How do I resolve chronic ear infections in dogs?

5 years ago

A dog sitting in the grass that gets chronic ear infections

Hi Jim,

Thanks for listening to the show. I really appreciate it.

It’s common for ear infections to recur and in a lot of cases, it can actually be the same infection rather than a new one every time. It’s possible that a bacteria is resistant to particular antibiotics. Whenever infection does not resolve and continues to recur, I always recommend a test called a culture and sensitivity. This is a test where you take a swab of the material from the ear and send it to the lab. They will grow the bacteria and expose it to many different antibiotics. They will report back what type of bacteria it is and what antibiotic will kill it. From this information you can then pick the right medication and you will likely have success.

Another reason is that it may not be a bacteria at all. It might be a yeast infection or parasitic infection. This may take a different protocol or medication to resolve the problem. You can have your veterinarian take a swab and look at it under the microscope. That will allow them to find any mites or yeast. Different yeasts will take different medications and treatment plans to work.

There are other factors to consider as well. You’ll want to have your veterinarian perform a thorough ear exam to make sure there’s not a lesion down there preventing the condition from resolving. For example, I’ve seen ear polyps that become inflamed and allow an infection to persist. Checking to see if this exists will allow your veterinarian to correct it with the surgical technique to help resolve the problem.

Another reason for treatment failure is that there could be an underlying condition. There are many medical conditions that will reduce the effectiveness of an implemented treatment. By performing routine diagnostics such as bloodwork and a urinalysis, you may find underlying conditions contributing to the problem. If they are found, they too can be treated and then the ear infection may respond to its treatment.

If you have performed the culture and sensitivity, then you can select the right medication to treat the condition. Every veterinarian will have a protocol for treating ear infections that may differ from others. I always use a compounding pharmacy which is a pharmacy that will custom make an ear medication for me that I base on the results of the culture and sensitivity. This means that I know I’m using the right medication. There are other treatment modalities that vets can consider. They may prescribe a course of oral antibiotics, steroid medication to reduce inflammation in the ear, an ear flush under sedation, repeat examinations to make sure the treatment is working, etc. You can review some of my recommendations in this article, “7 Strategies for Treating Ear Infections in Dogs and Cats” for more information on this topic.

Lastly, I cannot overstate the importance of performing a thorough ear cleaning. There are many owners who cannot handle their pets very well due to their behavior or because they have not been properly shown how to perform a thorough ear clean. I suggest you watch our videos about this topic and learn how to do this. In some mild cases, diligent ear cleaning can resolve infections even without medication. If there is always debris and pus left down in the ear, treatment failure becomes more likely. Utilize the registered veterinary technicians at your practice and have them show you how to do a proper ear clean. This alone in conjunction with the medication you have, may resolve the infection finally.

I hope this helps. Good luck.