issues for your pet. Your pet may exhibit a head tilt, a loss of balance and unusual back-‐and-‐forth eye movements called nystagmus. An infection in the middle ear can also cause paralysis of the facial nerve and lead to a slack-‐jaw appearance on that side of the face. Another problem that can occur in dogs is an ear hematoma. This occurs when a dog shakes and scratches vigorously at his ear causing a blood vessel in the earflap to rupture. This will lead to bleeding into the tissues of the pinna and a large collection of blood forms between the skin and the cartilage in the ear causing the earflap to swell or a large lump to appear. An ear hematoma is typically corrected through surgery under general anesthesia. Examining your pet Our veterinarian will examine your pet’s ear canal with an otoscope, which is an instrument that provides magnification and light. This will give us a good view of the ear canal and allows the doctor to determine whether the ear drum is intact and if there is any foreign material, polyp or a tumor in the ear canal. If there is a great deal of debris, discharge or inflammation within the ear canal, it may be difficult to examine the ear. In this case, our veterinarian may suggest a thorough examination under sedation. Since there are many varieties of bacteria that can dwell in your pet’s ear and can cause either an acute or chronic bacterial infection, yeast infection or a fungal infection, it may be necessary for us to perform an ear cytology of your pet’s ear to determine the source of the infection. We do this by taking a swab of the discharge from your pet’s ear and with a smear and staining on a slide we look at the sample under a microscope. This helps our veterinarian choose the proper medication for your pet. Treating Ear Infections The results of the otoscopic examination and/or ear cytology help determine the proper treatment for your pet. The first step in dealing with an ear infection is a good and thorough cleaning of the ear. Our veterinarian, or a trained technician will fill the ear canal with an ear cleansing solution to help soften the waxy buildup, they will clean out the ears, pluck any hair from the canal and then medicate the ears. If there is a foreign body lodged in the ear canal, the pet may need to be sedated so that it can be removed properly. In the event of a polyp or tumor, possible surgical intervention will be discussed. A specific medication will be prescribed for either bacteria, yeast or fungi infections. If more then one type of infection is identified, it may be necessary to use multiple medications. It may be also necessary to prescribe your pet with a course of antibiotics, corticosteroids or anti-‐histamines especially for those pets with allergies as an underlying cause. (Please see our article on skin conditions) For pet’s that are hard to medicate, we may pack the ears with a BCP ointment which is used to treat bacterial infections, reduce inflammation, and prevent fungal growth. The BCP ointment is a long lasting medication that stays in your pet’s ears and helps absorb moisture from the ear canal, keeping the canal dry. This treatment is usually re-‐applied two weeks after the initial dose. Home Care -‐ Ear Cleansing and Medicating! Our veterinarian will discuss the proper home care regiment for your pet. It usually will be necessary to cleanse your pet’s ears at home prior to medication. Cleaning of your pet’s ear will be limited to the ear flap and upper end of the vertical canal passage. You will need to apply a cleanser to each ear liberally and then massage the cleanser into the ear canal by gently massaging at the base of the ear to allow the cleaning solution to flow down into the ear canal. With a cotton ball over your fingertip you may wipe clean the accessible portions of the ear. Do not insert cotton swabs into the ear canal, as they tend to push debris back into the vertical ear canal. You may use cotton swabs only to clean the outer parts of the ear that you can actually see. After cleansing your pet’s ear, allow your cat or dog to shake out any excess cleanser. With a clean dry cotton ball, wipe out any of the excess cleaning solution. You may repeat this process if necessary. After the ears have been cleansed and dried, follow-‐up with applying the prescribed medication. Once the prescribed course of treatment is finished, your pet should return to our office for a recheck exam. One of our veterinarians will recheck your pet’s ears to make sure the infection has cleared up. It maybe necessary to continue further treatment to resolve a stubborn ear infection, and to discuss preventative home care to avoid recurrences once the infection is eliminated.