Key Reason for Doggie Vet Visits but Largely Preventable

Analysis by Dr. Karen Shaw Becker

dog ear infection

Story at-a-glance -

  • Chronic ear issues are one of the most common reasons dogs visit veterinary clinics each year
  • Dogs with inflamed or infected ears tend to shake their heads frequently or scratch at their ears; in addition, the ear canal is often red with an unpleasant odor
  • There are several potential causes for ear problems, the most common of which is a food or environmental allergy; moisture in the ears, heavy wax buildup and foreign material in the ear canal can be contributors as well
  • Ear infections in dogs can be fungal (e.g., yeast), or more commonly, bacterial; bacterial ear infections that are resistant to conventional antimicrobials can often be effectively managed with natural remedies
  • Preventing ear problems in your dog requires regular, often daily ear checks and cleaning to ensure the ear canal is always clean and dry

Chronic ear issues are a very common reason dogs visit the veterinarian each year. Inflammation or infection of the outer canal of the ear (called otitis externa) is a frustrating, sometimes painful condition that almost always has an underlying cause (e.g., allergies). I suspect many chronic ear infections are ineffectively treated, meaning these dogs aren't having multiple infections, but instead are dealing with a single infection that persists because it hasn't been fully resolved.

Signs Your Dog Has an Ear Problem

Unlike human ears in which the internal canal is straight and horizontal, your dog's ear canal is shaped like the letter "L," complicating things a bit. There are glands and hair lining the canal. The glands secrete wax, and the hair moves it up and out.

A normal, clean canine ear canal is a healthy pink color with no unpleasant odor. When inflammation or infection is present, you may notice your dog shaking her head more than usual, scratching at her ears or rubbing her head against the floor. The ear canal is typically red, and there can be an unpleasant smell as well.

There are two basic types of ear problems in dogs: chronic inflammation and infection. Untreated inflammation can lead to infection. If your dog's ears are warm to the touch, red, swollen or itchy, but there's little to no discharge, chances are the problem is inflammation. However, if one or more of those symptoms is present along with obvious discharge, it's usually a sign of infection.

Common Causes of Ear Inflammation and Infection

The most common reason for ear inflammation in dogs is an allergic response to food or something in the environment that causes inflammation throughout the body, including the ears.

Dogs with allergies are itchy, so if this is the cause of your pet's ear inflammation, you may notice him trying to relieve the itch by running his head along furniture or the carpet, scratching at his ears or shaking his head a lot. If you see any of these behaviors, check your dog's ears for redness and swelling.

Another frequent cause of inflammation is moisture in the ear. We see this primarily during the summer months when dogs are outdoors playing in lakes, ponds and pools.

Wet ear canals and a warm body temperature are the perfect environment for inflammation and/or infection to develop, which is why it's so important to thoroughly dry your dog's ears each time he comes out of the water, has been outdoors in the rain or snow, and after baths.

A third major reason for ear problems is wax buildup. The presence of earwax is normal, but dogs have varying amounts. For example, some have more than the average amount of wax- and sebum-producing glands in their ears. That's why some dogs need their ears cleaned daily, while others never have wax buildup.

Certain breeds produce more wax than others, but no matter your dog's breed or breed mix, it's a good idea to get her used to having her ears cleaned while she's a puppy.

Other causes of ear problems in dogs include foreign material in the ear such as from a plant like a foxtail, narrowing of the ear canal and heavy hanging ears (think Bassett Hound). When an inflamed ear progresses to an infected ear, it typically involves the outer canal. When the infection recurs (or never clears), we call it chronic otitis.

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Types of Infections

If your dog is diagnosed with an ear infection, it's very important for your veterinarian to identify whether it's a bacterial or fungal infection, or both, in order to treat the problem effectively. The most common cause of fungal ear infections in dogs is yeast. Yeast is always present on the bodies of animals, but when the immune system isn't in prime condition, the fungus can grow out of control and cause an infection.

Dogs prone to yeast infections should have their ears cleaned and dried frequently. If there's a persistent infection that just won't clear up, there's probably an underlying immunological cause that should be investigated.

