7 Key Strategies for Treating Ear Infections in Dogs and Cats
By: Dr. Clayton Greenway, B.Sc., DVM | Jan 5, 2017
Pets, like humans, can develop a buildup of ear wax that requires cleaning. While most do not require routine cleaning of the ears, it is always a good idea to perform it regularly. In doing so, you will reduce the possibility of getting infections. It is especially useful after a pet may get water in their ears from swimming or grooming. Most ear wash formulations will work as an astringent and dry the ear canal out so that the water present there is removed and won’t contribute to the development of infection.
How often you should clean your pet’s ears are dependent on the results of the cleaning. If you get wax and debris out during each cleaning, then you should increase the frequency until you are getting no debris, and then back up to the previous frequency. For instance, if you clean the ears once a week and there is always debris, increase it to twice a week and if little to no debris is found at that higher frequency, then continue at that rate.
If your pet frequently develops a buildup of dark wax in their ears, it may be a sign of infection. Have your veterinarian confirm this with an otoscopic exam. Here are my recommendations if an ear infection in dogs or cats is present.
1. Figure out what the infectious agent is.
I cannot overstate the importance of this. There are a lot of veterinarians who will simply hand over an ear medication off the shelf and have you apply it in the ear twice a day for a week or more, without ever doing a test. I highly recommend you perform a very quick test called an “ear cytology.” Your vet will swab the ear and look at it under a microscope. They will be able to tell if there are mites, yeast, and/or bacteria present.
Why? I have seen many cases of a yeast infection in cats and dogs ears that go on for years and years and people just keep buying a bottle of medication that is never getting rid of the root infection, they simply calm the ear for a few weeks or months until the same infection flares back up.
2. Have a ‘culture and sensitivity test’ performed.
This would be in cases of chronic ear infections or when puss can be seen by your veterinarian during an otoscopic exam. Your vet can do this test by swabbing the ear and sending the swab to a lab where over the course of a few days, it is plated and incubated. All the bacteria present will grow and then they are exposed to tablets of different antibiotics to determine which ones will kill the bacteria. This test is critical when dealing with a chronic recurrent infection of any kind. It will allow your vet to use a more specific and significantly more successful ear infection treatment in dogs.
Let me give you an example. I once saw a woman who brought a dog to me that had really terrible ear infections for the past eight years. She brought every veterinary bill she had for eight years which were from more than five different veterinarians and the infection had never gone away. She brought the bills to show me all the different medications she had been given in the past.
She asked me, “What medicine are you going to give me that I haven’t already tried?” I told her I wasn’t going to give her a medication. I simply performed the ear culture and sensitivity. It grew bacteria that was resistant to every single medication that had ever been administered to the dog in the 8 years. If someone had done this test eight years sooner, the owner could have saved thousands of dollars in vet bills. I ordered a medication with the specific antibiotic in it that the test showed was effective against the bacteria in the dog’s ear. The infection was finally resolved within 6 weeks of seeing me. It is vital that we know what we are treating before we initiate a plan.
3. Consider a compounded medication.
Not all veterinarians will use these, but they should all be aware of them. A compounded medication is made by a “compounding company” and ordered individually based on the results of the tests. These medications are often cheaper, stronger, better targeted to your pet’s infection and the viscosity is lower, so it will run down into the ear much better than a typical commercial products that are on the pharmacy shelves at a veterinarians office. By ordering a compounding medication, your veterinarian can tailor make a medicine for your pet’s particular infection and save you money in the meantime.
4. Continue treatment as long as necessary and perform frequent re-checks.
I have often encountered owners or veterinarians who have only treated an ear infection for a week. It calms the ear and the symptoms, but often it fails to completely kill the bacteria present. After a few weeks or months, the infection returns. Many vets and owners think it’s a new infection when in fact, it is the same infection that was never completely treated in the first place. Rechecks are vital in many cases. I recommend that you return to your veterinarian at the end of the treatment regime and have them inspect the ear canal. This allows them to confirm that the infection is truly resolved. In some cases, a small plug of pus and wax could remain. The dog can be completely symptom-free, but that plug of debris contains residual bacteria, yeast or mites that will eventually grow back. Rechecks ensure that you have achieved success and that the condition won’t return.
5. Consider oral medication as well.
In the case of chronic recurrent infections, it’s important to consider administering an oral antibiotic and oral anti-inflammatory to help the topical ear medication to successfully treat the ear infection.
6. Learn how to perform a proper ear clean.
In cases of even simple infections, I always take the time to demonstrate how to perform a proper ear clean. Again, I can’t overstate the importance of this. If you are not cleaning the ear properly, it can significantly contribute to treatment failure. Ask your veterinarian if their staff can demonstrate an ear clean procedure to you or at least watch our video about how to perform this.
7. Consider the possibility of allergies.
Pets can have allergies that cause inflammation in the ear canal and precipitate the right conditions for infection to happen. If this is present, you’ll have recurrent infections unless your vet identifies this and gives you a plan to keep the ear inflammation under control. You can use a simple and cheap topical anti-inflammatory ear medication on a semi-regular basis to control this so an infection doesn’t start up.
Disclaimer: healthcareforpets.com and its team of veterinarians and clinicians do not endorse any products, services, or recommended advice. All advice presented by our veterinarians, clinicians, tools, resources, etc is not meant to replace a regular physical exam and consultation with your primary veterinarian or other clinicians. We always encourage you to seek medical advice from your regular veterinarian.