Bacterial ear infections are more common than fungal infections in dogs. Bacteria are either pathogenic or nonpathogenic, and both can cause problems depending on the circumstance. Pathogenic bacteria are abnormal inhabitants of your dog's body, picked up from an outside source, for example, contaminated pond water.

Nonpathogenic bacteria are typically staph bacteria that are normal inhabitants of your dog's body. Beneficial bacteria can grow out of control and cause an infection in a dog with an underperforming immune system.

Veterinarians diagnose yeast infections by looking at a smear of the ear debris under a microscope. However, an accurate diagnosis of a bacterial ear infection requires an ear culture. Your veterinarian will swab your dog's ear and send the sample to a lab to determine what type of organism is present, and what medication will most effectively treat it.

It's bad medicine to guess at the type of bacteria involved, so be sure to let your vet know you want to wait for the results of the culture before starting treatment. It's also very important to finish the medication your veterinarian prescribes, even if your dog's ear infection seems to clear up before you run out.

Stopping the medication early can lead to regrowth of resistant organisms and chronic infection. While your dog is being treated, be sure to keep his ears clean and clear of gunk so the medication you put in there can reach the infected tissue.

When Traditional Medicines Don't Clear the Infection

Increasingly, canine ear infection culture results are showing the presence of bacteria that are resistant to most conventional antimicrobial drugs. These are cases in which complementary therapies are not only a last hope, but can provide highly effective, nontoxic relief.

One such remedy is Manuka honey. A 2016 study tested the effectiveness of Manuka honey to treat bacterial ear infections in 15 dogs.1 Researchers applied 1 ml of medical-grade honey in the dogs' ears for 21 days. The results showed the honey worked rapidly against bacteria, with 70 percent of the dogs achieving a clinical cure between seven and 14 days, and 90 percent by day 21.

In addition, the bacteria-killing activity of the honey worked against all bacteria species tested, including multiple strains of drug-resistant bacteria. However, it's also important to note that it doesn't appear the antimicrobial activity of honey is enough on its own to resolve every ear infection. Most of the dogs in the study had complete symptom relief by day 21; however, several still had bacterial infections.

Another natural remedy for resistant ear infections is medicinal clay. Green clay has been shown to effectively treat a variety of bacteria that have been implicated in chronic ear infections, including pseudomonas and MRSA.2

Preventing Ear Infections

If your dog is prone to ear problems or you want to make sure he doesn't ever have to deal with them, develop the habit of checking his ears daily or every other day for wax, moisture or other debris that has accumulated in the outer ear canal. If you're consistent with your inspections, you'll know soon enough how often your dog needs to be checked to keep his ears clean and clear of debris. The cleaning itself is simple, as long as you do it whenever your dog's ears need it.

If they collect a lot of wax every day, they need to be cleaned every day. If his ears don't produce much wax or other gunk you can clean them less often, but you should still check them every day and take action as soon as you see the ear canal isn't 100 percent clean and dry.

If you think your dog might already have an ear infection, it's important to make an appointment with your veterinarian before you begin a cleaning regimen. In many cases an infection leads to rupture of the eardrum, which requires special cleaning solutions and medications. For healthy canine ears, a few of my favorite cleaning agents include:

  1. Witch hazel
  2. Organic apple cider vinegar mixed with an equal amount of purified water
  3. Hydrogen peroxide, a few drops on a cotton round dabbed in coconut oil
  4. Green tea or calendula infusion (using cooled tea)
  5. One drop of tea tree oil mixed with 1 tablespoon coconut oil (for dogs only — never cats)
  6. Colloidal silver

You should never use rubbing alcohol to clean your dog's ears. It can cause burning and irritation, especially if the skin is inflamed. Use cotton balls or cotton rounds only to clean the inside of the ear canal. You can use cotton swabs to clean the outer area of the ear, but never inside the canal, as they can damage your dog's eardrums.

The best method for cleaning most dogs' ears is to saturate a cotton ball with cleaning solution and swab out the inside of the ear. Use as many cotton balls as necessary to remove all the dirt and debris. Just a few minutes spent cleaning and drying your pet's ears as often as necessary will make a huge difference in the frequency and severity of ear infections, especially in dogs who are prone to them.